In this AXIS Imaging News exclusive, Matthew A. Michela, president and CEO of Life Image, discusses the current state of imaging interoperability and how COVID and the U.S. Department of Health and Human Services’ Office of the National Coordinator for Health Information Technology (ONC) rules are shining a spotlight on issues with image exchange.

AXIS Imaging News: What is the current state of imaging data interoperability? And how are the ONC info-blocking rules impacting this?

Matthew Michela: Diagnostic images remain stubbornly difficult to access and there is still strong dependence on outdated approaches for sharing, such as CDs, fax machines, and mail. For decades, accessible healthcare data has been limited to claims data and, more recently, small parts of electronic health records, but this information has limited clinical value. The ONC info-blocking rules are reversing ingrained institutional and cultural practices that keep data siloed and outdated technology commonplace.

Matthew Michela

Adoption of technology that uses common industry standards and [application programming interfaces] to improve access to health information for patients and their care teams is now required. To ensure change, the rules are backed by stiff penalties for data-blocking practices and against those that attempt to slow-walk or resist change. This will create a more tech-forward industry and evolve data access to a point similar to most other industries. Like banking or ride-sharing, patients will soon be able to open an app and, with a few buttons, have the information they need.

AXIS: Why is there still reliance on CDs to share images between providers and patients?

Healthcare is decades behind other industries when it comes to frictionless data interoperability. CDs and fax machines are still used as the primary format for sharing patient information because more consideration is often placed on maintaining a historical workflow than the long-term benefits of shifting to a digital solution. According to a recent Life Image study, approximately 40% of patients receive their requested images on CD.

Lack of efficient, interoperable image exchange creates widespread challenges. For patients, it means they have to manually track down records, drive around, and courier physical copies. This results in delays in care or repeat imaging and appointments if the information is not available or a CD is unreadable. And these delays and additional testing drive up costs for both patients and health systems.

AXIS: What are the operational and financial implications of non-digital image exchange practices?

Michela: Lack of interoperability is driven by a host of misaligned financial incentives, in addition to business and cultural resistance to change and an overabundance of different standards and incompatible proprietary technologies. Non-interoperability results in suboptimal care and added costs for both patients and healthcare facilities. Along with ONC rules accelerating interoperability, patients are frustrated by the barriers and burdens they face trying to manage their health data offline—and, as a result, are putting pressure on the industry to remove technology barriers.

They are tech-savvy and expect the technology to access their health data to match that of other industries. The pandemic intensified the consequences of non-interoperability and why the ONC rules were needed long ago. Now, more than ever, it is imperative that healthcare workers have as much relevant clinical data in advance as possible to reduce unnecessary contact and make appropriate care decisions. Digital access to clinical data and imaging at scale has been fast-tracked to improve care coordination and infection control.

AXIS: What are some compliant alternatives to exchanging images via CDs?

Michela: Interoperable technology to access and share medical imaging has existed for nearly 15 years. It is widely adopted as a core solution for large institutions, but it is not always adopted universally or at the enterprise level. This is changing, however, as a combination of increasing interoperability and new evaluations of the true costs of CDs is better understood.

Additionally, the lag in creating digital connections, adopting APIs to exchange with patients within community hospitals and becoming interoperable with small facilities has a negative impact on patients and their care coordination just as consumers are becoming more involved in the healthcare decision-making. Healthcare facilities should be acting with urgency to find trusted vendors with proven interoperable solutions to accelerate seamless data exchange in response to market demands and federal rules.

Cloud adoption is another technology gaining interest to support the availability and scalability of data. With the cloud, providers have access to valuable patient data from numerous sources to enable better care coordination and treatment decisions. The value of this standardized data at the point of care is tremendous but also spurs innovation with access to more diverse sets of data for research teams to advance the understanding of diseases and treatments and AI developers to validate algorithms