On 1 July 2026, Australia’s Share by Default requirements took effect for pathology and diagnostic imaging reports. For many imaging organisations, the first priority was understandably technical: confirm scope, connect the right systems and make sure required reports could reach My Health Record.
Four months on, the more useful question is whether the workflow is doing what it was designed to do.
The change is significant because a written radiology report is no longer moving only between a reporting clinician and a referrer. It may also become visible to the patient through My Health Record, within the access timeframe that applies to that report. That wider audience does not change the clinical purpose of the report, but it does make clarity, ownership and communication more visible.
Start with scope and ownership
Most reports authored by or on behalf of a radiologist are now required to be uploaded by default, unless a valid exception applies or an extension has been granted. Images themselves are not included in the current upload requirement.
That sounds straightforward until several organisations contribute to one service. A practice may acquire the images, an external radiologist may report them and another system may handle distribution. The Australian Digital Health Agency advises that organisations involved in authoring need to agree who will upload the report. Duplicate uploads are not required.
A useful review therefore begins with a simple map: which services are in scope, which organisation uploads each report, how successful upload is confirmed and who responds when the workflow fails.
Check the exception pathway
Share by Default still allows exceptions. Examples include a patient asking for a report not to be uploaded, the patient not having a My Health Record, a serious concern for the person’s health, safety or wellbeing, or circumstances outside the provider’s control that prevent upload.
The practical issue is whether staff can recognise these situations and follow the correct process. Guidance also requires evidence of an exception to be retained for two years from the date of service. A policy that sits unread in a folder is not enough if the people receiving patient requests do not know what to do next.
Review reporting with the patient in mind
Clinical precision remains essential. Patient access does not mean turning a radiology report into general consumer content, and it does not transfer the referrer’s responsibility for discussing results. It does, however, make avoidable ambiguity easier to see.
Teams can ask whether the report clearly distinguishes findings from impression, uses abbreviations carefully, makes recommendations specific enough for the referrer to act on and avoids wording that is more alarming than the evidence supports. This is good clinical communication regardless of who reads the report.
It is also worth checking that reception and clinical teams can answer common patient questions without interpreting the result. Patients may need to know when a report is likely to appear, why some reports have an access delay, who can discuss the findings and how they can exercise control over their My Health Record.
Use incidents and questions as improvement data
The strongest post-implementation review is grounded in what has actually happened. Look at failed uploads, duplicate reports, patient requests, questions received by staff, uncertainty between partner organisations and cases where the expected report was not available.
These are not merely administrative inconveniences. They show where system design, team understanding or clinical governance needs attention. A short monthly review can reveal patterns that a one-off implementation checklist will miss.
The review should include both clinical and operational voices. Radiologists can identify reporting risks, while reception, records, IT and practice teams often see the first signs of upload failures or patient confusion. Bringing those perspectives together helps the organisation assign actions, test whether a change has worked and close the loop with reporting partners.
Five questions for the next team review
- Can we identify which services and reports are in scope?
- Is upload ownership clear, including for outsourced reporting?
- Can staff recognise, action and document valid exceptions?
- Do our reports remain precise while reducing avoidable ambiguity?
- Are we learning from upload failures and patient questions?
Share by Default is now part of the operating environment for Australian diagnostic imaging. The next stage is to make it reliable, understandable and useful. That requires more than software. It requires clear roles, informed teams and reporting practices that support both clinical decision-making and a more connected patient journey.
