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.