TY - JOUR
T1 - Moving Toward Seamless Interinstitutional Electronic Image Transfer
AU - Larson, David B.
AU - Krishnaraj, Arun
AU - Mendelson, David S.
AU - Langlotz, Curtis P.
AU - Wald, Christoph
N1 - Publisher Copyright:
© 2022 American College of Radiology
PY - 2022/3
Y1 - 2022/3
N2 - The fact that medical images are still predominately exchanged between institutions via physical media is unacceptable in the era of value-driven health care. Although better solutions are technically possible, problems of coordination and market dynamics may be inhibiting progress more than technical factors. We provide a macrosystem analysis of the problem of interinstitutional medical image exchange and propose a strategy for nudging the market toward a patient-friendly solution. The system can be viewed as a network, with autonomous nodes interconnected by links through which information is exchanged. A variety of potential network configurations include those that depend on individual carriers, peer-to-peer links, one or multiple hubs, or a hybrid of models. We find the linked multihub model, in which individual institutions are connected to other institutions via image exchange companies, to be the configuration most likely to create a patient-friendly electronic image exchange system. To achieve this configuration, image exchange companies, which operate in a competitive marketplace, must exchange images with each other. We call on these vendors to immediately commit to coordinating in this manner. We call on all other stakeholders, including local care provider institutions, medical societies, payers, and regulators, to actively encourage and facilitate this behavior. Specifically, we call on institutions to create appropriate market incentives by only contracting with image exchange vendors who are committed to begin vendor-to-vendor image exchange by no later than 2024.
AB - The fact that medical images are still predominately exchanged between institutions via physical media is unacceptable in the era of value-driven health care. Although better solutions are technically possible, problems of coordination and market dynamics may be inhibiting progress more than technical factors. We provide a macrosystem analysis of the problem of interinstitutional medical image exchange and propose a strategy for nudging the market toward a patient-friendly solution. The system can be viewed as a network, with autonomous nodes interconnected by links through which information is exchanged. A variety of potential network configurations include those that depend on individual carriers, peer-to-peer links, one or multiple hubs, or a hybrid of models. We find the linked multihub model, in which individual institutions are connected to other institutions via image exchange companies, to be the configuration most likely to create a patient-friendly electronic image exchange system. To achieve this configuration, image exchange companies, which operate in a competitive marketplace, must exchange images with each other. We call on these vendors to immediately commit to coordinating in this manner. We call on all other stakeholders, including local care provider institutions, medical societies, payers, and regulators, to actively encourage and facilitate this behavior. Specifically, we call on institutions to create appropriate market incentives by only contracting with image exchange vendors who are committed to begin vendor-to-vendor image exchange by no later than 2024.
KW - Health policy and practice
KW - image exchange
KW - informatics
KW - patient-centered care
UR - http://www.scopus.com/inward/record.url?scp=85124256572&partnerID=8YFLogxK
U2 - 10.1016/j.jacr.2021.11.017
DO - 10.1016/j.jacr.2021.11.017
M3 - Article
C2 - 35114138
AN - SCOPUS:85124256572
SN - 1558-349X
VL - 19
SP - 460
EP - 468
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
IS - 3
ER -