One Cloud, One Queue: Central Radiology Reporting with CloudX and Nexus AI CXR

Imaging capacity has outrun reporting capacity. A mobile unit can take a thousand chest X-rays in a week. A clinic can scan every patient who walks through the door. If there is no radiologist within reach, those images wait, and so does the patient.

Imaging is captured where there is no radiologist. Reporting capacity sits where there are no patients. CloudX is the queue in between.

What CloudX is

CloudX is a Central Radiology Reporting Solution: a centralised, cloud-based radiology workflow and reporting platform for low-resource settings and high-volume national screening programmes. Healthcare Framework (HCF) and Nexus Intelligence deliver it as part of an end-to-end ecosystem for lung health screening, clinical data management and radiological interpretation.

A study taken anywhere is uploaded to one central queue. A qualified radiologist anywhere else, in the next town, the next country or on another continent, opens it, reads it and reports it inside the platform. The structured report returns to the point of care.

Three ways a study gets read

The path is chosen per programme, per facility or per case, and changed without moving to another system.

• → AI only. A first-pass read with no radiologist in the loop. The highest-throughput option for population screening.
• → Radiologist only. Centralised teleradiology reporting, with structured templates and an embedded DICOM viewer.
• → AI + radiologist (hybrid). AI reads first and triages, then the radiologist confirms. Abnormal studies surface, normal studies clear.

Where an AI read is used, the chest X-ray module is Nexus AI CXR 1.0, CE MDR Class IIb certified, developed with Google and independently validated by the Stop TB Partnership in The Lancet Digital Health. Its outputs, meaning classification, score, isolines and heat maps, are returned into the CloudX case itself.

Fully in the cloud, from one facility to a continent

CloudX is a cloud-hosted reporting layer. Nothing is installed at the reading end, and studies and reports move as data, which takes printing, disc burning and couriers out of the programme cost.

• → One central worklist with automated triage: urgent and high-need studies are surfaced ahead of routine work, so the queue orders itself
• → Works offline: where connectivity drops, studies are held on site and uploaded to the cloud once the link returns
• → HL7, FHIR, DICOM and JPEG natively supported, so CloudX joins an existing estate rather than replacing it
• → Data protection by design: aligned with POPIA, GDPR and HIPAA principles, with role-based access, full audit trails, optional de-identification and hosting in the programme's own data region

Routing rules, reporting templates and turnaround SLAs are configured per country, facility and programme. It is the same platform at a screening day in Mafefe as in a national screening programme. What changes is the rule set.

In the field

At Mafefe in Limpopo, ultra-portable digital X-ray systems brought chest imaging into the community. Those studies flow into the screening workflow, where Nexus AI CXR supports analysis and triage, and in partnership with MBOD and Wits University, studies are routed through CloudX for reporting by specialist radiologists.

CloudX is not limited to chest X-rays or to TB screening. The same queue handles general radiography, including extremities, spine and abdomen, with AI-only, radiologist-only or combined reporting, second reads and quality assurance.

Nexus AI CXR is a decision-support tool. It supports, and does not replace, clinical interpretation and diagnosis. Final responsibility remains with the reporting radiologist. CloudX is the platform Nexus AI CXR runs inside. CloudX is not itself a medical device.