Operational fit and migration scope

• So we can make the best use of your time, roughly how many studies (images/series) do you expect to migrate or keep accessible at cutover? Options: Under 50,000, 50,000 - 500,000, 500,000 - 2,000,000, 2,000,000 - 5,000,000, Over 5,000,000, Unsure / need help estimating
• What uptime or availability target must the imaging platform meet to avoid unacceptable clinical disruption? Options: 99.99% (about 52 minutes downtime/year), 99.9% (about 8.8 hours/year), 99.5% (about 44 hours/year), 99% (about 87 hours/year), No strict SLA today, Unsure
• Which electronic health record(s) or clinical systems must the imaging platform integrate with at go-live?
• Will the migration or ongoing service process or store protected health information (PHI) or require a business associate agreement or specific data residency controls? Options: Yes - PHI involved and BAA/data residency required, No - PHI not involved, Unsure / need guidance

Budget

• Is there an allocated budget range for an enterprise imaging replacement, migration, or managed service? Options: Under $250,000, $250,000 - $1,000,000, $1,000,000 - $3,000,000, Over $3,000,000, No formal budget yet, Prefer not to share

Decision authority

• Who would sign the contract and which roles must be involved to approve this purchase? Select all that apply or add names/roles. Options: CIO or VP IT, Chief Medical Officer, Radiology Department Chair, Imaging Informatics Director, Procurement / Contracting, Practice or Network Executive, Other - will specify

Timeline and critical deadlines

• What is your target go-live window or the date driving this timeline? Options: Within 3 months, 3 - 6 months, 6 - 12 months, 12+ months, No fixed date / exploratory
• Is there a firm regulatory, contract, or operational deadline (for example EHR cutover, end of support, or lease expiry) that makes the timing non-negotiable? Options: Yes - there is a firm deadline, No - timing is flexible, Unsure / need to evaluate

Getting started, a quick snapshot of your imaging world

• Tell me briefly about your imaging environment today, including number of sites, modalities, and primary viewer types
• Identify the group that controls budget approval for imaging platform projects Options: Radiology administration, Imaging informatics/IT, CIO/central IT, Finance, Other
• Name the on-call owner we should contact for an urgent imaging outage
• On average, how many unique studies does your system handle per month? Options: Under 10k, 10k–50k, 50k–200k, 200k–500k, Over 500k
• Estimate the percent of reads performed after hours or by remote/subspecialty readers Options: Under 10%, 10%–25%, 25%–50%, Over 50%
• When do you expect to conclude a go/no go decision on a platform change Options: Immediately (within 30 days), Next quarter, Within 6 months, Longer than 6 months, No timeline yet

Where the current system actually breaks

• What single failure in your current imaging flow would make you stop the project discussion today
• Describe the last outage that affected diagnostic reads, how long it lasted, and the measurable impact on report turnaround or patient flow
• Who detects performance degradation first, radiology, IT, or referring clinicians, and what downstream tasks stop when the viewer or archive is slow Options: Radiology, IT/network, Referring clinicians, Scheduling/clinic staff, Other
• Why does archive migration register as a high risk for your team, and which archive segments cause the most anxiety Options: Old proprietary formats, Large oncology series, PACS vendor lock in, Incomplete metadata, Other
• If you put a dollar value on an extra hour of downtime in radiology, which bucket is closest to your estimate Options: Under $1k, $1k–$5k, $5k–$20k, Over $20k, Not sure
• Could you point to a single metric threshold, such as report backlog or outage frequency, that would accelerate procurement to replace the platform this quarter

What alternatives are actually in play right now

• Point to the single alternative most likely to win this procurement, and explain the concrete reason it feels ahead today
• Select the alternatives you have evaluated or are currently evaluating Options: Incumbent vendor refresh, Different commercial vendor, Build internal solution, Cloud archival only, Managed service from IT partner, Do nothing / postpone
• Describe what would have to be true about your current system for you to keep it instead of replacing it this year
• Has anyone proposed an internal rebuild or emergency upgrade as the preferred path, and who would lead that effort Options: Yes, clinical leadership, Yes, imaging IT, Yes, central IT, No one has proposed it, Other
• Should the incumbent commit to a fixed migration timeline and defined penalties, would that stop the evaluation process Options: Yes, evaluation stops immediately, It would reduce priority but not stop evaluation, No, we would continue evaluations, Unsure

Mapping who keeps reading moving

• Who outside radiology must retain guaranteed access to images for clinical workflows, and how often does lack of access delay care Options: ED physicians, Surgery teams, Oncology clinics, Primary care/referrals, Other
• List the stakeholders who must sign off on interfaces, migration, and go-live acceptance and their typical decision timelines Options: Clinical leadership, Imaging IT, Central IT/security, Procurement, Legal/compliance
• Which clinician groups require EHR embedded viewer access and how critical is embedded access for adoption Options: Critical (must have), Important but not required, Nice to have, Not required, Unsure
• Identify the executive who can clear budget slippage or timeline compression in a worst case
• If a single stakeholder refused migration due to perceived risk, who has authority to override and what would change their view

Integrations, interfaces, and the archive you really have

• What integration point is most likely to block a pilot, the EHR API, modality connections, or archive export, and why Options: EHR/API limitations, Legacy modality protocols, Archive egress/logistics, Network bandwidth/security, Other
• Provide the technical owner and best contact for your EHR and note whether standard imaging APIs are available for testing Options: Yes, standard APIs available, Limited/custom APIs, No APIs available, Unsure
• Which modalities have historically required custom work due to nonstandard DICOM or proprietary interfaces Options: CT/MR, Ultrasound, Nuclear medicine/PET, Radiography/fluoro, Cardiology modalities, Other
• Estimate the archive size and date range that must be migrated, and whether exams are active or read only
• Are there contractual egress fees or vendor restrictions that limit archive access Options: Yes, significant fees, Yes, limited access but manageable fees, No restrictions, Unsure
• Should the EHR vendor require a custom connector at extra cost, would you fund that work, pause the project, or accept an interim integration Options: Fund it, Pause project, Accept interim integration, Re-evaluate vendor choice

Deployment readiness, named owners, schedules, and gates

• Where are your named owners for deployment, who will provide credentials and data access, and who is the escalation contact during cutover
• State the maximum allowable downtime window per site or service for migration activities Options: No downtime allowed, Under 1 hour, 1–4 hours, Overnight window only, Weekend window available
• Are weekend or overnight cutovers possible and which teams must be on call during those windows Options: Weekend allowed with on-call teams, Only overnight weekday windows, No out of hours work allowed, Depends on site
• Confirm whether your network and storage teams can provision a test environment that mirrors production for a rehearsal Options: Yes, full mirror, Partial mirror possible, No, cannot provide mirror, Unsure
• Failing to secure named owners and a test environment within 30 days, would you pause the timeline or accept a higher risk go-live Options: Pause timeline, Accept higher risk go-live, Extend pilot scope, Escalate to executive decision

Success signals and acceptance criteria that will actually close a deal

• Name the operational metric that, if improved to your target, would be enough to sign within 30 days after a successful pilot
• Choose the KPIs you will track during a pilot Options: Viewer load time, Studies per hour per reader, Report turnaround time, Migration completeness by percent, EHR imaging access success rate, Uptime percentage
• Quantify your target for viewer load time, studies per hour per reader, and acceptable migration lag in days
• List the dashboard access or reports leaders will require to validate pilot success
• Given the pilot meets these KPIs but cost exceeds your target, what internal approval could still fast track procurement Options: CIO approval, Clinical director waiver, Contingent budget release, Executive steering committee sign off, No waiver available

Regulatory, contract, and security gates we must clear

• Pinpoint the compliance or legal approvals that would block the project unless cleared, for example state privacy review or data residency constraints
• Select the security certifications your organization requires vendors to maintain Options: Security standard A, Security standard B, Healthcare privacy certification, SOC2 or equivalent, Other
• Provide the team that must sign the business associate or data use agreement and the typical review timeline
• How many weeks does your internal security review usually take and which steps typically cause delays
• Faced with a regulatory approval delay beyond your target go-live date, would you prefer a scoped functionality go-live or pause until full compliance is obtained Options: Scoped go-live, Pause until full compliance, Hybrid phased approach, Undecided

Timeline, funding, and procurement triggers

• Point to the procurement milestone that would allow you to sign a statement of work the week after a successful pilot
• Choose your preferred contracting structure Options: Fixed price SOW, Time and materials, Subscription with migration fee, Managed service agreement, Other
• State the budget range allocated for platform replacement inclusive of migration and year one support Options: Under $250k, $250k–$1M, $1M–$5M, Over $5M, Undecided
• When procurement evaluates prior vendor transitions, which contractual term has most often delayed signing Options: Indemnity clauses, Uptime SLA terms, Migration acceptance criteria, Data residency clauses, Other
• Given funding is approved but procurement prefers incumbent vendors, would that preference block signing with a new vendor Options: Yes, blocks signing, No, we can override with approval, It depends on justification, Unsure

Next steps, pilot scope, and quick wins

• Pick the pilot scope that would prove value fastest: a performance test, a migration sample, or an embedded EHR workflow test Options: Performance test (viewer speed), Migration sample (archive subset), EHR embedded workflow test, Combined mini-pilot
• How soon can your team provide sample studies and API credentials for an initial connectivity test Options: Within 1 week, 1–2 weeks, 3–4 weeks, Longer than 4 weeks, Cannot provide yet
• Outline the success documentation or artifact your leadership will expect at the end of the pilot
• Share available dates for a two week proof of concept window in the next 60 days
• Assuming we demonstrate your target KPIs in a two week window, what process steps would let you move to contracting within 14 days

• current_state
• decision_readiness
• desired_state
• success_criteria
• gaps
• stakeholders
• desired_state
• decision_readiness
• gaps
• success_criteria
• current_state
• stakeholders
• desired_state
• current_state
• gaps
• decision_readiness
• stakeholders
• success_criteria
• current_state
• decision_readiness
• decision_readiness
• decision_readiness
• decision_readiness

• Deploy diagnostic viewer to reading stations
• Configure worklists and subspecialty routing
• Connect modalities via DICOM and HL7
• Migrate legacy archive studies (bulk transfer)
• Validate and reconcile migrated study integrity
• Deploy vendor-neutral archive with storage tiering
• Integrate platform with EHR for image access
• Configure voice recognition and structured reporting
• Implement peer review and quality tracking workflows
• Configure high-availability and disaster recovery
• Provision user accounts and role-based access
• Provide go-live support and hypercare

Deploy diagnostic viewer to reading stations

• Specify the target first-image load latency for the diagnostic viewer over your WAN in milliseconds (example thresholds: <500 ms, 500-1,000 ms, 1,000-2,000 ms). Options: <500 ms, 500-1,000 ms, 1,000-2,000 ms, >2,000 ms
• List the reading-station client types, operating systems, and display capabilities that must receive the viewer (for example: Windows 10 PACS workstations with diagnostic monitors, thin clients, macOS laptops).
• Identify the expected number of concurrent active readers at peak hour for sizing and licensing. Options: 1-10, 11-50, 51-200, 201+
• Confirm whether the viewer deployment must support diagnostic monitor DICOM Grayscale Standard Display Function calibration and hanging protocol persistence. Options: Yes, No
• What objective acceptance criteria will confirm the viewer deployment is successful (example: 1st-image load <500 ms for 95% of tests, hanging protocols present for 100% of configured series)?

Configure worklists and subspecialty routing

• Describe your reading workflows and subspecialty routing rules including priority types (stat, urgent, routine) and any time-based overrides.
• Specify the external worklist sources and standards to integrate (for example DICOM Modality Worklist, HL7 ORM order feeds, RIS worklist endpoints). Options: DICOM Modality Worklist, HL7 ORM/Order feed, RIS native worklist API, No external worklist
• Indicate queue SLA targets per modality or subspecialty (example: stat reads <30 minutes, urgent <4 hours, routine <24 hours). Options: Stat <30 minutes, Urgent <4 hours, Routine <24 hours, Custom
• Which roles should receive auto-escalation or re-routing when SLA thresholds are breached (for example: on-call radiologist, department admin)?
• Provide sample peak worklist sizes and steady-state throughput in studies per hour by modality to confirm routing and performance configuration. Options: <50 studies/hour, 50-200 studies/hour, 200-500 studies/hour, >500 studies/hour

Connect modalities via DICOM and HL7

• List all modality types to connect and include DICOM AE Titles and IP ranges for each (for example CT, MRI, ultrasound, X-ray, nuclear medicine).
• Specify whether modalities are on-premises, behind a hospital VLAN, across a wide area network, or in remote partner sites requiring VPN or firewall rules. Options: On-premises, Hospital VLAN, Remote via VPN, Third-party imaging center
• Indicate the required DICOM services for each modality (C-STORE, C-FIND, C-MOVE, Modality Worklist) and note any non-standard private tags that must be preserved. Options: C-STORE, C-FIND, C-MOVE, Modality Worklist, Private tags present
• Confirm whether HL7 ADT and order feeds must be mapped to accession numbers to ensure studies link correctly between the imaging platform and orders. Options: Yes, No
• Estimate daily and peak hourly study volumes by modality to validate throughput and network capacity planning.

Migrate legacy archive studies (bulk transfer)

• Provide the total number of studies and estimated raw data size to migrate from the legacy archive (studies and terabytes).
• Identify the retention tiers and retention periods to preserve during migration (for example immediate online, nearline object storage, deep archive tape). Options: Online, Nearline, Deep archive
• Specify allowed migration windows and any blackout periods where live system downtime is not permitted. Options: No downtime allowed, Nightly windows only, Planned weekend downtime, Other
• Indicate whether the migration must preserve original SOP Instance UIDs and study/series hierarchy or whether UID remapping is acceptable. Options: Preserve original UIDs, Accept UID remapping, No preference
• What objective acceptance criteria will confirm bulk migration completeness (example: 99.9% study count match with per-instance checksum reconciliation for migrated studies)?

Validate and reconcile migrated study integrity

• Describe the reconciliation methods you require after migration (study count match, per-instance checksum comparison such as MD5/SHA, and visual spot-checks). Options: Study count match, Per-instance checksum, Random visual checks, All of the above
• Specify the acceptable mismatch threshold between source and target archives before remediation is triggered (for example 0%, <0.1%, <1%). Options: 0%, <0.1%, <1%, Custom
• Identify who in your organization will authorize remediation and re-sync actions if discrepancies are found during reconciliation.
• Provide sample patient studies or accession ranges that must be included in the reconciliation QA sample set.
• State the level of audit trail detail required for migration and reconciliation events (for example timestamp, operator ID, source AE title, checksum values). Options: Basic (timestamp & operator), Detailed (includes AE titles and checksums), Full forensic log

Deploy vendor-neutral archive with storage tiering

• Specify initial capacity required at go-live and expected annual growth rate in terabytes for archive sizing.
• Identify the storage tiers and lifecycle policies you require (for example active SSD for recent studies, object nearline for medium-term, cold tape or cloud cold for deep archive). Options: Active SSD, Nearline object, Cold tape, Cloud cold
• Confirm encryption at rest, key management, and any compliance frameworks to satisfy (for example HIPAA encryption, local data residency rules). Options: Encryption required, Bring your own key (BYOK), No encryption requirement
• Indicate retrieval SLA expectations from each storage tier (example: nearline restore within 2 hours, deep archive within 24 hours). Options: Immediate (<1 minute), Within 2 hours, Within 24 hours, Custom
• Which audit and retention reporting formats do you need for regulatory reviews and internal audits (for example retention reports by patient, study purge logs)?

Integrate platform with EHR for image access

• List the EHR systems and versions to integrate and the preferred integration approach (for example SMART on FHIR embed, EHR deep-link, or HL7 image link).
• Specify single sign-on requirements for embedded viewers in the EHR and the supported protocols (for example SAML, OAuth2/OpenID Connect). Options: SAML, OAuth2/OpenID Connect, No SSO required, Other
• Indicate the context attributes you require from the EHR for correct patient and encounter matching (for example patient ID mapping, encounter ID, accession number). Options: Patient ID, Encounter ID, Accession number, Ordering provider
• Confirm which clinical contexts must have image access (inpatient chart, outpatient clinic, ED context) and whether access is needed inside the problem list or order result flows. Options: Inpatient, Outpatient, Emergency Department, All
• Provide a target round-trip time for EHR-to-viewer deep-linking acceptable to clinicians (for example <2 seconds, 2-5 seconds). Options: <2 seconds, 2-5 seconds, >5 seconds

Configure voice recognition and structured reporting

• Specify the voice recognition engine or transcription interface and the report template formats required (for example DICOM Structured Reporting, plain text, structured JSON). Options: DICOM SR, Plain text, Structured JSON, Third-party transcription API
• Identify which specialties and report templates need macros, structured fields, or decision-support prompts (for example neuro CT, mammography, cardiac MR templates).
• Indicate expected turnaround times for finalized reports by modality to support workflow SLAs (for example CT <1 hour, X-ray <24 hours). Options: <15 minutes, <1 hour, <24 hours, Custom
• Confirm whether integration with an existing transcription vendor or radiology information system reporting engine is required and provide the interface details. Options: Yes, No
• Provide target acceptance criteria for report accuracy and template fidelity (example: 98% template field accuracy across sampled final reports).

Implement peer review and quality tracking workflows

• Describe the peer review workflow and scoring rubric you use for quality assurance (for example RADPEER categories, frequency of reviews).
• Identify which user roles can initiate peer reviews and which roles receive automated QA notifications.
• Indicate the sampling strategy for peer review (for example random 1% of reads, targeted high-risk cases, all reports for a specialty). Options: All reads, Random 1%, Random 5%, Targeted only
• Confirm the set of quality metrics you need included in dashboards and reports (for example discrepancy rate, amendment rate, report turnaround time). Options: Discrepancy rate, Turnaround time, Amendments, All of the above
• Which accreditation or regulatory standards must peer review records support (for example Joint Commission, local health board requirements)?

Configure high-availability and disaster recovery

• Specify the target availability SLA percentage for the imaging platform. Options: 99.5%, 99.9%, 99.99%, Custom
• Identify required recovery time objective and recovery point objective targets for archive and clinical viewer services. Options: RTO <1 hour, RPO <15 minutes, RTO <4 hours, RPO <1 hour, RTO <24 hours, RPO <24 hours, Custom
• List preferred disaster recovery architectures and geographic separation expectations (for example active-active between two data centers, active-passive with async replication).
• Confirm whether you require scheduled automatic failover testing and the preferred frequency (for example quarterly, annually). Options: Monthly, Quarterly, Annually, On request
• Indicate the escalation contacts and on-call rotation details to be used for 24/7 incident response during DR events.

Provision user accounts and role-based access

• Provide the number of user accounts required by role at go-live for provisioning and license assignment. Options: <=50, 51-200, 201-500, 500+
• Identify authentication and directory services to integrate for account provisioning (for example LDAP/Active Directory, SAML SSO, OAuth). Options: LDAP/Active Directory, SAML/OpenID Connect, Local accounts, Other
• Specify privileged roles that must require multi-factor authentication and detailed audit logging (for example administrators, archivists). Options: Administrator, Archivist, Superuser, No privileged roles
• Confirm whether role-based access controls must map to your existing role taxonomy and provide a sample role-to-permission mapping if available. Options: Yes, No
• Which user training formats do you prefer for go-live (for example on-site instructor-led, virtual instructor-led, recorded modules, written runbooks)? Options: On-site instructor-led, Virtual instructor-led, Recorded modules, Documentation only

Provide go-live support and hypercare

• State the expected duration and coverage level for go-live hypercare support (for example 2 weeks 24/7, 1 week business hours).
• Identify the named stakeholders who will be involved in hypercare communications and escalation and provide their roles and contact methods.
• Provide preferred hours and response targets for hypercare incident triage and first response. Options: 24/7, Business hours, Extended hours (e.g., 06:00-22:00)
• List the tools and communication channels to use for hypercare issue tracking and collaboration (for example secure chat, ticketing system, phone bridge). Options: Secure chat, Ticketing system, Phone, Email
• Confirm whether post-go-live knowledge transfer, runbook handoff, and recorded training artifacts are required and in which formats. Options: Recorded modules, On-site handoff, Written runbooks, Not required

• Master Services Agreement (MSA)
• Statement of Work (SOW) — Implementation & Migration
• Order Form / Subscription Agreement
• Service Level Agreement (SLA) — Uptime & Migration
• Go-Live Acceptance & Sign-off
• Migration Plan & Rollback Agreement
• Payment and Invoicing Schedule
• Data Processing Agreement (DPA) / HIPAA Business Associate Addendum (BAA) — conditional
• Change Order Agreement

• Go-live Health Check (weeks 1-4)
• First Measurement Review (weeks 4-10)
• Acceptance Gate — Final Acceptance Decision (around day 90)
• 90-Day Post-Acceptance Realization Review
• Quarterly Operational Review (recurring)

• Update the operations runbook to reflect any new escalation paths or verification steps discovered during remediation.
• Produce a documented pass or fail outcome for each acceptance criterion recorded in Solution Scope and capture the named signatory's acceptance decision if applicable.
• Agree a remediation plan with dates for any conditional or failed criteria so the acceptance record is closed-loop.
• Confirm the incumbent decommissioning or retention approach and the timeline to avoid dual-system operations.
• Record the formal acceptance decision in writing and circulate the acceptance summary to all stakeholders.
• Publish the remediation tracker for any conditional items with completion dates and verification tests.
• Confirm and document the incumbent system disposition, including archive retention policies or read-only access details.
• Operational trend review vs Solution Scope targets
• Confirm whether uptime and EHR transaction success rates are sustained at or above Solution Scope targets.
• Close out the majority of remediation items or document concrete dates for remaining items.
• Agree the operational monitoring cadence and data sources for the ongoing quarterly reviews.
• Run a full archive integrity report and publish findings with any corrective tasks.
• Re-confirm success criteria and named owners
• Schedule follow-up verification tests for any items not yet validated and publish expected completion dates.
• Quarterly operational health summary
• Maintain confirmed operational health with documented actions for any items that threaten uptime or throughput targets.
• Ensure SLA performance is tracked and corrective plans exist for any breached or at-risk commitments.
• Keep the enhancement and operational backlog prioritized and avoid new untracked workarounds in the incumbent system.
• Run the quarterly capacity forecast and publish any required storage lifecycle changes.
• Produce an SLA performance summary and corrective action plan for any metrics below target.
• Update the operational backlog with prioritized items and expected delivery quarters.
• Confirm the cutover completed and the environment is functionally available for radiologists to begin reading.
• Identify and document the top 5 operational blockers with resolution timelines.
• Agree the verification tasks to run before the First Measurement Review.
• Publish a short hypercare status summary with the current ticket list and severity for async review.
• Run a scripted sample study retrieval and report the results against the integration checklist.
• Collect user onboarding feedback from the first cohort and surface any usability blockers.
• Present the first 30-day data vs Solution Scope targets
• Determine whether viewer load time and reading-workflow throughput are trending toward Solution Scope targets or require remediation.
• Agree a short list of corrective actions with verification tests and completion dates.
• Confirm the evidence and data sources that will be used at the Acceptance Gate.
• Execute the agreed performance tuning tasks and schedule verification tests using the agreed sampling method.
• Deliver an updated measurement pack that includes raw samples, aggregation method, and dashboard queries for acceptance review.
• Run an archive completeness scan and report the current migration completeness percentage.
• Restate acceptance criteria and numeric targets
• Remediation burn-down and verification
• Present outcome data for each acceptance criterion
• Diagnose root causes for gaps
• Deployment and migration validation
• SLA adherence and incident response times
• Archive integrity and migration completeness check
• Early adoption signals and usage patterns
• Document pass/fail per criterion and record the acceptance decision
• Agree corrective actions and verification tests
• Open issues and enhancement queue review
• Open operational issues and ticket prioritization
• Capacity and lifecycle considerations
• Confirm timeline to the Acceptance Gate
• Agree remediation plan for any failed or conditional criteria
• Blockers and open issues triage
• Incumbent wind-down and data retention confirmation
• Identify any additional data needs
• Agree next 90-day operational targets
• Agree operational actions and next review cadence
• Agree immediate remediation actions and timeline