Digital Health Transformation

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Digital Imaging Adoption Model (DIAM)

The HIMSS Digital Imaging Adoption Model (DIAM) helps healthcare organizations measure capabilities related to the secure delivery of medical imaging and its associated processes to improve quality of care, patient safety and organizational efficiency in both hospitals and diagnostic centers. The globally applicable DIAM facilitates enterprise imaging covering all areas of the health system, enabling management of digital imaging and multimedia content in a systematic, holistic, efficient and effective manner.

With the DIAM, realize operational and clinical improvements related to healthcare imaging while assessing and advancing IT-supported processes and collaboration across your entire organization. Organizations can leverage the DIAM to improve the person-enabled health and governance and workforce dimensions of digital health.


Engage Patients

Enable patients to access their images, image-related reports and other non-acute digital imaging-related materials to provide a comprehensive understanding that involves the patient in their own care journey.

Drive Clinical and Operational Collaboration

Focus on healthcare imaging technologies across multiple areas of the health system to encourage strong multidisciplinary collaboration and build a culture of stakeholder engagement.

Improve Patient Safety

Improve patient safety by using structured digital imaging reports that are easier for patients to understand because they are less ambiguous and more complete than traditional reports.

Standardize and Secure Healthcare Imaging Technology

Store, display and distribute medical images throughout the enterprise while standardizing and securing workflows to ensure protected health information is captured, exchanged and stored in a secure manner. Ensure medical images are fully traceable and retrievable to provide the best possible care outcomes.


Optimize the healthcare imaging capabilities of your system with the HIMSS DIAM.

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DIAM Stages

*Stages 5–7 are non-hierarchical and can be adopted in any order. 
To reach Stage 7, all three of the Stage 5–7 criteria must be met.
To reach Stage 6, two of the Stage 5–7 criteria must be met.
To reach Stage 5, one of the Stage 5–7 criteria must be met.

  • The majority of image-producing service areas are exchanging and/or sharing images and reports and/or clinical notes based on recognized standards with care organizations of all types, including local, regional or national health information exchanges.
  • The application(s) used in image-producing service areas support multidisciplinary interactive collaboration.
  • Patients can make appointments, and access reports, images and educational content specific to their individual situation online.
  • Patients are able to electronically upload, download and share their images.
  • Systems are in place that are capable of providing feedback about the appropriateness to perform an examination based on patient preconditions, history and approved guidelines.
  • Alternative examinations and suggestions for standardized care practices/best practice guidelines are directly integrated into the electronic workflow.
  • Imaging reports/notes are in a structured format and/or supported by natural language processing and produce discrete data elements that can trigger alerts and clinical decision support.
  • Patient-specific imaging data from at least two image-producing services are used and correlated in near time with evidence-based information sources (commercial or self-developed) to improve health outcomes.
  • The organization participates in regional, national or international registries in order to track patient safety-related information for imaging.
  • Clinical, organizational and financial parameters are systematically tracked, benchmarked (internally and externally), and can be presented in real time through dashboards, balanced scorecards, etc.
  • The organization uses internal and external data for making predictions about needed therapies and examinations, follow-up measures, etc.
  • Genetic information from patients is correlated with imaging biomarkers.
  • Technology use is captured and analyzed to influence user behavior.
  • The organization makes use of an enterprise-centralized repository where image content is stored.
  • Clinical image, multimedia and metadata capture and storage processes are standardized, enabling order and encounter-based image acquisition and sharing workflows across the enterprise.
  • Internationally recognized standards, protocols or profiles are used to support system integration and clinical workflows.
  • The organization has the capability to securely acquire and view images via mobile platforms (e.g., mobile ultrasound) and handheld devices (e.g., smartphones).
  • Image content, associated reports and clinical notes (DICOM/non-DICOM, structured/non-structured reports) can be ingested and stored electronically.
  • Clinicians are able to access medical images and reports securely from remote locations.
  • An enterprise imaging strategy in place, including appropriate governance and oversight.
  • Clinical image acquisition and communication workflows are formalized, implemented and designed to support clinicians within their normal care processes.
  • Quality, safety and operational parameters across multiple imaging services are measured and under control.
  • Imaging specialists can access all types of images/multimedia from a single point of entry that connects them directly to specialty clinical viewers as needed. Clinicians across the enterprise can access images/multimedia through a consolidated viewer for non-diagnostic purposes.
  • External referrers can access and view images through the organization’s network/repository.
  • Images and associated reports/clinical notes, created in at least three image-producing service areas or 80% of all medical images/videos produced in the organization, are accessed via multiple, unique links within the EMR (or similar enterprise-wide user interface when an EMR is not available).
  • External images can be imported to the organization’s image management system for clinician access (if the policy allows).
  • Key specialized medical imaging information systems are installed for managing image acquisition workflows (orders or encounters-based workflows), imaging-related reports and/or clinical notes, and/or digital image archiving, in at least two departments/service areas.
  • A supply and inventory management system, supporting the maintenance of inventory and consumables within the service area, may also be in place as appropriate (e.g., radiology/cardiology).
  • The organization has not installed key enterprise and/or specialized imaging information systems for imaging acquisition (orders or encounters-based workflows), image-related reports and/or clinical notes, and/or digital image archiving, in at least two service areas (image-producing departments/units).


Download DIAM Information

The DIAM was developed with the support of the Society of Imaging Informatics in Medicine (SIIM), the European Society of Radiology (ESR), and the European Society of Medical Imaging Informatics (EUSOMII).