December 27, 2019 — The Radiological Society of North America (RSNA) and Carequality have developed the Imaging Data Exchange Implementation Guide Supplement, expanding the scope of the Carequality Interoperability Framework to detail technical standards that enable the exchange of medical images. The publication is the result of RSNA’s partnership with Carequality and the Sequoia Project, two organizations dedicated to expanding online access to health records.
Currently, CDs and DVDs are the most common method of transmitting medical images. Patients frequently endure inconvenience, delay and expense in obtaining images and shuttling them among their care providers. A significant number of redundant imaging exams are performed each year, simply because prior images are not readily available. Network-based access to medical images addresses these quality, safety and efficiency issues in radiologic care.
A town hall event was held on Dec. 2, 2019, at RSNA’s annual meeting to announce publication of the supplement. David S. Mendelson, M.D., FACR, senior associate in clinical informatics and vice chair of radiology IT at the Mount Sinai Health System, and Curtis P. Langlotz, M.D., Ph.D., professor of radiology and biomedical informatics research at Stanford University Medical Center and RSNA board laison for information technology and annual meeting, spoke about RSNA’s longstanding efforts to develop and implement standards to enable secure and convenient network-based access to medical images.
Also at the event, Donald Rucker, M.D., the National Coordinator of Health Information Technology, spoke about the high value his agency places on enabling patient access to their complete medical record, including, critically, their imaging records, and Geraldine B. McGinty, M.D., M.B.A., FACR, chair of the American College of Radiology Board of Chancellors discussed the ACR’s shared commitment to this goal, championed through the #DitchtheDisk campaign.
The event also recognized Ambra Health, Life Image and Philips Healthcare for committing to be early adopters of the Carequality Imaging Data Exchange Implementation program. RSNA and Carequality welcome other imaging vendors to join them in the program.
“We are truly entering the era of safe, secure and expeditious exchange of imaging information, making it easily accessible for the patient’s benefit, when the patient most needs it,” Mendelson said. “We encourage other networks that support imaging to join and extend the availability of patient imaging exams.”
Carequality and Sequoia Project are closely allied, distinct nonprofit organizations supporting the advancement of health information exchange nationwide with complimentary strategies. The Carequality Interoperability Framework provides governance and technical specifications to enable the linking of health information exchange networks in the United States, regardless of geography or technology. More than 600,000 physicians exchange more than 80 million patient documents each month under the framework, which is now expanding with the adoption of the Implementation Guide supplement by imaging vendors.
“We look forward to working with the three pioneering imaging vendors and salute their commitment to empowering their customers to exchange imaging studies electronically via the Carequality Interoperability Framework,” said Dave Cassel, executive director of Carequality.
The Sequoia Project previously partnered with RSNA to administer the Image Share Validation testing program, which tests vendor compliance with the same standards used in the Implementation Guide. The standards on which the program is based were developed under Integrating the Healthcare Enterprise (IHE), an organization RSNA helped found in 1997. These standards were refined through their implementation in the RSNA Image Share Network, a pilot project funded by the National Institute for Biomedical Imaging and Bioengineering to demonstrate the feasibility of creating a nationwide network for image sharing.
Carequality is a national-level, consensus-built, common interoperability framework to enable exchange between and among health data sharing networks. Carequality brings together diverse groups, including electronic health record (EHR) vendors, record locator service (RLS) providers and other types of existing networks from the private sector and government.
April 14, 2025 
