Article: Stratus Imaging Reporting - Integration with Radiology Station

Version 2.5

Effective date:

Sep 11, 2026

Reporting

Stratus Imaging Reporting - Integration with Radiology Station

Overview

Note: This guide covers the bi-directional integration between Stratus Imaging Reporting (the Stratus Imaging Workflow and Reporting platform) and the Radiology Station application of Change Healthcare Radiology Solutions. In this workflow, Change Healthcare Radiology Solutions controls the PACS worklist and the viewer; Stratus Imaging handles reporting. The integration runs via the Stratus Imaging Reporting Client, which must be installed on every radiologist's workstation.

About the Applications

Application	Description
Change Healthcare Radiology Solutions	A medical image and information management software product intended to receive, transmit, store, archive, retrieve, manage, display, print, and process digital medical images and associated patient and medical information.
Change Healthcare Radiology Solutions Radiology Station (Radiology Station)	The primary Change Healthcare Radiology Solutions application for viewing, managing, and manipulating images from DICOM-compliant modalities.
Stratus Imaging Workflow and Reporting	The web-based worklist, reporting, and clinical workflow platform. Radiologists access it through the Stratus Imaging Reporting Client when integrated with Radiology Station.
Stratus Imaging Reporting Client	A Windows desktop application that hosts Stratus Imaging Reporting and manages bi-directional communication with Radiology Station via the Report Connector and Change Healthcare Radiology Solutions Inbound Connector (COM API). Must be installed on every radiologist's workstation.
Change Healthcare Radiology Solutions Report Connector	The Change Healthcare Radiology Solutions integration component that sends exam context (Open/Close/Status) from Radiology Station to the Stratus Imaging Reporting Client.
Change Healthcare Radiology Solutions Inbound Connector	A COM API that allows the Stratus Imaging Reporting Client to send commands to Radiology Station, including OpenStudy to launch images in Radiology Station from within Stratus Imaging Reporting.

Terms and Concepts

The following terms are used in Change Healthcare Radiology Solutions. The Stratus Imaging Workflow and Reporting platform equivalent is shown for reference.

Term or concept	Meaning	Stratus Imaging equivalent
Anchor study	The first study opened for a particular patient — usually the most recent study created for that patient.	Current exam
Patient context	Established when a study for a patient is opened. Changed when a user switches between studies belonging to different patients. While studies for multiple patients may be open simultaneously, only studies for one patient (one patient context) can be displayed at a time. Also referred to as clinical context.	Patient context
Radiology Station	The primary Change Healthcare Radiology Solutions application for viewing, managing, and manipulating images from DICOM-compliant modalities.	Viewer (external)
Reference studies	Studies opened after the anchor study, for the same patient. Typically, prior studies are relevant for interpreting the anchor study. May be opened manually by the radiologist or automatically based on the applied display (hanging) protocol.	Comparison exams
Study	A set of DICOM images and associated data for a patient encounter.	Exam

How the Integration Works

Radiology Station and Stratus Imaging Reporting communicate through the Stratus Imaging Reporting Client using two connectors.

Direction	Mechanism	What it does
Radiology Station → Stratus Imaging	Report Connector (Outbound)	Sends exam context (Open, Close, Status) to the Stratus Imaging Reporting Client when a study is opened or closed in Radiology Station. This triggers the reporting screen to load automatically. Also sends Close and Status responses back to Radiology Station when the radiologist signs, cancels, or navigates away.
Stratus Imaging → Radiology Station	Change Healthcare Radiology Solutions Inbound Connector (COM API)	Allows the Stratus Imaging Reporting Client to open images in Radiology Station when a radiologist clicks the eye icon in Stratus Imaging Reporting.

When a report is signed in Stratus Imaging Reporting:

Stratus Imaging sends a Close response with status Dictated to Radiology Station
Stratus Imaging sends an ORU (outbound report message) to the EMR
The EMR is responsible for sending the Final status and corresponding ORU back to Radiology Station

When a report is not signed — i.e., the radiologist closes the study before signing, whether by skipping the exam, returning to the worklist, or closing the study in Radiology Station — the outcome depends on whether report data has already been entered:

If no report data was entered (the report is still on the default template):

Stratus Imaging sends a Close response with status Canceled to Radiology Station
The exam assignment is removed, and the report editor is reset to default
No ORU is generated; the EMR is not notified
The exam remains available on the worklist for reassignment or subsequent reading

If report data was entered but not signed (a draft in progress):

Stratus Imaging auto-saves the draft and sends a Close response with the Prelim command to update the status in Radiology Station to Needs Over-Read
The assignment is retained; the draft remains available for you to resume later
No ORU is generated; the EMR is not notified
Needs Over-Read is a status signal only — it does not block another radiologist from reassigning or opening the exam

Section 1 — Administrator Setup

Complete all steps in this section before radiologists begin using the integration. Steps 1.1 through 1.4 are performed by IT or a system administrator. Step 1.5 is a pre-flight verification.

1.1 Prerequisites

Confirm all of the following before beginning installation:

Windows workstation (the integration is Windows-only; not supported in browser-only environments)
.NET 8 Windows Desktop Runtime (windowsdesktop-runtime-8.0.26-win-x64.exe) is available for installation — provided by the Stratus Imaging team
Radiology Station is installed and the user can log in successfully
Each user’s Stratus Imaging account (email address) must match the ‘Other ID’ field in their Change Healthcare Radiology Solutions account. In addition, user roles and permissions—such as radiologist or technologist—must be assigned consistently in both systems.
The Change Healthcare Radiology Solutions Inbound Connector, Change Healthcare Radiology Solutions Report Connector, and Change Healthcare Radiology Solutions are installed
Network access to Stratus Imaging Reporting platform (pacs.stratus.optum.com)
Administrator rights on the workstation for installation
Gateway is configured and operational, including Mirth Connect integration for HL7 message routing. This requires: an inbound HL7 feed from the HIS/RIS to Mirth on the Gateway (same HIS/RIS feed used by Change Healthcare Radiology Solutions), and an outbound HL7 feed from Stratus Imaging Reporting back to the HIS/RIS for report delivery.

1.2 Install the Stratus Imaging Reporting Client

Two components must be installed on every workstation where radiologists will report: the .NET 8 Windows Desktop Runtime (windowsdesktop-runtime-8.0.26-win-x64.exe) and the Stratus Imaging Reporting Client (StratusImagingReporting.msi). Both installers are provided by the Stratus Imaging team.

Step 1 Install the .NET 8 Windows Desktop Runtime
Locate the windowsdesktop-runtime-8.0.26-win-x64.exe file provided by the Stratus Imaging team. Right-click and select Run as administrator, then follow the on-screen prompts to complete installation. This runtime is required for the Stratus Imaging Reporting Client to run.
Step 2 Run the installer
Locate the StratusImagingReporting.msi file provided by the Stratus Imaging team. Right-click and select Run as administrator.
Step 3 Follow the installation wizard
Accept the license agreement and follow the on-screen prompts. The default installation path is:
C:\Program Files (x86)\StratusImagingReporting\
Do not change the installation directory unless specifically instructed to do so by the Stratus Imaging team.
Step 4 Install all add-on modules
Install all add-on modules listed in the pre-requisites. Contact the technical team to obtain the latest versions of the installers. Important: The minimum required Stratus Imaging Reporting Client version for bi-directional integration (including Change Healthcare Radiology Solutions Inbound Connector support) is version 5.0.5 or later. Earlier versions do not include the Change Healthcare Radiology Solutions Inbound Connector and will not support launching images from the Stratus Imaging Workflow and Reporting platform into Radiology Station.

1.3 Configure Radiology Station Access Options

Each radiologist must configure their Radiology Station preferences to enable automatic or manual access to Stratus Imaging Reporting. This is a per-user setting in Radiology Station.

Option A — Automatic launch (recommended)

Stratus Imaging Reporting opens automatically each time the radiologist opens a study in Radiology Station.

Step 1 Open Preferences in Radiology Station
In Radiology Station, click the Preferences button on the main toolbar.
Step 2 Enable Auto Display
In the Preferences dialog, select Auto Display in the left pane.
Under When appropriate, also display, select the Stratus Imaging Reporting for ALL studies check box.
Step 3 Save
Click Save. The next time a study is opened, Stratus Imaging Reporting will launch automatically.

Option B — Manual launch

Stratus Imaging Reporting is accessed on demand by clicking a button on the Radiology Station toolbar.

Step 1 Open Preferences in Radiology Station
In Radiology Station, click the Preferences button on the main toolbar.
Step 2 Add the button to the toolbar
In the Preferences dialog, select Main Tool Bar in the left pane.
From the Available list, select Stratus Imaging Reporting, then click Add.
Step 3 Save
Click Save. The Stratus Imaging Reporting button is now visible on the main toolbar. It appears dimmed until a study is open.

1.4 Pre-Launch Verification Checklist

Check	Expected result
Stratus Imaging Reporting Client installed (version 5.0.5+)	Application appears in C:\Program Files (x86)\StratusImagingReporting\
Report Connector and Inbound Connector OAF Adapters are installed	Module folder present inside the app version directory
Radiology Station installed and running	Radiologist can open studies successfully
User account linked (Change Healthcare Radiology Solutions ↔ Stratus Imaging)	Same email used in both systems
Radiology Station access option configured	Reporting screen opens automatically (or toolbar button visible) when a study is opened
End-to-end test completed	Open a test study in Radiology Station → reporting screen loads → click eye icon → images open in Radiology Station → sign report → study moves to Completed in Stratus Imaging and Dictated in Radiology Station

Section 2 — Radiologist Workflows

This section is for radiologists assigned to the Radiologist role in Stratus Imaging. The study must exist in both Radiology Station and the Stratus Imaging platform before reporting can begin.

Note: You will be prompted to log in to Stratus Imaging once per session after logging in to Radiology Station. Your Stratus Imaging username (email) is pre-filled. Enter your Stratus Imaging password to complete login.

2.1 Logging In

Step 1 Log in to Radiology Station
Go to the Radiology Station login page and click Log in with Radiology Station, then enter your Change Healthcare Radiology Solutions credentials.
Step 2 Log in to Stratus Imaging
The Stratus Imaging login page appears with your email address pre-filled. Enter your Stratus Imaging password and log in.
You only need to do this once per session. Stratus Imaging remains active in the background while you work in Radiology Station.

Note: Do not close the Stratus Imaging window during your session. If the window is closed, you may be prompted to log in again the next time you attempt to open a report.

2.2 Creating a Report

Step 1 Open a study in Radiology Station

Open a study from the Radiology Station worklist. Depending on your configuration:

If Auto Display is configured: Stratus Imaging Reporting opens automatically and loads the reporting screen for the matching study.
If Manual is configured: click the Stratus Imaging Reporting button on the main Radiology Station toolbar. The reporting screen opens for the currently selected study.

Step 2 Dictate and sign

Dictate the report using Stratus Imaging Reporting, then sign it to finalize.

When you sign the report using Sign & Next or Sign & Close:

The reporting screen closes. In Stratus Imaging, the study is marked Completed.
Radiology Station marks the study as Dictated and closes it.
Stratus Imaging sends an ORU report message to the EMR. The EMR then sends the Final status back to Radiology Station.

2.3 Linking a Report to Multiple Studies

If multiple unreported studies exist for the same patient, you can apply a single report to all of them.

Step 1 Open a study in Radiology Station
When other unreported studies exist for the same patient, the Associate Additional Studies dialog displays automatically in Radiology Station.
Step 2 Select studies to link
Select the studies you want to include in the report. Alternatively, link studies from within Stratus Imaging Reporting by selecting them from the Exam List panel and clicking Link Exam.
Step 3 Dictate and sign
Dictate the report, then sign it to finalize. All linked studies are marked Dictated in Radiology Station and Completed in Stratus Imaging. All linked studies are closed in both applications.

2.4 Reporting Reference and Prior Studies

When you need to report the anchor study (most recent) and reference studies (prior exams) as separate reports:

Step 1 Select studies in Radiology Station
Select two or more unreported studies for the same patient from the Radiology Station worklist and open them. The studies are locked in the Radiology Station worklist to indicate they are being reported.
Step 2 Report reference studies first
Click the arrow beside the Stratus Imaging Reporting button on the Radiology Station toolbar and select the first reference study (R1) from the list. The reporting screen for that study opens. Dictate and sign.
Repeat for any additional reference studies.
Step 3 Report the anchor study
Click the arrow beside the Stratus Imaging Reporting button and select the anchor study. Dictate and sign.
All studies are marked Completed in Stratus Imaging and Dictated in Radiology Station. The patient context closes in Radiology Station.

2.5 Switching Between Patients (Interruption Workflow)

If you open a study for a different patient in Radiology Station while a report is in progress:

Stratus Imaging Reporting automatically switches to the new patient's study. You can begin dictating immediately.
The first patient's study remains open in the background. It stays assigned to you and any dictation is auto-saved.
To return to the first patient, redisplay their study in Radiology Station. You cannot return to the auto-saved report directly from within Stratus Imaging — you must open the study again from Radiology Station first.

2.6 Situations in which an Auto-Saved Report is Discarded or Preserved as a Draft

If you perform any of the following actions while a dictation is in progress, the outcome depends on whether report data has already been entered. If no data has been entered, the auto-saved report is discarded as shown below. If report data has been entered, the draft is preserved instead — see the last row of this table.

If you...	In Radiology Station	In Stratus Imaging Reporting
Cancel or skip the report in Stratus Imaging Reporting.	The study is closed without any change to its status. Note: the integration may be configured so that the study is not closed in this context — contact your administrator.	The reporting screen closes and the study is unassigned.
Navigate to the Stratus Imaging exam worklist from the reporting screen.	The study is closed without any change to its status.	The study is unassigned.
Close the study in Radiology Station.	—	The reporting screen closes and the study is unassigned.
Close Stratus Imaging Reporting manually.	See Section 2.8 — Closing Stratus Imaging Reporting.	See Section 2.8 — Closing Stratus Imaging Reporting.
Close Radiology Station.	See Section 2.8 — Closing Stratus Imaging Reporting.	See Section 2.8 — Closing Stratus Imaging Reporting.
Any of the actions above — if report data was already entered (a draft in progress)	The study is closed with status Needs Over-Read. The assignment is retained.	The draft is auto-saved. The assignment is kept so you can resume the draft later.

2.7 Actions and System Responses

The following table describes what happens in each application when you take a specific action in Stratus Imaging Reporting. For actions where the outcome depends on whether report data has already been entered, both cases are shown separately.

Your action	In Stratus Imaging	In Radiology Station
Sign and Close	Study marked Completed. Reporting screen closes. ORU sent to EMR.	Study marked Dictated and closed.
Sign and Next	Same as Sign and Close.	Study marked Dictated and closed.
Return to Worklist (Exams button) — no report data entered	Assignment removed. Report editor reset. Redirected to splash screen.	Study closed. Status unchanged.
Return to Worklist (Exams button) — report data entered (draft)	Draft auto-saved. Assignment kept.	Study closed with status Needs Over-Read. Assignment retained.
Skip — no report data entered	Same as Return to Worklist.	Study closed. Status unchanged.
Skip — report data entered (draft)	Draft auto-saved. Assignment kept.	Study closed with status Needs Over-Read. Assignment retained.
Close Radiology Station — no report data entered	Report discarded. Study unassigned.	Study closed. Status unchanged.
Close Radiology Station — report data entered (draft)	Draft auto-saved. Assignment kept.	—
Close SI Reporting unexpectedly (Application crash or unintentionally clicking X)	Report auto-saved. Assignment kept. (Known limitation: no Canceled response sent on unexpected close.)	Study remains open.

2.8 Closing Stratus Imaging Reporting

When you log out of Radiology Station, Stratus Imaging Reporting closes automatically. If a dictation is in progress, the report is discarded and the study is unassigned in the Stratus Imaging platform.

If you manually close Stratus Imaging Reporting while a dictation is in progress, the report is discarded and the study is unassigned. To return to Stratus Imaging Reporting:

Step 1 Reopen Stratus Imaging Reporting
In Radiology Station, click the Stratus Imaging Reporting button on the main toolbar and log in to Stratus Imaging when prompted.
Step 2 Open the reporting screen
Click the Stratus Imaging Reporting button on the main toolbar again to open the reporting screen for the study currently open in Radiology Station.

Note: If no study is open in Radiology Station and Stratus Imaging Reporting is configured to auto-display, you will be prompted to log in to Stratus Imaging when you open a study in Radiology Station.

2.9 Addendum

When a finalized (Completed) study is launched from Radiology Station or Stratus Imaging Reporting, radiologists with edit rights can add an addendum in Stratus Imaging Reporting without resetting the report or changing the assignment. The addendum workflow follows the standard sign flow.

2.10 Error: Mismatch Detected on Exam Load

Every time an exam loads, Stratus Imaging validates the MRN, accession number, first name, last name, and date of birth against the data in the Stratus Imaging database. If there is a mismatch:

Stratus Imaging displays an error message and redirects to the splash screen.
The Stratus Imaging Reporting Client sends a Canceled response to Radiology Station.
Contact your administrator if this error occurs repeatedly for the same study.

2.11 Error: Unable to Launch Images

If you click the eye icon and the images cannot be opened in Radiology Station, the message 'Unable to launch images' is displayed. Common causes:

The Change Healthcare Radiology Solutions Inbound Connector is not running — confirm Radiology Station is open and running before clicking the eye icon.
The Change Healthcare Radiology Solutions Inbound Connector OAF adapter is missing from the Stratus Imaging Reporting Client installation (see Section 1.2, Step 4). Contact IT to reinstall the Stratus Imaging Reporting Client.
Accession number mismatch between systems.

Section 3 — Known Limitations

Limitation	Detail	Workaround
Single sign-on not supported	Radiologists must log in to Stratus Imaging once per session even if SSO is configured for the organization.	Log in once at the start of each session. Your username is pre-filled.
Unexpected app close does not send Canceled status	If the Stratus Imaging Reporting Client closes unexpectedly due to an application crash or the process being killed (note: if the user closes the application window by clicking X, the report is discarded), no Canceled response is sent to Radiology Station. The report is auto-saved and the study remains assigned.	Administrator must manually unassign the exam in Stratus Imaging if needed.
Cannot open study from Stratus Imaging Reporting	You can view images in Radiology Station from Stratus Imaging via the eye icon, but you cannot open a study in Radiology Station by navigating within Stratus Imaging Reporting directly.	Always open studies from the Radiology Station worklist.
No manual ‘save as preliminary’ button	There is no button to explicitly save a report as preliminary. However, if you close a study before signing after entering report data, the draft is preserved automatically and the study is marked Needs Over-Read in Radiology Station (see Sections 2.6 and 2.8) — you do not need to sign to avoid losing work.	None needed for draft preservation. Reopen the study and sign when ready to finalize.
Patient exam auto-assignment edge case	When auto-assignment is enabled, closing an anchor exam without signing it unassigns only the anchor exam. Secondary (comparison) exams remain assigned.	An administrator can disable Patient exam auto assignment under Accounts → [Account] → [Facility] → Facility details.
Peer review, critical findings, support workflows	These workflows must be managed in the Stratus Imaging platform. They are not accessible from Radiology Station.	Use the Stratus Imaging Reporting web application directly for these workflows.
Critical Results — status mismatch	When a Critical Results workflow resets an exam from Completed to Inflight in Stratus Imaging, the study remains as Dictated in Radiology Station and does not return to the Change Healthcare Radiology Solutions main worklist.	Contact your administrator. The status mismatch is a known issue pending resolution.