5 Challenges Hospitals and Imaging Departments Face in Rural Areas

Susanne Schlagl

Several days ago I spent a day with a PACS project leader responsible for 5 hospitals in a region of Austria. The region is a rural area and can be called “structurally weak” with a density of 42/km2, compared to 4,002/km2 in Vienna, Austria’s capital city.

We had a fruitful discussion about the challenges they face and how the healthcare industry could contribute by supplying solutions to help overcome these.

  1. Ageing population

“Population ageing is unprecedented” is highlighted in a United Nations report about the global trends in population ageing. In the case of this region in Austria, they see that the next biggest city, Vienna, attracts the younger population whereby the older population tends to move into the rural areas.

They expect to see more than 25% of the citizens (population) will be older than 60 (years) by 2027. This leads to the assumption that they will see a tremendous increase in chronic diseases and oncology cases in this region. (Source: United Nations, Department of Economic and Social Affairs Population Division: World Population Ageing:  1950-2050)

  1. European Working Time Directive

The European Union (EU) has released a directive (European Working Time Directive) designed to prevent employers requiring their workforce to work excessively long hours, with implications for health and safety. The directive requires EU countries to guarantee a limit to weekly working hours, which must not exceed 48 hours on average, including any overtime – for all workers, including medical doctors in hospitals.

The hospitals need to comply with this directive in the next few years, which will challenge them tremendously – they will face a growing lack of clinical staff. (Source: EU’s Working Time Directive (2003/88/EC))

  1. Clinicians moving towards urban areas

There is an increasing trend that clinicians and other university graduates relocate towards bigger cities to live and work in more attractive areas such as Vienna.  The future challenge is to work effectively with a decreasing amount of resources in a large area.

  1. Sharing of modalities and clinicians across hospitals

Hospitals in rural areas are forced to collaborate and it starts from sharing imaging equipment such as CTs, and MRs which may not be available in each of the collaborating institutions.

They have also built specialists networks across hospitals, due to the growing complexity in imaging, but also to enable them to offer a second opinion and out of hours coverage.

  1. Cross hospital pathways

As a result of sharing devices, patients are often forced to go to several locations for their treatment. Especially when it comes to oncology, the patient pathway flows through a variety of specialists and care providers where patients receive both examinations and treatment.

  1. IT Systems enabling collaborative care across networks

Whereas the healthcare industry can’t influence an ageing population or anticipate EU directives, it can help to provide tools to diagnosticians to work independently of their location and to have access to the complete patient history wherever they are working.

There is a need that IT solutions enable collaborative care across networks, providing a patient centric view. Solutions which realise access to patient data independent from where the patient has been examined or treated are crucial.

At the end, it is about providing the best possible patient care, independent from rural or urban areas.

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