Patient-Friendly Image Sharing

January 13, 2015
Sara Kubik, PhD

When patients ask for their imaging studies, they are usually provided with a CD with complicated instructions on accessing the files.

Recently, I obtained my mother’s CT scan of her sinuses saved as digital DICOM images burned to a CD by her radiologist. There were about 40 images in total. There were directions on the CD jacket presented as a numbered, step-by-step list instructing the user how to see the images once the CD was loaded into their computer. The CD included software so the user could view the images without having to install any additional software on their own computer.

The problem was, it turned out to be an extremely frustrating experience; one that opened my eyes to the potential problems that patients and doctors face when patients receive their own medical data.

I have a PhD in technology and have taught undergraduates how to use Adobe Photoshop for about 20 years. So I knew that I could, ultimately, just <File <Open these DICOM images into Photoshop. However, I’m not the everyday lay person. So, as a lay person would, I went through and tried to view the images following the instructions and software provided on the CD.

Here is what I learned:

1. Despite the directions listed on the CD as being only five steps, the entire process -viewing the digital images on my computer screen- took me about 30 minutes to do. The files were named oddly and not located in any sort of meaningful (to me) way.

2. I believe that few lay people will have the patience or knowledge to undergo this process and, ultimately, will not be able to see their own digital medical files.

3. I also believe that no doctor is going to take upwards of 30 minutes just to figure out how to view CT digital images taken by another doctor. They will just order a CT on their own.  But this is an issue for another article.

If the goal is to save digital medical images in a way that the everyday lay person can use, I’d suggest approaching digital medical images as photographs. Medical images given to a patient should be saved as JPGs.[[{"type":"media","view_mode":"media_crop","fid":"30941","attributes":{"alt":"Sara Kubik, PhD","class":"media-image media-image-right","id":"media_crop_8473152247023","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"3261","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 224px; width: 160px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":"Sara Kubik, PhD","typeof":"foaf:Image"}}]]

Digital photographs are most commonly saved as JPGs (or JPEGs). The lay public generally knows how to open and view photographs, so, by extension, they generally know how to open and view JPGs.

My point is, with patients demanding their own medical data, files need to be saved in a format that can be easily viewed by the patients. If the goal is to save the medical images to a CD that a patient can plop into their computer and view, then JPGs are the file formats the medical images should be saved as or exported to (this is referencing <File <Save As).

The default photo viewers on both MACs and PCs can easily open JPGs images. And JPGs can even be e-mailed because they are small, or posted to a web page because every browser can interpret these files.

The everyday person understands how to send photographs to one another. They understand how to view these images on their phones and computers. So a medical image should be saved in a way that “rides on the coat tails” on this inherent knowledge the lay person already has.