A Radiologist’s Perspective on Medical Image Storage

Not so long ago my brother-in-law banged his toe while he was vacationing in the Caribbean. When he came back home, the pain continued so he had an X-ray and subsequently an MRI.

He called me to look at the studies for him and asked if he could email me the images. I told him that it wouldn’t be that easy since radiology/medical images are not similar to photos that we take with a camera. After a long conversation trying to educate him on the differences between DICOM images and JPEG/TIFF images, we decided the best method would be to send me the CD in the mail. After a few days, I received the images and was able to view the X-ray and MRI.

This type of situation has happened to me time and time again. Why is it that we can view and share vacation albums, movie clips, PowerPoint documents, and credit card statements easily within seconds, but when it comes to sharing radiology images we have more obstacles?

This scenario comes up a lot during my work day, most often while reading women’s imaging studies such as screening mammograms. Not uncommonly, a patient comes in for a screening mammogram and forgets to bring in her prior studies from a different facility, either in the same neighborhood or from a different state.

Since I was faced with this problem both on a personal and professional level, I decided to create a web-based personal radiology storage service. In 2011, I began working on a site called KeepMyXray.com where users/patients can store their images online and even view and share them as long as they have internet access.

This way, patients do not have to rely on institutions to keep their medical images. In the recent wave of radiology centers going under due to the imaging cuts, many radiology records are being sent to a separate company for image storage. A few of my patients actually were told that they had to pay $25 per study to obtain a prior mammogram. Many of my patients decided not to get their prior images due to economic hardship.

KeepMyXray.com allows users to upload their radiology studies into the cloud in their own secure, private account. As of now the patient needs to have a CD of the images to upload the images. Eventually we are planning on connecting with health care providers to have the data sent directly to the patients’ accounts.

We recently launched the site at the beginning of this year and have had a favorable response. Since my extended family is spread out across the country, I had them create accounts to make it easier to keep track of their medical images and reports and make it easier to send the studies to me if necessary.

With the recent buzz around cloud computing including the recent article in the January 2013 ACR Bulletin “Taking Imaging to the Cloud” many associations including RSNA are trying to address the issue of a uniform platform where all the medical images can easily flow between different providers.

The problem is that there are too many companies competing for the market share and each one brings their own proprietary software which does not communicate with the other vendors. It’s like imaging having multiple DVD formats where you would need multiple DVD players to view your DVD collection. This is the case in medicine where the ability to evaluate data depends on what EMR you are using.

I think the field of medicine needs to come up with a universal standard for storing and accessing all radiology imaging and eventually all medical data. Until then, we needed a free, convenient, and secure way for patients to take control of their health. Patients are their best advocates and in today’s environment where patients are better educated about their health, why not allow them to keep track of their health information in a secure manner?