Interior Health Authority

  • Karen Omelchuk, Corporate Director, Health System Planning, Planning and Strategic Services, Interior Health Authority, Kelowna, British Columbia 

Supporting Rural Diagnostic Imaging: Remote GP-X-Ray Operators

Interior Health (IH) is a rural health authority in British Columbia. Rural communities and populations experience inequities in terms of health status and access compared to their urban counterparts. Within the broader context of rural health challenges, access to basic x-ray services is currently at risk in several of IH’s communities where shortages of X-Ray technologists are resulting in no service or overtime costs as staff from other communities are brought in to support the site.

Utilizing non-radiographer staff to perform X-Rays is a model that can address this problem. The literature on remote X-Ray operators is sparse, however it is noted to show promise in terms of improving access to services. Quality can be at risk and a robust quality improvement program is recommended to ensure standards are met. The model can result in professional tensions between radiography professionals who value quality and technical competency, and primary care providers who value community access.

One community in IH currently utilizes this model whereby general practitioners perform basic X-Ray services when X-Ray technologists are not available. This intervention focused on expanding the model across Interior Health and implementing a quality improvement initiative at the current site.

Family physicians at one site expressed interest in receiving training to perform X-Rays when technician coverage was not available. Prior to training there was a turnover in the physician complement at the site and expansion did not occur. 

A retrospective audit was conducted to inform refresher training and an ongoing quality improvement approach at the site that currently uses the remote GP X-Ray operator model. The focus of the refresher training was guided by a retrospective audit of tests performed at the site and covered: administrative processes, on site resources, setting the technique for the X-Ray machine, and positioning. Ongoing oversight of the model will be embedded into the Diagnostic Imaging Services Leadership Team terms of reference.

This intervention shows promise and opportunity to improve access to basic x-ray services in rural communities when X-Ray technologists are not available. Furthermore, it can improve physician/provider satisfaction in rural communities as they have more ability to diagnose and treat people in their home communities. Success however requires strong leadership, a physician champion, a robust quality improvement process, change management and acknowledgement that professional tensions may arise between radiographers and primary care providers.