radiology and enterprise imaging

The Essential Relationship Between Radiology and Enterprise Imaging

I was honored to be able to address a group of Agfa healthcare executives at RSNA 2019.  The topic was one that is near and dear to my heart - radiology and Enterprise Imaging. I first explored this topic in an article The Evolution of Enterprise Imaging and the Role of the Radiologist in the New World in 2017.

Radiology has the most advanced imaging informatics of any medical specialty.  We began on this journey nearly 40 years ago.  Our colleagues in cardiology have followed closely behind.  Now many other medical specialties are following in the footsteps of these imaging leaders including specialties like ophthalmology and dermatology.

In the current environment, where access to information is critical and interoperability is key, we have watched the consolidation of the electronic medical record into one large system creating a comprehensive view of the patient.  Imaging systems are following suit.  Just as the field of clinical informatics spans every specialty, the field of imaging informatics will evolve in the same way.  As this evolution progresses radiologists have a great opportunity to lead the way.

Enterprise Leadership

Leadership can be provided in multiple ways.  Most obvious is to serve as a clinical leader for Enterprise Imaging for the entire organization.  This position requires an organizational viewpoint, placing department specific concerns aside.  Radiologists in these roles will need to learn about the many challenges that are unique to other image-producing departments.  For example, the privacy and security concerns around photographs of sensitive anatomy and the many intricacies of encounters-based workflows.

Radiology plays a key selection in infrastructure selection.  The desire to replace the vendor specific long-term archive of the radiology department with a vendor neutral archive (VNA) is the event which often spurs exploration of an enterprise imaging strategy.   Because the VNA will serve as an enterprise resource radiologist need to reach out and include other specialties in the decision-making process.  This inclusion is critical for other specialty’s long-term buy-in to use of the VNA.

Clinical Care

Enterprise Imaging will also enhance the care that radiologists are able to deliver.   We can no longer confine ourselves to consuming only the information generated in our department.  We must examine the history of the patient and their problems by exploring the EMR.  Similarly we need avail ourselves of all imaging information.  Point-of-care ultrasounds generated outside the walls of radiology provide the foundation for many clinical decisions.  We need to include these images in our investigation to obtain a comprehensive picture the patient.

Final Thoughts

I continue to urge radiologists to embrace Enterprise Imaging for the opportunities it provides for us to contribute to the continued growth of our respective healthcare organizations, as well as for the additional information it provides us about our patients.   More information and thoughts are available in the complete summary of the presentation.



Petersilge CA.  The Evolution of Enterprise Imaging and the Role of the Radiologist in the New World. Am J Roentgen 209: 845-848, 2017.




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