Prospects for Centralizing the Radiological System in the Republic of Kazakhstan through the Creation ofa Teleradiology Center

Abstract

Many countries have already succeeded in improving diagnostic quality and equity in access to radiology services by developing a centralized teleradiological services using cloud technologies that support standardized workflows, intertwined with Artificial Intelligence (AI) algorithms. In those systems, a unified teleradiology system enables faster reporting, higher diagnostic accuracy, and better resource distribution across regions.Kazakhstan faces similar challenges: fragmented radiology infrastructure, uneven distribution of specialists, inconsistent reporting quality, and a lack of unified standards for teleradiology and AIassisted imaging. This policy brief assesses the current challenges in Kazakhstan’s radiology ecosystem, compares national capabilities with international best practices, and proposes three policy options aimed at building a unified, AIenabled teleradiology system, outlines a strategy for building a modern, nationwide imaging ecosystem that includes centralized data storage, unified workflows, and certified AImodules used for triage, detection, and decision support.The envisioned approach integrates regulatory reform, cloud-based imaging architecture, and workforce development to not only enhance diagnosticservices but also deliver a scalable and sustainable high-performing radiology network across the country.What is the problem? Kazakstan's radiology service is structurally, technically, and regulatory challenged to ensure equity in quality diagnostic services throughout the country.1. Fragmented radiology infrastructure with no centralized archiving of images.Regions use heterogeneous Picture Archiving and Communication System/Vendor Neutral Archive /Radiology Information System solutions without centralized storage or unified workflows. Imaging data cannot be shared effectively, and quality control is inconsistent. There is no centralized DICOM archive, and there is no unified monitoring of device loads, and lack of internet connectivity in rural and remote areas. Kazakhstan still stores data locally and inconsistently. . Radiologist shortage and uneven distribution, geographic inequality in access to diagnostics.In rural and remote settings, there is an overall lack of radiologists, particularly subspecialists such as neuroradiology, thoracic radiology, musculoskeletal studies, and pediatrics. These delays commonly result in misdiagnoses and increased referrals.3. There is no national framework of governance for teleradiology and AIThere are no regulations defining the operations of teleradiology, quality standards, turnaround times, AIvalidation pathways, or post-market monitoring of algorithm performance.4. Lack of Interoperability and Standardization of DataIncomplete implementation of Health Level 7 Fast Healthcare Interoperability Resources, Digital Imaging and Communications in Medicine –Web Services, Systematized Nomenclature of Medicine –Clinical Terms, Logical Observation Identifiers Names andCodes, and unified metadata schemas prevent seamless data exchange between regions and systems.5. Lack of Central Quality Assurance MechanismKazakhstan lacks a national “second-opinion” hub or expert review system to ensure consistent and high-quality reporting for computed tomography, magnetic resonance imaging, X-ray across all regions. There is no unified national standardization of descriptions, or audit of radiology services.6. Lack of a unified governmental AIintegration platform.While volumes continue to increase annually, there is a lack of a uniform national platform that allows systematic deployment, monitoring, and integration of AIbased diagnostic tools. Unified "Artificial Intelligence marketplace," enabling safe, controlled rollout of multiple AImodels.Policy options–Creation of a regulatory framework in the field of teleradiology and uniform standards for diagnostic imaging AI solutions;–Creation of an Integrated Teleradiology Platform;–Build Radiology and AIWorkforce Capacity.Vision for implementing policy optionsThe implementation will follow a phased national strategy that begins with establishing regulatory foundations and piloting a centralized imaging platform in selected regions. As the system matures, cloud-based storage, unified workflows, and AIassisted triage will be expanded to all major hospitals, ensuring consistent access to high-quality diagnostics. A central expert hub will be created to support complex case review, monitor reporting quality, and provide continuous professional development for radiologists. Over time, AI modules will be integrated into routine workflows to enhance accuracy, accelerate reporting, and balance workload between regions. By the end of the implementation period, Kazakhstan will have a fully unified, scalable, and data-driven radiology ecosystem that delivers equitable, efficient, and high-quality diagnostic services nationwide.Keywords: medical imaging, teleradiology, centralized radiology systems, structured reporting, radiology workflow optimization, interoperability, digital health transformation, quality assurance, health data governance, clinical decision support, nationwide imaging platform, Kazakhstan.

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