PT  - JOURNAL ARTICLE
AU  - Swanson, Jonathan O
AU  - Plotner, David
AU  - Franklin, Holly L
AU  - Swanson, David L
AU  - Lokomba Bolamba, Victor
AU  - Lokangaka, Adrien
AU  - Sayury Pineda, Irma
AU  - Figueroa, Lester
AU  - Garces, Ana
AU  - Muyodi, David
AU  - Esamai, Fabian
AU  - Kanaiza, Nancy
AU  - Mirza, Waseem
AU  - Naqvi, Farnaz
AU  - Saleem, Sarah
AU  - Mwenechanya, Musaku
AU  - Chiwila, Melody
AU  - Hamsumonde, Dorothy
AU  - McClure, Elizabeth M
AU  - Goldenberg, Robert L
AU  - Nathan, Robert O
TI  - Web-Based Quality Assurance Process Drives Improvements in Obstetric Ultrasound in 5 Low- and Middle-Income Countries
AID  - 10.9745/GHSP-D-16-00156
DP  - 2016 Dec 23
TA  - Global Health: Science and Practice
PG  - 675--683
VI  - 4
IP  - 4
4099  - http://www.ghspjournal.org/content/4/4/675.short
4100  - http://www.ghspjournal.org/content/4/4/675.full
SO  - GLOB HEALTH SCI PRACT2016 Dec 23; 4
AB  - 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.