Should medical images be saved indefinitely?

It has become standard practice over the years for imaging providers to maintain data for at least five years, but according to an article published in the Journal of the American College of Radiology, perhaps that data should be kept indefinitely. In other words, if I can paraphrase Shakespeare for just a moment, to delete or not to delete: that is the question.

Authors Jonathan L. Mezrich, MD, JD, LLM, MBA, Yale University School of Medicine, and^, Eliot Siegel, MD, University of Maryland Medical Center, cited “plummeting storage costs” as one reason providers should consider keeping medical images indefinitely. Doing so could also help limit administrative costs related to the “burdensome” process of deciding which images to keep and which to delete, they added. And it helps keep radiologists from falling behind their peers in the industry.

“It is likely that most facilities do not have a clear sense of how long they need to retain each particular image,” Mezrich and Siegel wrote. “PACS databases do not typically create an image retention flag/date. The typical practice at present is thus likely to err on the side of maintaining everything, forever; thus arguably, a practice that endeavors to delete files at the statutory minimum retention date actually runs the risk of running afoul of the ‘standard of care.’”

Of course, this might all fall under the category of “easier said than done.” No matter how else you slice it, keeping images indefinitely would cost money, and that is always a tough pill for administrators to swallow. Also, with so many concerns floating around right now about data security, this could be an even harder sell than normal.

But Mezrich and Siegel make a lot of interesting points, and I hope radiology leaders pay close attention. When deleting data results in more risks than rewards, it’s time to at least seriously weigh your group’s options and see where you stand. And as the authors concluded at the end of their article, guidance on this subject from imaging organizations is sorely needed.

Deciding to keep imaging data longer than five years will be an important debate in the coming years. What will your group, practice or department decide to do?