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Southern Ohio Medical Center (SOMC), a 232-bed community-based teaching hospital, is equipped with state-of-the-art equipment such as 2 16-slice computed tomography (CT) scanners, 3 MR scanners, 3 ultrasound scanners, 2 digital mammography units, and 3 nuclear medicine cameras. One hundred twenty-six employees--ranging from support personnel to technologists along with 7 board-certified radiologists--staff the medical imaging department. Procedure volume is approximately 164,000 per year and is performed in all American College of Radiology (ACR)-accredited modalities. Filmless since 1998, SOMC's medical imaging department has resulted in productivity gains to the estimated 164,000 procudures for fiscal year 2005. The catalyst for the department is a robust picture archiving and communication system (PACS). Working with the radiologists, staff, and transcription services, turnaround time was reduced to from 13 hours to 9 hours from exam start to report sign off. Additional technology intervention was essential to further decrease report turnaround time. SOMC served as a beta site for a radiology information system (RIS). The new RIS has allowed the medical imaging department to move from a paper department to a "pseudo paperless" department. Orders, history sheets, consents, and other forms are scanned into the RIS for staff and radiologist use. Requisitions are no longer printed, and staff has access to review workstations to ensure that patients are called back into the department for procedures. This new workflow has also reduced paper traffic within the department. The last piece of the technology puzzle to improve report turnaround time was voice recognition technology. From its implementation, voice recognition enhanced the RIS technology. All of the radiologists began to use the product as soon as it was available. They perform all the editing and corrections either by voice command or by manual typing. The medical imaging department has noted that voice command corrections and editing are more efficient for the radiologist. The overall impact on decreased radiology report turnaround times is not only seen in medical imaging, but also has a global affect within the hospital. SOMC plans to realize a reduction length of patient stays, and a faster process for plotting the course of patient treatment, e.g., faster visits from emergency department (ED) physicians to patients.