Radiology has spent two decades building shared vocabularies for how imaging procedures should be named. Logical Observation Identifiers Names and Codes (LOINC) and the Radiological Society of North America (RSNA) RadLex Playbook define a common language, DICOM constrains the metadata that travels with every study, and nearly every health system maintains a curated internal procedure catalog. What nobody has been able to measure is how well those efforts hold up at the moment a patient's imaging history crosses from one institution to another.

Medicom operates at that crossing point, moving imaging among hospitals, imaging centers, and specialty practices every day, and that traffic offers a view of standardization no single institution can produce from inside its own walls. We asked a simple question of that traffic: when institutions exchange imaging, how consistent is the language that travels with it?