Lindsey Minshew MD, Candice Bolan MD, Hector Robles MD, J Mark McKinney MD Department 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 Specifics Danang 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. A109