Welcome to the Radiology Haunted House: Escaping the Ghosts of Legacy Tech

Radiology has a heck of a haunted house. Legacy systems patchworked on top of one another have produced an estate that could rival that of the Haunted Mansion or the Addams family. However, unlike a fun Halloween movie or your town’s local attraction, the haunted house produced by the radiology imaging stack has real consequences. Imaging volumes are soaring and cost pressures are mounting, leading to a resource drain, diminished efficiency, AI held hostage, and ultimately, negative impacts on patient care.  

Let’s take a tour, shall we? We promise we won’t let it get too scary. 

Room 1: The Phantom PACS

Step carefully — the floors creak under decades of capital investment.

Here lies the Phantom PACS, once cutting-edge, now a relic tethered to on-premise servers and hardware refresh cycles that rise from the dead every 5–7 years. Legacy systems weren’t designed for elasticity, collaboration, or continuous evolution. The system technically works, but just like an old ghost, it lingers, consuming power, attention, and budget. The hidden layer runs deep for practices with capital refresh cycles costing up to $1M every few years, high operating costs, outages, and insufficient time for IT staff to maintain the system. 

As Kate Kovalenko, Sirona’s Chief Product Officer, recently said: “You can’t deliver innovation quickly or effectively when you’re bolting together legacy systems that were never built for the cloud.”

Room 2: The Maze

Follow the flickering light down the hall. There is a radiologist who is hard at work, surrounded by 200 open tabs, windows, and half-integrated tools. They are physically chained to their desk. 

This is a maze where PACS, reporting, and workflow systems operate like ghosts refusing to speak. Each component is alive in isolation, but together they form a patchwork of friction and fatigue. The dungeon persists because each upgrade over the years added another layer, producing an endless maze. 

And who is trapped in that maze? Physicians, of course! They have now needed to add “system manager” to their resumes. System complexity has increased the level of burnout in radiology. In the 2023 Medscape Radiologist Lifestyle & Burnout Report, 54% of radiologists reported feeling burned out. The top contributors were bureaucratic tasks, inefficient workflows, and the feeling of being “just a cog in the machine.” This is some truly scary stuff. 

Room 3: The Cost Crypt

Ah, yes, the room where money goes down the drain. This isn’t mismanagement; it’s the inheritance of an outdated economic model. Legacy radiology IT systems were built for a world of fixed infrastructure and static demand. In today’s reality, where imaging is involved in over half of all emergency visits and nearly 15% of patient encounters nationwide, clinging to legacy systems does nothing but increase costs. 

There are capital refresh cycles that cause unpredictable spikes in daily operations, high overhead costs for system upkeep and vendors, and wasted labor and time on both the IT and clinical sides. At large hospital systems, it’s estimated that each PACS “resurrection” demands $4 to $6 million in infrastructure renewal, plus $1 million a year in maintenance and vendor support.

Room 4: The AI Graveyard

And here lie the remains of a thousand bolt-on AI tools. Over 75% of FDA-approved AI tools focus on radiology, yet less than 2% of radiology practices actually use them.

Legacy systems sold AI as add-ons, which means extra subscriptions, extra clicks, extra friction. AI cannot thrive as an add-on to outdated PACS and reporting systems — it must live within the fabric of the workflow itself.

Room 5: The Cloudlight at the End of the Hall

And finally, the corridor opens into light.

Here, a radiologist works at a single workstation from the comfort of their home with only one tab open.  They can work from anywhere, free from manual constraints. Cloud-native unification isn’t just modernization; it’s liberation. It’s how health systems escape the cycle of hidden costs, fragmented tools, and burnt-out radiologists. This is the cloud native sanctuary powered by Sirona’s unified platform, RadOS™.  In this new world, the haunted house fades into history — replaced by a living, breathing platform that scales with both clinical demand and radiologist well-being.  AI is no longer a visitor from another world; it’s native. It’s woven into the same system that manages images, data, and reports. With this, costs are replaced by predictable usage-based models, innovation becomes continuous, and disruptive upgrades are eliminated. 

Sirona RadOS™ was designed to do what legacy systems never could: remove friction from the radiologist’s day. Sirona automatically surfaces relevant prior studies and series in the viewer. This reduces error by enabling side-by-side comparison and decreases the risk of unnecessary repeat imaging.  The platform also remembers how each radiologist prefers their studies displayed, reducing setup time for physicians, increasing consistency, and making personalized reading a reality.  Structured reporting is also embedded directly into the platform and can auto-populate from AI outputs and measurements. 

In this new world, the haunted house fades into history — replaced by a living, breathing platform that scales with both clinical demand and radiologist well-being.

Every haunted house has a way out — but only if you stop adding new rooms to it. This Halloween, the scariest thing in radiology isn’t a ghost. It’s staying in a house you’ve outgrown.

Happy Halloween from Sirona.
(We hope we didn’t scare you too much.)