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Tele-ultrasound, a typically hazard free medical imaging modality, is very useful for a rural telemedicine system. The speed requirements of the communicating network based on the typical data sizes of ultrasound images are discussed for still images, live video streaming and for ‘store and forward’ image transfer. In the low resource countries where high bandwidth is still not available, techniques for trade-offs have been discussed. Tele-radiology has a place in developing nations where the absence of qualified personnel may place constraints on the delivery of health care. Nevertheless there are several mitigating factors that must be considered. Probably the best solution provided here is the adoption of the WHIS-RAD system in combination with a CR system to transmit images for remote interpretation.

In the planning of medical imaging services, it is important to consider the minimum requirements of equipment and facilities. In this chapter, ultrasound and X-ray units considered appropriate for rural health centers are considered in terms of image quality, cost and tele-imaging capabilities. Equipment procurement issues such as acquisition schemes, development/review of technical specifications, warranties, and obsolescence issues are discussed. The need for the availability of operation and service manuals as well as replacement parts, accessories and software upgrades throughout the life of the machine is emphasized. Guidance is given on the actual process of acquiring a unit and the site preparations involved, including the various permits needed. Examples of ultrasound equipment for low resource settings and the possibility of having ultrasound probes connected to a personal computer are explored. WHO’s efforts in promoting the development of a versatile, high quality, low maintenance and inexpensive X-ray unit are reviewed.