In the June 2022 issue of the Journal of the American College of Radiology (JACR), Bibb Allen, MD, former ACR Board Chair and practicing radiologist from Birmingham, AL, and Chicago-based pediatric radiologist Safwan S. Halabi, MD, have authored an informative commentary on the challenges to inter-institutional radiology image exchange and the persistent ongoing use of antiquated technologies like CD-ROMs and fax machines to transfer diagnostic radiology images. Their commentary responds to a comprehensive dissection of this persistent problem in an earlier JACR  issue which called on stakeholders to facilitate widespread vendor-to-vendor image exchange by no later than 2024.

Despite obvious technological advances in diagnostic imaging -- and the widespread consensus in the industry of the need to #ditchthedisc -- barriers to seamless diagnostic image exchange between healthcare institutions persist. In this notable commentary, the authors describe the significant impediments such as market dynamics, incentives, and other coordination problems that impede progress toward seamless electronic exchange of these healthcare records.

The authors note that the information blocking provisions of the 21st Century Cures Act do not currently mandate that radiologists or their facilities purchase new technologies or eliminate sharing of discs. But the information blocking rules do encourage providers, certified health IT developers, and the health information networks and exchanges to appropriately enable electronic health information sharing using current technological capabilities. Drs. Allen and Halabi believe the information blocking rules could help end reliance on the physical CD-ROM disc as the medium of image exchange, but that may require the Department of Health and Human Services to establish penalties for non-compliance and for HHS to engage in enforcement action. I agree with their assessment.

Much work needs to be done. The leading radiology specialty societies, notably ACR and the Radiological Society of North America (RSNA), state they will be required, "to play a central role in this process by working with Congress, federal regulators, organized medicine, healthcare IT standards groups, and the vendor community to continue to facilitate electronic image transfer."

In the meantime, they raise the issue as to whether there is a need for unique patient identifiers beyond name and birth date for faster electronic image transfer. Additionally, they believe that solutions must be found to give caregivers in physician office settings or other facilities that do not have access to long-term storage of their patients’ imaging data on PACS to gain prompt and seamless access to their patients’ imaging examinations. These are admirable goals. Are they achievable?

Count me in as one who is rooting for success in meeting the 2024 goal to #ditchthedisc!