Who owns the image?

Though imaging facilities maintain ownership rights of the images that they produce, patients have a right to inspect their own images and obtain copies of them, according to an article published online Feb. 5 by the Journal of the American College of Radiology.

Confusion often arises amongst patients as to the ownership of radiologic images and the extent to which they possess rights over their images. Authors Jonathan L. Mezrich, MD, JD, MBA, LLM, of the University of Maryland in Baltimore, and Eliot Siegel, MD, also of the University of Maryland, clarify the confusion.

“In general, the facility that performs imaging maintains ‘ownership’ rights,” they wrote. “Individuals have a right to inspect their images and obtain copies but may not have medical records modified or stricken.” 

Medicare and most states require that images be retained for at least five years, and many states penalize facilities that do not abide by this requirement with fines. Lack of image retention can also lead to medical malpractice suits, often placing liability on radiologists in cases where images go missing.

Imaging facilities have rights to use images beyond treatment purposes, including for educational training, quality control, and research, though these uses are subject to HIPAA requirements, according to Mezrich and Siegel.

If a hospital or facility goes out of business, the U.S. bankruptcy laws mandate that patients be given one year to claim their images before they are destroyed. In some scenarios, the department of health becomes involved in the storage of medical records.

With the recent transition to the digital age, questions remain regarding ownership rights of images. Cloud technology has produced the advent of inter-facility image sharing, creating a complex scenario in which the party responsible for retaining images may be unknown or unclear.

“Novel technologies always bring (later rather than sooner) a need to realign legal relationships among the users (at all levels) of those technologies,” Mezrich and Siegel wrote. “Awareness and continued discussion of the areas that have not yet been resolved will be useful to radiology and the institutions (including private practices) to which radiologists provide services.”