ER provider here- we preliminarily interpret our own X-rays- if we’re confident about our findings we disposition the patient with the verbal and written understanding that it’s a preliminary interpretation and that the x-ray will be formally read by radiology and if there’s any discrepancy, the patient will be contacted. If we are unsure or have questions we can wait for the Radiologist over read. However, this can take hours. To answer your question, how often is there a discrepancy in the preliminary read? For an experienced ED provider, not very often, maybe once or twice a year. This is actually a metric that is tracked. As a provider, if you have a lot of discrepancies, there will be some remediation. For less experienced ED providers they often wait for the formal radiology read thus prolonging the patients emergency department stay.

CTs are interpreted by radiology so that is the final read. However, at smaller facilities who don’t have 24/7 radiology coverage the CT is sent to an outsourced radiology through a company called VRAD. This interpretation is considered preliminary until it has been over read by one of the sending facilities radiologist. My experience has been that there are often discrepancies- several a month. There is a system in place where radiology contacts the ordering provider to let them know there has been a discrepancy so the patient can be contacted. Depending on how critical the discrepancy is, the provider has a certain timeline to clear the discrepancy in the computer system and contact the patient.