Banner Imaging Replaces Dropbox, Egnyte, and ShareFile With Files.com, Where Deletion Is Proof of Delivery

Banner Health is one of the nation's largest nonprofit health systems, with 33 hospitals and more than 400 outpatient locations across six states. It is Arizona's largest healthcare provider and the state's largest private employer. Banner Imaging is its outpatient diagnostic radiology division, launched in 2019 with 23 imaging centers offering CT, MRI, PET/CT, mammography, ultrasound, and X-ray.

An imaging study is not finished when the radiologist signs the report. It is finished when the physician who ordered it has the result in hand. Many of those physicians work at independent practices outside Banner's network, on electronic medical record systems Banner does not run. Banner Imaging performs the scan, and the follow-up care happens somewhere Banner cannot see. The gap between "we sent it" and "they have it" is where this story lives. Banner Imaging closed that gap with a Files.com clearinghouse built around a simple convention: pickup ended in deletion, and deletion became the receipt.

Dozens of Practices, Five EMR Platforms, No Common Path

The practices receiving Banner Imaging's results run five different EMR platforms among them, and each platform ingests files its own way. Building a direct integration into every practice's records system was never realistic: Banner controls neither the software on the other end nor the vendor roadmap behind it. The exchange had to work for dozens of independent recipients through one common mechanism.

The cost of getting it wrong is not measured in IT hours. A result that a practice never retrieves is a patient whose follow-up care may not happen.

“If there is a folder with files in it - beyond about a day or so - that's a concern for us as it could mean a risk in terms of follow up patient care.”

The tools carrying the work were a patchwork of file sync and share products: Dropbox, Egnyte, and ShareFile. Those are built for people sharing documents, not for machines exchanging clinical results with counterparties who each need to be walled off from one another. Spread across three separate products, the exchange had no single answer to the only question that mattered: has this practice actually collected this result?

What Banner Imaging needed was one exchange that every practice could reach with the tools its EMR vendor already had, with each recipient isolated from every other, transfers that machines could run unattended, and a verifiable record that each result had been picked up. Banner Imaging selected Files.com to be that exchange, and retired Dropbox, Egnyte, and ShareFile from the workflow.

One SFTP Gateway, One Folder per Practice

Files.com became a clearinghouse: a single point where Banner Imaging drops results and every external recipient collects them. Each independent practice, or the EMR vendor that manages its records, was provisioned with a single SFTP login scoped to a results folder of its own. That login sees nothing else on the site. SFTP is the reason the pattern works across five different EMR ecosystems: every vendor already speaks it, so nobody on the receiving end installs anything or changes how they work.

The exchange runs on machines, not people. Banner also scripted repeatable administrative work against the Files.com REST API using PowerShell; system accounts have outnumbered human accounts on the site from early in the relationship.

Deletion Is the Receipt

The clearinghouse runs on a convention that turns the absence of a file into evidence. A practice collects its results and then deletes them, and the deletion is the acknowledgement of receipt.

“Vendors and others will pick up files and delete them - the deletion is how we know they got them.”

The same convention makes the failure case visible. A folder still holding files past the one-day threshold means a result nobody has retrieved, and that is a signal to act on, not a curiosity. Confirming pickup began as manual work: staff traversed the entire folder structure by hand to see which folders still held files. Files.com's folder auditing and history reporting replaced that walk. Staff can review the report to identify folders that still hold files beyond the threshold, then follow up on the outstanding result. The site's full access history exports to CSV, and Banner has pulled download reports for audit covering years of activity.

An Unretrieved Result Now Surfaces Instead of Being Hunted

With the clearinghouse in production, Banner Imaging replaced three sharing tools and hand verification with one auditable exchange.

• Five external EMR platforms are served through one gateway and one repeatable pattern. Onboarding the next practice is a folder and an SFTP credential, not an integration project.
• Delivery verification is a report, not a walk through the folder tree. Staff can use it to find results that remain after about a day and follow up with the recipient.
• Dropbox, Egnyte, and ShareFile are gone from the workflow. The exchange runs on one platform with one audit trail.
• The pattern spread beyond radiology: Banner Facility Operations stood up its own Files.com site to exchange design and construction documents with outside vendors and project managers.

Proof of Delivery Without a Single EMR Integration

Banner Imaging never integrated with any practice's records system. It made the exchange simple enough for every counterparty to run with what it already had: a folder, a credential, and a convention, with the Files.com audit trail carrying the burden of proof. Today, the question that once required staff to walk an entire folder structure is answered by the folder itself. If it is empty, the practice has the result. If it is not, the report shows Banner which result remains outstanding so staff can follow up before the delay puts patient care at risk. Delivering clinical results verifiably to organizations you don't control turned out not to require reaching into their systems at all.