The modern radiology department is built around the flow of information. Ordering providers request imaging studies to be performed, technologists complete the work required to perform the imaging studies, and radiologists interpret and report on the imaging findings. As each of these steps is performed, data flow between multiple information systems, most notably the radiology information system (RIS), the picture archiving and communication system (PACS) and the voice dictation system. Even though data flow relatively seamlessly, the majority of our systems and processes are inefficient. The purpose of this article is to describe the radiology value stream and describe how radiology informaticists in one department have worked to improve the efficiency of the value stream at each step. Through these examples, we identify and describe several themes that we believe have been crucial to our success.