Access to ultrasound imaging: A qualitative study in two northern, remote, Indigenous communities in Canada

Abstract

Ultrasound imaging is an essential component of healthcare services. This study sought to explore perceptions of access, and factors which shape access, to ultrasound imaging in two northern, remote, Indigenous communities in Canada. Using interpretive description as a methodological approach and a multi-dimensional conceptualisation of access to care as a theoretical framework, 15 semi-structured interviews were conducted in the northern Canadian communities of Stony Rapids and Black Lake, Saskatchewan. All participants had an obstetrical or non-obstetrical ultrasound exam performed in the past 10 years. Interviews were audio recorded and interview transcripts were analysed using constant comparative analysis. Geographic isolation from imaging facilities was a central barrier to participants accessing ultrasound imaging. Other barriers became apparent when participants had to travel for ultrasound, including fear of air travel, isolation from family, financial means, and unfamiliarity with larger cities. Barriers such as family and work responsibilities were exacerbated by the barrier of geography. Participants overcame these barriers as they were motivated by potential diagnostic benefits of ultrasound imaging. This study highlights disparities in access to ultrasound for northern, remote, Indigenous populations. Future efforts to improve access to imaging should consider barriers of distance to imaging facilities and strategies to bridge these barriers.

Successful Use of a 5G-Based Robot-Assisted Remote Ultrasound System in a Care Center for Disabled Patients in Rural China

“…However, the use of 5G-based robot-assisted remote ultrasound system in persons with disabilities decreases the total process time, as compared with routine ultrasound. In particular, patients from remote areas take a longer time to arrive at medical facilities and undergo an ultrasound examination ( 29 ). This study suggests that the 5G-based robot-assisted remote ultrasound system will hopefully provide patients at rural care centers with the same diagnostic possibilities as those at tertiary hospitals where experts are instantly available.…”

Sociodemographic and Geographic Factors Associated With Non-Obstetrical Ultrasound Imaging Utilization: A Population-Based Study

“…Lower rates of non-obstetrical ultrasound utilization in many remote areas of the province may reflect barriers which patients face in accessing ultrasound, such as the need to travel far distances-sometimes by plane-to reach an ultrasound facility. 2 However, it is interesting that utilization rates did not continue to decrease with higher levels of geographic remoteness, but were lowest in mid-geographically remote areas. 14 This may be explained by ultrasound and radiography being the most accessible imaging modalities in many rural and remote areas, leading physicians to order ultrasound imaging even in cases where another imaging modality may be more appropriate.…”

“…1 Despite its importance in clinical care, ultrasound is not available in many rural and remote communities in Canada and around the world, creating inequities in access to this important imaging modality. 2 While disparities in access to ultrasound imaging among specific sociodemographic groups-including individuals in rural and remote communities-have been reported, 2 it is less clear how disparities in access to ultrasound imaging impact utilization of non-obstetrical ultrasound imaging. One of the most frequently cited theoretical models of healthcare utilization, first described by Andersen in 1968, proposes that healthcare utilization can be predicted by an individuals' predisposition to use services, factors which enable or impede use, and individuals' perceived and evaluated need for care.…”

“…1 Despite its importance in clinical care, ultrasound is not available in many rural and remote communities in Canada and around the world, creating inequities in access to this important imaging modality. 2…”

Economic Evaluation of Telerobotic Ultrasound Technology to Remotely Provide Ultrasound Services in Rural and Remote Communities

“…4 In other communities where an itinerant sonographer visits the community on a monthly basis, long wait times often result. 4 Telerobotic ultrasound is a new technology which equips a sonographer or radiologist with the ability to remotely manipulate an ultrasound probe, control all ultrasound machine settings, and remotely perform an ultrasound exam (Figure 1). 5 Clinical trials which have demonstrated the feasibility of a telerobotic approach for performing abdominal and obstetrical ultrasound imaging 6,7 and recent commercialization of telerobotic ultrasound systems [8][9][10] have paved the way for the implementation of this technology in remote communities.…”