From MRIs to X-rays to bone scans, there’s probably no part of our medical record more critical than the diagnostic images of the body. Yet as those hard-copy images multiply, neither we nor medical personnel can keep track of them all. X-ray and other films are routinely lost or misfiled. And tons of them are purged each year by cost-conscious hospitals and labs. State laws vary, but mandated archival periods for adult tests generally range from five to seven years, after which films can be discarded, often without prior patient notification. (Kids’ tests are stored longer.) The loss of patient films can prove troublesome, especially for crucial images like old mammograms. “Subtle change over time may mean something, so you need the archival record,” says Dr. Bruce McClennan, head of diagnostic radiology at Yale-New Haven Hospital.
To help ease the image-banking glut, bigger hospitals and health systems in recent years have gone digital, using technology known as PACS (Picture Archiving and Communication System), and more recently using the Web for easy distribution of images to both other doctors and patients themselves. The payoff has been significant. Managing diagnostic images digitally is not only more cost-effective for hospitals, but more reliable. And for patients with a PC, the Web makes access easy.
Here’s how the system works at imaging centers and hospitals that use a Web-based service offered by RadVault, a California start-up. Once an X-ray, CT scan or MRI has been taken, a digital image of the test is delivered to a database at the imaging facility. Here, it’s converted to a special computer language and encrypted (to comply with new federal privacy rules). The image is then sent over the Web to RadVault’s data center, where it can be transmitted to others. Company-provided software enables end users to decrypt and store the image on a PC. For patients who want a record of their test at the time it’s conducted, images can also be burned onto a CD or other portable storage medium–for under $25. Smaller businesses offering services similar to RadVault’s include NovaRad, InSiteOne and Radiology.com.
In addition to preserving one’s medical records, the big plus for patients is facilitating second opinions. You can simply print out your images before visiting a doctor, or ask the imaging center to transmit them online directly. A personal image bank can also help if you’re changing doctors.
There are some potential problems, of course. If you don’t have a broadband Internet connection (such as cable or DSL), don’t count on instant imaging. Pictures travel slowly along telephone lines. And, like any Web-based service, digital-image banking is subject to computer crashes and transmission brownouts. In the worst-case scenario, data might be lost. Or the “lifetime storage” promises that many companies make may be impossible to keep. No problem if the company survives your lifetime, but start-ups are not renowned for their longevity. To soothe such fears, some companies are buying continuation-of-business insurance, which guarantees their service will survive even if they don’t.
If you’re scheduled for imaging tests, here’s some advice: look for a hospital or facility that manages test images digitally. Either one should also be ready to give your own digital record of a test, whether over the Web or on a CD. The digital-imaging solution isn’t technologically foolproof. But it could increase the chances your critical photos will last as long as you do.
