Wednesday, November 02, 2016

It's Just Another Manic Monday...And Tuesday...And Wednesday...

I'm still here in Accra, this morning working on some stuff before my appointment with the Head of Nuclear Medicine here at Korle Bu Teaching Hospital. More on nuclear things momentarily.

We hit the ground running on Monday, after the emotional trip to Cape Coast the day before. We were to meet with the Head of IT and tour the facilities (Brian tells me there is a server room that is right up there with most he's seen) and speak with those knowledgeable in a locally-developed mini-EHR designed for the OB-GYN Department. But due to various scheduling conflicts and the Head of PACS IT taking ill, we ultimately met simply with one of the designers directly, who demonstrated the capabilities of their software. I was most impressed; this system is as good as any in-house developed product I've seen, and better than most.

I delivered my PET/CT talk to the Radiology residents yesterday morning, and they were as attentive as any audience I've had over the years, again asking some of the most insightful questions. Imagine how much good they could do with the actual scanner itself!

Thanks to Dr. B.'s monitoring of misbehavior of a worklist, I've discovered a glitch in the Merge PACS 7.0.x software. Worklists are comprised of a worklist "frame" (my term, but it helps me understand the new structure) and blocks that actually do the heavy lifting of determining which exams show up on the list. A worklist can contain multiple blocks, so one can create a list of all CT's and MRI's done today by combining the individual "Today" blocks. A key element in the block is the "Time Constraint" which tells the worklist the time-frame of exams to display:


The glitch, which my friends at Merge were able to reproduce, is that the Start Time Hours entry can blank itself, simply erasing the entry. It doesn't go to zero, it goes to nothing. Which fouls the block, which fouls the worklist. But now that Merge knows about it, I'm sure it will be fixed.

In the meantime, I'm still slogging away at a solution for those with limited-capacity Mac's. "Dr. Mary", one of the residents, has very graciously lent me her Macbook Air (128 Gb SSD) for experimentation. Unfortunately, the drive is way too small to accommodate BootCamp for a Windows installation, so I've tried anything and everything to work around this. Dr. B. suggested Wine, sort of a program-by-program Windows emulator. I tried this, with some minimal success on other Windows programs, but the Merge client is a large Java app, and getting Java running within Wine so as to run Merge is beyond my abilities, at least within the time I have left to make anything work. My last possibility is to use a program called WinToUSB to turn a USB Hard Drive (won't work on a flash drive, we tried) into a bootable Windows environment. The first disk we tried failed utterly, and I'm trying with another. The installation seems to always fail at the 95% mark. This is one I might have to leave in Ben's able hands. I asked "Dr. Mary" if perhaps there is a new Mac coming for Christmas. She smiled and asked if perhaps she should simply get a Windows laptop next time. Frankly, much as I love my Macs, it is probably the best thing to do if running Windows software is your main focus. Can someone explain to me why a program written in Java, supposedly a platform-independent environment, will only run on Windows? We Mac-lovers feel slighted!

On to Nuclear Medicine. As above, I will meet with the Head of Department today, and hopefully I'll have the opportunity to show her how the Merge PACS works, and explain my idea of connecting their Siemens e.cam (which is currently down for service) to the PACS. Keep in mind that here, as in much of the rest of the world, NM is a completely separate entity from Radiology, but I can tell you from long experience that having both Radiology and Nuclear examinations available to compare to each other and to newer studies is incredibly helpful. I'm expecting the same happy reaction I've seen on everyone's faces when I demonstrate the capabilities of soft-copy reading in general, and the power of this particular PACS client in particular. That alone has made this trip worthwhile.

I cannot believe how quickly my time here has passed. We have today and tomorrow remaining here at Korle Bu, and then back to the USA on Friday. (And back to work on Monday!) As I'm donating this laptop to the hospital, I probably won't have another blog entry until I'm back home. Which will allow much time for me to process what I've seen, done, and learned here. I can tell you already that a trip like this is life-changing. You cannot spend this length of time outside your comfort-zone and not come back just a little different. I've been accepted by people of a culture very different than mine, to the point that I feel very comfortable among my new friends. Yes, we stand out as obviously different, but I really stopped thinking about that after Day One, to the point that when I ran into another Obroni here at Korle Bu, my first thought was that HE was out of place. But not me. Perhaps I'll be able to wrap more words around the feelings with time.

Hopefully, I've absorbed some of the profound kindness and hospitality we've been shown on this trip. The common Ghanaian greeting is, "You are welcome!" (Which makes a lot more sense than saying it in response to "Thank you".) We really were welcome here. While I'm anxious to get back home to the family and the puppies, I will truly miss Ghana, and if they'll have me again, I do hope to return someday.

2 comments :

Stacey Gordon said...

Good stuff here!

A Doc 2 Be said...

Told you you'd love it... so different so interesting so kind. Love Ghana!