As major lessons learned during the process of implementing iGuide within the country, clinical imaging guidelines has a potential for positively impacting the quality of medical care in Egypt and are critical tools to implementing evidence-based medicine. A well-structured strategic planning by local expertise can attain success for the CIG implementation and strongly improve health care systems. The presence of a policy-backed support by the government, volunteering expert Champions, reliable good quality guidelines and shared decision making are the key elements for successful implementation of CIGs. During this study, iGuide proved useful to reduce the inappropriate examinations in Egypt. Finally, electronic health records is considered the radical solution that ensures  the full integration of CIG at the point of care thereby ensuring competent and practical appropriateness where real practice can be measured and compared with the established standards and expectations.