Provider Resources

Imaging Records Have a Portability Problem. Here’s Why

PocketHealth imaging records and chest X-ray scan on desktop

Three key factors offer insight into why medical imaging records struggle to achieve portability and what can be done to get there.

In 1996, when less than 10% of U.S. adults had internet access, Congress recognized the growth potential in electronic health records (EHRs) and set out to standardize their usage through the passage of the Health Insurance Portability and Accountability Act (HIPAA). With three sets of provisions, the Act stipulates a broad spectrum of regulations related to health information and insurance. The first set – the portability provisions, originally referred only to the portability of health insurance coverage, but today, it also applies to secure portability – or the flow – of health information across the health ecosystem.

Recently, the Journal of Digital Imaging published an Op-ed titled “The “P” in HIPAA Stands for Portability”. Since HIPAA governs the security of personal health information (PHI), it’s natural to think the “P” stood for privacy, but portability is crucial to how we store and access our data. 

In the article, the journal’s Editor In Chief, David Avrin discusses how medical imaging is an area of EHRs that remains slow to adopt when it comes to making records portable and accessible. With radiology clinics across North America continuing to burn thousands of CDs everyday, patients and providers are left wondering why the industry has been so slow to adopt. 

It’s difficult to identify one main  reason for the use of CDs. There are a number of factors keeping imaging records from digitally advancing and each one presents an obstacle for patients, providers and the healthcare system as a whole. These are some of the major barriers:

Security and privacy concerns 

The healthcare industry has always prioritized privacy – HIPAA mandates it. But these concerns often come at the expense of portability and quality of care. Since the rise of PACS in the 1980s and 1990s, imaging has become a potential target for cyber attacks and breaches. Unfortunately, hacks are on the rise with healthcare going increasingly digital with virtual medicine, connected devices and artificial intelligence incorporated into medical practices across North America.

There’s more frequent news coverage of phishing scams and ransomware attacks, so hospitals understandably take extra precautions to protect any and all PHI (personal health information). 

As a consequence, however, patients and physicians deal with headaches when it comes to sharing access to imaging between providers in different networks. Hospitals either close their platforms, making it difficult for outside providers to access and view patient imaging, or they stick to using CDs, resulting in patients physically trafficking their own records across town and sometimes across states. As well, computer manufacturers have phased out CD drives, which makes it almost impossible for patients to view their own imaging at home. The solution is complex, but there are opportunities for clinics to implement encrypted, HIPAA-compliant platforms with robust security systems.

No universal patient identifiers (UPI) in the U.S. 

Patient matching has been a topic of discussion for decades, and in 2020 Congress voted to repeal a ban on funding a National Patient Index (NPI). But meanwhile, providers face barriers of limited interoperability and data governance. 

Patient matching aims to connect patient records across different medical providers or facilities, so one patient visiting two different doctors or two different hospitals should always have the correct medical records brought up. It would also link imaging studies to patients and provide both a means of identification and authentication. However, this does not always happen, and a mistake can be both lethal to the patient and carry a heavy financial burden for the health system.

Data collected by Patient ID Now – an advocacy group dedicated to advancing an NPI matching strategy, revealed that after a routine mammogram, a woman didn’t receive her results. She assumed that no news was good news, but then months later she mentioned the mammogram to her doctor during her annual physical. The conversation led to the discovery that her results had been misfiled in the chart of a deceased patient who shared her name. The mammogram showed cancer which, due to the one-year delay in diagnosis, had become terminal. NPIs not only facilitate better info transparency, they also create guardrails to ensure data-matching based on more than just name.

A lack of commercial incentive to share patient records 

Hospital networks and clinics compete for patients. Once they successfully treat those patients, they’re left with patient records. For healthcare stakeholders, these are assets to be protected. 

For example, a patient fractures his ribs, and sees his primary care physician affiliated with a large Baltimore-area hospital. He gets a referral to an orthopedic surgeon within that network. The provider benefits from the referral by maintaining the patient’s loyalty and the patient is guaranteed continuity of care.

But Baltimore patients have choice when it comes to providers. He may decide to see a specialist at Johns Hopkins, University of Maryland or in the MedStar Health network. Retrieving his imaging records from his PCP is possible, but a long process. The frustrated patient experiences delays in care and is dissatisfied with the provider, resulting in a poor quality of care.

Patients will and often do, go outside their primary healthcare network.  And with the ONC’s Cures Act Final Rule, which bans info blocking in the healthcare industry, there’s more incentive than ever to make patient records accessible and reduce administrative hurdles.

How does PocketHealth achieve portability?

In this new post-COVID phase of healthcare, the way we store and share health information looks different than three years prior. PocketHealth is leading the movement to advance medical imaging and make patient records portable. As the world’s first patient-centric image sharing platform that completely eliminates CDs from hospital workflows, PocketHealth gives both patients and providers a simple way to store and share imaging along with peace of mind. 

With bank-level encryption, the platform enables patients to securely access and share their imaging with any provider in any network, from anywhere. It’s network agnostic, so patients and administrators avoid facing headaches when transferring records to outside providers.

While it may be frustrating to wait for the medical imaging field to catch up technologically, there are strong signs of advancement. A combination of regulations and patient demands are driving the need for more portable and digital solutions for storing and sharing medical imaging. With PocketHealth, providers can stay compliant while giving patients a quality care experience, generating greater patient satisfaction and loyalty to their chosen provider.  The future is bright –  with zero CDs, zero gatekeeping and more portability for all. 


To learn more about improving the portability of imaging records, contact PocketHealth to request a demo.

Access My Records