Self-contained teleradiology units find use in developing world

A new telemedicine and teleradiology initiative is tapping digital imaging technology to bring medical care to some of the world's most underserved regions.

"In sub-Saharan Africa, 14 countries do not have a single radiologist," said Dr. Hamish S.F. Fraser, an instructor in pediatrics at Harvard University Medical School.

Teleradiology in the form of satellite-operated telecenters housed in recycled 20-foot metal ISO shipping containers has begun to ease this shortage in several areas in the developing world.

The containers, called LINCOS (or Little Intelligence Communities) were created by the Massachusetts Institute of Technology's renowned Media Lab and outfitted by Hewlett-Packard. They house wireless telecommunications equipment with which poor rural patients can access medical services via the Internet.

Each LINCOS contains a telemedicine kit - a durable case holding a portable computer and several medical peripherals, including an x-ray system, digital stethoscope, and ECG recorder. The kit allows healthcare providers in remote areas to capture images and other patient data and forward them over the Internet to radiologists or other physicians for diagnosis.

"Studies by our group and others have shown that adequate quality x-ray digitization can be achieved by 1 to 2 megapixel digital still cameras costing as little as $300," Fraser said.

One such LINCOS unit positioned in West Bengal, India, for instance, supports the remote town of Siliguri in the foothills of the eastern Himalayas, where the population of 257,000 has limited access to medical facilities and no access whatsoever to radiologists or cardiologists. Patients requiring the care of a specialist must travel 300 miles to Calcutta, and even then appointments are uncertain.

The LINCOS program, part of an HP initiative called e-Inclusion that's designed to broaden developing countries' access to the social and economic wonders of the digital age, has equipped a hospital in Siliguri with x-ray, ultrasound, ECG, and catheterization devices, each operated by local technicians trained by the Asia Heart Foundation.

The technicians run tests on patients in Siliguri and then transmit the images via the LINCOS/Internet connection to Calcutta to be read by radiologists.

The telecenters are satellite operated and solar power enabled and offer state-of-the-art information technology equipment with high-speed Internet connections that operate independently of local infrastructures. The idea is to use the Internet connections to facilitate applications such as telemedicine, teleradiology, education, and environmental monitoring.

Other containers are in use in the Philippines, Costa Rica, Tanzania, Vietnam, Russia, Brazil, Kenya, Uganda, and Togo.