The new teleradiology order: what changes for radiologists and hospitals

In 2026, the Ministry of Health amended the regulations governing teleradiology in Romania. We explain in plain terms what the change actually means - without complicated legal jargon.

Why this order matters

Since 2023, Romania has had a dedicated legal framework for teleradiology - Order of the Minister of Health No. 1,584/2023, which established what teleradiology is, who is involved in it and what technical standards must be met. In practice, that order laid the foundations of the field.

In 2026, the Ministry of Health went a step further. Through Order No. 1,089 of 21 April 2026, published in the Official Gazette No. 386 of 7 May 2026, the 2023 rules were amended by a change of substance: until now, teleradiology was conceived mainly as an ad-hoc solution - for emergencies, for a second opinion or to supplement the activity of a radiologist physically present at the hospital. The new order officially recognises it as a form of permanent practice as well, with the same medical and legal standing as conventional face-to-face radiodiagnosis.

Specifically, the order introduces a new article (Art. 121) under which healthcare facilities may organise and carry out radiology-medical imaging activity through teleradiology services, including when the radiologist is not permanently physically present at the hospital or clinic. The physical absence of the radiologist no longer affects, in itself, the validity of the medical act - as long as the conditions set out in the regulation are met.

This is particularly important news for Romania, where the shortage of radiologists has been affecting hospitals in small towns and areas without large university centres for years, with the Minister of Health citing the need to reduce waiting lists and patient travel to other cities for a simple MRI or CT interpretation as the very reason for the change.

In brief, what changes

Teleradiology becomes a form of permanent practice, not just an occasional solution.
The physical absence of the radiologist from the hospital no longer affects the validity of the report, provided the regulations are followed.
New rules appear for contrast-enhanced examinations decided remotely.
Interventional procedures and certain fluoroscopic examinations remain, by law, exclusively "face-to-face".
Hospitals wishing to operate this way must meet a series of technical and organisational requirements.

What it means for radiologists

Teleradiology, recognised as a full-rights form of practice

A radiologist who chooses to work remotely - whether collaborating with a teleradiology provider or directly with a hospital - is no longer viewed as a stopgap, suitable only for exceptional situations. In practice, a hospital's imaging activity can be permanently covered by a radiologist who is not physically on site, as long as the technical standards already established in 2023 are met: image quality, connection speed, data transmission security.

For radiologists who prefer this mode of working, a legally clearer space opens up for collaboration with multiple healthcare facilities at once, for subspecialisation and for greater geographical flexibility - without having to justify teleradiology as an exception to the rule.

Responsibility and the right to refuse remain unchanged

An important point to note: the standard of the medical act remains the same as in face-to-face radiodiagnosis. The radiologist retains the right to refuse to issue a report if the images or information received are insufficient, in quantity or quality. And, just as before, no radiologist can be compelled to practise teleradiology - neither on a routine basis nor in emergencies.

Contrast media: more decision-making, but also more coordination

One of the most concrete changes: the remote radiologist can now decide on the appropriateness of using contrast media - a decision that, until now, was practically the prerogative of the physician physically present with the patient. However, the decision remains conditional: a prior clinical assessment is required, carried out at the hospital, along with direct communication between the physician who evaluated the patient and the radiologist interpreting the case. The radiologist thus gains more decision-making authority, but also greater dependence on the quality of communication with the local team.

What remains exclusively "face-to-face"

Teleradiology extends the radiologist's activity; it does not replace it entirely. Non-contrast examinations can be performed without the radiologist's physical presence, and contrast-enhanced ones only under the conditions described above. However, interventional imaging procedures and certain diagnostic fluoroscopic examinations remain, by law, exclusively the responsibility of the radiologist physically present with the patient.

What it means for hospitals and clinics

It is possible to operate without a permanently present radiologist - but not just any way

The biggest opportunity for hospitals, especially those in small towns or with a chronic shortage of radiologists: they can now legally organise their imaging activity by relying on teleradiology as a permanent solution, not just as a fallback. A hospital with good equipment but no full-time employed radiologist can operate through a collaboration with an authorised teleradiology service provider.

The obligations that come with it

This flexibility does not come without conditions. The hospital or clinic (referred to in the regulation as the "beneficiary") must ensure:

a contract with an authorised teleradiology service provider;
permanent, real-time communication between local staff (technicians, nurses, physicians) and the remote radiologist;
compliance with the technical standards already established by the regulation - connection speed, data transfer security, quality of diagnostic monitors;
clear operational protocols, both for the routine flow of examinations and for managing emergency situations;
designation of a physician at the hospital responsible for emergency interventions, including any adverse reactions to contrast media.

The concrete benefit: faster access, shorter waiting lists

The rationale behind the change, as publicly explained by the Ministry of Health, is straightforward: reducing interpretation times for imaging examinations, increasing patient access to diagnosis - especially in medically underserved areas - and making more efficient use of equipment already in hospitals. For a medical facility, this translates into fewer patients sent to another city for a simple CT or MRI, shorter waiting lists and better return on imaging equipment investment.

What remains the hospital's responsibility

Even though image interpretation passes to the remote radiologist, the hospital remains responsible for everything related to the decision to perform the examination, contraindications, justification and radiation dose, or the management of any adverse reactions to contrast media - a rule unchanged from the 2023 regulation.

A model already familiar to us

At Atlas Imagistica, we have been working according to this model for years: subspecialised radiologists, available 24/7, technically and organisationally integrated with partner hospitals and clinics. The new order does not change the way we work - it confirms it legally, at the level of the entire healthcare system.

If you would like to discuss how this model can work for your medical facility, you can reach us at [email protected] or +40 770 341 500.

This article is for informational purposes and does not constitute legal advice. The full text of Order No. 1,089/2026 and Order No. 1,584/2023 can be consulted in the Official Gazette of Romania and on the Ministry of Health website.

About Atlas Imagistica

Atlas Imagistica is a Centre of Excellence in Medical Imaging based in Targu-Mures, Romania, founded and led by Dr. Sorin Rosca MD. We provide AI-assisted post-processing teleradiology services to hospitals and clinics across Romania, 24 hours a day, 365 days a year.

[email protected] | +40 770 341 500 | www.atlasimagistica.com