How it works
Read first. Analyse independently. Decide together.
The doctor-in-the-loop workflow keeps clinical judgement at the centre. The second reader adds a careful, independent check — and explains itself when it disagrees.
The six steps
The doctor-in-the-loop workflow
Select a step to explore it, or let the walkthrough play.
Step 1 of 6 · System
Study arrives
A new imaging study reaches the lab's existing worklist from PACS. Nothing changes about how it is acquired or routed.
The AI never signs a report. Only the radiologist can finalise a decision.
Step by step
What happens, and who is responsible
- 1
Study arrives
Responsible: System
A new imaging study reaches the lab's existing worklist from PACS. Nothing changes about how it is acquired or routed.
- 2
Radiologist reads first
Responsible: Radiologist
The radiologist completes their own read and records an impression before any AI output is shown, so their judgement is never anchored.
- 3
AI analyses independently
Responsible: Second reader
The second reader analyses the same study on its own, without seeing the radiologist's impression.
- 4
Flag with reasoning
Responsible: Second reader
If it finds something suspicious or disagrees, it raises a flag and shows why: the region, the overlays and a plain-language explanation.
- 5
Radiologist accepts or overrides
Responsible: Radiologist
The radiologist reviews the reasoning and decides. Overrides take a short rationale. The physician always has the final word.
- 6
Decision logged
Responsible: Audit trail
The decision, the rationale and the AI's reasoning are written to an append-only audit trail for quality review.
Steps 4 & 5
Reasoning in, decision out
The flag shows its evidence. The radiologist weighs it and decides. Try the overlay toggles and decisions in the panel.
Read comparison
DisagreementRadiologist
No focal finding recorded in Region A.
Second reader
Localised change suggested in Region A.
Reasoning
- 1. Texture in the boxed region differs from the surrounding area.
- 2. The heat region shows where the model focused its attention.
- 3. Measured extent is shown for the reader to verify.
Awaiting the radiologist's decision.
Illustrative example — not real patient data.
Step 6
Nothing happens off the record
Each study's history — who read it, what the AI raised, what was decided and why — is preserved for governance and quality review.
Study received
09:02 · System
Routed from PACS to the reading worklist
Radiologist read submitted
09:15 · Radiologist
Initial impression recorded before any AI output was shown
Second reader analysis completed
09:15 · Second reader
Independent analysis of the same study
Disagreement flagged
09:16 · Second reader
Reasoning, overlays and region references attached
Radiologist decision
09:21 · Radiologist
Flag reviewed; decision and written rationale captured
Report signed
09:24 · Radiologist
Final report signed by the radiologist
Each record is append-only and attributable.
Illustrative example — not real patient data.
Guardrails
Built-in limits on what the AI can do
Clinician sign-off only
The AI cannot finalise or sign a report. Every outcome requires a qualified clinician's decision.
No anchoring
AI output is withheld until the radiologist has recorded their own read.
Overrides are welcome
Disagreeing with the AI is a normal, expected part of the workflow — and the rationale makes the system better understood.
Silence is not reassurance
No flag simply means the second reader found nothing to raise. It is never presented as a clearance.
FAQ
Workflow questions
What does the radiologist see if the AI agrees?
A quiet confirmation that the second read is complete. There is no extra step unless the AI has something to raise.
How long does the AI analysis take?
The analysis runs in the background while the radiologist reads, so in most workflows results are ready by the time they are needed. We'll discuss timings for your setup during a demo.
Can the workflow be configured?
Yes. Which studies are routed for a second read, how flags are prioritised and who reviews them are agreed with each partner lab.
See the second reader in your own workflow
Book a walkthrough with our team. We'll show how doctor-in-the-loop decision support fits alongside your existing systems, and answer your clinical, technical and governance questions.