/
Radiology / Imaging Orders

Radiology / Imaging Orders

4 Must-Do’s

1. Problem Description: Have you clearly defined the user problem(s) you intend to solve, and what value this creates? Write down a story, user insight, or quote about this problem (this is important because (1) this will motivate your team, and (2) without this your problem might not actually be a big problem for the users themselves).
2. User Stories: Have you clearly written at least 3 user stories and use cases? 
3. Market Analysis: Have you surveyed what the market is doing here (e.g. comparison to other EMRs, or paper approaches; and don’t forget about learning from historic/existing OMRS instances)? Have you written down any possible gaps in your understanding of your users or their workflows? Have you reviewed the topic in FHIR to see what requirements or fields the global community references? (Eg if working on insurance, should look here)
4. Technical Considerations & Dependencies: Have you outlined what you need from cross-functional areas for success of the feature? E.g. do you need the platform to support a new API call? Have you explained how you’ve addressed dev concerns, such as designs that may not be feasible, or will be extra time-intensive to implement? 

Optional/Encouraged

Sketches: Have you added a drawing or description of how the feature could work to solve the problem at hand? (Pictures of sketches are ok!) 
Project Management: Have you created the Epic and JIRA tasks so you can share work clearly? Roll-out plan: Do you have an idea whether this will be an experiment, gradual roll out, and when? Have you added this to the timeline view? Have you planned how you will promote and/or work with communications folks in order to help this feature reach the widest audience and have the biggest impact it can?

Later but should do

QA Plan: Have you mentioned the plan for QA, such as how you will discover and address edge cases? Does your team/squad have a plan for automated tests to be added to new components (unit tests) or workflows (e2e tests)?
Safety & Tech Risks: Is there any reason you could regret rolling out this feature? (e.g. possible patient harm, heavy tech debt like introducing an unsupported library) Have you thought through the risks for this particular solution? And, how to reduce/address those? 

This checklist was inspired by this article. Additional Business Analyst Resources here.

Status: Requirements In Progress ready for Work In Progress Done

Technical Complexity: Easy Medium Hard / Complex

Summary:

  • The MVP deliberately starts with manual image upload to deliver immediate value without requiring PACS infrastructure.

  • The workflow establishes — order placement, image capture, worklist management, completion — the MVP provides the foundation.

Imaging Order mockup

image-20260304-142127.png

 

1. Problem

Context:

Radiology and imaging are essential to longitudinal clinical decision-making. They enable clinicians to monitor disease progression, differentiate chronic findings from acute pathology, and establish a clinical baseline. A practical example: comparing a chest X-ray from 2022 against one from 2026 allows a physician to determine whether a finding represents a stable, long-standing scar or a new, fast-growing concern requiring urgent intervention.

The Gap:

  • Currently, the OpenMRS Reference Application (O3) lacks a structured way to place and record radiology/imaging orders. Without this history, clinicians suffer from "diagnostic blindness," where every "shadow" on a scan may trigger an unnecessary, expensive, and invasive biopsy simply because there is no way to verify if the finding has changed over time.

Proposed solution:

Enable clinicians to place structured radiology and imaging orders directly within the Order Basket. This will ensure that every imaging request is captured as a permanent milestone in the patient's medical history, facilitating safer, longitudinal care.

There are two approaches to managing radiology workflows in practice:

  • Manual Radiology Upload (MVP): The clinician photographs and uploads the physical X-ray film directly into the patient record. This is the initial delivery target.

  • PACS Integration (Deferred): The imaging modality (machine) automatically stores a digital representation of the image in DICOM format on a PACS server, eliminating manual steps and ensuring higher image fidelity.

2. User Stories

  1. As a clinician, I want to be able to place a radiology order so that the imaging request is formally captured in the patient's medical history.

  2. As a clinician, I want to specify the body site and side (laterality) when placing an order so that the imaging team scans the correct area.

  3. As a clinician, I want to upload an image (photograph of an X-ray film) against a radiology order so that the visual result is permanently linked to the patient's record.

  4. As a clinician, I want to see a history of past imaging orders so that I can compare new scans with old baselines and avoid redundant testing.

3. Market Analysis

Solutions

Visuals

Remarks

Solutions

Visuals

Remarks

TaifaCare

image-20260219-075631.png
image-20260219-075703.png
image-20260219-075739.png
image-20260219-083558.png
image-20260219-083725.png
image-20260219-083904.png
image-20260219-085836.png
image-20260219-083843.png

 

 

 

 

4. Technical Considerations & Dependencies

  • Radiology orders need a new order type in OpenMRS (Radiology Order) - the same way we have Drug and Lab orders

  • The Order Basket UI (ESM) will need a new radiology order form with fields for: imaging type, body site, laterality, priority (routine/urgent) etc

  • Needs to plug into the existing orders app module without breaking existing order types

  • Concepts (representing imaging types e.g., Chest X-ray, Ultrasound, MRI, etc.): https://app.openconceptlab.org/#/orgs/openmrs/collections/radiology/

  • Storage of images: Use the attachment module as it supports file upload linked to a patient

    • Question: Should the uploaded image be explicitly linked to the originating radiology order and not just loosely attached to the patient?

  • A new widget to the patient chart that displays past radiology orders and linked images

5. Sketches

Imaging Widget:

image-20260304-123329.png

Imaging Order Form

image-20260304-124626.png

Active Orders

image-20260304-134115.png

 

Worklist - Image Upload

image-20260304-140107.png

 

Add Imaging Order:

image-20260304-124401.png

Radiology and Imaging (Home)

image-20260304-133627.png

 

 

Worklist

image-20260304-134411.png

Completed Orders

image-20260304-141802.png