Recognizing Cardiology as an Enterprise Within the Enterprise

In the world of modern healthcare, Enterprise Imaging has become more than just a buzzword — it’s a strategic imperative. Across hospitals and health systems, leaders are investing in solutions that bring medical imaging from different specialties under a single, unified patient record. The promise? Reduced technical complexity, standardized tools and workflows, improved collaboration across departments, and most importantly, better care for patients.

From radiology and pathology to dermatology and beyond, imaging data is critical to diagnosis and treatment planning. When this information is siloed in disconnected systems, clinicians lose valuable time and context. Enterprise Imaging helps break down those barriers by enabling centralized image management and access. It’s a foundational piece of the connected care ecosystem.

But here’s the catch: most Enterprise Imaging strategies are still rooted in radiology.

Radiology is, understandably, the largest image-producing specialty in healthcare by volume. So, it’s no surprise that most Enterprise Imaging platforms (and the RFPs that drive them) are still heavily radiology-centric. Radiology stakeholders and IT departments often lead the charge in technology selection, prioritizing broad functionality and high throughput to support radiologists’ needs. In this process, other imaging-heavy departments like cardiology often take a back seat.

This can be a costly compromise.

While cardiology may not produce the same volume of images as radiology, the complexity and critical nature of cardiovascular data cannot be overstated. Cardiologists treat patients across every stage of life, from infants with congenital heart disease to seniors with advanced heart failure. This care often relies on a wide array of diagnostic tools and modalities—from echocardiography and cardiac MRI to nuclear medicine, EP studies, and catheter-based interventions.

Each of these areas comes with its own unique workflows, data types, integration needs, and clinical decision points. Unlike general imaging, where the workflow is often linear, cardiology workflows are deeply nuanced and often non-linear, requiring real-time access to prior studies, dynamic measurements, structured reporting, and device-generated data—all of which must be seamlessly integrated into the broader clinical picture.

Unfortunately, many Enterprise Imaging systems fall short in this regard. When cardiology is folded into enterprise strategies as an afterthought, the result is often frustration: fragmented workflows, limited functionality, and inefficient systems that don’t support the way cardiovascular specialists actually work.

In some cases, cardiology departments are offered low-cost EHR modules that check the basic boxes — like viewing images and generating reports — but fail to support the specialized tools, integrations, and analytics that truly power cardiovascular care. The financial rationale is clear: why invest in a best-of-breed cardiology solution when a bundled EHR module comes at a fraction of the cost?

But let’s take a step back and look at the bigger picture.

Cardiovascular disease is the leading cause of death globally and remains a top-three cause of death in the United States [CDC, 2024]. Over half of cardiology expenditure in the U.S. is inpatient (acute care), and cardiology patients can be amongst the sickest in the hospital, frequently requiring resource-intensive, and expensive critical care services, with the subset of patients requiring mechanical circulatory support (IABP, Impella, VA-ECMO) averaging hospital costs of $150-250K. Cardiologists aren’t just image consumers, they are front-line specialists managing complex, high-risk patients using sophisticated diagnostic and therapeutic technologies. They work across a wide array of invasive and non-invasive subspecialties that span imaging, monitoring, intervention, and longitudinal disease management.

So why are their imaging and information needs treated as secondary?

If the purpose of Enterprise Imaging is to harmonize the many types of clinical images and information across departments then we must recognize that Cardiology itself is an Enterprise. One that encompasses:

• Cardiac CT, MRI and Nuclear medicine
• Echocardiography and stress testing
• Electrophysiology studies
• Cardiac catheterization and interventional procedures
• Pediatric and Adult congenital heart disease
• Multimodality image fusion and 3D visualization
• Structured measurements and registries
• Time-sensitive, data-rich workflows

These aren’t simply variations of radiology workflows — they are distinct, high-stakes processes that require purpose-built tools, interfaces, and integrations. Cardiologists need real-time access to prior imaging, integrated measurement tools, seamless connectivity between imaging systems and hemodynamic data, and intuitive user interfaces tailored to their clinical responsibilities.

It’s time for cardiologists to recognize this reality: You are not just another imaging department. You are your own enterprise.

Settling for imaging systems that don’t meet the specific demands of cardiovascular care doesn’t just hurt efficiency, it impacts patient care, staff satisfaction, and long-term clinical outcomes.

As healthcare organizations continue to evolve their Enterprise Imaging strategies, it’s essential that cardiology is not merely invited to the table — but empowered to lead its own conversation. That means advocating for solutions that are purpose-built for cardiovascular workflows, that integrate with existing enterprise platforms while preserving the sophistication and nuance of cardiology practice.

In future posts, we’ll explore the distinct needs of various cardiology subspecialties, the role of analytics in modern cardiovascular care, and how technologies like AI and telepresence are reshaping the landscape. But for now, we leave you with this:

Cardiology is an enterprise. And it’s time it was treated like one.