The signature gate
No report leaves the clinical service without a licensed radiologist’s signature. The rule is enforced in the platform’s code, not in a policy document.
Reading as infrastructure
One pathway carries a film from a clinic's phone to a signed report — built from parts Afghan clinics already have, spending the scarce resource, a radiologist's attention, only where it is needed.
The reading pathway
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1
A film on a lightbox
What the clinic already has. No PACS, no DICOM feed.
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2
Photographed to WhatsApp
The thread the clinic already uses, on the phone in their hand.
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3
Normalized, de-identified
Orientation, crop, exposure. Identifying detail minimized at intake.
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4
Queued by urgency
The sickest patient first — not the most recent upload.
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5
Read and signed
A licensed radiologist, by name and license number.
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6
Returned to the thread
A Dari or Pashto PDF carrying a verification code.
Software sits alongside steps 3 and 4 — normalizing the photograph, ordering the queue, and pre-drafting text for the radiologist to correct. It does not read, it does not clear, and it does not sign.
Four decisions the pathway makes
A film, not a DICOM feed
Most Afghan clinics have no PACS and never will. The pathway starts from what they do have: a film on a lightbox and a phone. The platform accepts a WhatsApp photograph of the film and normalizes it — orientation, crop, exposure — into something readable.
De-identified, then queued by urgency
Identifying details are minimized at intake and the study is ordered by urgency, so a radiologist’s scarce attention lands on the sickest patient first, not the most recent upload.
A human read, under a name and a license
A licensed radiologist reads the study in a purpose-built cockpit and signs the report. The signature is not a flourish: the reader’s name and license number are stamped onto the report, and nothing is delivered without them.
Delivered where the clinic already is
The signed report returns as a Dari or Pashto PDF in the same WhatsApp thread, typically about an hour after the photo. Every report carries a verification code any recipient can check — so a paper printout in a district clinic can still be trusted.
Assistive by design
On the general pathway, software triages the queue and pre-drafts reports for the radiologist to correct. It does not read, it does not clear, and it does not sign. There is no WHO-recommended algorithm that rules out a wrist fracture or a pneumonia — those reads are human work.
The one place the evidence supports a larger role for software is tuberculosis screening, where the WHO has conditionally recommended computer-aided detection for triage in people aged 15 and over. That architecture — and its limits — is laid out in full on the TB screening program page.
Governance, in the code
Verifiable reports
Every delivered report resolves at a public verification page — the Mohr-e Asil seal. A forged or altered report fails the check.
An append-only record
Every step of every study is written to an audit log that cannot be edited or deleted — the raw material of both accountability and research.