---
title: "Radiology Workflow"
description: "How to manage radiology services — configure imaging tests, create service requests from the billing page, enter narrative reports with AI assistance, and understand how radiology fits into the diagnostic workflow."
date: 2026-07-19
lastModified: 2026-07-26
category: "radiology"
author: "Dr. Umesh Bilagi"
beta: false
---

## Overview

Radiology in NICE HMS uses the same ServiceRequest / DiagnosticReport workflow as laboratory services. There is no separate "Radiology" sidebar menu — imaging orders, result entry, and billing all flow through the same pages as other diagnostic services. The difference is in **configuration**: radiology tests use category "Radiology" and typically use the **Document (Doc)** scale type for narrative imaging reports.

See [Laboratory Workflow](/docs/lab-workflow) for the full ServiceRequest to DiagnosticReport flow — this page focuses on what is specific to radiology.

## Configuring Radiology Tests

Radiology tests are configured in **Admin → Service Request Masters**, the same as lab tests. See [Laboratory Workflow](/docs/lab-workflow) for the complete form reference.

Key settings for radiology:

| Setting | Radiology Value |
|---------|-----------------|
| **Category** | Radiology |
| **Scale Type** | Document (Doc) — imaging reports are narrative, not numeric |
| **After Billing** | Set to TRUE to require billing before the report can be created |
| **Sale Price** | Price of the imaging procedure |

Common radiology tests configured this way: X-Ray (Chest PA, Abdomen, Extremities), Ultrasound (Abdomen, Pelvis, KUB, Obstetric), CT (Brain, Chest, Abdomen, Spine), MRI (Brain, Spine, Joints), Mammography, and Doppler studies.

## Creating a Radiology Order

Radiology orders are created as Service Requests from the same entry points as lab tests:

| Entry Point | Path |
|-------------|------|
| **Billing page** | Patient Dashboard → Billing → **Lab & Services Billing** → Create |
| **Services Console** | Sidebar → Patient → Services → **Services Panel** |

When filling the Service Request form:
- **Category** defaults to "Laboratory procedure" — change to the appropriate category if needed
- **Services** — select the configured radiology tests
- **Note** — add clinical history and the specific question to be answered (e.g., "R/O pneumothorax," "Trauma — rule out fracture")

The form, post-creation links (Report, Invoice, Specimen), and the afterBilling gate work the same as lab — see the [Laboratory Workflow](/docs/lab-workflow) Service Request section.

## Result Entry (Radiology Reports)

**Access:** Service Request form → **Click Here to Report**

Radiology tests use the **Document (Doc)** scale type, which provides a TinyMCE rich text editor instead of numeric value fields. This is where the radiologist writes the narrative report.

### Report Writing Tools

| Tool | Function |
|------|----------|
| **TinyMCE Editor** | Full rich text editor for structured reports (findings, impression, recommendations) |
| **Templates** | Load pre-written report templates from a dropdown (e.g., normal chest X-ray template) |
| **Editor Shortcuts** | Pre-configured text expansions for common phrases |
| **Abbreviation Expansion** | Auto-expands medical abbreviations |
| **Dictaphone** | Voice-to-text button to dictate findings directly into the editor |
| **Generate Report** | AI-assisted generation: the AI takes the report template plus dictated/transcribed findings and fills the template sections with structured clinical content |

### Report Structure

A typical radiology report follows this structure (configurable via templates):

1. **Clinical History** — from the service request notes
2. **Technique** — imaging modality, views, contrast (if used)
3. **Findings** — descriptive findings from the images
4. **Impression** — summary diagnosis or differential
5. **Recommendations** — further imaging, clinical correlation, follow-up

### Report Finalization and Delivery

After saving, the report can be printed (PDF in browser) or sent to the patient via WhatsApp. When the status is set to "final," the ServiceRequest is auto-completed and the report is pushed to ABDM (if configured).

The printed report includes the organization's **Report Header** letterhead image and the radiologist's **Signature** (if uploaded). See [Printing and Letter Pad Header](/docs/printing-and-set-up-of-letter-pad-header).

## Billing

Radiology charges follow the same billing flow as other diagnostic services:

- Charges are added to the patient's bill via the invoice system
- Pricing is per-test from the configured Sale Price
- The **afterBilling** gate on the test configuration controls whether the report can be written before billing

## FAQ

**Q: Is there a separate Radiology module or sidebar menu?**
A: Not currently. Radiology uses the same Service Request and Diagnostic Report pages as laboratory services. The "Radiology Console" is planned but not yet implemented.

**Q: How do I upload DICOM files or images?**
A: Images can be attached as part of the diagnostic report. Large files are stored in Google Cloud Storage and linked to the patient record.

**Q: Can I use AI to generate radiology reports?**
A: Yes. Document-type observations include a **Generate Report** button that uses AI to fill the report template from dictated or transcribed findings.

**Q: Does NICE HMS integrate with PACS?**
A: PACS integration is planned for a future release. Currently, images are uploaded directly through the diagnostic report interface.