MetroHealth improves access to clinical content and imaging with Hyland

Industry: Healthcare
Location: Cleveland
Hyland solutions: Hyland OnBase™, Hyland Acuo™, Hyland NilRead™

MetroHealth consolidated clinical documents and imaging with Hyland solutions, creating more consistent, enterprise-wide access to information within existing workflows. The approach reduced missing reports by more than 80%, supported access to more than 4.7 million images by 8,000 staff members over three years and enabled 33,000 patients to view images through the patient portal.

MetroHealth — approaching its 200th anniversary and long recognized as a technology leader — is a public, safety-net health system in Northeast Ohio. Yet for years, seeing a patient’s images meant working across disconnected tools and locations. Dr. David Kaelber, a practicing internist and pediatrician who orders imaging every week, remembers a time when reviewing a study meant physically traveling to it. After inpatient rounds, “everybody walk down to radiology … we’d walk like 10 flights of stairs down” to view images with the radiologist,” Kaelber said.

Early improvements helped but didn’t solve the fragmentation. Specialized high-resolution viewers were installed in clinics, but each required a separate login and reauthentication, and there was still no way for patients to see their own images. As Kaelber puts it, an image is “worth 1,000 words” — clinicians and patients gain far more from seeing the picture than from the report alone.

Imaging had also outgrown radiology.

“It’s hard to find a medical specialty these days that doesn’t use imaging,” Kaelber said.

As imaging expanded into nearly every specialty, separate systems, viewers and processes made it harder for clinicians, staff and patients to access a unified view of a patient’s images. MetroHealth set out to reduce that fragmentation, guided by a clear north star: making every image, internal and external, available to anyone, anywhere.

MetroHealth treated enterprise imaging as an organizational initiative, not a standalone technology deployment. Working with Hyland, leadership recognized that success would depend far more on people and process than on technology alone. Kaelber often frames it as roughly “10 to 15% about the technology” and “85 to 90% about all the other … non-technology things.”

To align efforts, MetroHealth formed an Enterprise Imaging Steering Committee, spending months mapping where imaging actually occurred across the system, then bringing every imaging discipline to the table alongside radiology, IT, clinical engineering, clinical informatics and point-of-care ultrasound. Co-chaired with the chair of radiology, the committee provides transparency and makes recommendations that guide system-wide imaging decisions.

“Bringing together the right people across the system was critical to developing our enterprise approach,” Kaelber said.

That model helped MetroHealth move from department-specific practices to a more consistent, system-wide approach to managing clinical content.

MetroHealth’s work with Hyland began with Hyland OnBase, selected to support administrative and clinical workflows and integrate with existing systems such as Epic. OnBase helped the health system reduce its reliance on paper, improve document access, standardize administrative processes, support audit trails and accelerate turnaround times.

MetroHealth later expanded its approach with Hyland Acuo as a central imaging repository and Hyland NilRead as a universal viewer embedded within clinical workflows. Together with OnBase, these solutions helped MetroHealth connect clinical documentation and imaging across the organization.

With Hyland solutions, staff and clinicians can access documents and images without navigating multiple systems. Images can be viewed alongside clinical documentation, helping streamline how information is reviewed and used during care delivery.

In the first three years after implementation, more than 8,000 staff members accessed more than 4.7 million images. Administrative teams also reduced missing reports by more than 80% and eliminated paper storage in areas such as HR, removing thousands of physical files.

MetroHealth extended image access through its patient portal, allowing patients to view images alongside reports and share them externally when needed. In the first seven months after rollout, nearly 33,000 patients viewed images through the system. Usage continued to grow to 10s of thousands of views per month as the capability became part of everyday workflows.

“It went from zero use to tens of thousands of uses per month by patients.” Kaelber said.

MetroHealth continues to expand its approach, focusing on consistent access to clinical content across the organization.