No one manages the images but me. Even the doctors can't make changes to them after they are done. It is considered part of the medical record and lets say it is itched in glass. That way if anything happen later and it goes to legal everyone can have faith in the system. Even I cant delete them. I can hide them so the average user (doc and nurse) cant see them but they are always there.

the main reason images are not in portals is a matter of speed. These files are hugh. To transfer an image across a network like a portal would take about 2 minutes an image. Now do the math of a 2000 image MRI. It also requires a program to view them (DICOM Viewer). They are not .JPG file but .DCM files. So most people don't have a program on their computer to be able to view them (you can download free viewers) You can, and I would suggest, at the end of any exam ask them to be burned you a disk. We do it for free. I would think most do. And that disk contains a built in viewer. (FYI, most viewers do not work on MAC, PC only. Sorry MAC people). You should be able to see the radiologist reports in portals.

Hope that helps.