Digital x ray imaging has brought obvious benefits to health care, but, as with all new technologies, it both requires and leads to changes in behaviour and processes, some obvious and some less so. The issues include cost and productivity, the need to acquire new skills, radiation doses, overuse, and image quality. Moreover, some of the ethical and legal issues surrounding teleradiology remain unclear.1

Physicians have long been accustomed to viewing and interpreting images on film. Film is now being replaced with digital images in the same way as film cameras are being replaced with digital cameras. Digital x ray imaging does away with film processing, and the images can be viewed just minutes after exposure via computer networks, to be seen by many people at once, in many different places. So what are the issues surrounding the transition to digital imaging?

The initial cost of buying digital systems has dropped substantially during the past two decades, but such systems are still more expensive than a conventional system. …