Saturday, October 29, 2016

Weekend Update

I have a short report covering the past couple of days' activities, but despite the relative brevity, you may rest assured that things remain busy here in Accra!

On Thursday, Ben had asked me to look into sending exams back to the modalities in case something needed to be printed from the console and not PACS. (Brian continues to make progress in DICOM printing from Merge PACS; there is still a contrast issue with the printed films.) While I was able to find the mechanism to do this, the transmissions did not go through completely, and I think this indicates a problem with the configuration on the modality end.  However, the CT and MRI both have functions that query the PACS, which would accomplish the same thing we are attempting. I'll test the function if I can ever get some time on the scanner!
In and among that bit of tail-chasing, I was able to spend some time with the residents. A FEW are still using the Query function rather than the worklist, and several were logged in with a generic ID. I cautioned Ben and the resident that this could lead to a number of problems in the future and strongly advised that the generic sign-on not be used except in very extreme circumstances. (I was thrilled to discover the generic login and password on the backgrounds of most of the workstations!) And I made another little discovery...One of the monitors, a 30" consumer-grade HP, was set for a lower-than-optimal resolution. I grabbed the mouse and set it to the proper, higher resolution...and I was then schooled by the resident..."Doc, many thought the icons were too small at the high resolution, so we run it at low resolution to make the icons bigger..." I'm going to have to see if I can buck this trend, as the low-res causes us to lose some of the drop-downs off the lower edge of the screen. That's not a reasonable trade. Keep in mind, many/most of the stations are running on one monitor. There are several Barco's in the waiting, but their workstations lack power-supplies, which are coming. Apparently on a slow boat!

Friday was a bit more frustrating. We had meetings scheduled with various people critical to the project, but many had other obligations, and we did a bit of hurry-up-and-wait. The meetings ultimately did occur, and we had good discussions. There appears to be an in-house team developing a RIS-like program for another division, which hopefully can be adapted and interfaced to PACS. I'm to cast eyes on that on Monday.

One high point was my first lecture here at Korle Bu, an introductory talk about PET/CT, delivered to an apt (and awake!) audience of Nuclear Medicine residents, and many folks from RT as well. You have to keep in mind that the NM residency program is completely separate from Radiology, and these kids have not been exposed to CT. Still, they grasped the concepts readily, and asked some very astute questions. And they even laughed politely at my feeble attempts at humor...  While I think there is only a small chance of PET/CT coming here in the near-future, I believe everyone needs to be aware of its capabilities and know when sending the patient off to South Africa (where the closest PET/CT lives) might be worthwhile. And who knows? Maybe some very nice scanner company will donate one to this very busy (and worthy) Oncology site. Oh, and we'll have a cyclotron on the side with that, please. (Please?)

Finally for Friday, what I thought would have been an easy task turned difficult. You might recall that I mentioned putting the Merge client on the residents' laptops. Well, a couple of them have Macbooks, and I was asked if I could make the Windows/Java-based program work. But of course! I replied naively... Well, the Macs in question are Macbook Air's with 128 Gb SSD's. Oops. I'm having one of the residents try to clear 50 Gb off of her drive (she had exactly 2.5 Gb free) and I'll try to do the most minimal Windows 7 installation possible. If that doesn't work, I've found a reference to creating a bootable Win7 (or any Windoze) runtime external USB disk, and maybe that will work. This is one I might have to dump on Ben.

We are playing tourist for the weekend. We went to the Big Mall, as nice and modern as any in the States, and then had drinks and dinner at the Bojo Beach Resort, a rustic but still quite beautiful site:

Tomorrow we are off to the slave-trader castles at Cape Coast.

I suddenly realize that my time here is more than half over, and I still haven't accomplished all I came to do. So for Monday through Thursday, here's my agenda:

  1. Spend more time with the residents, smoothing out their Merge experience
  2. Give more lectures to NM and Radiology residents
  3. Connect the NM gamma camera, a 2005 Siemens, to Merge PACS
  4. Work on the Macintosh problem above.
I could spend another 2 weeks on those alone. I also come to realize, however, that I'll probably not have much reason to be asked back here, as by the time I would return, the staff will be better versed in the PACS than I am, and could probably teach me how to use it. I'm hoping there will be many more sites, assisted by Rad-Aid, that install Merge PACS, and I would love to be on site at go-live! I'm ready, willing, and able! That's the joy of working part-time, right? 

In the meantime, I bid you good night from Accra. 

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