Because of the establishment of the patients' right of access under the Health Insurance Portability and Accountability Act, patients have the right to access all information that is included in their designated record set, including imaging studies such as radiography and CT (1). Although federal regulations and policies have focused broadly on improving patient access to their medical information (2-4), there has been little emphasis on access to imaging studies, not merely radiology reports, despite studies that indicate patients prefer to view imaging studies in addition to receiving written radiology results (5-7).Previous studies (8,9) highlighted issues of noncompliance with federal regulation and barriers to access in the general medical records request process. We sought to assess the request process specifically for imaging studies to investigate whether similar barriers exist. Requests for imaging studies are subject to the same laws as requests for other portions of the medical record, in that requests must be fulfilled within 30 days of receipt, in the format requested by the patient if readily producible in that format, with health care providers permitted to impose a reasonable cost-based fee (1). To evaluate U.S. hospital compliance with federal regulations and patient ease of access to imaging studies, our study focused on assessing formats of release, costs of release, processing times, and, more generally, challenges to how patients request imaging studies in a subset of top-ranked U.S. hospitals through a simulated patient experience. Materials and MethodsThis cross-sectional study, conducted between June 6 and December 3, 2018, was approved by the institutional review board as a not human research protocol at Yale University. The requirement of written informed consent was waived for this study.
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