Original Research
Health Policy and Practice
Evaluation of the Patient Request Process for Radiology Imaging in U.S. Hospitals
Carolyn T. Lye, Harlan M. Krumholz, Jillian E. Eckroate, Jodi G. Daniel, Dave deBronkart, Marilyn K. Mann, Allen L. Hsiao, Howard P. Forman
Author Affiliations
From the Section of Cardiovascular Medicine (H.M.K.) and Departments of Internal Medicine (A.L.H.), Emergency Medicine (A.L.H.), Pediatrics (A.L.H.), Radiology and Biomedical Imaging (H.P.F., C.T.L.), Yale School of Medicine, 333 Cedar St, New Haven, CT 06510; Yale School of Management, New Haven, Conn (H.P.F.); Department of Health Policy and Management, Yale School of Public Health, New Haven, Conn (H.M.K., H.P.F.); Yale College, New Haven, Conn (J.E.E.); Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Conn (H.M.K.); Yale New Haven Health System, New Haven, Conn (A.L.H.); Crowell & Moring LLP, Washington, DC (J.G.D.); Circulation: Cardiovascular Quality and Outcomes, Waltham, Mass (M.K.M.); Society for Participatory Medicine, Newburyport, Mass (D.D.); and e-Patient Dave, LLC, Nashua, NH (D.D.).
Address correspondence to H.P.F. (e-mail: howard.forman@yale.edu).
Published Online:Jun 11 2019https://doi.org/10.1148/radiol.2019190473
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Abstract
Patient access to radiologic imaging results is primarily limited to obtaining imaging studies on a compact disc, with less online availability of their imaging studies.

Background
In the United States, patients have the right to access their protected health information. However, to the knowledge of the authors, no study has evaluated the patient request process and the barriers to patient access of their radiology images.

Purpose
To assess U.S. hospital compliance with federal regulations and patient ease of access to imaging studies.

Materials and Methods
In this cross-sectional study conducted from June 6 to December 3, 2018, 80 U.S. hospitals were contacted by telephone to determine their patient request process for imaging studies. A scripted interview was used to simulate the patient experience in requesting imaging studies. Hospitals were compared in terms of formats of release (compact disc [CD] via pick up, CD via mail, e-mail, online patient portal, or other online access), departments from which cine files can be requested, fees, and processing times.

Results
All 80 hospitals stated that they could provide imaging studies on CDs. Only six (8%) hospitals provided imaging studies via e-mail and three (4%) via an online patient portal. Requests for cine files were fulfilled by a department separate from diagnostic radiology in 47 of 80 (59%) hospitals. Patient charges ranged from $0 to $75 for a single CD, no charge to $6 via e-mail, and no charge via an online patient portal. Fifty-nine (74%) hospitals stated that they could release copies within 24 hours, 10 (13%) within 2–5 days, eight (10%) within 5–10 days, and three (4%) within 10–30 days from request date. Imaging studies from outside of the diagnostic radiology department may need to be requested through the departments that performed the study.

Conclusion
This study demonstrated that although fees and processing times are compliant with federal regulations, patient access to imaging studies is limited primarily to compact disc format. The request process is also complicated for patients because of dispersion of imaging studies across departments.

© RSNA, 2019