Despite numerous technological advances in imaging, sharing of images between institutions relies on outdated media and patient effort. This leads to unnecessary repeat imaging and patient anxiety. This is a multifactorial problem of misaligned incentives despite widespread availability of image sharing platforms. A multi-stakeholder effort will be needed to address this issue. The American College of Radiology led an informal effort known as "Ditch the Disk" which is now evolving to a more formal effort to bring professionals and industry together to advocate for a regulatory framework to support positive change.