HealthMark Group
On January 30, 2026, the Assistant Secretary for Technology Policy (ASTP), in coordination with the Office of the National Coordinator (ONC), released a request for information (RFI) focused on diagnostic imaging interoperability. The agency is seeking public input on how standards and certification criteria can better support the exchange of radiology images for patients and providers.
In announcing the radiology RFI, ASTP National Coordinator Dr. Thomas Keane emphasized the need to move diagnostic imaging out of siloed, antiquated workflows and into the modern health data ecosystem, where images can be accessed and shared as seamlessly as lab results or clinical notes.
For those who don’t live and breathe federal health IT policy, an RFI is not a new rule; it’s a formal listening phase. And in the case of radiology imaging, that listening phase is long overdue.
With the release of this RFI, healthcare has a real chance to finally solve the radiology exchange problem that has frustrated patients and clinicians for decades. Public comments from healthcare organizations, vendors and other stakeholders will be accepted until March 16, 2026.
A Brief History of Radiology Imaging
Healthcare has undergone a near-complete digital transformation over the past thirty years. What does this look like? EHRs are the standard, APIs growth is exponential and digital patient data is protected via strict security standards.
Much of radiology exchange, however, still relies on physical discs, manual uploads and proprietary portals. PACS (Picture Archiving and Communication System) environments were built for storage and viewing – not seamless, cross-organizational exchange. The result is a patchwork system that slows care and creates unnecessary administrative work.
The main challenges of medical imaging today include:
- Burning and shipping CDs is a huge administrative strain and cost center
- Delayed access to prior imaging can result in treatment delays
- Duplicate scans are sometimes inevitable due to missing records
- HIM and release of information teams feel more burdened by these outdated workflows
Unlike EHRs, imaging systems have largely fallen outside federal certification programs, even though diagnostic images are part of the designated record set. That regulatory gap has allowed imaging to lag behind other clinical data in standardization and interoperability.
Why Is ASTP Addressing Diagnostic Imaging Interoperability Now?
If new standards are adopted, digitizing radiology at scale will be incredibly complex.
Standards such as DICOM (Digital Imaging and Communications in Medicine) exist, but the technical building blocks to modernize radiology exchange have never been uniformly adopted, operationalized or required across systems. Without clear national alignment, imaging exchange has remained fragmented, forcing teams to rely on physical media more often than anyone would like.
It sounds counterintuitive, but while the technology to capture images is modern, the workflows to share them are not.
But that begs the question: After all this time, why is ASTP prioritizing digital medical imaging now? Three reasons could be:
- Healthcare is entering a phase where true interoperability is no longer optional.
- Patient access rules, information blocking regulations and growing expectations around digital health have raised the bar for what “accessible health information” should mean.
- Radiology images represent one of the last major blind spots in that vision.
This RFI acknowledges that if the industry is serious about modern interoperability, diagnostic imaging can no longer be the exception.
What Does This Radiology RFI Mean for Providers and Patients?
If ASTP/ONC moves forward with a proposed rule based on industry feedback, the impact of standardized digital radiology exchange would be felt across the healthcare ecosystem. The transition won’t be simple, but the benefits for providers and patients alike will be worth the effort.
| For providers: | For patients: |
| Digitizing radiology image exchange, while complex, will result in less administrative burden for teams in the long run. Eliminating physical media like CDs/DVDs would cut time spent on manual burning, shipping and re-importing images. Digitizing radiology image exchange will create better, more streamlined clinical workflows. Providers could query and retrieve diagnostic images electronically from disparate systems. Compliance will become a major priority if this RFI becomes a proposed rule. If standards and certification eventually become part of ONC’s program, healthcare organizations will need to plan ahead to stay compliant. | Mandatory digital imaging standards would directly benefit patients by reducing duplicative imaging and care delays. When prior radiology results are easily accessible across providers, patients avoid redundant repeated imaging requests. Patients will receive faster, more informed care when their radiology images are more accessible. Immediate access to imaging improves safety, reduces delays and enhances decision-making. Improved access empowers patients with their own health information. Patients would be able to store and access their radiology images digitally, giving them immediate and self-service access to this important piece of their clinical information set. |
The Road Ahead: How HealthMark Is Modernizing Radiology Exchange Today
While the benefits are undeniable, modernizing radiology would be a massive lift for individual healthcare organizations that don’t have the time or resources to take on such an implementation – and HealthMark’s recent acquisition of Purview is a direct response to that reality.
Purview’s cloud-based imaging technology simplifies the secure ingestion, storage, viewing and sharing of medical images. Its digital imaging solution allows organizations to access imaging data quickly and reliably via a secure link. The platform is already trusted by leading academic medical centers and five of the top ten children’s hospitals nationwide.
As Bart Howe, CEO of HealthMark Group and president of AHIOS, explained in the acquisition announcement:
“The acquisition of Purview is an important step in our journey to provide digital, self-service and immediate access to patient health data for authorized recipients. Medical imaging has been the long pole in the tent when it comes to providing timely access to health information due to the challenges inherent in DICOM exchange. Our investment in Purview will provide a more complete and immediate clinical picture to providers, patients and other key stakeholders, accelerating care delivery and improving patient outcomes.”
By integrating Purview into HealthMark’s clinical data exchange solution, we will provide secure and more immediate access to complete health information for millions of patients across the country.
Key Takeaways
We’ve tackled a lot over the past two decades to make health information more digital and accessible, but that journey is far from over. As most medical information has become increasingly digital, radiology has lagged behind due to its unique complexities. That’s why this news from ASTP is so transformative.
While lawmaking and the actual changes that follow take time, this digital radiology RFI is an important starting point, and HealthMark is thrilled to see that a change is coming, not just in our ecosystem thanks to our recent acquisition of Purview, but for the industry as a whole.
Want to stay in the know with ASTP’s recent RFI? Subscribe to the HealthMark blog to get timely updates on everything happening in HIM!
Where do you want to start?
Tell us a little bit about yourself, and we’ll match you with the right expert to help you optimize your patient information.