Dr. Bhavya Rehani presenting at the
virtual 2020 RSNA Annual Meeting

Neuroradiologist outlines plan to improve global healthcare at RSNA

December 07, 2020
by Lauren Dubinsky, Senior Reporter
Global disparities in access to healthcare was already a major problem when COVID-19 arrived on the scene and exacerbated it. Neuroradiologist Dr. Bhavya Rehani, president and co-founder of Health4TheWorld, said last week at the Radiological Society of North America annual meeting that virtual education, telemedicine, mobile health and machine learning together are the keys for solving this issue.

“The power and vision of global education in radiology is for every physician to have access to free and reliable education no matter which part of the world they live in,” said Rehani. “For that, we have to work together as a global radiology family.”

More than half of the world has little or no access to radiology services, according to the World Health Organization.

Surveying 80 countries, Rehani and her team attributed this to a lack of education and training. In Africa, for instance, which has a population of 1.3 billion, countries like Chad have no radiology residency programs, and only 15 percent of African countries offer subspecialty training. Sixty percent of radiologists in Latin America have asked for more subspecialty training and five of 19 Asian countries surveyed have little or no subspecialty training.

The team set up a virtual education platform, but ran into challenges such as low bandwidth internet for live teaching, language and time differences, coordinating with speakers nationwide, and designing a curriculum with outcome metrics. Pushing through these setbacks, it was able to set up a web platform optimized for low internet settings in 2015 at the University of Nairobi, and expanded training over the next five years to Thailand, Ecuador, Ghana, Zambia and other African countries.

“We do not have time to go to these countries to educate and leave our medical careers here in the U.S., so we decided to start [offering] online education,” said Rehani.

Some courses offered include CT dose reduction, breast imaging calcifications, imaging of cardiac masses and ultrasound of the head and spine. Because many countries cannot join the virtual classrooms due to time differences, Rehani and her team created a learning management system that allows the students to access training in their own time.

Health4TheWorld also developed an app that helps stroke patients around the world who don’t have access to physicians, physical therapists or speech therapists. The app takes the patients through a step-by-step exercise regimen, teaches them how to prevent stroke and provides them with a communication tool to help with speech difficulties.

In addition, AI-powered chatbots are used to train healthcare workers in rural villages who might not have been able to attend medical school. “[The healthcare worker] has to take care of patients with abdomen pain, chest pain and headaches, but he doesn’t know what tests to order and what tests are done in the city,” said Rehani. “This is where the chatbot can help him. This is an excellent tool that can be with the healthcare worker 24/7, 365 days.”

Another vital way the medical community is improving global health is through Health4TheWorld chapters at academic institutions around the country. These chapters are made up of faculty, residents, fellows and medical students, and they work together to solve common problems in education, technology and COVID-19-related issues.

Multiple radiology societies including RSNA, the Association of Program Directors in Radiology (APDR) and Society of Breast Imaging (SBI) also launched free online education for the radiology community during COVID-19, which can be used alongside other global efforts in radiology such as RSNA Global Learning Centers & CIRE, Imaging the World, and RAD-AID International.

“Technology can reach parts of the world where radiologists and physicians cannot and it can stay and help people all the time, which is really powerful,” said Rehani. “That is why all of us have to work together to design technology solutions in radiology globally.”

Radiologists can get involved by volunteering to teach online, mentoring international residents, donating personal protective equipment through nonprofit organizations, working together with Health4TheWorld on technology solutions and spreading hope.