Top 5 DICOM Routing Rules Every Imaging Center Should Implement
- anthonyjpapasso
- Oct 11
- 3 min read
Managing medical imaging data efficiently is critical for today’s imaging centers and teleradiology providers. A key technology that helps make this happen is the DICOM router, which moves images and related data between modalities, PACS, RIS, and reading workstations. But the value of a DICOM router depends heavily on how it’s configured.
DICOM routing rules define the logic used to decide where and how studies are sent. Without clear, well-planned routing rules, imaging workflows can suffer delays, misrouting, or excessive manual work — impacting radiologist productivity and patient care.
Because imaging data often comes from multiple modalities and sites, and must be delivered to different reading teams or systems, routing rules are essential for:
Ensuring studies go to the right place on time
Automating study prioritization, such as STAT exams
Integrating with existing PACS and RIS systems without disruption
Supporting complex workflows across multiple locations or cloud platforms
In this article, we explore five fundamental DICOM router rules that every imaging center should consider. These best practices can improve workflow efficiency, accuracy, and scalability in any medical imaging environment.
Rule #1: Route by Modality Type to Streamline Workflow
Routing studies based on their modality—such as CT, MRI, ultrasound, or X-ray—is a foundational rule. It helps ensure each imaging study is sent directly to the right specialist or reading group with minimal delay.
For example, MRI scans can automatically route to neuroradiologists, while ultrasound studies go to general radiologists. This reduces manual sorting and speeds up the reading process.
Benefits of modality-based routing include:
Specialized readings by modality expert
Balanced distribution of workload
Faster turnaround for urgent studies
Reduced human error in sorting
Most routers filter using DICOM tags like Modality (0008,0060). Properly configuring this rule helps create an efficient, reliable medical imaging workflow that scales with growing exam volumes.
Rule #2: Use AE Title-Based Routing for Precise System Control
Each DICOM-enabled device has an AE Title (Application Entity Title) that uniquely identifies it on the network. Routing by AE Title lets imaging centers direct traffic based on the device or system sending or receiving images.
This rule is especially useful in multi-site facilities or networks where images need to flow differently depending on their origin or destination.
Common uses include:
Routing images from specific scanners or clinics to designated PACS systems
Sending backup copies to cloud storage or disaster recovery systems
Separating research studies from clinical workflows
Controlling routing to AI processing tools or specialized archives
AE Title routing adds structure to complex environments and reduces manual work in managing data flow, enhancing overall radiology data management.
Rule #3: Implement Time-Based Routing for After-Hours and STAT Studies
Imaging centers often operate 24/7, requiring different workflows for daytime, after-hours, or urgent cases. Time-based routing allows studies to be routed differently based on time of day, day of week, or holidays.
For instance, after-hours scans can automatically route to on-call radiologists or teleradiology providers, ensuring timely reads without manual handoffs.
Advantages include:
Automated coverage for night and weekend shifts
Reduced errors from manual reassignment
Faster reading of urgent cases
Support for global workflows across time zones
Time-based rules keep your medical imaging workflow running smoothly around the clock.
Rule #4: Route by Patient Location or Department to Prioritize Critical Cases
Knowing the patient’s location or referring department allows more precise routing of studies. Scans from the ER or ICU, for example, may require faster turnaround and specialized reading.
By routing based on location or department, imaging centers can:
Prioritize inpatient or emergency cases
Separate outpatient workflows
Align routing with clinical teams’ needs
Reduce delays for critical patients
This rule improves communication between radiology and clinical departments and supports better patient outcomes.
Rule #5: Use Study Description or Procedure Code Routing for Subspecialty Workflow
Some exams require subspecialized radiologists or different processing pipelines. Using study descriptions or standardized procedure codes as routing criteria allows precise assignment of studies.
For example, mammograms can route to breast imaging specialists, while cardiac CTs go to cardiothoracic radiologists. This ensures expertise is matched to the exam type, increasing accuracy and efficiency.
Key benefits:
Targeted subspecialty reading
Improved reporting quality
Streamlined exam handling
Consistent workflows for complex cases
This rule helps build an intelligent and adaptable imaging center PACS integration environment.
Conclusion
Effective DICOM routing rules are essential for imaging centers seeking to optimize their workflows and improve patient care. By implementing rules based on modality type, AE Title, time, patient location, and study description, facilities can ensure images flow correctly and efficiently through their networks.
Partnering with a vendor-neutral solutions provider experienced in healthcare IT can help tailor these routing strategies to your unique needs. UltraRAD Corporation brings decades of expertise delivering scalable, reliable software and services that integrate smoothly with existing RIS/PACS environments. Their proactive approach and commitment to customer satisfaction make them a trusted partner for healthcare organizations aiming to advance radiology data management and workflow efficiency.
