A Global Perspective on Closing the Radiology Gap

Applied Radiology Publisher Kieran Anderson recently spoke with Daniel Mollura, MD, a radiologist who founded RAD-AID International, a nonprofit organization dedicated to increasing health and radiology medical care to underserved and resource-poor communities around the world. This article is based on their conversation.

According to the World Health Organization (WHO), it’s estimated that two-thirds of the world’s population lack adequate access to basic radiology services, such as X-ray imaging. As a fellow in radiology and nuclear medicine at Johns Hopkins University School of Medicine, Daniel Mollura, MD, wondered why and how the imaging capabilities that surrounded him every day could be absent throughout most of the world. As a result, in 2008 Dr. Mollura founded RAD-AID International, which now has more than 12,000 volunteers helping more than 80 hospitals in 38 countries, to bring medical imaging services to those living in these regions. “Because radiology is a part of many medical care decisions across the healthcare system, it meant that there’s a ripple effect in terms of healthcare loss of access when radiology is absent,” he said. “I wanted to make a difference because there’s so much our field can contribute to the world.”

Discovering hidden opportunities in the COVID crisis

When the COVID-19 pandemic began spreading worldwide, Dr. Mollura faced the challenging of figuring out how RAD-AID could continue to deliver care while protecting the staff of his own institution and the volunteers at RAD-AID member facilities. Like colleagues at other medical facilities, he and RAD-AID’s management team worked on increasing radiology professionals’ access to personal protective equipment (PPE) and other safety measures. His team also hosted webinars and one-on-one discussions to educate volunteers around the world on COVID-19 and related issues impacting medical imaging.  “We decided to lean in and pivot because that's what we have to do to protect the health and safety of the whole world and our volunteers. We continued pushing radiology development because radiology was central to the diagnosis and treatment of COVID,” he said.

RAD-AID also began focusing on social justice issues that underlie the lack of access to health care among men and women of color.“ We started to shift more attention to the issues of systemic racism in health care because global health is not just about poverty, it’s also about race relations,” he said.  To that end, RAD-AID partnered with Hologic and the Black Women’s Health Imperative to form the RAD-AID USA Women’s Health Initiative to increase access to breast and cervical cancer screenings for women of color throughout the United States. “What you started to see throughout 2020 is a reformation of how we think about global health, poverty, racism, equality and social justice. And that’s why COVID-19 has been a big turning point for the world and RAD-AID itself,” Dr. Mollura said.

The RAD-AID 2020 International Conference

In November 2020, RAD-AID held its 12th annual Conference on Global Health Radiology for Low-Resource Regions and Medically Underserved Communities. The conference brings together the RAD-AID community of leaders, volunteers, partners, and supporters from around the world. “It became a personal way of people connecting to each other. So much of radiology can be done virtually through images and communications, but so much of global health and team building is done by seeing people and just sharing the day,” he said.

The conference’s virtual format was a challenge to coordinate across time zones and re-engineer the meeting with engaging content, including quizzes, breakout sessions, interactive rooms, and Q&A sessions. “This year exceeded my expectations because the people really did feel like they were connected. And they were able to learn about our programs, volunteer, and submit applications to our program leaders,” said Dr. Mollura.

Building Partnerships for the Future of Radiology

Like many organizations, RAD-AID is focused on the emergence of artificial intelligence (AI). The group received a grant from the Google Foundation in 2020 to spend three years researching racial bias in AI-based radiology tools. RAD-AID will use this knowledge to educate partner hospitals on validating, testing, appraising, and correcting bias in AI data. “This ability to look at racial bias and other forms of limitations on AI performance will actually help AI to have a greater role in low-resource environments, so that’s very exciting,” he said.

In 2020, the organization expanded its online learning component through a partnership with Applied Radiology. “The contribution of so much great Applied Radiology content into the RAD-AID learning center is going to be a big accelerator throughout 2021,” Dr. Mollura said. “As radiology has become even more complicated, the need to synthesize different topical reviews and put them together in a useful and practical format has been invaluable. That’s why I wanted to bring Applied Radiology into those low-resource hospitals that we’re partnered with because they really need that synthesis.” Inundating clinicians with vast amounts of literature without a useful format, however, can limit their progress. He says Applied Radiology offers clinicians a useful, powerful, and integrated format to process that information. “It’s such an important mission of bringing important information to the bedside, to the real lives of patients through high-value educational radiology content,” Dr. Mollura said.

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