Image Exchange – With Anyone

The most common way of sharing patient data between stakeholders – be they healthcare systems, insurance providers, or the patients themselves – has historically been via physical media: first written notes, then faxes, and ultimately CDs. But these are awful from a security, efficiency, and usability perspective. As a result, my colleagues and I are moving to a digital image exchange portal (IEP), which allows us to share images quickly and securely. All National Health Service (NHS) hospitals in the UK have a proven, trusted, and ubiquitous IEP network connecting them, so enabling secure digital exchange and access for all stakeholders over this platform was the logical choice. For instance, Oxford University Hospitals NHS Trust, where I work, shares the care of its patients with other hospitals, so enabling patients to quickly access their scans and X-rays using the IEP with Anyone extension will allow other clinicians to plan better care for them.

When a patient places a request for their imaging, we require either two email addresses or one email and a mobile phone number. The patient details are added to the IEP forms and the required images are chosen from a list. The transaction is then created and an email is sent to the patient, inviting them to download their images. The second email or phone number will receive an authorization code, which helps us keep the system secure. It works very well, but it’s not entirely foolproof yet. We’re currently looking into why certain studies fail to transfer, causing us to rely on CDs to get them to the clinical teams. Two-part authentication has caused us a few problems – but then, the previous password system did too, and we value the extra security. The vast majority of transactions go smoothly, though.

In addition, the transaction is usually done overnight. That offers patients quick access to their imaging, which they can then forward to clinicians of their choosing within IEP with Anyone. Many of our patients are overseas students or visitors; we need to ensure that they have quick access to their studies in their home country, so they can continue any necessary treatment with a full diagnostic imaging history. (You can also use the system to send the reports, but the Trust has chosen not to do this at the present time.)

A couple of examples: I have provided images to armed forces personnel so that they can access them from wherever they might be stationed to ensure their treatment is continued. Studies have been provided to patients who have appointments at private clinics the day after their imaging has been conducted at our site.Patients searching for treatments and second opinions overseas can forward their studies in fewer than two days after they receive their IEP transacted images – something that could previously take two weeks by post.

There’s a good argument for doing away with physical media and instead making patients’ images accessible via secure web-based products. First, the vast majority of laptops and PCs no longer have CD drives. Second, the time needed to create CDs and print password letters, along with the cost of consumables used in their production, greatly outweighs the time and costs of IEP with Anyone transactions. Moreover, there are no lost or misdirected CDs or passwords – and, if we do have to issue a physical product, our software automatically creates CDs for Windows (although we still use a manual process for Mac CDs).We use physical media to transfer studies to hospitals that don’t yet have IEP technology – some private clinics, Ministry of Defense medical sites, and remote hospitals in locations like the Falkland Islands.

Because of occasional image transfer failures, it’s vital to make sure you have a backup mechanism (such as a CD) to deliver the studies – but, as more IEP transfers are completed and the system is refined and improved, the need for that secondary delivery mechanism will reduce to almost zero. Regardless of whether patients access their imaging via IEP transfer or CD, though, you must provide clear and robust documentation in plain language to help patients download their images. Although accessing images is no more difficult than most online processes, it is still fairly new to people as a method of obtaining parts of their medical record, so user questions do arise.

In my view, digital image access for both patients and healthcare providers is the way of the future. It greatly reduces the costs and timeframes associated with sending studies back and forth, enhances the security of the process, and ensures that nothing can be lost or misdirected. I hope to see many more healthcare systems using this type of technology in the near future.