Quick Tour of Your Current Imaging Footprint

• To begin, how do you currently manage image storage, viewing, and EHR access across your facilities? Options: Multiple local PACS with separate viewers, Site-level PACS with an enterprise archive, Centralized archive with EHR in-context access, Hybrid cloud and on-prem archive, Other
• How many hospital sites, outpatient imaging locations, and reading hubs are in your system today? Options: 1-3, 4-10, 11-25, 26-100, More than 100
• Tell me about the imaging modalities and specialty systems we must include, for example CT, MRI, nuclear medicine, cardiology, ultrasound, digital pathology. Options: CT, MRI, X-ray/DR, Ultrasound, Nuclear medicine/PET, Cardiology (echo/vascular), Digital pathology, Other
• Estimate your typical enterprise monthly study volume and the busiest single site. Options: Under 50,000 studies per month, 50,000-150,000, 150,000-500,000, 500,000-1,000,000, Over 1,000,000
• Who on your team currently owns archive strategy and migration decisions, and are they available for planning sessions? Options: Radiology informatics director, Imaging IT manager, CIO/IT operations, Clinical applications team, Shared responsibility, Not assigned yet
• When was the last time you consolidated an archive or migrated a PACS, and what unexpected issue came up?

Where Consolidation Is Most Fragile

• Which single site, system, or interface would force you to pause consolidation if it could not be integrated?
• Walk me through the top legacy systems or appliances that still hold critical imaging data you cannot replace.
• List the local systems that require real-time in-EHR viewing versus those that can remain in a separate viewer. Options: Real-time in-EHR required, Separate viewer acceptable, Both depending on site, Unknown
• Describe any contractual exit penalties, retention clauses, or vendor device decommission constraints tied to your current imaging vendors.
• If one of those legacy systems cannot be migrated, what contingency would you accept and who must approve it?

How Radiologists' Day Would Improve

• Imagine your radiologists reclaimed 30 percent of non-interpretive time, what would their day look like differently?
• Identify the reading workflows that currently require toggling between viewers or systems during a single study. Options: Cross-modality reads, Advanced visualization in a separate tool, AI results in a separate UI, Reporting in a separate system, Scheduling and reporting split
• Who typically configures worklists, hanging protocols, and report templates today, and how often are those configurations updated? Options: Imaging IT, Radiology informatics team, Vendor support, Site superuser, Not regularly updated
• What single productivity metric change, for example studies per hour or report turnaround time, would make leadership approve consolidation now?
• How comfortable are your reading teams with AI-assisted reads and integrated advanced visualization inside the primary reading workflow? Options: Very comfortable, Somewhat comfortable, Cautious but curious, Resistant, Not sure
• Should a pilot show measurable improvement in throughput, what obstacles would still delay a system-wide rollout?

The Migration Reality Check

• Walk me through the riskiest migration you have run and the clinical or operational fallout that followed.
• Which studies must be migrated verbatim, including private tags, overlays, and structured reports, and which can be archived as read-only? Options: All studies verbatim, Studies from last 2-5 years verbatim, Critical modalities only verbatim, Read-only archive acceptable for older studies
• Identify who owns the source data and who can authorize metadata transformations during migration. Options: Site IT, Radiology department, Health information management, Legal/compliance, Shared approvals
• Estimate the total size to be actively migrated versus cold storage, in terabytes or approximate study counts. Options: Under 10TB / under 50k studies, 10-100TB / 50k-500k studies, 100-500TB / 500k-2M studies, Over 500TB / over 2M studies, Unknown
• Detail the acceptance gates you will require during migration for data fidelity, viewer parity, and clinician sign-off.

Security and Compliance That Can Stop a Project

• Name the security or legal approvals that have blocked past projects or could veto this one outright. Options: Privacy officer sign-off, State health authority approval, Legal BAA review, Cybersecurity risk committee, Other
• Confirm whether your environment requires on-prem data residency, customer-managed encryption keys, or specific encryption-at-rest standards. Options: On-prem data residency required, Customer-managed keys required, Standard encryption acceptable, Unsure
• Indicate the named approver for security exceptions and the typical length of their review cycle. Options: CISO or security lead, Security operations, Legal, IT governance, Not defined
• Have you experienced a security incident involving imaging systems in the last five years, and what remediation was required? Options: Yes, major incident, Yes, minor incident, No incidents, Prefer not to say
• When our platform requires a business associate agreement or SOC attestation, what internal timeline do you need for legal and procurement sign-off? Options: Under 2 weeks, 2-6 weeks, 6-12 weeks, Over 12 weeks, Unsure

Competitive Landscape and Alternatives

• Select the alternative paths you are actively considering instead of an enterprise consolidation platform. Options: Keep incumbent vendor and renew, Build an internal archive solution, Assemble best-of-breed point solutions, Evaluate another full-platform vendor, No alternative identified, Other
• Under which conditions would you choose to keep your current approach instead of moving to a new platform?
• Has anyone on your team formally proposed solving this internally, and if so what resources and timeline did they estimate? Options: Yes, formal proposal with timeline, Informal proposal only, No internal proposal
• Compare your initiative budget and timeline to the typical procurement cycle for the incumbent or an internal build. Options: Shorter than incumbent/internal, About the same, Longer than incumbent/internal, Unsure
• Select the vendor evaluation criteria your team will weight most heavily, for example migration cost, radiologist adoption, EHR integration depth, or total cost of ownership. Options: Migration cost and risk, Radiologist productivity gains, EHR integration depth, Total cost of ownership, Security and compliance, Analytics and AI integration, Other

Operational Readiness and Integration Dependencies

• Name any missing connector, unavailable API, or third-party dependency that would stop us from starting work on schedule.
• List each external system we must integrate with and indicate whether APIs, HL7, or direct DICOM access is available. Options: EHR / in-context viewer, Local PACS instances, RIS, Scheduling/HIS, Modality gateways, Vendor-proprietary archive, AI/analytics platforms, Other
• Confirm the platform technical owner on your side and whether they have dedicated time allocated for the project. Options: Dedicated full-time resource, Shared part-time resource, External contractor, No owner assigned yet
• Can you provide a test environment, representative test patients, and temporary credentials for validation? Options: Full test environment and data available, Test data only, Vendor sandbox required, Not available yet
• Provide the maintenance windows available for cutover at each major site and name any blackout periods we must avoid. Options: Weekends only, Weeknights, Planned holiday windows, No windows available, Varies by site
• If latency or network bandwidth is inadequate during testing, what escalation path or remediation budget exists for network upgrades?

Decision Gates, Success Signals, and Next Steps

• Assuming a pilot proves the consolidation and productivity gains we discuss, what exactly would stop you from signing the next phase this quarter?
• Choose the measurable acceptance criteria you will use to evaluate success during pilot and after full deployment. Options: Radiologist studies per hour, Report turnaround time (TAT), Percent of archives consolidated, Total cost of ownership reduction, Security audit pass, Referrer access from EHR, Other
• Provide the names and roles of stakeholders who need to be at the final decision table and identify any single-point sign-off authority.
• Choose your target timeline for pilot start and expected production cutover. Options: Pilot within 4-8 weeks, Pilot within 8-12 weeks, Pilot in 3-6 months, Production cutover within 6-12 months, Unsure
• What would be a reasonable first technical milestone that would let both teams commit to a full deployment plan?
• Share names and availability for your proposed technical kickoff attendees.

• Solution Experience Session

• Confirm the current state and its cost to your team
• Customer confirms the demonstrated consolidation flow delivers image access in the EHR and removes the need to open separate viewers.
• Deliver a tailored archive consolidation plan showing estimated data volumes, proposed migration waves, cutover windows, and rollback contingencies.
• Customer confirms the shown reading workflow with embedded visualization and AI reduces steps and would address read-time and productivity concerns.
• Proof: End-to-end archive consolidation on a buyer scenario
• Provide a sample set of 3 representative clinical studies, a list of current PACS/RIS instances, site-level study volumes, and EHR endpoints to validate migration assumptions.
• Agreement on the remaining evidence and data required to finalize migration scope and timelines.
• Proof: Radiologist workflow with embedded visualization and AI
• Run a short proof-of-concept using the provided clinical scenario with advanced visualization and one AI model, and deliver the results and measured time/step savings.
• Migration and integration plan walkthrough
• Identify named facility owners and integration owners for each site to participate in migration planning and acceptance criteria definition.
• Validate alignment with your needs

• Solution Experience Session
• Solution Experience Deck
• Solution Brief

• meeting
• slides
• document

• Consolidate imaging into vendor-neutral archive
• Migrate legacy studies and metadata to archive
• Integrate platform viewer with EHR access
• Configure radiologist reading workflows and worklists
• Deploy advanced 3D visualization applications
• Integrate AI algorithms into the reading workflow
• Implement structured and voice-enabled reporting
• Deploy peer review and quality assurance workflows
• Enable dose monitoring and regulatory dose reporting
• Activate radiologist productivity and utilization analytics
• Provision referring physician image access via EHR
• Train clinical staff on platform applications and workflows

Consolidate imaging into vendor-neutral archive

• List the sites and modality types (e.g., CT, MR, US, X-ray, Nuclear) you expect to consolidate into the archive
• Estimate the current archive size to be consolidated (total studies and terabytes) Options: Less than 10,000 studies / <5 TB, 10k-100k studies / 5-50 TB, More than 100k studies / >50 TB
• Describe the retention policies per site or modality (years, legal hold, image types such as priors or outside studies)
• Identify the ingestion protocols your current PACS and modalities support (DICOM C-STORE, WADO-RS, DICOMweb, S3), for routing into the archive Options: DICOM C-STORE, DICOMweb (WADO-RS/Q/R), S3/object store, Other
• Provide the AE Titles or gateway endpoints that will be used to receive studies from each site

Migrate legacy studies and metadata to archive

• Which source systems require migration (list PACS/RIS exports by site and include expected study date ranges)
• Estimate the volume for migration by modality and site (studies per modality per site)
• What migration completeness threshold will you accept per site and modality (percentage of studies and metadata that must be validated as migrated)? Options: 90%, 95%, 99%
• How should patient and accession ID mapping be handled when source patient identifiers differ (retain source IDs, map to enterprise master patient index, or append mapping file)? Options: Retain source IDs, Map to enterprise master patient index, Append mapping file / crosswalk
• Describe validation checks required post-migration (checksum match, study counts by accession, visual spot-checks, DICOM header field accuracy)

Integrate platform viewer with EHR access

• Select the EHR launch and integration methods your EHR supports for image access from the chart Options: SMART on FHIR launch, IHE XDS-I / XCA, Context-link URL launch, HL7 v2 context + URL, Other
• Provide the preferred single sign-on protocol for physicians (SAML, OAuth2/OpenID Connect, or built-in SSO) Options: SAML, OAuth2 / OpenID Connect, Integrated SSO, Other / None
• Identify required EHR clinical context fields to be passed at launch (patient ID, encounter ID, accession number, order ID)
• Describe expected viewer behavior when launched from the EHR (embedded inline viewer, new tab, or separate window) and any persistent link requirements Options: Embedded inline viewer, New browser tab, Separate native window, Deep link to specific study
• List performance targets for EHR-launched reads such as first-image-load time over your WAN (e.g., <3 seconds, <5 seconds) Options: <2 seconds, <3 seconds, <5 seconds, <10 seconds

Configure radiologist reading workflows and worklists

• Describe your reading model for each site (local reads only, centralized reads across sites, hybrid teleradiology) Options: Local only, Centralized enterprise reads, Hybrid / mix
• Specify how worklist routing should occur (by modality, by subspecialty, by shift schedule, by acuity tag such as STAT) Options: Modality-based, Subspecialty, Shift schedule, Acuity routing (STAT/urgent)
• Provide the RIS message types used for order lifecycle integration (order placed, modality performed, MPPS, result post via HL7 ORU) and any custom HL7 fields required Options: ORM/ORU/MFN/MDM, MPPS support, Custom HL7 fields required, Other
• Identify hanging protocol requirements and whether protocols should be per-radiologist, per-site, or shared enterprise templates Options: Per-radiologist, Per-site, Enterprise-shared, Mixed
• State prefetch rules for priors (how many prior studies, within what date ranges, and whether priors come from the archive or external sources)

Deploy advanced 3D visualization applications

• List the clinical use cases that require 3D (e.g., cardiac CT post-processing, neuro MR tractography, vascular CTA), by modality
• Choose preferred rendering model for each 3D use case (server-side GPU rendering, client GPU/WebGL, or hybrid streaming) Options: Server-side GPU rendering, Client GPU (WebGL), Hybrid streaming
• Provide minimum concurrent-seat and GPU requirements for 3D users (number of simultaneous 3D sessions) Options: 1-5 seats, 6-20 seats, 21-50 seats, 50+ seats
• Describe integration needs for measurement and CAD outputs (DICOM SR, DICOM SEG, or vendor JSON) into the final report Options: DICOM SR, DICOM SEG, JSON / REST payload, Other
• Identify any regulatory or data residency constraints for 3D processing if rendering will occur off-premises Options: On-prem only, Cloud allowed with regional controls, Cloud not allowed, TBD

Integrate AI algorithms into the reading workflow

• Select the AI use cases you plan to enable (triage/prioritization, quantification, detection, structured measurements) Options: Triage / prioritization, Quantification (volumes, measurements), Detection / CAD, Structured measurement extraction, Other
• Indicate the preferred inference location for AI (on-prem inference appliance, cloud inference, or hybrid) Options: On-prem inference, Cloud inference, Hybrid
• Specify the AI input and output formats your integration must support (DICOM instances, DICOM SEG, DICOM SR, FHIR DiagnosticReport, JSON) Options: DICOM instances (C-STORE), DICOM SEG, DICOM SR, FHIR DiagnosticReport, JSON REST
• Describe the routing rules for AI results into the reading workflow (inline overlay to viewer, separate AI queue, or push to PACS/RIS) Options: Inline overlay in viewer, Separate AI worklist/queue, Push back to PACS/RIS, Other
• Identify validation and governance required before AI results appear to readers (model version control, clinical validation dataset, QA sign-off)

Implement structured and voice-enabled reporting

• Which reporting output formats must be supported for EHR ingestion (HL7 ORU, FHIR DiagnosticReport, PDF, plain text)? Options: HL7 ORU, FHIR DiagnosticReport, PDF, Plain text
• State whether you will use discrete templates with coded fields (SNOMED, LOINC) and for which study types Options: Yes, enterprise templates, Yes, per-site templates, No structured templates, Partial
• Describe your speech recognition requirements (integration to existing speech engine, platform-provided SR, or hybrid with correction workflows) Options: Integrate existing SR, Use platform SR, Hybrid / other
• Provide the sign-off and amendment workflow you require in the report lifecycle (draft, preliminary, final, amended; who can sign)
• Identify discrete report data fields you need captured for analytics or registry submission (measurements, exam indication, staging codes)

Deploy peer review and quality assurance workflows

• Select the peer review model desired (random sampling, triggered review on discrepancies, mandatory double read for certain exams) Options: Random sampling, Triggered on discrepancy, Mandatory double read by modality, Voluntary peer review
• Specify sampling rates and escalation thresholds for QA (for example, 5% random sample, or >X discrepancy rate triggers review)
• Describe whether peer reviews must be anonymized to the reviewer and how reviewer identities are recorded for QA metrics Options: Anonymized to reviewer, Identified reviewer, Mixed depending on case
• List the QA KPIs you want tracked (discrepancy rate, concordance, time-to-correction, reviewer turnaround time) Options: Discrepancy rate, Concordance, Reviewer turnaround time, Time-to-correction, Other
• Identify integration points for QA results (link to peer review module, addendum to report, or separate quality dashboard) Options: Addendum to report, Quality dashboard, Separate QA repository, Other

Enable dose monitoring and regulatory dose reporting

• Which modalities must send Radiation Dose Structured Reports (RDSR) to the platform (CT, fluoroscopy, interventional, mammography)? Options: CT, Fluoroscopy / IR, Mammography, Nuclear / PET, Other
• Provide the expected format and endpoint for dose registry submission if required (state/national registry API, file export, or manual upload) Options: Automated registry API, Periodic file export, Manual upload, Not submitting to registry
• Describe dose alert thresholds and notification routing required (e.g., CTDIvol > X mGy triggers notification to physics team)
• Identify retention and audit requirements for dose records and which teams need access (radiology QA, medical physics, compliance)
• State whether dose data needs normalization or recalculation (e.g., legacy devices without RDSR require DICOM header parsing) Options: No normalization needed, Require parsing and normalization, Partial / site-dependent

Activate radiologist productivity and utilization analytics

• List the productivity KPIs you want tracked (studies per hour, first-read time, report turnaround time, case mix by RVU/complexity) Options: Studies per hour, First-read time, Report turnaround time, Case mix / complexity
• Provide the baseline metrics and target improvement goals for analytics reporting (e.g., baseline 4.2 studies/hour target 4.8)
• Describe required data sources for analytics (worklist events, RIS timestamps, voice recognition logs, PACS access logs)
• Indicate reporting cadence and distribution (real-time dashboard, daily digest, weekly executive report) Options: Real-time dashboard, Daily digest, Weekly report, Monthly executive summary
• Identify role-based access for analytics (radiologists, operations managers, medical director, CIO) and any CSV/BI export requirements

Provision referring physician image access via EHR

• Specify which user groups require image access from the EHR (referring physicians, clinic staff, ambulatory providers, external partners) Options: Referring physicians, Clinic staff, Ambulatory providers, External partners
• Identify expected authentication flow for referring physicians opening images (SSO via EHR context, re-authentication, or guest access) Options: SSO via EHR context, Re-authentication required, Guest access with token
• What first-image-load time will you accept for a physician launching an exam from the EHR (target network condition example: WAN with 50-100 ms RTT)? Options: <2 seconds, <3 seconds, <5 seconds, <10 seconds
• Describe audit and logging requirements for referring physician access (what must be logged: user, patient, timestamp, IP, reason for access)
• State whether outside images must be visible to referring physicians and how outside-study ingestion should be presented in the EHR (inline with priors or as separate study) Options: Visible inline with priors, Shown as separate outside-study list, Not shown

Train clinical staff on platform applications and workflows

• How many users in each role require training (radiologists, technologists, schedulers, PACS admins, IT integrators)?
• Select preferred training delivery formats (on-site instructor-led, virtual instructor-led, recorded e-learning modules, train-the-trainer) Options: On-site instructor-led, Virtual instructor-led, Recorded e-learning, Train-the-trainer
• Provide acceptance criteria for successful training (for example, a set number of supervised reads, completion of competency checklist, or passing score on knowledge check) Options: Competency checklist completed, X supervised reads, Passing knowledge check, Other
• Identify documentation and runbooks required at go-live (integration runbooks, cutover checklist, rollback procedures, user quick-reference guides)
• State your target training timeline relative to cutover (weeks before go-live and post-go-live support window) Options: 2-4 weeks pre-go-live, 1-2 weeks pre-go-live, Concurrent with deployment, Post-go-live only

• Master Services Agreement (MSA)
• Statement of Work (SOW)
• Subscription Order Form
• Data Processing Agreement (DPA) and HIPAA Business Associate Addendum (BAA)
• Security and Access Addendum
• Service Level Agreement (SLA)
• Acceptance Criteria & Test Plan
• Operational Responsibilities and RACI
• Change Order Agreement

• Go-live Health Check (weeks 1-4)
• First Measurement Review (weeks 4-10)
• Acceptance Gate Review (around day 90)
• Quarterly Outcomes Review
• Annual Outcomes Review

• Maintain the shared issue channel with weekly status updates until high-priority tickets are resolved.
• Publish the formal acceptance record with evidence links and the named signatory captured.
• Produce and circulate the incumbent decommissioning certificate and migration verification report.
• Create a remediation and retest plan for any failed criteria with clear resolution dates.
• KPI trend review
• Confirm KPIs continue to trend toward or maintain the targets recorded in Solution Scope.
• Have a prioritized enhancement list for the next quarter with owners and estimated timelines.
• Ensure all critical operational issues are assigned and on a burn-down plan.
• Re-confirm success criteria and owners
• Publish the prioritized enhancement list and schedule feasibility reviews for high-priority items.
• Run a quarterly security and compliance checklist and report any deviations.
• 12-month KPI and TCO summary
• Validate the solution delivered the annual productivity and TCO outcomes as measured against Solution Scope targets.
• Agree a prioritized set of enhancements for the next 12 months and an ownership model for delivering them.
• Confirm the shared issue channel and annual security review schedule remain in place for continuous optimization.
• Publish the annual outcomes report with metric evidence, cost analysis, and the prioritized enhancement roadmap.
• Maintain the shared issue channel and circulate a quarterly summary of unresolved high-priority items.
• Schedule the next year's quarterly review dates and assign owners for the top three enhancements.
• Confirm deployment is operational for critical integrations and that no showstopper defects remain.
• Identify the top 3 open issues with owners and target resolution dates.
• Confirm where the numeric acceptance targets are recorded, Solution Scope, and that owners acknowledge them.
• Publish an open issues log with owners, severity, and target resolution dates.
• Run a targeted migration integrity check for a representative sample of migrated studies and report results.
• Circulate a short adoption checklist for trained users to capture early usability blockers.
• Present first measurement data
• Confirm whether average reads per radiologist per day and data migration completeness (%) are moving toward Solution Scope targets.
• Agree corrective actions with timelines to close any metric gaps prior to the acceptance gate.
• Document the expected date when acceptance criteria will be met or a remediation plan will be complete.
• Perform root-cause investigations for each off-target metric and deliver findings within the agreed timeline.
• Implement the prioritized remediation tasks and report progress in the shared issue channel weekly.
• Update the training roster and schedule targeted refresher sessions for low-adoption sites.
• Restate acceptance criteria and numeric targets
• Produce a documented acceptance decision for the deliverable set recorded in Solution Scope.
• Verify the incumbent system has been decommissioned or formally retained read-only and that migration evidence is archived.
• Agree remediation tasks and a retest schedule for any failed acceptance criteria.
• Open issue and ticket burn-down
• Security and compliance posture review
• Present outcome data against each criterion
• Gap diagnosis and root-cause analysis
• Deployment and migration validation
• Enhancement requests backlog and prioritization
• Document pass/fail per criterion and formal acceptance decision
• Enhancement capture and prioritization for continuous optimization
• Corrective actions and timeline to acceptance gate
• Early adoption and usage signals
• Confirm ongoing issue-management channel and cadence
• Open issues triage
• Update adoption and training plan
• Confirm ongoing operational ownership and SLAs
• Incumbent system wind-down verification
• Agree immediate remediation actions
• Agree remediation items and resolution timeline for any failed criteria