The Future of Teleradiology in Pakistan: Boon or Burden for Healthcare

By Muhammad Haseeb Malik

Affiliations

1. Department of Radiology, Quaid-e-Azam Medical College / BV Hospital, Bahawalpur, Pakista

doi: 10.29271/jcpsp.2025.12.1638

Sir,

This letter sheds light on the growing impact of teleradiology in Pakistan, a field that has transformed radiological services by making early reporting and cost-effective solutions more accessible. As the demand for radiological interpretations continues to rise, teleradiology has emerged as a practical solution. It enables remote access for radiologists and ensures timely reporting. Despite its benefits, there are several key challenges that need to  be  addressed  to  maximise  its  effectiveness  in Pakistan.

One of the major advantages of teleradiology is its ability to provide faster turnaround times, which is particularly valuable in emergencies where quick decision-making is essential.¹ It also helps healthcare facilities to reduce costs by lessening the dependence on on-site radiologists, ultimately making specia- lised care more affordable.¹ Furthermore, it connects patients in rural and underserved areas with experienced and sub- specialised radiologists.

Despite these benefits, teleradiology comes with its own set of challenges. A lack of direct communication with referring physicians can sometimes lead to misinterpretations due to misunder- standings about the indications for investigation. On-site radiologists often play a key role in guiding technologists to ensure that imaging is performed correctly; without their supervision, there is a risk of suboptimal imaging, which can affect diagnostic accuracy. The reduced opportunity for direct patient interaction—a crucial component of comprehensive radiological assessment—is another limitation. In certain cases, particularly with some MRI studies, including joints or abdominal scans, additional complementary imaging, such as x-rays or ultrasound, may be needed to confirm findings. Without an on-site radiologist, arranging these supplementary studies becomes difficult, reducing diagnostic confidence.

Pakistan faces infrastructural hurdles, including inconsistent internet connectivity, a lack of high-end diagnostic imaging equipment, and cybersecurity risks, all of which create obstacles to the smooth operations of teleradiology services.² Moreover, the absence of well-defined telemedicine policies and quality control measures raises concerns about standardisation and accountability. Another issue relates to the use of outdated imaging equipment and inconsistent scanning protocols in some urban centres, which can result in poor-quality images, making accurate inter- pretation more challenging.

Recent studies have highlighted the rapid growth of teleradio- logy in Pakistan, along with its limitations. For example, a review study of telemedicine in Pakistan noted its potential but also pointed out challenges such as high implementation costs and the difficulty of integrating it into the current healthcare system.³ One international study further underlined that shortcomings related to technology, as well as unclear regulatory frameworks, remain among the most significant challenges for successful tele- radiology practice.⁴

In summary, teleradiology holds a bright future for Pakistan’s evolving healthcare system. While it offers undeniable benefits in terms of accessibility and cost-effectiveness, it is essential to tackle the associated challenges, especially those related to limited clinical interaction and technological barriers. A more effective approach to improving patient care may involve adopting a hybrid form  of  both  remote  and  on-site  radiological  services.

COMPETING   INTEREST:
The   author   declared   no   conflict   of   interest.

AUTHOR’S   CONTRIBUTION:
MHM: Writing, drafting, and critical revision of the manuscript for important intellectual content and approval for the final version of the  manuscript  to  be  published.

REFERENCES

1. Bashshur RL, Krupinski EA, Thrall JH, Bashshur N. The empirical foundations of teleradiology and related appli-cations: A review of the evidence. Telemed J E Health 2016; 22(11):868-98. doi: 10.1089/tmj.2016.0149.
2. Qurat Ul Ain H, Junaid Tahir M, Farooq F, Fadelallah Eljack MM, Yousaf Z. Teleradiology: Legislations and ethical issues in low- and middle-income countries. Acad Radiol 2023; 30(11):2800. doi: 10.1016/j.acra.2023.02.036.
3. Bilal W, Qamar K, Siddiqui A, Kumar P, Essar MY. Digital health and telemedicine in Pakistan: Improving maternal healthcare. Ann Med Surg (Lond) 2022; 81:104425. doi: 10.1016/j.amsu.2022.
4. Hanna TN, Steenburg SD, Rosenkrantz AB, Pyatt RS Jr, Duszak R Jr, Friedberg EB. Emerging challenges and opportunities in the evolution of teleradiology. AJR Am J Roentgenol 2020; 215(6):1411-6. doi: 10.2214/AJR.20. 23007.