CHICAGO – Patients at three major medical institutions can control the sharing of their medical images and reports with their doctors and medical providers, which potentially reduces unnecessary exams, minimizes patient radiation exposure and makes for better informed medical decisions, according to the leaders of RSNA Image Share Network, who demonstrated the project Monday at the annual meeting of the Radiological Society of North America (RSNA).

"The RSNA Image Share network can improve quality, safety and efficiency while engaging patients and families in their own care," said the project's principal investigator, David S. Mendelson, MD,  chief of clinical informatics at The Mount Sinai Medical Center in New York City and a member of the RSNA Radiology Informatics Committee. "Our patients have begun successfully using the network to access and distribute their medical images."

The project was launched in 2009 through a $4.7 million contract with the National Institute of Biomedical Imaging and Bioengineering (NIBIB) to build a secure, patient-centric medical image-sharing network based on common open-standards architecture that would enable patients to control access to their information through personal health records (PHR) without relying on CDs.

"A patient's access to his or her personal medical information is critical for more patient-centric healthcare where each patient is an active participant and partner in medical decision making and in realizing high value care," said Roderic Pettigrew, MD, director of the NIBIB.  "The RSNA Image Share network provides patients with direct access to and greater control of their medical images, allowing them to electronically share important diagnostic information with their entire healthcare team. The NIBIB is delighted to help the healthcare enterprise take this technological leap forward, providing patients with more control, improved continuity of care, greater safety and cost savings by eliminating redundant tests."
 
RSNA is overseeing development of the Internet-based network for sharing images and reports at five pilot institutions. Mount Sinai was the first to begin accepting patients. The University of California – San Francisco and University of Maryland Medical Center in Baltimore have also enrolled patients. Mayo Clinic in Rochester, Minn., and the University of Chicago Medical Center will enroll patients soon.

Participating sites also educate patients on establishing PHR accounts with selected providers that will enable patients to retrieve, view, archive and share medical images, reports and other medical documents, creating a detailed medical history accessible through any secure Internet connection.
To ensure patient privacy, the project is modeled on the type of security systems used by banks. Patients are given an eight-digit code and then create a password or PIN known only to them.

After signing into the network, patients follow a series of steps that tell a component of the system, called the Edge Server, to retrieve their reports and images. From a "jacket" of imaging records, patients can select those they would like to share with their healthcare team.
"By default, there is a 72-hour delay built into the process to ensure that the patient's physician sees new imaging results before the patient does, enabling the doctor to be prepared to have a discussion with the patient," Mendelson said.

In coming years, project investigators will work on developing direct transfer of images for immediate accessibility – necessary, for example, if a patient is flown into a trauma center from another facility.

RSNA Image Share is based upon the XDS.I.b profile of Integrating the Healthcare Enterprise (IHE), an initiative among medical leaders, software developers, medical societies and vendors to improve communication among healthcare equipment, systems and software. The goal is to move closer to a universal electronic health record and help physicians meet federal meaningful use requirements in practice.