To guarantee the quality of teleradiology services in Austria we have developed an easy-to-use and continuously re-evaluated teleradiology workflow model. This is based on the quality management model (ISO 9001:2000) of the International Standardization Organization (ISO) and guarantees the quality of the process. From January 2002 to January 2003 we examined 544 emergency teleradiology computerized tomography studies transmitted to the Department of Radiology 2 in Innsbruck. The patients were from the rural hospital of Reutte. In 450 cases (83%) the sending of the written legal final report took less than 1 h. The numbers of mistakes (mostly minor workflow errors) were reduced from 23 errors per month in January 2002 to 9 errors per month in January 2003. The continuous cross-checking of the workflow and the training of the employees involved guaranteed a better standard of teleradiology in our department. Since December 2002, the whole Tyrolean teleradiology process has been ISO 9001:2000 certified.