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.

The Perils of Worklist Cherry-Picking

If you’re a radiologist, chances are at some point in your career you’ve cherry-picked the worklist. But picking easy, high-RVU imaging studies to read before your colleagues isn’t just rude – it’s bad for patients and bad for healthcare.

That’s according to a new study in Journal of Operations Management that analyzes radiology cherry-picking in the context of operational workflow and efficiency. 

Based on previous research, researchers hypothesized that radiologists who are free to pick from an open worklist would choose the easier studies with the highest compensation – the classic definition of cherry-picking.

To test their theory, they analyzed a dataset of 2.2M studies acquired at 62 hospitals from 2014 to 2017 that were read by 115 different radiologists. They developed a statistical metric called “bang for the buck,” or BFB, to classify the value of an imaging study in terms of interpretation time relative to RVU level. 

They then assessed the impact of BFB on turnaround time (TAT) for different types of imaging exams based on priority, classified as Stat, Expedited, and Routine. Findings included:

  • High-priority Stat studies were reported quickly regardless of BFB, indicating little cherry-picking impact
  • For Routine studies, those with higher BFB had much lower reductions in turnaround — a sign of cherry-picking
  • Adding one high-BFB Routine study to a radiologist’s worklist resulted in a much longer increase in TAT for Expedited exams compared to low-BFB studies (increase of 17.7 minutes vs. 2 minutes)
  • The above delays could result in longer patient lengths of stay that translate to $2.1M-$4.2M in extra costs across the 62 hospitals in the study. 

The findings suggest that radiologists in the study prioritized high-BFB Routine studies over Expedited exams – undermining the exam prioritization system and impacting care for priority cases.

Fortunately, the researchers offer suggestions for countering the cherry-picking effect, such as through intelligent scheduling or even hiding certain studies – like high-BFB Routine exams – from radiologists when there are Expedited studies that need to be read. 

The Takeaway 

The study concludes that radiology’s standard workflow of an open worklist that any radiologist can access can become an “imbalanced compensation scheme” that can lead to poorer service for high-priority tasks. On the positive side, the solutions proposed by the researchers seem tailor-made for IT-based interventions, especially ones that are rooted in AI. 

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