I've been to enough conference booths and demo sessions to know what a polished pitch looks like. But there's something different about walking into a real imaging center on day two of a live Royal deployment. That's exactly what I got to do when I visited Cardinal Points Imaging in Raleigh, NC, and it was one of those days that reminds you why this work matters.
The team was live. Patients were walking in. Staff were working. And the overall vibe? It was calm.
The Calm You Don't Expect on Day One
Go-lives are expected to be stressful. Anyone who's been through a healthcare IT implementation knows that feeling: everyone bracing, someone troubleshooting in the corner, patients waiting a little longer than usual. That's the baseline expectation.
That's not what I saw.
The OIA team was relaxed. Staff were moving with confidence. Patients were checking in without confusion. I pulled a few people aside to hear what they were experiencing in real time, and what came back were genuine, unscripted observations about how the platform was working.
What OIA Told Me: Straight from the Floor
Referring physicians finally have a real connection to the process
Adam Ray put it simply: referring physician practices can now place orders electronically, schedule patients while they still have them on the line, and actually support continuity of care. That last part is what gets overlooked. When a referring physician's office can schedule the imaging visit in the same workflow as placing the order, the patient is far more likely to follow through.
Self-scheduling is available for patients too, and Susan Hawkins shared a day one statistic with me:
30% of Cardinal Points' patients scheduled themselves.
"We would have never expected that," she said, "First day!"
Patients arrive less anxious because they already know what to expect
Robin Briggs described it as "the power to choose."
That framing stuck with me. When patients can see their prep instructions, know what they're bringing, and understand what they'll be asked before they ever walk in the door, the entire tone of their arrival changes.
Melissa Baggett captured it well. When patients have to fill out intake paperwork in a waiting room, knowing their exam is coming up, that's an anxiety moment. When they can do that at home, in their own time, they walk in ready.
Melissa said it directly: "Our patients love it."
Kiosks and iPads catch anyone who didn't prep ahead of time
Not every patient completes registration before arriving, and that's fine. Adam described the flow: patients who didn't fill out paperwork on their phones can walk up to a kiosk or take an ipad to their seat. Registration gets completed, payment is captured, and they're on their way back to see their technologist.
That's not a workaround. That's the system working as designed.
Technologists are doing their job, not paperwork
This one landed quietly but it's significant. When a technologist can walk a patient back toward the modality and gather clinical information conversationally, instead of filling out paper forms to scan in later, the entire dynamic of that interaction changes. They're consultative. They're present. And when they get to the modality, the patient is ready, the data is in the system, and the exam can start.
Adam described it as getting the patient through and letting them get on with their day. That simplicity is the point.
Why This Matters for Outpatient Imaging Centers
The common pressure points in outpatient radiology workflow aren't mysteries: patients who don't show up, patients who arrive unprepared, staff handling administrative tasks instead of clinical ones, referring physicians sending orders into a void with no feedback loop.
What I saw at Cardinal Points was each of those pain points being addressed in practice, not in a demo environment.
Self-scheduling reduces the friction between order and appointment. Pre-arrival intake reduces anxiety and front desk bottleneck. Kiosk check-in handles the exceptions. Mobile technologist workflows return clinical staff to their clinical role. And everything connects to billing without a manual handoff.
That's what straight-through processing looks like when it's working.