TY - JOUR T1 - Web-Based Quality Assurance Process Drives Improvements in Obstetric Ultrasound in 5 Low- and Middle-Income Countries JF - Global Health: Science and Practice JO - GLOB HEALTH SCI PRACT SP - 675 LP - 683 DO - 10.9745/GHSP-D-16-00156 VL - 4 IS - 4 AU - Jonathan O Swanson AU - David Plotner AU - Holly L Franklin AU - David L Swanson AU - Victor Lokomba Bolamba AU - Adrien Lokangaka AU - Irma Sayury Pineda AU - Lester Figueroa AU - Ana Garces AU - David Muyodi AU - Fabian Esamai AU - Nancy Kanaiza AU - Waseem Mirza AU - Farnaz Naqvi AU - Sarah Saleem AU - Musaku Mwenechanya AU - Melody Chiwila AU - Dorothy Hamsumonde AU - Elizabeth M McClure AU - Robert L Goldenberg AU - Robert O Nathan Y1 - 2016/12/23 UR - http://www.ghspjournal.org/content/4/4/675.abstract N2 - Newly trained sonographers improved performance through a quality assurance process that merged (1) evaluation by remote experts of images uploaded to a website, with (2) periodic in-person skill tests. To promote sustainability, in-country supervisors gradually assumed more responsibility for image evaluation. The user-friendly and efficient interface used simple menus and forms, customized based on the user's role.High quality is important in medical imaging, yet in many geographic areas, highly skilled sonographers are in short supply. Advances in Internet capacity along with the development of reliable portable ultrasounds have created an opportunity to provide centralized remote quality assurance (QA) for ultrasound exams performed at rural sites worldwide. We sought to harness these advances by developing a web-based tool to facilitate QA activities for newly trained sonographers who were taking part in a cluster randomized trial investigating the role of limited obstetric ultrasound to improve pregnancy outcomes in 5 low- and middle-income countries. We were challenged by connectivity issues, by country-specific needs for website usability, and by the overall need for a high-throughput system. After systematically addressing these needs, the resulting QA website helped drive ultrasound quality improvement across all 5 countries. It now offers the potential for adoption by future ultrasound- or imaging-based global health initiatives. ER -