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Ohene-Botwe B, Amedu C, Antwi WK, Abdul-Razak W, Kyei KA, Arkoh S, Mudadi LS, Mushosho EY, Bwanga O, Chinene B, Nyawani P, Mutandiro LC, Piersson AD. Promoting sustainability activities in clinical radiography practice and education in resource-limited countries: A discussion paper. Radiography (Lond) 2024; 30 Suppl 1:56-61. [PMID: 38905726 DOI: 10.1016/j.radi.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 06/07/2024] [Accepted: 06/10/2024] [Indexed: 06/23/2024]
Abstract
OBJECTIVE Urgent global action is required to combat climate change, with radiographers poised to play a significant role in reducing healthcare's environmental impact. This paper explores radiography-related activities and factors in resource-limited departments contributing to the carbon footprint and proposes strategies for mitigation. The rationale is to discuss the literature regarding these contributing factors and to raise awareness about how to promote sustainability activities in clinical radiography practice and education in resource-limited countries. KEY FINDINGS The radiography-related activities and factors contributing to the carbon footprint in resource-limited countries include the use of old equipment and energy inefficiency, insufficient clean energy to power equipment, long-distance commuting for radiological examinations, high film usage and waste, inadequate training and research on sustainable practices, as well as limited policies to drive support for sustainability. Addressing these issues requires a multifaceted approach. Firstly, financial assistance and partnerships are needed to adopt eco-friendly technologies and clean energy sources to power equipment, thus tackling issues related to old equipment and energy inefficiency. Transitioning to digital radiography can mitigate the environmental impact of high film usage and waste, while collaboration between governments, healthcare organisations, and international stakeholders can improve access to radiological services, reducing long-distance commuting. Additionally, promoting education programmes and research efforts in sustainability will empower radiographers with the knowledge to practice sustainably, complemented by clear policies such as green imaging practices to guide and incentivise the adoption of sustainable practices. These integrated solutions can significantly reduce the carbon footprint of radiography activities in resource-limited settings while enhancing healthcare delivery. CONCLUSION Radiography-related activities and factors in resource-limited departments contributing to the carbon footprint are multifaceted but can be addressed through concerted efforts. IMPLICATIONS FOR PRACTICE Addressing the challenges posed by old equipment, energy inefficiency, high film usage, and inadequate training through collaborative efforts and robust policy implementation is essential for promoting sustainable radiography practices in resource-limited countries. Radiographers in these countries need to be aware of these factors contributing to the carbon footprint and begin to work with the relevant stakeholders to mitigate them. Furthermore, there is a need for them to engage in education programmes and research efforts in sustainability to empower them with the right knowledge and understanding to practice sustainably.
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Affiliation(s)
- B Ohene-Botwe
- Department of Midwifery & Radiography, School of Health & Psychological Sciences, City, University of London, Northampton Square, London EC1V 0HB, United Kingdom.
| | - C Amedu
- Department of Midwifery & Radiography, School of Health & Psychological Sciences, City, University of London, Northampton Square, London EC1V 0HB, United Kingdom.
| | - W K Antwi
- Department of Radiography, School of Biomedical & Allied Health Sciences, University of Ghana, Ghana.
| | - W Abdul-Razak
- Department of Medical Imaging, Fatima College of Health Sciences, AI Ain, United Arab Emirates.
| | - K A Kyei
- Department of Radiography, School of Biomedical & Allied Health Sciences, University of Ghana, Ghana.
| | - S Arkoh
- Department of Radiology, York and Scarborough Teaching Hospitals NHS Trust, United Kingdom.
| | - L-S Mudadi
- Royal Papworth Hospital, NHS Foundation Trust, Cambridge, United Kingdom.
| | - E Y Mushosho
- Harare Institute of Technology, School of Allied Health Sciences, Harare, Zimbabwe.
| | - O Bwanga
- Radiology Department, Midlands University Hospital Tullamore, Ireland.
| | - B Chinene
- Harare Institute of Technology, School of Allied Health Sciences, Harare, Zimbabwe.
| | - P Nyawani
- Harare Institute of Technology, School of Allied Health Sciences, Harare, Zimbabwe.
| | - L C Mutandiro
- Harare Institute of Technology, School of Allied Health Sciences, Harare, Zimbabwe.
| | - A D Piersson
- Department of Imaging Technology & Sonography, University of Cape Coast, Central Region, Ghana.
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Grewal H, Prasad N, Dhillon G, Kashyap R. Teleradiology and the Compensation Conundrum in India. Cureus 2023; 15:e51342. [PMID: 38288194 PMCID: PMC10824502 DOI: 10.7759/cureus.51342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/30/2023] [Indexed: 01/31/2024] Open
Abstract
Teleradiology, an established telemedicine practice globally, has significantly enhanced the accessibility of high-quality radiological interpretations in remote areas worldwide, especially in India, thereby improving healthcare outcomes. The utilization of teleradiology services has seen a marked increase, expanding its reach into more distant regions of the country. However, this burgeoning field faces numerous regulatory, financial, and technical challenges. The current scenario regarding teleradiology in India is a double-edged sword. There is an increasing demand for it due to the expanding population, resulting in larger imaging volumes needing radiologist services. This editorial aims to examine the prevailing challenges in teleradiology in India, with an emphasis on the compensation model for teleradiologists, which has not kept pace with the growing demand for services and often remains inequitable.
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Affiliation(s)
- Harpreet Grewal
- Radiology, Florida State University College of Medicine, Pensacola, USA
| | | | - Gagandeep Dhillon
- Internal Medicine, University of Maryland Medical Center, Glen Burnie, USA
| | - Rahul Kashyap
- Medicine, Drexel University College of Medicine, Philadelphia, USA
- Research, Harvard Medical School, Boston, USA
- Research, Global Remote Research Program, Saint Paul, USA
- Critical Care Medicine, Mayo Clinic, Rochester, USA
- Research, WellSpan Health, York, USA
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Dolar-Szczasny J, Barańska A, Rejdak R. Evaluating the Efficacy of Teleophthalmology in Delivering Ophthalmic Care to Underserved Populations: A Literature Review. J Clin Med 2023; 12:jcm12093161. [PMID: 37176602 PMCID: PMC10179149 DOI: 10.3390/jcm12093161] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Technological advancement has brought commendable changes in medicine, advancing diagnosis, treatment, and interventions. Telemedicine has been adopted by various subspecialties including ophthalmology. Over the years, teleophthalmology has been implemented in various countries, and continuous progress is being made in this area. In underserved populations, due to socioeconomic factors, there is little or no access to healthcare facilities, and people are at higher risk of eye diseases and vision impairment. Transportation is the major hurdle for these people in obtaining access to eye care in the main hospitals. There is a dire need for accessible eye care for such populations, and teleophthalmology is the ray of hope for providing eye care facilities to underserved people. Numerous studies have reported the advantages of teleophthalmology for rural populations such as being cost-effective, timesaving, reliable, efficient, and satisfactory for patients. Although it is being practiced in urban populations, for rural populations, its benefits amplify. However, there are certain obstacles as well, such as the cost of equipment, lack of steady electricity and internet supply in rural areas, and the attitude of people in certain regions toward acceptance of teleophthalmology. In this review, we have discussed in detail eye health in rural populations, teleophthalmology, and its effectiveness in rural populations of different countries.
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Affiliation(s)
- Joanna Dolar-Szczasny
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
| | - Agnieszka Barańska
- Department of Medical Informatics and Statistics with E-Learning Laboratory, Medical University of Lublin, 20-090 Lublin, Poland
| | - Robert Rejdak
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-079 Lublin, Poland
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Rackimuthu S, Hasan MM, Ray I, Sahito AM, Chawla P, Ghosh D. Teleradiology in India during the COVID-19 pandemic: Merits, pitfalls and a Future Perspective. Health Policy Plan 2022; 37:1203-1206. [PMID: 35699565 PMCID: PMC9214175 DOI: 10.1093/heapol/czac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 05/07/2022] [Accepted: 06/09/2022] [Indexed: 12/02/2022] Open
Abstract
The field of teleradiology has been of interest for almost 55 years and its potential prospects for health care have been constantly assessed and investigated. In view of the global preventive measures, such as social distancing and hand hygiene, the ongoing COVID-19 pandemic has further accentuated the necessity of telemedicine and teleradiology. In a country as densely populated as India wherein radiologists are often fragmented, teleradiology can prove to be a lifesaving technology and aid dampen the repercussions stemming from the highly skewed doctor to patient ratio. Although innovative, the effective adoption of teleradiology faces several obstacles in India such as inadequate technological infrastructure, a lack of knowledge among most medical practitioners, urban-rural disparities, and a lack of financing. Similar challenges continue to also be faced by several other developing countries across the globe. This article therefore aims to elaborate on the most important facets of implementation of teleradiology observed in the Indian context to help provide salient pointers to the readership of relevant jurisdictions who may be embracing comparable teleradiology challenges. Despite the hurdles, the future of teleradiology seems promising. The respective governments, policymakers and all relevant stakeholders must continue to take decisive action to ensure that this potential is fully exploited by allocation of necessary funds, strengthening of Information Technology and its related units, involvement of human resources with adequate technical and administrative expertise as well as take continued action to better existing telemedicine and teleradiology services.
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Affiliation(s)
| | - Mohammad Mehedi Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
| | - Ishita Ray
- Mahatma Gandhi Memorial Medical College, Indore, India
| | | | | | - Diya Ghosh
- Department of Biotechnology, Heritage Institute of Technology, Kolkata, India
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Goelz L, Arndt H, Hausmann J, Madeja C, Mutze S. Obstacles and Solutions Driving the Development of a National Teleradiology Network. Healthcare (Basel) 2021; 9:healthcare9121684. [PMID: 34946410 PMCID: PMC8701208 DOI: 10.3390/healthcare9121684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 02/07/2023] Open
Abstract
Background: Teleradiology has the potential to link medical experts and specialties despite geographical separation. In a project report about hospital-based teleradiology, the significance of technical and human factors during the implementation and growth of a teleradiology network are explored. Evaluation: The article identifies major obstacles during the implementation and growth of the teleradiology network of the Berlin Trauma Hospital (BG Unfallkrankenhaus Berlin) between 2004 and 2020 in semi-structured interviews with senior staff members. Quantitative analysis of examination numbers, patient numbers, and profits relates the efforts of the staff members to the monetary benefits and success of the network. Identification of qualitative and quantitative factors for success: Soft and hard facilitators and solutions driving the development of the national teleradiology network are identified. Obstacles were often solved by technical innovations, but the time span between required personal efforts, endurance, and flexibility of local and external team members. The article describes innovations driven by teleradiology and hints at the impact of teleradiology on modern medical care by relating the expansion of the teleradiology network to patient transfers and profits. Conclusion: In addition to technical improvements, interpersonal collaborations were key to the success of the teleradiology network of the Berlin Trauma Hospital and remained a unique feature and selling point of this teleradiology network.
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Affiliation(s)
- Leonie Goelz
- Department of Radiology and Neuroradiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany; (H.A.); (J.H.); (C.M.); (S.M.)
- Correspondence: ; Tel.: +49-30-56813829; Fax: +49-30-56813803
| | - Holger Arndt
- Department of Radiology and Neuroradiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany; (H.A.); (J.H.); (C.M.); (S.M.)
| | - Jens Hausmann
- Department of Radiology and Neuroradiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany; (H.A.); (J.H.); (C.M.); (S.M.)
| | - Christian Madeja
- Department of Radiology and Neuroradiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany; (H.A.); (J.H.); (C.M.); (S.M.)
| | - Sven Mutze
- Department of Radiology and Neuroradiology, BG Klinikum Unfallkrankenhaus Berlin, Warener Straße 7, 12683 Berlin, Germany; (H.A.); (J.H.); (C.M.); (S.M.)
- Institute for Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
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Tye ML, Honey M, Day K. School-based telemedicine: Perceptions about a telemedicine model of care. Health Informatics J 2020; 26:2030-2041. [PMID: 31912759 DOI: 10.1177/1460458219895380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In New Zealand, a store-and-forward telemedicine programme is implemented in schools to address common health conditions. This study aimed to investigate perceptions of the non-clinical school staff involved on this telemedicine model of care. Interviews and analysis were framed by sociotechnical theory under constructs of identities, affiliations, interactions and environments. Findings show that telemedicine aligned with identities of staff as carers. Affiliations via close relationships with children and community support enabled the programme. Delivering telemedicine enhanced interactions with children. Environments related to practices and physical characteristics of the school were viewed as constrainers and enablers for delivery. School-based telemedicine delivered by school staff is perceived as an acceptable model of care. Benefits include empowerment, school cohesion and potential improvement in health literacy, with no major issues perceived. Telemedicine may be effective for treating common health conditions in school children, with potential for community members to be involved in health care.
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Affiliation(s)
| | | | - Karen Day
- The University of Auckland, New Zealand
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Ayatollahi H, Nourani A, Khodaveisi T, Aghaei H, Mohammadpour M. Teleophthalmology in Practice: Lessons Learned from a Pilot Project. Open Med Inform J 2017; 11:20-28. [PMID: 29081869 PMCID: PMC5633703 DOI: 10.2174/1874431101711010020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 05/21/2017] [Accepted: 06/02/2017] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Ophthalmology is a medical specialty which may benefit from using telemedicine and teleophthalmology services. Such services are significantly important in the poor, remote, and impassable geographical areas, where there is no access to the ophthalmology services and ophthalmologists. This study aimed to design and implement a teleophthalmology system using the method of store-and-forward. METHODS The study was conducted in 2015 and consisted of two main phases. The first phase was based requirement analysis, and in the second phase, after designing the prototype, an initial usability testing was undertaken in a teaching hospital. The participants of the study were 10 optometrists and 10 ophthalmologists (cornea specialists). For each phase of the research, a questionnaire was used to collect data, and the collected data were analyzed using descriptive statistics. RESULTS In this study, users' requirements were initially investigated. Then, the teleophthalmology system was designed based on the literature review and the results derived from the requirements' analysis. Finally, usability testing showed that the users were relatively satisfied with the system. CONCLUSION According to the results, it can be concluded that the teleophthalmology technology can be used in the country by optometrists and ophthalmologists to improve eye health care services and to prevent the prevalence of curable eye diseases.
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Affiliation(s)
- Haleh Ayatollahi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Aynaz Nourani
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Taleb Khodaveisi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Aghaei
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Mohammadpour
- Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
INTRODUCTION The smartphone simplifies interprofessional communication, and smartphone applications can facilitate telemedicine activity. Much has been written about the steps that need to be followed to implement and establish a successful telemedicine service that is integrated into everyday clinical practice. A traditional and systematic approach has evolved incorporating activities such as strategy development, needs assessment, business cases and plans, readiness assessment, implementation plans, change management interventions, and ongoing monitoring and evaluation. This "best practice" has been promoted in the telehealth literature for many years. In contrast, several recent initiatives have arisen without any such formal undertakings. This article describes the strengths and weaknesses of two "spontaneous" telemedicine services in dermatology and burn management that have evolved in South Africa. METHODS Two spontaneous services were identified and reviewed. RESULTS In one unsolicited service, doctors at rural referring hospitals have been taking photographs of skin lesions and sending them with a brief text message history to dermatologists using the instant messaging smartphone app, WhatsApp. In the other, burns service, admissions to the burns unit or the clinic were triaged by telephonic description of the case and completion of a preadmission questionnaire. More recently, management and referral decisions are made only after completion of the questionnaire and subsequent submission of photographs of the burn sent by WhatsApp, with the decision transmitted by text message. DISCUSSION Although efficient and effective, potential legal and ethical shortcomings have been identified. CONCLUSION These "spontaneous" telehealth services challenge traditional best practice, yet appear to lead to truly integrated practice and, therefore, are successful and warrant further study.
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Affiliation(s)
- Maurice Mars
- 1 Department of TeleHealth, Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban, South Africa
| | - Richard E Scott
- 1 Department of TeleHealth, Nelson R Mandela School of Medicine, University of KwaZulu-Natal , Durban, South Africa .,2 Office of Global e-Health Strategy, University of Calgary , Calgary, Canada .,3 NT Consulting-Global e-Health, Inc. , Calgary, Canada
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