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Description
We report ten years of experience in developing sustainable medical imaging solutions for low-resource settings, from the development of a CBCT prototype in 2016 to the implementation of radiology service digitalization in three sub-Saharan African countries.
The CBCT project, ImagXEco, was funded by the University of Louvain-la-Neuve and the Walloon Region with the aim of developing a multifunctional X-ray medical device capable of 3D CBCT, 2D radiography, and fluoroscopy imaging. However, the project fell short due to market uncertainties and the complexity of the medical device certification process.
At the end of the ImagXEco project, the digitalization of existing radiology services was identified as the best option to pursue the initial goal of providing sustainable solutions and a commercial company, MDS-Imaging srl, was founded in May 2020 to implement the following solutions:
1. “DRuP” to upgrade existing film or CR X-Ray installations to full Digital Radiography
2. “DRuP+” to replace existing X-Ray generator with a model designed for low and/or unstable power sources
3. “RadStream” to install a completely new Digital X-Ray system
4. “PACS” to provide access to images for all authorized personnel within the hospital, using Orthanc, an open-source lightweight DICOM server
5. “PACS+” to integrate radiology services with the hospital Electronic Medical Record ”EMR”, store and distribute images within the hospital, using Orthanc and OpenclinicGA.
The CBCT project (2016–2019) was a valuable learning experience in terms of technical implementation and needs assessment, and it contributed to the creation of MDS-Imaging in 2020. The need for diagnostic imaging is considerable; however, many examinations are not performed because patients often cannot afford them.
Since 2020, MDS-Imaging srl has installed and maintained the following systems: six “DRuP” (five in District Hospitals and one in a Teaching Hospital); six “PACS+” (in five District Hospitals and two Teaching Hospitals); one “DRuP+” in a District Hospital; and one “RadStream” in a District Hospital.
These installations were funded either directly by the hospitals (50%) or donated by NGOs (50%). In both cases, these installations are sustainable only if they are financially viable and can be maintained by the hospitals. Therefore, the population must have sufficient income to pay for the services or benefit from national health insurance.
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