This white paper explores the considerations of standards-based interoperability of medical images between organizations, patients, and providers. In this paper, we will look at three different standards-based image exchange implementations that have been deployed to facilitate exchange of images between provider organizations. The paper will describe how each implementation uses applicable technology and standards; the image types that are included; and the governance policies that define participation, access, and trust. Limitations of the solution or non-standard approaches to solve challenges will also be identified. Much can be learned from successes elsewhere, and those learnings will point to recommendations of best practices to facilitate the adoption of image exchange.
Keywords: Austrian Radiology Archive; Canada Health Infoway; DICOM; Diagnostic image repository; ELGA; FHIR; Governance; Health information exchange; Image exchange; Interoperability; Medical images; Personal health record; RSNA Image Share; Standards-based image exchange; Standards-based interoperability; VNA; WIA; Web-based Image Access; XCA; XDS; XDS registry; XDS repository; XDS-I.