In this episode of After the Chaos, Angela and Kandice break down their conversation with David Facchini, Director of Radiology at Yale. From starting as a transporter to building a fully manual follow-up program before technology existed, David brings hard-earned lessons on creating—and sustaining—high-reliability care. Angela and Kandice explore the real cost of “just building it internally,” the hidden resource burden behind manual worklists, and why leaders must think long-term when choosing technology partners. This debrief offers candid insights for any radiology or quality leader navigating Epic-first pressures, limited FTEs, and rising expectations for follow-up care.

This Success in Chaos episode, The Front-Lines of Chaos, explores what it truly takes to lead in today’s healthcare system. Yale New Haven Hospital’s David Facchini, MBA joins Angela and Kandice to discuss culture change, incidental findings, and building trust in high-pressure environments.

From his journey as a transporter to becoming a system executive, David shares how authenticity, connection, and persistence can transform patient safety and follow-up reliability. Through real cases and real leadership lessons, this episode shows why solving care gaps requires more than technology—it requires people willing to lead from the front lines.

Episode Chapter Guide

04:02 Understanding Incidental Findings in Healthcare

10:11 Building a Quality Improvement Program

15:42 The Role of Culture in Healthcare Initiatives

20:43 David's Journey from Technologist to Executive

24:43 Inspiration and Leadership in Healthcare

David's Resource Recommendations

Not Impossible Labs

ACR Learning Network

RSNA marked a turning point for radiology AI.

For years, the exhibit hall was filled with impressive algorithms and flashy demos. This year, the focus shifted to something far more important: workflows, interoperability, and follow-up.

Radiology leaders are no longer asking, “Is this cool?” They are asking:
Can it integrate?
Can we measure outcomes?
What happens after a finding is detected?

As shared on After the Chaos, one of the biggest risks in today’s AI adoption is turning on detection without a plan for care. A worklist is not a follow-up. Without orchestration, AI can actually increase liability instead of improving outcomes.

Another major shift is the demand for proof over hype. Leaders want real clients, real workflows, and real results—not marketing promises.

The future of radiology AI isn’t about one-off algorithms or closed platforms. It’s about interoperable, end-to-end workflows that ensure patients actually receive the care their images identify.

At RSNA, the message was loud and clear: Interoperability is now the competitive advantage.

Episode chapter guide:

01:50 Insights from RSNA: Technology and Quality Improvement
04:41 Navigating Technology Selection in Radiology
08:39 The Evolution of AI in Radiology
12:23 Interoperability and Workflow Integration
17:59 Demand for Proof: Moving Beyond Hype
20:33 Care Orchestration and Follow-Up Challenges