Epic and some big health systems are pushing back against an HHS proposal to require health IT vendors to create hyperlinks to access medical images electronically.
Here is what some major players in the hospital IT business recently said in public comments both for and against the proposed ONC rule set to go into effect Jan. 1, 2028:
Epic: "It is atypical for healthcare providers to use their EHR system to store diagnostic images. Instead, they implement specialized picture archiving and communication systems (PACS) and vendor neutral archiving (VNA) systems. … PACS and VNA systems, not EHRs, would need to be able to generate a link to a medical image for a given patient."
Kaiser Permanente (Oakland, Calif.): "We are particularly concerned with security risks: use of unsecured URLs significantly increases the risk for unauthorized access to protected health information (PHI). We are also concerned with the lack of clear technical standards and requirements to support sharing images via imaging links between providers and between patients and providers."
Amazon: "The proposed certification requirements that would mandate access to an imaging link with electronic viewing or retrieval capabilities will increase patient and clinician access to this diagnostic information without the need to rely on CD-ROMs or other physical media. … This real-time, electronic access will also obviate the need for patients to shuttle between clinician offices to pick up and drop off their images, or redo these expensive procedures."
Providence (Renton, Wash.): "We remain concerned about how quickly some specialties, like radiology, will be able to implement these changes because they have not historically used hyperlinks to share large image files. We request that ONC convene subject matter experts in imaging specialties along with IT developers and EHR vendors to determine best practices for incorporating this into the existing workflow in a way that causes the least disruption for patients."
American College of Radiology: "This proposal is generally aligned with the ACR's longstanding goal — shared broadly by many radiologists, companies, and organizations in the radiology provider community — for medical images to be electronically exchanged without use of physical media (known on social media as the "#DitchTheDisk" campaign)."
Oracle Health: "The root of the problem is that most imaging data is not stored natively in EHR systems that would be the audience of these proposed requirements, but rather in third-party imaging vendor systems which, in most cases, do not support the modern technologies to facilitate these capabilities in a secure and effective manner."
Sutter Health (Sacramento, Calif.): "Directing users to external platforms via hyperlinks introduces the risk of unfamiliarity with third-party tools, which could hinder access to critical images. Additionally, storing images externally rather than integrating them within the patient's chart raises concerns about future accessibility to images integral to medical decision-making."