ABSTRACT:
Objectives - Population ageing has increased the prevalence of chronic cardiometabolic, oncologic, and neurodegenerative diseases, substantially raising demand for CT and MRI imaging. This demand has outpaced workforce supply, with relevant shortages of radiologists and technologists estimated for North America and the United Kingdom, for instance. , These constraints are particularly acute in remote and underserved areas, especially in developing countries. We evaluate the impact of remotely operated CT and MRI exams implemented through a partnership between a large public hospital and a private hospital in Brazil. By enabling exams to be operated by off-site professionals, remote operation may mitigate local shortages of qualified personnel, expand access to diagnostic services in underserved locations, and improve efficiency while reducing costs. This study provides the first causal quantitative evidence on exam quality and patient satisfaction, complemented by qualitative evidence on health professionals’ experiences and perceptions. Methods- We use patient-level data to compare remotely operated and in-person CT and MRI exams. Patients are assigned to machines on a first-come, first-served basis, generating as-if random allocation to remote exams; balance tests confirm no significant differences in observable characteristics. Outcomes include exam preparation time, image quality indicators, and patient satisfaction. We also conduct post-exam patient surveys and interviews with technicians, nurses, and physicians. Results - Overall patient satisfaction does not differ between groups. Patients undergoing remote exams report slightly lower comfort (−0.5%) and higher perceived effort (+10%), differences that largely disappear when excluding exams with contrast. Remote exams reduce preparation time by 16.6 minutes relative to a 74.3-minute control mean, while image acquisition is about one minute faster. Technicians rate remote exams marginally lower on some quality criteria; a composite quality index is 4.4% lower than for in-person exams. Although small quality differences persist, overall performance remains comparable, with time savings indicating meaningful productivity gains.