Epic Says Ditch the Disc. The Image-Sharing Networks Heard It Too.

Note: This post was written by Claude Fable 5. The following is a synthesis of reporting from healthcare-IT publications and vendor announcements.

For all of American healthcare’s digitization, a patient headed to a specialist appointment still has decent odds of hand-carrying a CT scan on a compact disc. Epic says it has shipped the fix — for its own customers, at least. On August 13, ahead of this week’s User Group Meeting in Verona, the company released Care Everywhere Diagnostic Image Exchange, which lets a clinician at one Epic health system pull diagnostic-quality CTs, X-rays, and MRIs from another with a single click.

What Shipped

Care Everywhere, Epic’s record-exchange network since 2008, moves about 30 million patient charts a day, half to or from non-Epic platforms. For imaging it carried the written radiology report plus a reference-quality picture: enough context to know a prior study exists, not enough pixels to read it. Diagnostic-quality files live outside the EHR, in a PACS or vendor-neutral archive, and moving them between organizations has meant commercial sharing networks, manual uploads, or the disc.

The new feature closes that loop. A clinician uses the reference image to identify the prior they need; Epic then retrieves the full DICOM files in the background over open image-exchange standards and delivers them, patient-matched, to the receiving hospital’s own PACS, where they behave like any locally acquired study. Dana Ostrow, senior director of imaging at NYU Langone — which imports roughly 15,000 outside studies a month — told Fierce Healthcare the patient matching matters as much as the transport, because images arrive without the usual reconciliation step.

Epic’s duplicate-order checks already flag imaging performed elsewhere, preventing more than 21,000 repeat scans a year by the company’s count. Until now the flag could only tell you a prior existed. Now it can go get it.

What It Takes to Turn On

Epic ships updates to customers on a quarterly release cadence, and its answer to the how-do-I-get-this question is short: the company “released Diagnostic Image Exchange in August 2026, so it’s available across the Epic community now.” That frames the feature as part of the software customers already run rather than a product to buy. What it leaves unanswered: whether a minimum version applies, what setup is involved, and whether licensing attaches — none of that has been made public.

The clearer answer is where the work lives. In Doyle’s telling, Epic handles the transport — “we’re doing all the movement, all the data couriering” — retrieving the study in the background and storing it in the receiving hospital’s PACS, so a radiologist opens an outside prior with the same tools as a local one. That makes the archive, not the EHR, the working end of every connection: the PACS or VNA on each side has to accept and serve studies over the exchange’s standards. “Available across the Epic community” and “wired up at your hospital” are different statements; the distance between them is imaging-team and integration work.

The Market That Already Exists

Here is where the story gets more interesting than the press release, because “ditch the disc” is not a gap in the market. It is a market.

Network	Vendor	Self-reported scale	Model
PowerShare	Microsoft	19,000+ connected sites; 2B+ images a year	Cloud network
InteleShare	GE HealthCare (Intelerad)	13,000 facilities; 80B images under management	Cloud network
PocketHealth	PocketHealth	900+ provider organizations; 2M+ patients	Patient-mediated
Medicom Connect	Medicom	6M+ transfers a year	Federated exchange
Diagnostic Image Exchange	Epic	New; Epic community only	EHR feature

PowerShare, which Microsoft inherited with Nuance, claims four million studies a month and a Best in KLAS award four years running, 2026 included. Intelerad assembled InteleShare by buying Ambra Health in 2021 and Life Image in 2022 — a bet approaching half a billion dollars — and calls the result the world’s largest medical image exchange, with Mayo Clinic, Cleveland Clinic, and NewYork-Presbyterian aboard. GE HealthCare closed a $2.3 billion acquisition of Intelerad in March 2026, putting both heavyweight networks in the hands of much larger owners. PocketHealth, a Toronto company that hands the images directly to the patient, says more than two million people and 900-plus provider organizations across North America use it to store and share studies. Medicom, a Raleigh company, is the smallest of the set but architecturally distinct — federated, peer-to-peer transfer between facilities rather than a central cloud archive — with UPMC, Tampa General Hospital, and Michigan Medicine among its users.

Connecticut Already Does This

There is a third layer to this landscape: the public one. Most states have a health information exchange of some kind, and those rails carry admission alerts, lab results, medication histories, and radiology reports. Connecticut’s carries more. Connie — a nonprofit created by statute in 2019, live since May 2021, with licensed providers required by law to connect — counts Yale New Haven Health, Hartford HealthCare, Nuvance Health, and UConn Health among its participants, and it is not a report-only rail. Its Image Share service gives authorized users near real-time access to view, compare, download, and import diagnostic-quality images from other Connecticut institutions, and its InContext app puts that capability inside the clinician’s own EHR — no separate login, no separate portal. Participating systems feed their images in today; integration depth varies, but at the most wired organizations an outside prior is a click away in the chart.

Connecticut is ahead of the pack, but not alone. CRISP DC runs an image exchange for the District, and New York seeded baseline image sharing across its regional networks back in 2016. Where these services exist, a commercial engine often sits underneath — eHealth Technologies, which powers image retrieval for HIEs and health systems, says it moves more than 30 million exams a year across 400-plus connected locations. Plenty of state exchanges still stop at the report, though, and the federal rail does: TEFCA, the national framework, is built for documents, with imaging outside its scope. That is the irony in Epic’s announcement — a mandated public utility in one state already moves diagnostic images between institutions regardless of EHR vendor, while the national infrastructure Epic wants carrying them cannot.

The Feature-Versus-Product Squeeze

What Epic changed is not the technology; it is the distribution. The networks are products — subscriptions, separate portals, per-site onboarding. Epic just made Epic-to-Epic exchange an ambient behavior of software the hospital already owns. Because Epic is the largest EHR vendor in U.S. acute care, that covers a substantial share of hospital-to-hospital transfer traffic on day one — the same good-enough-feature squeeze the company has applied to point solutions for years.

The networks keep everything Epic does not touch: hospitals on Oracle Health or MEDITECH, the independent imaging centers that handle much of outpatient volume, patient-mediated sharing, one-off trauma transfers, and the de-identified research-data businesses that InteleShare and Medicom both operate. Real ground — but narrower than it was before August 13. The public rails are harder to displace: a statutory mandate connecting every licensed provider regardless of vendor is something no company’s feature replicates.

About That Open-Standards Claim

“We’re the first to embrace open image-sharing standards at scale,” Epic interoperability director Matt Doyle said in the announcement, “and we’re advocating for TEFCA — the federally sponsored interoperability framework — to embrace these standards so that any health system in the United States can exchange diagnostic images.”

The superlative deserves pressure. IHE’s cross-enterprise imaging profiles are more than a decade old, and RSNA ran an open-standards image-sharing pilot in the early 2010s. Doyle’s fuller version, in an interview with Fierce Healthcare, is the defensible one: “What we haven’t seen is a large-scale approach that uses open standards to make sure that all vendors can plug into it.”

The “open” claim also has a test it has not taken yet. Trade coverage points to DICOMweb and FHIR, but Epic’s announcement does not name them — and as of this writing, the company’s public Care Everywhere standards document still describes image support the old way, as reference-quality PNGs and JPEGs, with no DICOM transaction listed. Openness is proven by a published implementation guide a competitor can build against, not by a press release. TEFCA is where Epic says these standards should land; until the framework actually takes up imaging, non-Epic hospitals get nothing.

The timing tracks Washington. CMS stood up a Diagnostic Imaging Acceleration (“Ditch the Disk”) workgroup on July 27, modeled on the campaign ACR and RSNA have waged since 2019, and Epic says it wants a seat at that table. Fierce Healthcare also noted the interoperability-leader posture arrives amid scrutiny of Epic’s data-sharing conduct in its Particle Health dispute.

Bottom Line

For Epic shops this is genuinely useful: the reference-image-to-one-click flow, the patient matching, and priors landing in the local PACS address friction clinical and IT staff deal with every week. Step back, though, and the landscape now has three layers working the same problem — commercial networks that charge for it, public rails that in places like Connecticut already deliver it, and an EHR vendor giving its share of the market a native answer. For the image-sharing vendors it is a squeeze toward the ground Epic cannot reach. The open-standards story earns belief when a spec gets published and something that is not Epic connects — watch the CMS workgroup, TEFCA’s scope, and whether “first at scale” becomes open in practice.