Viewing and reading
- Is the viewer zero-footprint, meaning it runs in a browser with nothing to install?
- How does it perform on a home internet connection?
- Does it support the tools your radiologists use: hanging protocols, comparison with priors, measurements, 3D where needed?
- Are reporting templates, voice recognition and macros built in?
Workflow
- Is the RIS part of the same system, with scheduling, intake, exam tracking and results in one place?
- Can worklists be assigned by modality, site, subspecialty or urgency?
- Does it exchange orders and results with your EHR and your referrers' systems using HL7?
- Does it support several locations and outside reading groups?
Sharing
- A portal where referring physicians see images and reports without installing software
- A secure way to share images with patients, replacing discs
- Controls over who can see what, with a record of every access
Migration
Ask how prior studies move from your current system, how long it takes, what it costs and whether you can read during the move. Ask how you would get your images back out in standard DICOM format if you ever leave.
Reliability and security
- Where are images stored, and is there a second site?
- What uptime is promised, and what happens during an outage?
- Is the vendor HIPAA compliant with a BAA, and independently audited?
- Does the vendor run its own infrastructure or depend on third parties?
AI
AI tools for triage, measurement and workflow are developing quickly. Ask whether AI is built into the platform, whether third-party tools can be connected, and how results appear to the radiologist.
Pricing
Cloud systems are usually priced per study or per month. Check what is included: storage growth, long-term archive, interfaces, the referring portal, training and support.