Who owns the image? Archiving and retention issues in the digital age

Patients are often confused with respect to the ownership of radiologic images and the extent to which they may exert rights over their own imaging. In general, a facility that generates imaging maintains "ownership" rights. Patients have a right to inspect their images and obtain copies but they may not have the images or reports modified or stricken. Facilities may use images not only for treatment purposes but also have rights to use images with respect to educational training, quality control, and research, subject to HIPAA requirements. A facility has statutory obligations with respect to record retention and may face financial penalty and malpractice consequences for failure to retain images. Bankruptcy and state laws address issues of transfer of ownership of a patient's images in cases in which a facility goes out of business. Future questions remain as to whether the length of time a facility maintains images should increase as digital storage media improve and whether the use of inter-facility image sharing via "cloud" technology should alter obligations with respect to which facility must retain the images.