Radiology Untethered: Sirona’s Approach to Unified Radiology

Radiology stands at a breaking point. 

Hospitals and imaging practices are overwhelmed by fragmented IT systems, cumbersome technology integrations, and staff burnout. Medical imaging is the central hub through which more than 80% of healthcare data flows, but it’s become hobbled by technology that was never designed to work together.

Sirona Medical is changing the equation by rebuilding radiology software from the ground up with a cloud-based architecture that’s as simple as launching a web browser. The company hopes to free radiologists from the constraints of legacy infrastructure and redefine how diagnostic medicine operates in the cloud era, and is demonstrating its approach to radiology professionals.

The fragmented roots of radiology IT. For over two decades, diagnostic imaging has relied on three separate technological worlds that each evolved independently: PACS, reporting, and worklists…

  • PACS revolutionized image storage and viewing in the 1990s, replacing film with pixels. 
  • Reporting software brought speed through voice recognition, ending the days of transcription backlogs. 
  • Worklists organized the chaos of multi-site reading, giving radiologists a unified queue.

Yet these systems were never designed to function as one. Every integration became a brittle patchwork of custom connections. Every update risked breaking the workflow. 

The result was a “house of cards” of on-prem servers, co-located databases, and expensive maintenance contracts. Radiologists found themselves acting as system operators rather than clinical specialists, forced to navigate between screens and dictate into isolated software, losing valuable time that could be spent on patient care.

The hidden cost of separation. This disconnected infrastructure carries enormous financial, operational, and human costs. Hospitals often juggle dozens of software solutions that must be maintained, updated, and bridged by manual effort. 

A single broken link can break the entire workflow. Meanwhile, legacy vendors profit from the complexity, locking customers into long-term contracts that drain budgets and stifle innovation.

The radiologist shortage and rising imaging demand only worsen the problem. Real progress requires not another integration, but a complete re-architecture of the radiology technology stack.

Sirona’s break from the past. Enter Sirona Medical with the mission of rebuilding radiology software as a single, cloud-native platform where PACS, reporting, and worklist live together seamlessly. Delivered entirely through a Chrome browser, Sirona’s system eliminates handoffs, brittle integrations, and costly local servers.

At the platform’s foundation is RadOS, a unified data model and operating system that ingests, normalizes, and orchestrates imaging and text data across formats including DICOM, HL7, FHIR, PDFs, and clinical notes. By consolidating all this information into one consistent data model, RadOS replaces thousands of fragile interfaces with a single source of truth.

RadOS does more than unify; it enables intelligence. Built-in large language and ontology-classification models transform raw imaging and text data into structured, machine-readable insights. As a result, radiologists can work as fast as they can think, and organizations can operate profitably while improving care quality.

Powered by AWS: Streaming radiology to the world. Sirona’s platform runs on AWS, the world’s most robust cloud infrastructure. Sirona delivers massive imaging datasets to radiologists, ensuring near-instant access regardless of geography.

This design provides…

  • Low-latency performance through local caching.
  • HIPAA-compliant, military-grade security across devices and networks.
  • Global reliability backed by AWS’s resilient backbone.
  • Automatic updates via simple browser refresh.
  • Scalable storage without hardware investment.

Hospitals and imaging practices can now connect radiologists worldwide without maintaining physical servers or dealing with VPN bottlenecks.

The application layer: Intelligence built in. Sirona’s application layer sits on top of RadOS and is a seamlessly integrated environment that merges the universal worklist, diagnostic viewer, and AI-driven reporting solution. 

Key capabilities include…

  • Auto-Impressions: AI generates customizable draft impressions, fine-tuned for each reader.
  • Focus Mode: Radiologists dictate naturally while AI maps findings to structured report sections.
  • Quality Assist: A radiology-specific large language model detects speech-to-text errors and clinical inconsistencies in real time.
  • AI Orchestration: Third-party AI tools plug directly into reporting, no brittle middleware required.
  • Priors Summary and Auto-Priors: AI retrieves and summarizes prior exams automatically, accelerating interpretation and ensuring continuity of care.

These features turn the radiology report from a static document into a dynamic, intelligent artifact that supports decision-making across the care continuum.

The time is now for cloud-native PACS, and for the unified approach to radiology viewing, reporting, and worklist that Sirona Medical has pioneered. Radiology’s next era has arrived: one PACS, one worklist, one reporter – and it’s a reality right now.

Learn more about Sirona Medical’s approach to radiology software by booking a demo today.

Sirona Medical Acquires Nines AI, Talent

Sirona Medical announced its acquisition of Nines’ AI assets and personnel, representing notable milestones for Sirona’s integrated RadOS platform and the quickly-changing imaging AI landscape.

Acquisition Details – Sirona acquired Nines’ AI portfolio (data pipeline, ML engines, workflow/analytics tools, AI models) and key team members (CRO, Direct of Product, AI engineers), while Nines’ teleradiology practice was reportedly absorbed by one of its telerad customers. Terms of the acquisition weren’t disclosed, although this wasn’t a traditional acquisition considering that Sirona and Nines had the same VC investor.

Sirona’s Nines Strategy – Sirona’s mission is to streamline radiologists’ overly-siloed workflows with its RadOS radiology operating system (unifies: worklist, viewer, reporting, AI, etc.), and it’s a safe bet that any acquisition or investment Sirona makes is intended to advance this mission. With that…

  • Nine’s most tangible contributions to Sirona’s strategy are its FDA-cleared AI models: NinesMeasure (chest CT-based lung nodule measurements) and NinesAI Emergent Triage (head CT-based intracranial hemorrhage and mass effect triage). The AI models will be integrated into the RadOS platform, bolstering Sirona’s strategy to allow truly-integrated AI workflows. 
  • Nine’s personnel might have the most immediate impact at Sirona, given the value/scarcity of experienced imaging software engineers and the fact that Nines’ product team arguably has more hands-on experience with radiologist workflows than any other imaging AI firm (at least AI firms available for acquisition).
  • Nine’s other AI and imaging workflow assets should also help support Sirona’s future RadOS and AI development, although it’s harder to assess their impact for now.

The AI Shakeup Angle – This acquisition has largely been covered as another example of 2022’s AI shakeup, which isn’t too surprising given how active this year has been (MaxQ’s shutdown, RadNet’s Aidence/Quantib acquisitions, IBM shedding Watson Health). However, Nines’ strategy to combine a telerad practice with in-house AI development was quite unique and its decision to sell might say more about its specific business model (at its scale) than it does about the overall AI market.

The Takeaway

Since the day Sirona emerged from stealth, it’s done a masterful job articulating its mission to solve radiology’s workflow problems by unifying its IT infrastructure. Acquiring Nines’ AI assets certainly supports Sirona’s unified platform messaging, while giving it more technology and personnel resources to try to turn that message into a reality.

Meanwhile, Nines becomes the latest of surely many imaging AI startups to be acquired, pivoted, or shut down, as AI adoption evolves at a slower pace than some VC runways. Nines’ strategy was really interesting, they had some big-name founders and advisors, and now their work and teams will live on through Sirona.

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