Thursday, April 1, 2010

Building a Better World

A team of Rotarians and I just came back from our annual trip to Nicaragua--where we build clinics, schools, and deliver medical supplies. The state of medical care in much of the developing world can be eye opening. In the rural area where we work, the local hospital has an X-ray unit which is 40 years old, and had a portable unit that belongs in a museum, rather than in a medical facility. 

One might not realize how fortunate we are to have access to basic medical care. The World Health Organization estimates that two-third of the world's population does not have access to even rudimentary radiological services. 

In the developing world, there is a need for about 80,000 X-ray units. One of the major stumbling blocks is the cost of film and processing chemistry, as the price of these supplies might be the equivalent of a day's wage (or more)--assuming that they can be transported to some of the more remote areas. 

Digital technology, such as CR and DR, which has been widely available since the late 90’s, eliminates the need for film and chemicals; enables consultation through teleradiology; allows electronic archiving, retrieval, and image and patient management; and delivers immediate results that can be distributed directly to physician offices. In environments where film and chemicals are expensive, have a designated shelf life, and are in irregular supply, digital technology has obvious advantages. 

In addition, where there are virtually no radiologists and physicians are scarce, remote consultation is greatly needed. Clinical management requires review of individual patient records and can be assisted remotely through telecommunication assets as well as service, administrative support, troubleshooting, education, and training. The nature of digital image technology and the related information associated with its use provides a wealth of information that can be evaluated and used to improve care management. 

It seems an obvious solution that implementing digital health imaging technologies in the developing world can make a major impact. However, there are many aspects and support issues involved in implementing these technologies that are taken for granted in the developed world. Air conditioning for a server room (or in many clinics) is a luxury in much of the developing world. Clean, reliable power can be an issue, as well as Internet connectivity. 

Helping people meet these challenges is a very rewarding and humbling experience. If you are interested in getting involved with any of these projects, do not hesitate to contact me.