Harmonizing CT Across a Health System to Improve Consistency and Access

Delivering consistent imaging quality across a geographically dispersed health system presents both operational and clinical challenges. In a recent conversation with Applied Radiology, Sean Bortnem, Director of Imaging Services at Avera Health, discussed how his organization is implementing a harmonized CT platform across more than 100 communities in five states, with the goal of improving consistency, workflow integration, and patient access.

Standardizing the Patient Experience

For Bortnem, the primary driver behind CT harmonization was patient experience. “The number one priority for us when we embarked on this mission was how do we go about making it so the patient’s experience at any Avera site across our health system is the exact same,” he said.

Serving rural communities across the Midwest presents unique logistical realities. Patients may travel hours for care, making it impractical to redirect them to a tertiary center simply for access to more advanced imaging. Bortnem emphasized that patients presenting at a rural critical access hospital should receive a consistent level of imaging quality as those seen at a flagship facility. Creating uniformity across sites was therefore not only an operational goal, but a commitment to equitable care.

Platform Uniformity and Technologist Consistency

Achieving that consistency required starting at the technologist level. Avera operates a shared staffing model in which technologists often rotate between facilities. Historically, that meant adapting to different vendors and user interfaces depending on location.

We wanted to standardize our fleet specifically from a user interface perspective, Bortnem explained. By selecting a platform with a consistent interface across scanner tiers, the organization established a foundation for operational uniformity. Canon’s CT portfolio, including the Serve SP systems now being deployed, was selected in part because of its consistent user experience and clearly defined technology roadmap.

Bortnem noted that imaging equipment often remains in service well beyond its depreciation timeline. Selecting a platform with long-term development continuity was therefore a key consideration. The goal was not simply to unify today’s fleet, but to ensure that future upgrades would maintain compatibility and consistency.

Workflow Efficiency and Technology Support

Beyond image consistency, harmonization was closely tied to workflow efficiency. Staffing shortages and burnout remain widespread challenges, and Bortnem described technology as a tool to support, rather than replace, technologist expertise.

Features designed to support consistent positioning such as low-dose axial acquisition paired with AI-driven landmark identification help standardize positioning and reduce variability.1 2 While experienced technologists bring critical clinical judgment, automation can help newer or cross-trained staff achieve consistent results more quickly.

There’s no substitute for experience,” Bortnem noted, “but technology can help ensure consistent results, across technologists. By reducing reliance on individual operator familiarity for routine positioning tasks, the department aims to produce consistent image quality regardless of who is scanning.

Early implementation suggests the learning curve has been manageable. Bortnem noted that technologists have been able to scan independently with a manageable learning curve, supporting smoother onboarding and faster operational transition.

Protocol Management and Enterprise Alignment

As more scanners are deployed, Bortnem anticipates additional benefits in protocol management and quality assurance. Standardizing platforms simplifies oversight for medical physicists, who no longer need to manage multiple vendor-specific protocols across the fleet.

“When you’re managing multiple platforms, it’s challenging to optimize them all equally,” he said. Moving toward a unified platform allows greater attention to refining and optimizing a single protocol framework.

This consistency also extends to protocol management and system oversight. When platforms are standardized, medical physicists and imaging leaders can focus on refining a single framework rather than dividing attention across multiple systems. For a large health system, that level of alignment supports broader enterprise goals related to imaging quality and operational coordination.

Partnership Beyond Procurement

Bortnem emphasized that harmonization is not solely about technology specifications. Vendor partnership played a central role in the decision-making process. Avera already had relationships with Canon in other modalities, and the broader strategic alignment influenced the CT selection.

In his view, most vendors today offer capable technology. The differentiator lies in long-term partnership. Rather than maintaining numerous transactional relationships, Bortnem recommended focusing on a smaller number of strategic partners who understand the organization’s mission and operational priorities.

“The technology across vendors is strong,” he said. “The real distinction is the strength of the partnership beyond the transaction.” That includes support responsiveness, service coordination, and shared commitment to long-term system goals.

Ultimately, Avera’s CT harmonization effort reflects a broader strategy to align technology, workforce, and patient access. By prioritizing platform uniformity and operational consistency, the health system aims to ensure that patients receive the same level of care regardless of where they enter the network. As Bortnem framed it, harmonization is less about standardizing machines and more about standardizing care.

References

1. Canon’s Aquilion ONE Insight edition offers AI based deep learning technology to identify anatomical features on the surface of the body. These features allow the system to automatically align the patient to the start position for the 3D Landmark scan.
2. 3D Landmark Scan is an ultra-low-dose helical scan performed using the SilverBeam filter, at the same dose as traditional 2D scanograms.