Despite healthcare's digital transformation, millions of patients still transport CT scans, MRIs and X-rays from provider to provider on CDs.
Medical images are often very large files that are stored in image archiving systems outside the electronic health record. The healthcare industry still lacks a unified, cross-network digital infrastructure for medical imaging.
To tackle this interoperability challenge, Epic released a new diagnostic image exchange solution that enables healthcare providers at Epic-connected health systems to retrieve and share diagnostic-quality medical images, such as CT scans, X-rays and MRIs, with a single click.
Released this month, the capability is now available across the Epic community. The company shared the news first with Fierce Healthcare ahead of its 2026 User Group Meeting, which will be held next week at its headquarters in Verona, Wisconsin.
Using open image exchange standards and its existing interoperability pipelines, Epic expanded its Care Everywhere platform to radiology images. The diagnostic image exchange tool reduces the need for manual image transfers and helps clinicians access prior scans more quickly, which can help prevent duplicate imaging and speed diagnosis and treatment, according to executives at the EHR company.
"The goal is that when a patient is coming in for a visit, that might be for a specialist consult, it might be for a second opinion, it might be follow-up on a cancer diagnosis, we need to make sure that the imaging studies done in the past are available to the provider for prep leading up to the visit, and then for use during the visit with the patient," Matt Doyle, Epic’s director of interoperability, told Fierce Healthcare in an exclusive interview about the new exchange solution.
"This is using the same workflows that we've created before where providers can really choose what they need to see. They can retrieve it in real-time to access as part of their care with the patient and really making sure that the provider is in the driver's seat to get that information, so that they can focus on what's most important, the patient sitting there in front of them who needs their medical judgment and expertise," Doyle said.
Care Everywhere, which has been in use since 2008, is Epic's health information network that facilitates the exchange of 30 million patient charts every day, half of those with other platforms, according to the company's website. The company hit a monthly milestone of 725 million records exchanged in June.
To date, organizations using Epic have been able to share written radiology reports and reference-quality images, which provide useful context with less detail than larger diagnostic-quality images that are more expensive to store. Until now, diagnostic image exchange has not used open standards, so sharing has been limited. Health systems typically rely on manual image retrieval with patients carrying their images on CDs from appointment to appointment.
"The challenge is figuring out how can we help providers access the images that they need, even if those images are at another hospital, at another organization. There's been several attempts at this over the years. Some standards have gradually emerged over time, but what we haven't seen is a large-scale approach that uses open standards to make sure that all vendors can plug into it. We haven't seen both of those come together: open standards and large scale so that it can go across vendors. That's what really excites me about this opportunity," Doyle said.
The overarching goal, Doyle said, is that this initiative could be a pathway for other vendors and providers to adopt open image-sharing standards, with Epic-connected hospitals as the "first movers."
"Patient care doesn't know boundaries by organizations. Patient care goes wherever patients go, so we want to find the solution that's the most inclusive and brings everyone in," Doyle said.
Epic is advocating for the Trusted Exchange Framework and Common Agreement (TEFCA), a federally-sponsored health data-sharing initiative, to use the same open image exchange standards, which would help scale it nationwide and enable any health system in the U.S. to share diagnostic images, Doyle said.
More broadly, Epic has made a sweeping push to migrate its provider customers to TEFCA. This latest announcement bolsters Epic's efforts to cast itself as a leader in healthcare interoperability. But it arrives amid heightened scrutiny of the company's own data-sharing practices, including accusations tied to its dispute with Particle Health over access to records exchanged through the Carequality network.
The effort also aligns with the Trump administration's "ditch the disk" initiative. The Centers for Medicare and Medicaid Services (CMS) recently launched a diagnostic imaging acceleration workgroup to focus on making imaging data seamlessly and electronically retrievable across organizations.
"From my perspective, it's excellent timing. For many years, folks have been trying to tackle this problem. I think this is the first opportunity where we're really seeing the technology ready to go. We're seeing the open standards ready to be adopted, and so it's wonderful timing to see our federal partners really looking at a convening role to say how do we bring more people into this vision and understanding that open standards will make data more fluid, will reduce patient burden and will help support staff and organizations to be more efficient," Doyle said.
Epic is seeking a seat at the table in that CMS workgroup, he noted.
Through Care Everywhere imaging exchange, providers can view patients' past imaging studies with access to radiology reports and reference-quality images. The clinician can use reference images to identify which diagnostic image they need and then retrieve that image with one click, according to Doyle. "We will use these open standards to start retrieving all of those images in the background and get them stored in the local PACS (Picture Archiving and Communication System). The idea is we're doing all the movement, all the data couriering, getting it to where a provider is used to it, so that then when a specialist opens it up, it's in their local PACS. It's using all the normal tools that they're accustomed to, and it just feels like any other imaging study that they look at," he noted.
The imaging exchange capability reduces friction for patients and streamlines workflows for providers, according to Dana Ostrow, senior director of imaging, MCIT clinical systems at NYU Langone Medical Center. Having faster access to diagnostic-quality images can potentially improve diagnosis and reduce duplicate scans.
Patients sometimes undergo a scan they’ve already had because their clinician doesn’t know it was done elsewhere—delaying treatment and adding unnecessary radiation exposure. Epic’s duplicate-order checks flag imaging already performed at another organization—a capability that has prevented more than 21,000 repeat scans a year, according to the company. The diagnostic image exchange lets clinicians retrieve those prior images directly.
NYU Langone Medical Center imports roughly 15,000 imaging studies a month, Ostrow noted. The data size of medical imaging studies can span from under 1 MB up to several gigabytes per study.
"The interesting part is not just that Epic is using the open standards to be able to pull the images out of the PACS and put it back into the PACS, but it's also the patient matching that really helps to remove some of that burden so that you know where those images are coming from as well as you don't need that extra step as it's coming in because the system is doing that interoperability for you," Ostrow said.