Teleradiology in Low and Middle-income Countries (LMICs): The Mbingo Baptist Hospital Experience

Abstract

Background: 

Mbingo Baptist Hospital (MBH) is a not-for-profit religious entity and a tertiary referral center in the northwest region or Cameroon. MBH has approximately 310 in-patient beds. MBH also serves a teaching hospital for the Pan African Academy of Christian Surgeons (PAACS) and the Christian Internal Medicine Specialization Programs (CIMS). Teleradiology is the electronic transmission of diagnostic imaging studies from one location to another for the purposes of interpretation and/or consultation. In 2017, a 16 multislice CT Scanner was   installed at  Mbingo Baptist Imaging Center with the help of several external partners.

Keywords: Teleradiology, CT SCAN, Imaging, low and middle-income countries.

Material and Methods:

It is an observational study. Radiology training and infrastructure in Cameroon is limited. There were only 50 practicing radiologists in Cameroon as of 2017 (1:500,000 inhabitants), and most imaging centers are located in the major cities of Douala and Yaounde. After the acquisition of  a CT scanner, MBH began searching  Teleradiology service options through the US  web/cloud based RadConnect platform which later became Nucleushealth. All the CT images were sent to the Radiology Department of Rush University in the United States for interpretation as negotiated by one of our American missionaries. Our CT studies were interpreted by a radiology fellow and reviewed by the consultant radiologist of the concerned subspecialty. Final results were available within 24 hours and were printed by the CT technologist and handed over to the patient. Frequent delays  occurred due to slow internet connectivity to upload the CT studies. Beginning in 2019, a new partnership was created between MBH and the University of Alabama Birmingham (UAB) Hospital Department of Radiology whereby UAB radiologists would review CT exams and the preliminary reports created by the local Cameroon radiologist and provide feedback.

Results:

As of September of 2017, A CT Scanner had been installed in the Mbingo Baptist Imaging Center with a teleradiology service for remote reading. In 2020, during the first wave of COVID-19, CT imaging was utilized, not only for patient care, but for training purposes in collaboration with the radiology residency program at UAB. Presently, we also use teleradiology for sharing studies during weekly  online multidisciplinary conferences.  

Conclusion:

Imaging is vital for the management of complex diseases commonly encountered at MBH. Given an increasing need of imaging for diagnosis and management of complex disease, MBH successfully established a sustainable imaging department with CT technology and Teleradiology services for quality care, imaging interpretation and ongoing education.