Radiology leaders call on imaging community to create blueprint for digital image exchange by 2024

Medical images are still primarily exchanged between institutions via compact discs (CDs) or other physical media. But a group of radiology leaders says the time has come for change, calling on industry stakeholders to establish a framework for electronic image transfer by 2024.

With technology now enabling seamless data transfer, it has become “unacceptable” to force patients and their families to hand-deliver images, experts charged Monday in JACR. This antiquated practice is unreliable, burdensome, inconvenient and often delays care.

“The ability to electronically exchange images holds promise to prevent possible unnecessary duplication of examinations, decrease administrative costs, potentially decrease unnecessary radiation exposure, and provide comparison examinations for additional context,” David B. Larson, MD, MBA, a radiologist at Stanford and member of the American College of Radiology Board of Chancellors, and co-authors added.

The researchers described seven network configurations that could facilitate image exchange, ultimately pointing to a hybrid "linked multi-hub model" as the most promising.

Under this approach, images are exchanged between institutions via one or two centralized hubs. These likely for-profit companies develop and enforce communication and formatting standards and compete with one another to serve customers (entities sending and receiving images). This prohibits a single entity from monopolizing images and encourages healthcare orgs to connect to a hub that is linked to other hubs, since that would link them to the entire network.

This will not be an easy task, the authors noted. Companies managing image exchange for healthcare systems must immediately commit to sharing images with one another, the authors said. Medical societies, payers, regulators and providers must also increase the proportion of images being exchanged electronically.

Technical infrastructure, including protocols, contracts and other logistics are needed by 2024, Larson et al. underscored. Images shared via digital transfer or physical exchange must also be recorded and publicly reported to track progress.

“Since exhortations to achieve interoperability as soon as possible have been met with limited success, we offer 2024 as a target for achieving this goal,” the authors added. “If vendors have not reached this key milestone by this time, changes will likely need to be enforced through regulation.”

Read much more from the authors, including challenges, additional proposals and solutions, in the Journal of the American College of Radiology.


Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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