Nigatu Araya Mesfin, Yilma Tesfahun Melese, Gezie Lemma Derseh, Gebrewold Yonathan, Gullslett Monika Knudsen, Mengiste Shegaw Anagaw, Tilahun Binyam
Department of Health Informatics Institute of Public Health University of Gondar, Gondar, Ethiopia.
Department of Epidemiology and Biostatistics Institute of Public Health University of Gondar, Gondar, Ethiopia.
Int J Telemed Appl. 2024 Jun 6;2024:5578056. doi: 10.1155/2024/5578056. eCollection 2024.
Teleradiology allows distant facilities to electronically transmit images for interpretation, thereby bridging the radiology service gap between urban and rural areas. The technology improves healthcare quality, treatment options, and diagnostic accuracy. However, in low resource settings like Ethiopia, teleradiology services are limited, posing challenges for implementation. Therefore, this study is aimed at exploring the factors that facilitated or hindered the implementation of web-based teleradiology in the public hospitals of the South Gondar Zone, Northwest Ethiopia. In this study, a purposive sampling method was employed to select seventeen participants, including hospital managers, physicians, emergency surgeons, and radiologists, for an in-depth interview (IDI). The interviews were conducted from March to May 2023. A reflexive thematic analysis was conducted using an abductive coding technique at the semantic/explicit level. Data were collected through semistructured interviews conducted face-to-face and virtually, with audio recordings transcribed, translated, and analyzed using Open Code version 4.02 software. Trustworthiness was ensured through prolonged engagement, reflective journaling, and review by coauthors. The study examined eight main themes, with barriers to sustainable teleradiology implementation falling into five categories: technological, organizational, environmental, individual, and workflow and communication. Conversely, identified facilitators included improved radiology service efficiency, system accessibility, collaboration opportunities, and user trust in the radiology ecosystem. Within each theme, factors with potential impacts on teleradiology system sustainability were identified, such as the lack of system handover mechanisms, absence of a central image consultation center, and inadequate staffing of full-time radiologists and technical personnel. The study highlights the positive user perception of a web-based teleradiology system's user-friendliness and efficiency. Overcoming challenges and leveraging facilitators are crucial for optimizing teleradiology and improving service delivery and patient outcomes. A centralized consultation center with dedicated radiologists and technical personnel is recommended for maximizing efficiency.
远程放射学使偏远地区的医疗机构能够以电子方式传输图像以供解读,从而缩小城乡之间的放射学服务差距。这项技术提高了医疗质量、治疗选择和诊断准确性。然而,在像埃塞俄比亚这样资源匮乏的地区,远程放射学服务有限,这给其实施带来了挑战。因此,本研究旨在探讨促进或阻碍埃塞俄比亚西北部南贡德尔地区公立医院基于网络的远程放射学实施的因素。在本研究中,采用了目的抽样方法,选择了包括医院管理人员、医生、急诊外科医生和放射科医生在内的17名参与者进行深入访谈(IDI)。访谈于2023年3月至5月进行。使用归纳编码技术在语义/显性层面进行了反思性主题分析。通过面对面和虚拟方式进行的半结构化访谈收集数据,录音进行转录、翻译,并使用Open Code 4.02版本软件进行分析。通过长期参与、反思性日志记录和共同作者审核确保了可信度。该研究考察了八个主要主题,可持续远程放射学实施的障碍分为五类:技术、组织、环境、个人以及工作流程和沟通。相反,确定的促进因素包括放射学服务效率提高、系统可及性、合作机会以及用户对放射学生态系统的信任。在每个主题中,确定了对远程放射学系统可持续性有潜在影响的因素,例如缺乏系统交接机制、没有中央图像咨询中心以及全职放射科医生和技术人员配备不足。该研究强调了用户对基于网络的远程放射学系统的用户友好性和效率的积极看法。克服挑战并利用促进因素对于优化远程放射学以及改善服务提供和患者结局至关重要。建议设立一个配备专门放射科医生和技术人员的中央咨询中心以实现效率最大化。