Table 1.

SWOT analysis of tele-ultrasound with a scope

Strengths	Weaknesses
•Bandwidth requirements are low for satisfactory image quality •Quality assessment tools are available for grading images •Access to imaging is possible in areas with limited health care infrastructure •Patients at home who are immobilized or with reduced mobility can be examined •There is no need for additional commuting to imaging facilities for patients •Uninterrupted end-to-end health care is available at a single-point location •Android/iOS compatibility allows imaging on vast majority of mobile phones •Handheld portable devices work as stand-alone devices without relying on additional computer hardware •Mobile apps are more user friendly compared with traditional ultrasound software •Some devices allow immediate sharing, saving and storing of images to a cloud storage •A selection of different ultrasound heads is available for different examinations (cost savings)	•Acquisition costs are high for individual practitioners •Software updates and compatibility are not guaranteed •Handheld devices often require an internet connection for full functionality •There are subscription fees for some services •Different ultrasound heads drive up the price •There are high battery drains for devices that are USB powered •USB-OTG (On-The-Go) port is needed for some handheld devices •Screen size is comparatively small for adjustments on mobile phones and smaller tablets •Cloud storage without multiple backup systems can result in the loss of data •Devices are more easily lost or stolen because of their small size
Opportunities	Threats
•Multiple expert opinions are available through sharing, recorded examinations or live-streaming •Health care systems save because of reduced costs for dedicated imaging centers •Diagnostic imaging capacity in underdeveloped countries is improved •Usage of ultrasound is expanded globally •Teaching in ultrasound imaging is expanded globally •Deployability is easy in disaster situations	•Legal regulations may restrict sharing of patient data/images •Regulations for telehealth do not exist or are vague in many countries •Android/iOS based handheld devices require high-end mobile devices for full compatibility of apps •Acquisition costs of devices may not allow for mass adoption in low-income countries •Purchase of ultrasound devices may be limited to licensed physicians/clinics •Whether devices are prone to error long-term under rough environmental conditions (such as high/low humidity, temperature fluctuations) is unknown

SWOT = Strengths, weaknesses, opportunities and threats.