However daunting the concept might appear, migration to image sharing via Web portal or the cloud is seemingly well worth the effort, given the disadvantages of other options, such as paper printouts, film, and CDs. David S. Mendelson, MD, is chief of clinical informatics and director of radiology information systems at the Mount Sinai Medical Center, New York, New York. He admits that although film and paper printouts can sometimes serve as stopgap or one-time vehicles for sharing isolated conventional radiographs or sets of summary images, they are not sufficiently robust to address all imaging needs on a continuous basis (or on a large scale).
The bulky nature of film and printed images makes them difficult to transport. Moreover, producing film is time consuming, and there is no adjustment for window width and level. The benefits offered by CDs—portability, compactness, the ability to store multiple images from multiple exams, and a low reproduction cost ($0.50 or less)—do not, for the most part, outweigh their disadvantages.
Mendelson says, “With CDs, be careful what you wish for, because you might get it. About 5% of the discs that we receive at the Mount Sinai Medical Center cannot be imported; similarly, the Mayo Clinic has reported a 0.6% unreadable-disc rate. There
is also the rare instance of receiving a different disc than the one that was expected.”
Moreover, Mendelson points out, there is no getting away from the fact that although they are more easily moved around than film is, discs still need physical transportation. The wait for courier services and patients to deliver them interferes with efficient image sharing, especially if a physician needs to seek an opinion from a specialist outside the originating institution. “All in all, image sharing via other means is a preferable approach,” Mendelson believes.