For institutions with fewer resources, what “minimum viable” setup would you recommend and what pitfalls should be anticipated?
Dr. Gal Ben-Arie: “Minimum viable” setup for lower-resource hospitals:
Designate a single, safest CT (ideally shielded) and place a radiologist at the CT console for protocol adjustments and immediate prelims.
Enable secure remote PACS access (pre-tested VPN, adequate licenses) and line up pre-credentialed teleradiology partners for surge coverage.
Standardize documentation with a one-page disaster report for critical findings and scan it to PACS, with a named lead for post-event second read/QA.
If available, use AI as a safety layer (critical-finding alerts; basic image-report discrepancy checks); limit alerts to high-value targets to reduce alarm fatigue.
Implement these measures now and train staff regularly so all personnel understand their roles during an MCI.
Anticipate pitfalls:
- Alarm fatigue from overly broad AI panels
- Documentation gaps if handwritten notes/POCUS are not archived
- IT chokepoints (insufficient remote seats/VPN capacity)
- Worklist chaos without a clear on-site imaging triage lead
- Worst-case planning: conduct tabletop and live drills to stress-test assumptions and surface likely failure points in advance.
Dr. Ben-Arie is with the Department of Medical Imaging at Soroka University Medical Center in Beersheba, Israel.
