by
Sean Ruck, Contributing Editor | December 01, 2019
From the November 2019 issue of HealthCare Business News magazine
From a financial sustainability side, Imaging the World has a business model set up at each facility, which charges a small fee for a scan. “The difference between fee-for-service here at home and there is that there, the fee is determined by the community,” DeStigter said. So it’s deemed affordable by the community members and they pay a fee that supports the scanning’s use of the consumables — the ultrasound gel that’s required, the power, the network, and supervision costs. According to DeStigter, generally about a year-and-a-half into a program, a clinic that has integrated ultrasound into its care is fully financially sustainable. And the management isn’t all coming from Vermont where the headquarters is based. “We have a great team — Imaging the World Africa — that’s in Kampala, they run the operations. We have a Ugandan surgeon who’s the clinical director of the program,” said DeStigter. “We’ve trained hundreds of nurses and midwives over the years and it’s difficult to provide the precise number, but we know we’ve done more than 300,000 obstetric scans in the last 12 years, identifying complications that need to be referred to a higher level of care.”
Smaller and less expensive ultrasound designs made it possible to provide scans at the point of care in remote regions.
Before the organization introduces ultrasound at a site, they confirm that the site has a stable referral system in place. They won’t integrate ultrasound at any facility where there’s not access to a higher level of care. Sometimes efforts are made to build referral capacity to allow for integration of ultrasound. But it’s not just the general community that’s benefitting. There are also professionals taking steps toward a better life; of the nurses that have been trained, six enrolled in medical school. “We believe this will improve the line of succession. We have an exit strategy. Eventually, we’ll be able to entirely hand this off to the Ugandans and then Malawians, and so on,” said DeStigter.
When it comes to getting support for Imaging the World’s work, DeStigter said the organization is not looking for older equipment since it can be challenging to find parts, people with the knowledge to repair the equipment or even to get customer support from the manufacturer on old equipment. Instead, she prefers either new equipment, or funding for the purchase of equipment.
In the future, DeStigter hopes to get the funding to expand their efforts to an area where there isn’t exactly an exit strategy needed, and that’s because it’s already where she lives, or more broadly, where she’s a citizen. “We’re looking to expand into rural areas even in high-income countries. By that, I mean the United States. We’ve cultivated a program that works really well and I would really like to see it be operational here. There are barriers to that, including nurses and midwives being able to scan independently in this country, but we need to find a way to improve outcomes at home too.”
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