Catawba Valley Medical Center

Robin Cox

Radiology Practice Leader

Trends Driving Smarter Imaging Operations

Several major trends are shaping imaging today. First, reimbursement pressure—driven by recent and anticipated policy changes—is forcing organizations to operate more efficiently while managing a growing uninsured or underinsured population. Second, there is a continued shift of imaging volume from inpatient to outpatient settings, which is driving strategic investment in outpatient access, convenience, and throughput. Third, the rapid emergence of AI is influencing priorities around both productivity and clinician satisfaction, as imaging leaders look for tools that can improve efficiency while reducing burnout.

Responding to those trends effectively starts at the operational level. Optimization starts with a data-driven evaluation of current equipment utilization, including scan times, downtime, scheduling gaps, and no-show rates, to identify untapped capacity within existing assets. Before considering capital investment, I focus on maximizing what we already have—standardizing protocols, reducing variability in exam times, and aligning scheduling templates with actual demand patterns.

In many cases, expanding operating hours—whether early mornings, evenings, or weekends—can significantly improve patient access and throughput. While this may require incremental staffing, the return in both patient satisfaction and net revenue is often substantial. Equally important is optimizing staffing models by aligning technologist coverage with peak demand and ensuring cross-training across modalities where appropriate.

From a workflow standpoint, leveraging technology plays a critical role. This includes using AI and advanced scheduling tools to reduce scan times, automate routine tasks, and prioritize higher-acuity cases. Reducing administrative friction—such as streamlining prior authorizations, improving order accuracy, and enhancing communication between referring providers and imaging departments—can also significantly improve throughput.

Additionally, strategic partnerships—particularly with larger health systems—can expand access to specialized services in underserved areas without duplicating infrastructure. For example, collaborations like Catawba Valley Health System’s partnership with Wake Forest Baptist Health for Maternal Fetal Medicine demonstrate how organizations can extend specialty care into rural markets while maintaining high quality.

Finally, I view patient access as a key performance metric. That means continuously monitoring key indicators such as days to appointment, turnaround times,patient experience, and making iterative adjustments to ensure we are meeting both clinical and community needs efficiently.

Three Lenses for Evaluating New Technology

With the rapid growth of AI and imaging technologies, it’s critical to take a disciplined and intentional approach to adoption. While there is no shortage of innovation in the market, not all solutions create meaningful value. I evaluate opportunities through three primary lenses:

1. Does the technology improve diagnostic quality or clinical confidence?

2. Does it streamline workflows and reduce friction for clinicians and staff?

3. Does it deliver a measurable and sustainable return on investment?

"I view technology as an enabler—not a replacement—for clinical expertise. The goal is to reduce cognitive burden, improve consistency, and allow clinicians to practice at the top of their license."

Beyond those criteria, I believe successful implementation is just as important as selection. Even the best technology will fail if it disrupts workflows or lacks clinician buy-in. That’s why I prioritize involving radiologists, technologists, and operational leaders early in the evaluation process to ensure the solution aligns with real-world practice.

I also focus heavily on integration and interoperability. Technologies that seamlessly integrate into existing PACS, RIS, and EMR environments are far more likely to drive adoption and deliver value. If a tool adds steps or creates parallel workflows, it often undermines both efficiency and satisfaction.

From a leadership standpoint, I view technology as an enabler—not a replacement—for clinical expertise.

The goal is to reduce cognitive burden, improve consistency, and allow clinicians to practice at the top of their license. This is especially important in today’s environment, where burnout and workforce shortages are ongoing challenges.

Finally, I emphasize continuous measurement and accountability. Post-implementation, we track key metrics such as turnaround times, diagnostic accuracy, patient throughput, and user satisfaction to ensure the technology is delivering on its promise. If it’s not, we reassess quickly.

At its core, the balance comes down to staying focused on the patient. Technology should enhance outcomes, improve access, and support clinicians—not add unnecessary complexity or distraction.

Trust, Credibility and the Leadership Foundation

Even with optimized workflows and disciplined technology adoption, the imaging department faces significant challenges. The most significant one is the ongoing shortage of radiologists, which impacts turnaround times and access to care. Closely behind that is continued reimbursement pressure. Addressing these challenges requires a combination of workflow optimization, strategic use of technology (including AI), and innovative staffing models such as partnerships or teleradiology.

For professionals looking to lead through those challenges, building trust is foundational. Strong relationships with both staff and physicians are essential—without trust, even the best strategies are difficult to execute. Additionally, having a clinical background can significantly enhance credibility with frontline teams. Leaders who understand the day-to-day realities of imaging operations are better positioned to drive meaningful change.