Challenges and optimization strategies in medical imaging service delivery during COVID-19

Table 1 Summary of the challenges in the provision of medical imaging service during coronavirus disease 2019

Challenge	Experiences of medical imaging departments
Coping with limited manpower	Team segregation; Increased workload; Increased responsibility; Increased procedure time due to infection control measures and terminal cleaning of equipment; Self-isolation due to contact with positive cases; Statutory paid sick leave
Coping with strict infection control measures	Shortage of PPE; Increased risk of exposure from prolonged patient contact; Resource and labour intensive due to terminal cleaning of equipment
Coping with limited resources	Equipment segregation; Inadequate mobile radiography units; Delay in delivery of equipment due to increased orders; overseas shipment of equipment delayed; Poor imaging service delivery due to a lack of imaging equipment
Safeguarding of medical imaging professionals’ well-being	Aggravated psychological pressure and mental illness; Physical and emotional distress among medical imaging professionals; Burnout; Fatigue

PPE: Personal protective equipment.

Table 2 Summary of the strategies to optimize medical imaging service delivery during coronavirus disease 2019

Theme	Strategies
The need for strong and compassionate leadership	Staying calm, communication, collaboration, coordination and providing support; Practising adaptability, flexibility, and teamwork; Ensuring the safety of patients and staff; Safeguarding the well-being of staff; Instilling hope in times of crisis
Embracing technological usage	Adopting mobile DR units in the department; Adopting AI to reduce contamination of equipment; Harnessing capability of AI in: (1) Remote diagnosis; (2) Data-driven management of COVID-19 operations; (3) Mounting imaging backlog; (4) Ongoing monitoring and research on COVID-19; and (5) Supporting and provision of guidance to patients
Clear communication	Communication among staff through: (1) Routine instructions; (2) Newsletters; (3) Open forum; and (4) One-to-one communications. Timely updates and dissemination of current guidance and policies through: (1) Websites; (2) Virtual telecommuting; and (3) Team-based communication. Structured reporting in communicating imaging results
Enhancing processes, protocol, and policies	Postponement of elective/non-urgent imaging procedures; Review and prioritisation of outpatient schedules by radiologists; Triaging of patients prior to entering the radiology department; Temporal and physical segregation; Suspension of students’ placement; Dedicated workflow management process; Development of isolation mobile radiography workflow; Involvement of medical imaging professionals in technical operations; Reorganisation of radiological equipment and assigning of dedicated equipment for suspect and confirmed cases; Implementation of dedicated transport team, routes, lift lobbies and waiting area for COVID-19 patients; End of day schedules for COVID-19 patients
Innovation	Developing new solutions to minimise patient contact

COVID-19: Coronavirus disease 2019; AI: Artificial intelligence; DR: Digital radiography.