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When you're confronted with a complex or critical health care diagnosis, you may be scared or confused by the prognosis or treatment recommended. This is often the time patients seek another opinion. Generations ago, patients relied on their personal physicians to make all their healthcare-related decisions. But no single physician is infallible, and most decisions are better when scrutinized by another informed source.

As a patient, when and how do you go about getting a second opinion?

The 21st Century Cures Act is intended to transform our health system in the US by improving interoperability of health IT and specifically preventing information “blocking.” These new legal standards in part empower patients to take command of (or at least participate in) their own health care.

It's understandable why subspecialists might default to using a hospital's picture archiving and communication system (PACS) rather than a system of their own.

There is a growing list of hospitals adopting online or remote second opinions (RSOs). Second opinions, in general, are becoming more accepted by both patients and physicians, and telemedicine or remote medical encounters are becoming increasingly popular. This has led patients who are diagnosed with critical medical issues to seek ways to avail themselves of specialty medical knowledge and experience from providers that are not necessarily local to them.

Many hospitals that are completing the early stages of adoption of remote second opinion (RSO) systems may now be thinking through the integration of this system with their downstream systems. Most of the work performed by RSOs is intentionally performed outside of the hospital's EHR, PACS, pathology, or other electronic clinical records storage systems. However, should a patient that receives a remote second opinion visit the hospital for a procedure or inpatient visit, these records will need to become part of the hospital's permanent patient file.