Health Screening

Healthcare Guide

Taiwan Screening Results and Follow-Up With Your Own Doctor: What Actually Travels

September 22, 2026

8 mins to read

No US law obliges your doctor to accept a foreign result. 45 CFR 164.524 gets you records; it does not make them diagnostic. What decides follow-up is whether imaging travels as DICOM.

By New Dawn Health Editorial

Editorial Team

Taiwan Screening Results and Follow-Up With Your Own Doctor: What Actually Travels - Health information for international visitors in Taiwan

Nothing in United States law obliges your own physician to accept a foreign result as diagnostically sufficient. What decides whether your Taipei results survive the flight is the form they travel in.

Federal rule	Who it binds	What it does for you
Right of access, 45 CFR 164.524	Covered entities	Gets you your records
Information blocking, 45 CFR Part 171	US providers, certified health IT developers, health information networks	Nothing; a hospital in Taipei is none of those

Neither rule tells a clinician in Boston what to believe.

Will a US doctor accept a report from a Taiwanese clinic?

Sometimes, and the answer turns on what the report contains rather than on where it was written. It helps to separate two questions that get run together.

The first is access. Under 45 CFR 164.524, a covered entity must act on a request for records in a designated record set no later than 30 days after receipt. One 30 day extension is allowed if it explains the delay in writing.

Fees are limited to reasonable, cost based charges for labor in copying, supplies, postage and preparing a summary. Denials are narrow, and some of them are reviewable by an independent licensed professional.

The second is acceptance. The Office of the National Coordinator describes information blocking as "a practice by an actor that is likely to interfere with the access, exchange, or use of electronic health information", and it names the three kinds of actor it covers.

None of that reaches a clinic outside the United States, and none of it converts a foreign PDF into a study your radiologist is willing to sign an opinion on.

So the useful question is not whether your doctor is allowed to accept the report. It is whether the report and the images arrive in a state that lets a clinician do something with them.

What is DICOM, and why does it matter more than the PDF?

Because a DICOM file carries the full image set at the resolution the scanner produced, with the acquisition parameters attached, and a printed picture does not.

DICOM is the medical imaging standard published by the National Electrical Manufacturers Association, formally designated NEMA PS3, and maintained through NEMA's Medical Imaging and Technology Alliance. The current edition runs to 22 parts covering information object definitions, data structures and encoding, message exchange, media storage and file formats, and web services.

The ACR, the American Association of Physicists in Medicine and the Society for Imaging Informatics in Medicine set that expectation directly in their technical standard for the electronic practice of medical imaging: "The DICOM Standard is to be used for image transactions with the image management system."

The same standard makes three further demands of a facility.

It should be able to export and import data compliant with the IHE Portable Data for Imaging profile.
"Physical media containing proprietary formatted images should not be used".
Any embedded viewer should display standard DICOM images rather than depend on a proprietary format.

It also quotes a statement from the American Medical Association expert panel on medical imaging, signed by the AMA, the ACR, the American College of Cardiology, the American Academy of Orthopaedic Surgeons and three neuroscience societies: "All medical imaging data distributed should be a complete set of images of diagnostic quality in compliance with IHE-PDI."

A PDF of selected pictures fails that test. It is a record of what someone else saw, not a study anyone can reread.

What does a radiologist actually do with an outside study?

There are three realistic outcomes: an informal look, a formal second interpretation written and archived as a report, or a repeat scan on local equipment.

The ACR practice parameter for communication of diagnostic imaging findings treats the informal look with visible caution. It notes that curbside consults and wet readings "may preclude immediate documentation and may occur in suboptimal viewing conditions without comparison studies and their accompanying reports or adequate patient history".

It adds that informal communications "carry inherent risk", and that "a system for reporting outside studies is encouraged".

The same parameter sets out what a real report contains, and comparison is part of it. Under the body of the report it lists comparison studies and reports, saying that "comparison with relevant examinations and reports should be part of the radiologic consultation and report when appropriate and available".

It also asks that "when feasible, a copy of the final report should accompany the transmittal of relevant images to other health care professionals when such images are requested".

Formal second interpretation is real work that often goes uncompensated, which is part of why some departments decline it. A 2022 study in the Journal of the American College of Radiology reviewed three years of outside film review requests at a National Comprehensive Cancer Network designated cancer center.

Outside film review at one cancer center, 3 years	Figure
Unique patient requests	2,513
Average requests per year	837
Patient reports in one sampled quarter across three years	645
Studies reinterpreted in those reports	2,216
Estimated physician effort	2,660 work relative value units
Internal credit awarded, at 0.44 units per report	284 units

Why would a clinician reasonably repeat a test?

Because the outside study is sometimes technically unfit for the decision in front of them, and sometimes it is not.

A 2022 study in Clinical Imaging looked at 915 consecutive outside CT and MR abdominal studies submitted to a tertiary cancer center over four months.

What the study found	Share
Suboptimal quality compared with the center's own images	65%
Judged inappropriate for oncologic care	31%
CT studies with an optimal slice thickness below 3 mm	21%
Of 375 outside reports assessed, discrepancies between first and second interpretation	131, or 34%
Of 88 confirmed discrepant studies, patients whose treatment changed	42, or 48%

Those last two rows are the other half of the ledger. Reinterpretation is not busywork.

Repeating is more likely when	Repeating is less likely when
Only a printed picture or PDF arrives, with no image data	A complete diagnostic quality DICOM set arrives on media or by secure transfer
Acquisition is unsuited to the question, for example slice thickness or contrast phase	The acquisition matches what the local protocol would have ordered
The written report has no comparison, no limitations section and no impression	The report names findings, limitations and an impression, as the ACR parameter describes
The performing facility cannot be identified or contacted	The facility, the date and the contact details are on the report
A laboratory value must be compared against a different assay or calibration	The result carries units, method and the laboratory's own reference interval

Whether any specific test should be repeated for you is a judgment for the clinician holding the study, not one this article can make.

What does the laboratory side need to survive the flight?

The same information a domestic report is required to carry. Under 42 CFR 493.1291, a United States test report must show:

The patient identifier.
"The name and address of the laboratory location where the test was performed".
The report date.
The test performed, and the specimen source where appropriate.
"The test result and, if applicable, the units of measurement or interpretation, or both".

The regulation also requires that "pertinent reference intervals or normal values, as determined by the laboratory performing the tests" be available to whoever uses the result.

That is the checklist to hold a foreign report against. If the units, the method and the laboratory's own reference interval are missing, a second reader cannot tell whether a flagged value is meaningful or is an artifact of a different assay.

Our guide to reading a health screening report goes through why those three items decide so much.

What should you leave Taipei holding?

Six items, collected before departure.

Every imaging study as a complete diagnostic quality DICOM set, on physical media or through a secure transfer, not as a printed picture.
The final written report for each study, in English, with findings, limitations and an impression.
The full laboratory report, with units, the method or platform where named, and the laboratory's own reference intervals.
The name and address of each performing facility, so a home clinician can identify whose limits and protocols apply.
A named contact at the facility, with an email address that answers from outside Taiwan.
Your own copy of everything, kept independent of any portal you may lose access to.

The CDC advises travelers who receive care abroad to "request copies of their overseas medical records in English and to provide this information to any healthcare professionals they see subsequently for follow-up".

Ask for all of it before you fly, not after. Requesting records from another country's health system once you are home is slower than requesting them at the desk.

What we deliver, and when

New Dawn Health delivers the digital report 2 to 3 weeks after screening. An English physician debrief is available on request.

Screening tiers run from Convenient at $299 to Advanced at $3,499, and what each includes is listed on our packages page. If a finding needs chasing, our piece on incidental findings describes what usually happens next.

The bottom line

Follow up does not break because a report is foreign. It breaks because the images travel as pictures instead of as data, because the laboratory numbers arrive without units or reference intervals, and because nobody at the performing facility can be reached to answer a question.

Fix those three things before you leave and a home clinician has something to work with. Whether they act on it, repeat it, or send it for a formal second interpretation is their call, and it should be.

Sources

FAQ

Does HIPAA require my US doctor to accept results from a Taiwanese clinic?

No. 45 CFR 164.524 gives an individual a right of access to protected health information held in a designated record set by a US covered entity, and requires the entity to act within 30 days. The information blocking rule at 45 CFR Part 171 applies to US healthcare providers, certified health IT developers and health information networks. Neither rule reaches a clinic in Taiwan, and neither obliges any clinician to treat a foreign result as diagnostically sufficient.

Why do radiologists want DICOM files instead of a PDF report?

DICOM is the medical imaging standard published by NEMA as PS3, and a DICOM set carries the full image data at acquisition resolution rather than selected pictures. The ACR, AAPM and SIIM technical standard states that the DICOM standard is to be used for image transactions, that proprietary formatted media should not be used, and that distributed imaging should be a complete set of diagnostic quality images compliant with IHE-PDI. A PDF records what one reader saw and cannot be reread.

How often does a second reading of an outside scan change treatment?

In one 2022 Clinical Imaging study of 915 outside CT and MR abdominal studies at a tertiary cancer center, 34 percent of the 375 assessed outside reports carried discrepancies against the secondary interpretation. Of the 88 confirmed discrepant studies, 42 patients, or 48 percent, had a change in treatment as a result. The same study found 65 percent of the outside images were of suboptimal quality compared with the center's own.

What should I ask the clinic in Taipei for before I fly home?

Ask for every imaging study as a complete diagnostic quality DICOM set rather than printed pictures, the final written report for each study in English, and the full laboratory report with units, method and the laboratory's own reference intervals. Ask for the name and address of each performing facility and a named contact who answers email from abroad. The CDC advises obtaining overseas records in English and giving them to any clinician you see for follow-up.