Bridging the gap: opportunities, challenges, and future directions for teleradiology in rural healthcare
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20243423Keywords:
Teleradiology, Rural health, Opportunities, ChallengesAbstract
Teleradiology, the electronic transmission of radiological images and data for diagnostic purposes, holds significant promise for improving healthcare access in rural and underserved regions. This review explores the opportunities and challenges of implementing teleradiology in rural settings, where limited access to radiology services exacerbates healthcare disparities. Teleradiology offers multiple benefits, including improved access to timely diagnostics, enhanced decision-making, and cost savings for rural patients who would otherwise need to travel to urban centers for radiology services. It has shown positive outcomes globally, with examples in India, Mali, the Democratic Republic of Congo, and Brazil, demonstrating its feasibility and potential to reduce geographic health inequities. However, implementing teleradiology in these settings faces several challenges, such as technological limitations, workforce shortages, regulatory and legal barriers, data security concerns, and cultural acceptance issues. Solutions and recommendations include investments in infrastructure, workforce training, supportive regulatory frameworks, secure data management, and adaptable telehealth models that consider socioeconomic factors in rural areas. By addressing these challenges, stakeholders can enhance the impact of teleradiology in rural healthcare systems, ultimately contributing to reduced disparities and improved healthcare outcomes. This review provides a comprehensive overview of the current landscape and suggests actionable pathways for advancing teleradiology in rural settings worldwide.
References
Gurupur VP, Miao Z. A brief analysis of challenges in implementing telehealth in a rural setting. Mhealth. 2022;8:17.
Chandramohan A, Krothapalli V, Augustin A, et al. Teleradiology and technology innovations in radiology: status in India and its role in increasing access to primary health care. Lancet Reg Health Southeast Asia. 2023;23:100195.
Ryu S. History of Telemedicine: Evolution, Context, and Transformation. Healthc Inform Res. 2010;16(1):65-6.
Tahir MY, Mars M, Scott RE. A review of teleradiology in Africa-Towards mobile teleradiology in Nigeria. SA J Radiol. 2022;26(1):2257.
European Society of Radiology. ESR white paper on teleradiology: an update from the teleradiology subgroup. Insights Imaging. 2014;5:1-8.
Loria K. Accessible Care: Challenges and Opportunities Related to Radiology Services in Rural Areas. Radiology Today. 2019;20(20):22.
Butzner M, Cuffee Y. Telehealth Interventions and Outcomes Across Rural Communities in the United States: Narrative Review. J Med Internet Res. 2021;23(8):e29575.
Franken EA, Berbaum KS, Smith WL, Chang PJ, Owen DA, Bergus GR. Teleradiology for Rural Hospitals: Analysis of a Field Study. J Telemed Telecare. 1995;1(4):202-8.
Bashshur RL, Shannon GW, Smith BR, Dale CA, Nina A, William GB, et al. The empirical foundations of telemedicine interventions for chronic disease management. Telemed J E Health. 2014;20(9):769-800.
Hadian M, Jelodar ZK, Khanbebin MJ, Atafimanesh P, Asiabar AS, Dehagani SMH. Challenges of Implementing Telemedicine Technology: A systematized Review. Int J Prev Med. 2024;15:8.
Franken EA, Whitten P, Smith WL. Teleradiology services for a rural hospital: a case study. J Telemed Telecare. 1996;2(3):155-60.
Smith AC, Bensink M, Armfield N, Stillman J, Caffery L. Telemedicine and rural health care applications. J Postgraduate Med. 2005;51(4):286-93.
Thrall JH. Teleradiology. Part I. History and clinical applications. Radiology. 2007;243(3):613-7.
Agrawal A. Emergency Teleradiology-Past, Present, and, Is There a Future? Front Radiol. 2022;2:866643.
Katz ME. Pediatric teleradiology: the benefits. Pediatr Radiol. 2010;40(8):1345-8.
Rosenkrantz AB, Hanna TN, Steenburg SD, Tarrant MJ, Pyatt RS, Friedberg EB. The Current State of Teleradiology Across the United States: A National Survey of Radiologists' Habits, Attitudes, and Perceptions on Teleradiology Practice. J Am Coll Radiol. 2019;16(12):1677-87.
Britton N, Miller MA, Safadi S, Siegel A, Levine AR, McCurdy MT. Tele-Ultrasound in Resource-Limited Settings: A Systematic Review. Front Public Health. 2019;7:244.
Greyson KA. Asynchronous Transmission Mode as the Entry Point of Teleradiology Connectivity in Developing Countries: Case Study Tanzania. 2021 IST-Africa Conference (IST-Africa). IEEE. 2021.
Reiner BI. Strategies for radiology reporting and communication: part 4: quality assurance and education. J Digit Imaging. 2014;27(1):1-6.
Nittari G, Khuman R, Baldoni S, Graziano P, Gopi B, Ascanio S, et al. Telemedicine Practice: Review of the Current Ethical and Legal Challenges. Telemed J E Health. 2020;26(12):1427-37.
Whitehead L, Talevski J, Fatehi F, Beauchamp A. Barriers to and Facilitators of Digital Health Among Culturally and Linguistically Diverse Populations: Qualitative Systematic Review. J Med Internet Res. 2023;25:e42719.
Chen J, Amaize A, Barath D. Evaluating Telehealth Adoption and Related Barriers Among Hospitals Located in Rural and Urban Areas. J Rural Health. 2021;37(4):801-11.
Char A, Kalyanpur A, Puttanna Gowda VN, Bharathi A, Singh J. Teleradiology in an inaccessible area of northern India. J Telemed Telecare. 2010;16(3):110-13.
Crowe BL. A review of the experience with teleradiology in Australia. J Telemed Telecare. 2001;7(2):53-4.
Bagayoko CO, Anne A, Fieschi M, Geissbuhler A. Can ICTs contribute to the efficiency and provide equitable access to the health care system in Sub-Saharan Africa? The Mali experience. Yearb Med Inform. 2011;6:33-8.
Crumley I, Halton J, Greig J, Lucien K, Jean-Paul M, Arlene C, et al. The impact of computed radiography and teleradiology on patients' diagnosis and treatment in Mweso, the Democratic Republic of Congo. PLoS One. 2024;19(2):e0299648.
Mwogi T, Nyameino J, Tylleskar T, Were MC. A scalable low-cost multi-hospital tele-radiology architecture in Kenya. J Health Inform Afr. 2018;5(2):10.
Jones CR, Cardoso RB, Oliveira HW, Maria HIL, Edison H, Eder H, et al. Telemedicine experience in the Brazilian Amazon. Int J Integr Care. 2012;12(1):e70.
World Health Organization (WHO). Telemedicine: Opportunities and Developments in Member States. Report on the second global survey on eHealth. WHO Press. 2010. Available at: https://apps.who.int/iris/handle/10665/44497. Accessed 25 October 2024
Stamford P, Bickford T, Hsiao H, Mattern W. The significance of telemedicine in a rural emergency department. IEEE Eng Med Biol Mag. 1999;18(4):45-52.
Schoeman R, Mario H. Radiologists’ experiences and perceptions regarding the use of teleradiology in South Africa. S Afr J Radiol. 2023;7:27
Ganapathy K, Ravindra A. Telemedicine in India: the Apollo story. Telemed J E Health. 2009;15(6):576-85.
Weinstein RS, Lopez AM, Joseph BA, Kristine AE, Michael H, Gail PB, et al. Telemedicine, telehealth, and mobile health applications that work: opportunities and barriers. Am J Med. 2014;127(3):183-7.
Bashshur RL, Shannon G, Krupinski EA, Grigsby J. Sustaining and realizing the promise of telemedicine. Telemed J E Health. 2013;19(5):339-45.
Taylor P. Evaluating telemedicine systems and services. J Telemed Telecare. 2005;11(4):167-77.
Amjad A, Kordel P, Fernandes G. A Review on Innovation in Healthcare Sector (Telehealth) through Artificial Intelligence. Sustainability. 2023;15(8):6655.
Davidson M, Kielar A, Tonseth RP, Seland K, Harvie S, Hanneman K. The Landscape of Rural and Remote Radiology in Canada: Opportunities and Challenges. Canadian Asso Radiologists J. 2024;75(2):304-12.
Alanazi AT, Al Hader B. Telemedicine Patient Satisfaction and Cost: A Comparative Study in the COVID-19 Era. Cureus. 2022;14(10):e30671.