Before the protocols could be turned over to GE, UW Radiology had to become ISO compliant (an industry standard for quality). It is not typical for an academic institution to go through this high degree of quality evaluation, but since this is a product intended for public clinical use, it was deemed necessary. An ISO specialist joined the UW team to generate formal documentation of the protocol management and optimization framework that developed organically from our early days of CT. This quality management program meets and or exceeds the AAPM Medical Physics Practice Guidelines which were recently published for CT protocol management. To ensure that patient exams are accepted internally at the UW Madison, a robust quality assurance (QA) procedure had to be put in place. Every exam read by UW radiologists from CT scanners participating in the GE protocol project is subject to this QA procedure to ensure image quality. The radiologists leave feedback in the form of “good” or “bad” responses and if bad, provide details as to why the image was not adequate for their needs. To date, over 100,000 unique image quality reviews have been received. Drs. Timothy Szczykutowicz, Ph.D. and Robert Bour, M.D. are spearheading the compilation and analysis of the QA data. We routinely analyze the performance of our protocols across each of our scanners, for each of our patient size categories. This QA data lets us take an aggregate view of our protocol performance, and often spurs changes or consultations between the physicists and clinical staff. That would be difficult to accomplish without an automatic QA system as our protocol set contains hundreds of protocols, each tuned to a specific model of CT scanner.