In a hospital that runs Epic, the radiology department rarely lives in a separate system any more. Orders, scheduling, technologist work, reading and follow-up all happen inside Radiant, Epic's radiology application, while the images themselves sit in a PACS from another vendor. Making those two halves feel like one system is the integration job.
This guide explains what Radiant does as Epic and its customers describe it publicly, how each role uses it, and which interfaces connect it to PACS, dictation and other imaging tools. It is written for radiology leaders, imaging IT teams and vendors whose products need to work alongside Radiant.
What is Epic Radiant?
Connecting imaging systems to Epic?
Agnotic builds Epic integrations for imaging workflows, from HL7 order and result interfaces to PACS context sharing.
Epic Radiant is Epic's radiology information system. Epic says Radiant supports scheduling, performing and resulting radiology exams, and helps radiologists prioritize and report studies, track actionable findings and follow-up, and monitor department operations with dashboards. It shares the patient record with the rest of the Epic system.
Radiant does not store or display diagnostic images itself. That remains the job of a PACS, with Radiant handling orders, workflow and reports, and the two systems kept in step through interfaces and shared context.
How does Radiant fit into the imaging workflow?
Radiant follows an imaging exam from order to follow-up. A clinician orders the exam in Epic, schedulers book it, technologists perform it, the PACS stores the images, the radiologist reads and reports, and the result returns to the ordering clinician in the same chart.
- 1. Order: The ordering clinician places an imaging order in Epic, with decision support where the organization uses it.
- 2. Schedule: Schedulers book the exam and the modality slot.
- 3. Protocol: A radiologist or technologist reviews the order and assigns a protocol.
- 4. Perform: Technologists check the patient in, perform the exam and complete the exam in Radiant.
- 5. Read: The study appears on the radiologist's reading work list, and the report is created in dictation or in Epic.
- 6. Result and follow-up: The final report files to the chart, and actionable findings are tracked until closed.
How do different roles use Radiant?
Each role sees a different part of Radiant. UI Health Care's Epic education pages describe Radiant as covering scheduling, documentation, results communication and film tracking for schedulers, technologists and physicians, with default workspaces that differ by role.
- Schedulers: Book exams against modality resources, handle preparation instructions and manage changes.
- Technologists: Work from the technologist work list, verify orders, record the beginning and end of each exam, and document contrast.
- Radiologists: Protocol orders, read from a prioritized work list and sign reports.
- Ordering clinicians: Place orders, see status and receive results in their usual Epic workflow.
- Department leaders: Use dashboards for volumes, turnaround times and backlog.
For providers, the main benefit is that imaging is not a separate world. The ordering clinician sees the exam status and report in the same chart as everything else, and the radiologist sees the clinical context behind the order.
What does a radiologist's day in Radiant look like?
A radiologist's day in Radiant runs through a few core activities: an imaging dashboard, the protocol work list, the reading work list and study review. UI Health Care's training material describes the reading work list as the place to find completed exams that need results, and study review as the radiologist's reading palette.
- Imaging dashboard: A starting view that shows exams and other information the radiologist needs during a shift.
- Protocol work list: Orders waiting for a protocol, so the right sequence or technique is set before the patient arrives.
- Reading work list: Completed exams waiting to be read, filtered and sorted by priority, modality or location.
- Study review: The chart context for the exam being read, including the order reason and relevant history.
- Study history: Prior imaging exams for the same patient, which radiologists compare against the current study.
The images themselves open in the PACS viewer next to these activities. UI Health Care, for example, notes that its radiologists train on a separate imaging viewer within the department, which is typical of Epic sites. Every click that keeps Radiant and the viewer on the same study saves time over hundreds of reads a day.
Interventional radiologists use more of the clinical side of Epic: procedure orders, consent, status boards and clinic notes. Their integrations reach beyond PACS to procedure documentation, supplies and billing, so they deserve their own design work rather than inheriting the diagnostic setup.
How does Radiant connect to PACS?
Radiant connects to PACS through HL7 v2 order and result interfaces and through context-sharing APIs. The open.epic catalog describes Outgoing Imaging Results and Orders as the only interface that sends orders and results from Radiant or Cupid, the cardiology module, to PACS and transcription systems.
- Order message triggers: The outgoing interface sends a message when an order reaches scheduled or arrived status, when status changes, when results are entered and when an appointment is canceled.
- Modality worklist: The PACS or broker uses those orders to build the DICOM modality worklist, so technologists do not retype patient details.
- Results: Reports created outside Epic can return through incoming result interfaces.
- Order sources: Epic also lists an Incoming Orders from CPOE interface that routes radiology orders from external systems to Radiant.
Accession numbers are the thread that ties everything together. Each exam needs a single accession number that the order, the DICOM images and the report all carry, and many integration defects trace back to a mismatch in that one value.
What PACS context sharing does Epic support?
Epic's open.epic imaging page lists APIs for PACS vendors covering single sign-on, patient context synchronization, study context synchronization and real-time exchange of measurements. These let the radiologist work in Epic and the PACS viewer side by side without selecting the patient or study twice.
- Single sign-on: The radiologist logs in once and both systems recognize the user.
- Patient context: Opening a patient in one system opens the same patient in the other.
- Study context: Selecting an exam on the reading work list opens that study in the PACS viewer.
- Measurements: Values measured in the viewer can be sent to Epic in real time, avoiding retyping.
Context sharing is also a safety feature. A reading setup where the report and the images can show different patients is a known source of wrong-patient errors, and synchronized context closes that gap. Epic also publishes a DICOM conformance statement that PACS vendors use when planning integration.
How are radiology reports created and returned?
Radiology reports are created either in a third-party speech recognition and reporting system or in Epic, and in both cases the signed report files to the patient's chart through Radiant. Many departments keep dedicated reporting tools because radiologists rely on their templates and voice workflows.
- Orders to reporting: The reporting system receives orders from Radiant so it knows which exams need reports.
- Context: The reporting tool, PACS and Epic open the same study when the radiologist starts dictation.
- Results back: The finalized report returns to Epic as a result message tied to the accession number.
- Addenda: Corrections and addenda follow the same path and must update the chart without creating duplicates.
Critical results need extra attention. Epic describes Radiant's tracking of actionable findings and follow-up, and teams should confirm that findings flagged in the reporting tool reach that tracking in Epic, not just the report text.
What should imaging teams plan for in a Radiant integration?
Plan for identifiers, procedure codes, status mapping and downtime. Most integration problems in radiology are not about message format but about two systems disagreeing on what an exam is called or which state it is in.
- Procedure master: Align Epic procedure codes with PACS and reporting procedure lists, including modality and body part.
- Status mapping: Agree how scheduled, arrived, completed, read and final map across systems.
- Merges and corrections: Plan how patient merges and order corrections reach the PACS so images move with the patient.
- Downtime: Define how exams performed during an outage are reconciled once systems return.
- Prior studies: Decide how prior images and reports from outside organizations are matched and shown.
Test each of these with the radiologists and technologists who will use the system. A work list that looks right to an interface analyst can still put the wrong exams in front of the wrong reader, and only the people who read all day will notice quickly.
How does Radiant differ from a standalone RIS?
Radiant differs from a standalone radiology information system mainly because it shares one database with the rest of Epic. Orders, results, problem lists and notes are already in the same record, so many interfaces a standalone RIS needs are not needed at all.
The trade-off is that imaging workflows follow Epic's design and release cycle. Departments that relied on a specialized RIS sometimes need to adjust work lists and reports, and vendors who built on a standalone RIS must now integrate with Epic's interfaces instead.
Moving from a standalone RIS to Radiant is also a data project. Historical exams, reports and accession numbers from the old system have to stay findable, either by loading history into Epic or by keeping the old archive reachable from the chart. Decide which approach you will take early, because radiologists will look for prior reports from the first day after go-live.
How Agnotic can help
Agnotic Technologies builds integrations around Epic imaging workflows. We work on HL7 order and result interfaces between Radiant and PACS or reporting systems, procedure and status mapping, accession number handling and testing with the imaging team.
For imaging software vendors, we help plan and build the interfaces and context integration their product needs to work alongside Radiant in Epic hospitals, and we prepare the test scripts and documentation hospital imaging teams ask for before go-live.
Plan your imaging integration with Epic
Explore our Epic integration services, or browse the EHR integration hub.
Related reading on Agnotic
Read about radiology systems, imaging informatics, HL7 orders and results, Epic modules and EHR integration methods.
