Radiology is at an inflection point. As the baby boomer generation ages into higher-acuity care, demand for imaging surges while the supply of radiologists falls behind. This imbalance is straining practices already hindered by siloed IT systems, fragmented workflows, and inconsistent access to patient data across sites.
Large, multisite groups face particular challenges in managing volumes and maintaining clinical quality without a unified view of work. With more radiologists seeking flexible, remote roles and competition for talent intensifying, many practices find their current systems can’t scale, driving interest in more networked, interoperable radiology operations built on shared infrastructure and coordinated workflows for a distributed workforce.
Enterprise-wide reading
Charles Morris, Agfa HealthCare.
Many large practices are moving beyond traditional teleradiology toward enterprise-wide operating models that allow radiologists to work across facilities, systems, and geographies within a unified environment.
Unlike traditional teleradiology, which is often siloed or outsourced, network-based radiology operations integrate with the health system, enabling real-time collaboration, subspecialty coverage, a federated worklist, and intelligent workload balancing.
Traditional teleradiology depends on transferring data or third-party readers, but network radiology creates a federated reading environment across all customers of a reading practice and their enterprise, eliminating most data movement. This improves turnaround times and reduces friction between radiologists and IT systems.
Still, network-based radiology operations are not just about federation; it’s about scale. Large radiology practices handling millions of studies must contend with the data load that comes with retrieving prior images, often four or more per new study. That five-times data multiplier can quickly overwhelm legacy PACS architectures, forcing practices to segment operations across multiple systems. At that point, radiologists are back to siloed data, fragmented workflows, and uneven access; the problem network radiology is trying to solve.
This offers a new way forward: a flexible, scalable, and clinically aligned operating model that connects radiologists to work, wherever they are, without disconnecting them from the health system.
Infrastructure
Supporting a highly distributed radiology workforce requires infrastructure designed for scale, speed, and clinical precision. While many radiology departments still rely on fragmented legacy systems, others still operate disconnected PACS/RIS environments. However, the shift toward enterprise imaging and cloud-native platforms is gaining momentum.
To enable real-time collaboration, subspecialty access, and intelligent workload balancing across a distributed workforce, radiology practices must modernize key components of their IT architecture. That includes a federated enterprise imaging platform with remote rendering capabilities, AI-enhanced orchestration engines, and seamless interoperability with EHRs, voice recognition, and reporting platforms.
At the core of this transformation lies remote rendering. Instead of transferring large imaging files, radiologists securely stream studies, improving access speed, reducing lag, and preserving full image fidelity. AI-optimized orchestration dynamically assigns cases based on urgency, subspecialty, and workload, eliminating the burden of juggling hundreds of static worklists and associated worklist fatigue.
Interoperability is essential. This concept fails if radiologists must switch between disconnected systems to access studies, reports, or the EHR. Seamless integration across systems, vendors, and sites is nonnegotiable.
Lessons from early adopters
Early adopters in large U.S. and Canadian health systems report improvements in turnaround times after implementing unified reading environments supported by remote rendering and intelligent case distribution. For them, it offers a strategic path forward but demands careful planning and change management.
Implementation involves technical and cultural shifts. Many departments rely on outdated systems and undocumented workflows, making the transition to cloud-native platforms and modern networks challenging until the benefits become clear.
And those benefits are beginning to materialize. Feedback from enterprise imaging radiology networks indicate improved turnaround times after deploying a unified reading environment; others have seen productivity gains from remote rendering and AI orchestration. Even a small 3% gain in a 100-radiologist practice equates to reduction equivalent to three full time radiologists and breathing room for the practice.
These improvements go beyond productivity. These networked Radiology environments also offer clearer visibility into service-level agreement compliance, helping practices meet contractual obligations across multiple client sites. Radiologists, meanwhile, benefit from a streamlined reading experience that reduces mental overhead and system-switching fatigue. The goal isn’t just better performance. It's a better quality of life and happy, productive physicians that we’re working toward.
There are also compliance benefits. By using remote rendering instead of physically ingesting patient data, radiology groups can reduce their exposure to PHI, minimizing risk while maintaining access.
For organizations considering the move to a network-friendly solution, these early use cases reveal a common theme: The technology works. However, success depends just as much on strong change management, infrastructure readiness, and a shared vision for how imaging must evolve.
Human impacts
At its core, enterprise imaging isn’t just a technology mode -- it’s a response to growing human needs within the imaging ecosystem. As the demand for imaging soars and radiologist shortages deepen, practices must find ways to work smarter without sacrificing quality of care or physician well-being.
With 54% of radiologists reporting burnout, integrated, network-based operating models can help relieve pressure through intelligent worklists, reduce administrative burden, and location flexibility. The ability to log in from anywhere and receive an intelligently organized, subspecialty-appropriate worklist is more than a convenience; it’s a lifeline for radiologists.
By reducing administrative burden, eliminating unnecessary system-switching, and enabling radiologists to focus purely on reading, network radiology improves both productivity and morale. Flexibility in location and schedule also supports better work-life balance, a major factor in retention as practices compete for a shrinking pool of radiologists.
Just as important are the clinical and access benefits for patients, especially in rural or underserved communities. As small, local radiology groups are absorbed or outcompeted by larger, better-resourced practices, community hospitals are increasingly turning to regional and national networks for coverage. While the shift can feel disruptive, it often results in more consistent and higher-quality care.
Strategic considerations
The shift to networked radiology goes beyond a technology upgrade -- it demands a fundamental rethink of how radiology practices operate and scale. For imaging leaders considering this transition, early strategic planning and alignment are essential. Leaders should evaluate whether their current operating model supports distributed work, subspecialty access, and consistent turnaround across sites. Once informed, leaders should evaluate their current operations and pain points -- such as declining turnaround times, excessive system-switching, or burnout -- that often indicate the need for change.
Key challenges include harmonizing governance across multiple hospital clients, modernizing infrastructure, and moving away from hardware-centric approaches toward smarter, network-based solutions. Success metrics extend beyond turnaround times to include service-level agreement compliance, reduced manual workload, improved satisfaction, and broader subspecialty access. Even modest productivity gains can yield significant financial and operational benefits.
Looking ahead, health systems will increasingly favor radiology groups that provide their own centralized radiology network models, shifting responsibility and autonomy to the practice. This shift grants radiologists greater control over performance and upgrades, while providers can focus on acquisition and archiving.
This infrastructure is not turnkey. It requires vision, cross-functional buy-in, and a willingness to rethink traditional roles. But the rewards include better patient access, reduced burnout, and a future-ready practice.
Conclusion: Imaging without boundaries
Radiology faces growing workloads, staffing shortages, and fragmented infrastructure. Enterprise-wide, interoperable imaging environments offer a scalable path forward -- one centered on people, performance, and access rather than geography.
This isn’t a flip-the-switch transition. It’s a multiyear evolution. Incremental improvements in workflows, infrastructure, and governance can lead to transformational changes.
The result: Subspecialty reads distributed across geographies, more satisfied radiologists, and faster, more confident diagnoses for patients, regardless of location. For imaging leaders, the future belongs to the connected.
Charles Morris is director of enterprise imaging strategy, North America, for Agfa HealthCare.
The comments and observations expressed are those of the author and do not necessarily reflect the opinions of AuntMinnie
