Scaling Ultra Low-Field Portable Brain MRI in Rural and Remote Canada Using an Implementation Science Approach to Improve Diagnostic Access
Advanced neuroimaging in Canada is concentrated in urban centres, leaving rural, remote, and Indigenous communities with limited access. While ultralow field portable MRI has shown early technical promise, widespread adoption is hindered by implementation gaps, not technology alone. This project addresses barriers related to workforce training, workflow integration, governance, and community trust by engaging diverse stakeholders to co-design a practical implementation toolkit. Using a mixed-methods, implementation science approach grounded in CFIR, we aim to generate evidence-informed guidance to support equitable, sustainable scaling of portable MRI in underserved Canadian health systems.
Background
Conventional MRI systems require specialized infrastructure, shielding, and on-site expertise that make them unsuitable for geographically isolated or resource limited settings. This structural reality contributes to diagnostic delays, unnecessary patient transfers, and inequitable access for rural, remote, and Indigenous communities across Canada.
Recent advances in ultralow field portable MRI have demonstrated technical feasibility and early clinical utility in non traditional environments, including pilot implementations in remote Canadian hospitals. However, the evidence base for how to implement these technologies sustainably, accounting for governance, staffing, cultural safety, and community trust, remains limited.
This capstone applies implementation science frameworks, specifically the Consolidated Framework for Implementation Research (CFIR), to address this gap. The study follows a four-phase, mixed-methods design:
- Exploratory interviews (12–15 participants) with radiologists, MRI technologists, administrators, policy stakeholders, and Indigenous advisors to identify barriers, enablers, and readiness factors.
- Stakeholder survey (40–60 participants) to assess perceived feasibility, acceptability, and priorities for toolkit components
- Toolkit development to synethsize interview and survey findings into a practical, transferable implementation resource
- Validation (5–8 participants) to assess usability and real-world applicability of the draft toolkit
The study is conducted virtually via Zoom/Teams and is classified as minimal risk by the University of Toronto Health Sciences REB. It involves no patient data, no clinical interventions, and no health records. Indigenous perspectives on trust, cultural safety, and governance are incorporated through advisory input in partnership with the Weeneebayko Area Health Authority (WAHA).
The final deliverable is a co-designed implementation toolkit intended to support health systems planning for portable MRI adoption across diverse rural, remote, and Indigenous-serving contexts in Canada.
Project team
- Kareem Draz
- Karina Pacholczyk
- Pardaman Setia
TRP supervisors
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