© 2016 Mayo Foundation for Medical Education and Research

Lindsey Minshew MD, Candice Bolan MD, Hector Robles MD, J Mark McKinney MDDepartment of Radiology; No financial disclosures or conflicts of interest.

Mayo Clinic, Jacksonville, Florida•  Project site specifics: Location, demographics, resources,

facilities, staff, finances•  Project goals: Developing relationships, education and

infrastructure•  Project duration: Continued on site and remote

collaboration•  Project results: Readiness assessment and PACS

assessment, symposiums, case conferences, education and donations

•  Plans for next steps: Report on assessments, teleradiology, PACS infrastructure, next on site visit

Overview

Radiology Department Specifics:•  9 radiologists, several specialty/fellowship trained•  No residents or fellows•  >10 X-ray technologists and sonographers•  All modern modalities available, including radiography,

fluoroscopy, CT, MR, US, IR, NM and Mammography •  Large total daily study volumes: >700 radiographs, >400

US, >150 CT and >45 MR exams per day•  Outpatient wait for most radiology exams is <24 hours

•  Develop relationships between Danang Vietnam radiologists and Mayo Clinic Florida radiology trainees and faculty

•  Assess the needs of radiology physician education in Danang•  Assess the needs of the physical radiology infrastructure in

Danang•  Early assessment has highlighted the need for a PACS

infrastructure, further discussed in presentation•  Annual visit to Danang by MCF physicians to:

•  Provide education to radiologists in Vietnam•  Review difficult imaging cases while onsite•  Perform and teach new minimally invasive procedures

•  Develop an infrastructure to have teleradiology monthly conferences between radiologists in Danang Vietnam and Mayo Clinic Florida

Project Goals

•  Annual onsite radiology visits lasting 1-2 weeks in duration are part of a larger multispecialty effort by physicians coordinated from Mayo Clinic Florida

•  Collaboration will continue as long as there is a need

Project Duration

Plans for Next steps

Educational Partnership For Human Resources and Medical Devices: Danang, Vietnam

Project Site SpecificsDanang General Specifics:•  Danang General Hospital, located in Danang, Vietnam•  Government/publicly owned •  Tertiary referral center•  Serve >1 million•  1,250 inpatient beds with a daily census >2,200

(occupancy rate >200% on average)•  >2,000 outpatients seen daily•  Pediatrics thru geriatrics treated•  Wide variety of pathology seen:

•  Common and rare infectious diseases•  Many primary cancers•  Chronic illness such as COPD, diabetes,

CAD, psychiatric, alcohol related•  Maternal/fetal conditions

•  All modern chemistry, microbial, hematological, pathology tests and resources are available

•  All modern pharmaceuticals, medications, and vaccines available

•  Average income of patients’ ranges from >3x to <1/3 the national income

•  Approximately 75% of patients are insured, most through government sources

Project Results•  Two onsite visits have been made, the most recent being in June 2016•  Radiology Readiness assessment and PACS assessment were completed

in June 2016•  A national educational symposium for Vietnam radiologists was provided

June 20-22, 2016 at Danang General Hospital•  Case conferences were provided for onsite radiologists•  Interventional radiology procedures have been performed and taught for

trauma embolization, abscess drainage, and nephrostomy tube placement

•  Interventional radiology catheters, wires, drains have been donated and delivered onsite

Readiness Assessment: Needs and limitations•  Continuing medical education, training in person, training online,

journals and conferences are considered to be “accessible, but in limited supply” or “usually accessible” by the radiologists and technologists

•  Both expensive and inexpensive equipment is often in short supply, such as radiopharmaceuticals, needles, catheters, sheaths and ultrasound probe sleeves

•  Minimally invasive procedures are not performed by radiology, but instead by surgeons

•  Lack of a Radiology Information System (RIS) to support work flow management, radiology results entry and radiology reports output

•  Lack of a Picture Archiving and Communications Systems (PACS). Images are deleted after 3 weeks

•  Lack of a radiology specific technical support team

Readiness Assessment: Strengths•  All modern modalities available, including radiography, fluoroscopy, CT, MR,

US, IR, NM and Mammography•  Enthusiastic personnel including radiologists, technicians and support staff•  Sufficient radiology image viewing work stations •  Power source, telephone and internet service considered reliable

Readiness Assessment: Local interest•  Improving their continuing medical education•  Acquisition of a Picture Archiving and Communications Systems (PACS) •  Building relationships with outside institutions to serve as a source of

learning and growth•  Financial support to purchase, repair and maintain medical imaging

equipment•  Equipment donations

•  Complete project summary from the Radiology Readiness and PACS assessment forms data

•  Develop teleradiology conference infrastructure, with monthly conferences between Mayo Clinic and Danang General Hospital

•  Submit proposals through Rad-Aid for PACS infrastructure•  Plan next onsite visit in 2017

•  Develop new IR procedures•  Provide additional radiologist education•  Conduct Case conference•  Conduct National symposium

•  Continued assessment of the radiology department education•  Improve education through future on site visits

IMAGES: Above: Danang General Hospital. Right: Four of the 9 radiologists at Danang General.

IMAGES: Above: Clinician performing an US exam on a patient at Danang General. Right: Parking lot at Danang General displays many 2-wheeled motorized vehicles, a very common means of transportation in Danang.

IMAGES BELOW: Left: One of the CT scanners at Danang General. Middle: Several radiologists working in the Emergency Department reading room in Danang General. Right: The IR suite at Danang General

IMAGES ABOVE: Clockwise: Dr. Candice Bolan providing informal teaching in Danang. The National Symposium itinerary 2016, lead by the Mayo Clinic visiting radiologists. Dr. Robles providing education at an informal teaching/case conference session for the Danang radiologists. Dr. McKinney, Dr. Bolan and Dr. Robles at the National Symposium.

Images: Above: Group photo from the second on site visit in 2016 in front of Danang General. Right: Dr. McKinney and 2 radiologists from Danang holding catheters donated by Mayo Clinic.

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