Eye in the sky: how virtual collaboration can improve access to care around the world

The World Health Organization (WHO) has estimated that two-thirds of the world’s population lack access to basic medical imaging technology, causing preventable and sometimes fatal delays in diagnosis and treatment [1]. What if we could bridge those gaps in care – virtually?

As a mom who was fortunate enough to have access to top-tier medical technology and expertise when I faced complications in childbirth, the numbers still stop me in my tracks. Every day, more than 800 women around the world die from complications in pregnancy and childbirth. Although most of these deaths occur in low- and middle-income countries, maternal mortality rates in developed nations such as the US tell an equally sad story, with women in rural areas being affected disproportionately hard [2,3]. What breaks my heart is that many of these deaths could be prevented – if only those women had access to a routine ultrasound check-up that would bring complications to light earlier [4].

And this example doesn’t stand alone.

Having access to medical imaging technology – whether it’s a basic ultrasound or an X-ray exam, or more advanced modalities like CT and MR – can make the difference between life and death. Just consider the countless lives that have been saved with routine mammography and lung screening exams alone.

Yet today, two-thirds of the world’s population lack access to even basic imaging technology. Even in those underserved regions where the technology is available, what’s often lacking are enough skilled hands to operate it, and experienced eyes to interpret the findings. Patients, on their part, may be deterred by long and expensive trips to the nearest healthcare facility; with safety concerns posing another barrier in times of COVID-19. The result: delayed testing, diagnosis, and treatment, with increased downstream costs for healthcare systems and increased risk of adverse outcomes for patients.

It doesn’t have to be this way.

For patients in remote and underserved communities as well as the healthcare providers that struggle to serve them, there’s new hope on the horizon. We can now bring better care to patients – through virtual collaboration that supports local staff from a distance. Here’s what that looks like.

A digitally integrated maternal care ecosystem allows doctors, midwives, and community healthcare workers to share patient data and consult each other virtually for remote diagnostics


Using a simple mobile app, midwives can build a health profile of pregnant women by collecting data from physical exams at primary care facilities or even at the soon-to-be-mom’s home. From this data a risk score is generated, which can help caregivers identify women who need extra care. On top of that, expecting moms can engage in their own care through an educational app that delivers pregnancy-related tips. The app also allows them to track data such as kick count, pregnancy symptoms, and medication usage – and to share that data with caregivers for an even more complete picture.

Through this cloud-based model, authorized obstetricians and gynecologists are able to keep a caring eye on patients from any location.

The Philips Foundation has piloted elements of this approach with Amref Health Africa’s Amref International University in Kenya, and is now working with Aga Khan University Centre of Excellence in Women and Child Health to assess its impact on clinical outcomes more systematically. Initial experiences are highly encouraging, showing how trained midwives in primary care facilities – with the right remote support – can play an integral role in early detection, diagnosis, and follow-up of pregnancy and pregnancy-related complications. As an additional advantage, because all patient data is shared digitally, it leaves less of a paper trail, making it a more environmentally friendly approach too. Everyone benefits.

Midwives at rural health clinics in Kenya can now conduct basic ultrasound exams in pregnant women and share data remotely for virtual collaboration (Photos: Amref Health Africa)


What I find most exciting about this kind of remote education model is that it’s not just a temporary band-aid. It elevates local knowledge and skill levels to help improve access to care in an enduring and sustainable way, right where it’s needed, in the heart of communities.

In the same spirit, the Philips Foundation has provided emergency medicine physicians in US hospitals with a platform to train their peers in Peru in the use of point-of-care ultrasound (POCUS) – through live virtual collaboration. Trained physicians in Peru have since become local champions who leverage their learnings beyond their own practice by educating colleagues. During the pandemic, these local champions have also taken a leading role in using POCUS to support diagnosis and treatment guidance for COVID-19 patients.

Hear more about this cross-continental collaboration in the video below:    

The power of this approach is that it can make specialized care more accessible and affordable, while improving consistency in the quality of care and reducing safety risks in times of COVID-19. For patients, getting instant reassurance from an expert – rather than having to wait 1-2 weeks – also saves a lot of stress and anxiety.

In the future, one can even imagine a nurse performing a routine ultrasound exam at home or at a local retail clinic, using the kind of portable handheld device that already exists today, with an expert sonographer looking over the nurse’s shoulder remotely, and with AI extracting basic information from the scan. In the post-COVID-19 era, where patients will have come to expect convenient access to care close to home, this will open up entirely new pathways to diagnosis and treatment.

And it’s not just ultrasound that will become more widely available through remote guidance and education. In other imaging modalities, which face similar shortages of specialized staff, virtualization will also help to distribute expertise more evenly across locations and thereby improve access to care.

Similarly, when it comes to the diagnostic interpretation of images, remote services will be critical for reaching underserved communities. In the past few months, teleradiology has proven to be particularly valuable in addressing backlogs in breast cancer screening, which was largely put on hold when the pandemic hit [5]. Especially in geographically challenged areas, where subspecialty radiologists are in short supply, having remote access to a dedicated women’s imaging specialist can make a huge difference in getting women their mammography results more quickly. And we know that turnaround times matter: the earlier we find a cancer, the better it is for patients, caregivers, and health systems alike.