Pediatric Radiology Worldwide Collaboration and Education Report

1. President and Treasurer’s Report1 May 2012 – 30 April 2013

2. Contents • Collaboration between physicians: membership • Education • Outreach & training in lower resource settings • Child Imaging safety • Telecommunications • Institutional performance • Treasury

3. WFPI MembershipTimothy Cain, MDMembership Secretary

4. Principles • Engage national and supranational Paediatric societies with assistance and support of Regional (Founding) Society • Fit into regional society networks • complement, rather than compete • So far, societies only. “Working groups” not approached.

5. Problems • Bank fees • Accept multi-year payment to reduce proportion of society funds going to bankers! • Offer refund (money back guarantee) if 5 year payment made up front • Definition of Society • Working groups – sub-divisions of Adult radiology societies • Interested individuals in Adult radiology societies, non-radiologists (technicians, clinicians, other) • Provide allied or associate (non-voting) membership????

6. Progress - regional • African Society for Paediatric Radiology (AfSPI) • Joined the Council in 2013

7. Progress – national/supranational (1) • Europe • British Society of Paediatric Radiology • Société Francophone d'Imagerie Pédiatrique et Prenatale • Sociedad Española de Radiología Pediatrica (being processed) • Pending: • Gesellschaft für Pädiatrische Radiologie • Others need approaching: Swiss, Dutch, Italian societies • Asia • Indian Society of Paediatric Radiology • Others: need approaching, often working groups • Africa • South African Society of Paediatric Imaging

8. Progress – national/supranational (2) • Latin America • Mostly working groups, few societies • North America • State & regional societies not yet approached • Pacific • Need approaching

9. EducationDorothy Bulas, MDChair, Education Committee

10. WFPI Education Committee • To promote pediatric radiology educational needs globally for • non-radiologists, • radiologists • pediatric radiologists. • To collate materials and tools via WFPI website, providing access to pediatric radiology education for targeted audiences worldwide. • To promote and develop international education opportunities • To support and promote educational efforts by pediatric radiology groups at regional and national levels

11. Audience • Nonradiologists – • nurses, RT, sonographers, • MD - pediatricians,cardiologists,neonatologists • Radiologists – • adult, trainees • Pediatric Radiologists – • fellows, attendings

12. WFPI website • Provide easily available access to pediatric radiology education for targeted audiences worldwide. • To collate developed materials and tools – in various languages • Identify and create materials not currently available

13. WPFI Web SITE • www.wfpiweb.org

14. Links • Existing virtual forums • http://globalcastmd.com/wp-content/uploads/2012/02/Navigating-the-GlobalCastMD-Virtual-Medical-Symposium.pdf. syllabus: http://globalcastmd.com/wp-content/uploads/2012/02/Trauma-Syllabus.pdf(http://www.isrvirtual.org/lms/). • Educational links • http://www.kinderradiologie-online.de/radiology/Links.shtml • www.isradiology.org • http://www.aium.org/resources/guidelines.aspx • http://content.yudu.com/Library/A1wsis/DiagnosticImagingEur/resources/48.htm • World Interactive Network Focused on Criticial UltraSoundhttp://www.winfocus.org/home • St. Jude Cure4Kids. New users can register at http://www.Cure4Kids.org/register • Partners in Health ultrasound manual for resource limited settings • http://www.pih.org/publications/entry/manual-of-ultrasound-for-resource-limited-settings • WHO ultrasound guidelines • http://apps.who.int/bookorders/anglais/detart1.jsp?codlan=1&codcol=15&codcch=393 • NB any “outreach” links could be posted separately from education to delineate the boundaries between the two • Grant application for international work links • Pediatric radiology educational/outreach initiatives by WFPI-associated departments or individuals - information and contact • Radiology initiatives run by other organisations

15. ? Create material if needed? • Who determines what is needed • Who vets the material • What logo should it be under • Who updates these resources

16. Promote and develop international education opportunities • Online free access to journals • Online free access to books • Michael D'Alessandro's link - "pediatric radiology". RadiologyEbooks.com http://www.radiologyebooks.com • Collection of pediatric radiology lectures/ posters: • TB - Savvas/Bernie • Flag meetings /courses of interest • Team up with RSNA/ AAP/ ACR international traveling grants • grants for fellows to come to a USA centre for a few months (currently done with ESPR/ESR)

17. Initial Members • George Taylor, Kassa Darge, Jennifer Nicholas - SPR • Jean-François Chateil, Philippe Devred - ESPR • David Stringer, Ed Lee, Winnie Chu – AOSPR • Pedro Daltro, Antonio Souza – SLARP • Quentin Moore - RT

18. World Federation of Pediatric Imaging • Become a Member of the Education committee!! • Give us your time, attention, and support • For more information contact us at: wfpi.office@gmail.com

19. Overlap: education –> outreach

20. ACR-WFPI Haiti, March 2013 • ACR partnership Grace Children’s Hospital, Port-au-Prince • Basic pediatric radiology course • Offering advice and guidance to clinicians and radioligists lacking access to experienced pediatric radiologists

21. ACR-WFPI Haiti, March 2013 • L-> R Drs. Eva Rubio, Marthe Munden, Ron Cohen, Jennifer Nicholas, Rebecca Stein-Wexler • Follow up: tuberculosis?

22. Ethiopia: introduction of a pediatric radiology fellowship (presented by Prof. K. Darge during the Annual Meeting) • Partnership: Radiological Society of Ethiopia/Addis Ababa University/Children’s Hospital of Philadelphia, US/AfSPI/SASPI ->WFPI • Under the curatorship of Prof. Kassa Darge (CHOP), a 5-person training & teaching trip organized in Dec 2012: • one week lecture program, on-site training in X-ray reporting, US and interventional/biopsy techniques • combined team for examination of final year radiology trainees • lectures for CME program, Radiological Society of Ethiopia • Further collaboration with South Africa/WFPI mutually beneficial

23. Outreach in Lower Resource SettingsSavvas Andronikou, MDChair, Outreach & Training Committee

24. Audit and Feedback: Khayelitsha • Duration = since 26 July 2012 • Referrals = 551; Reports + 400 • Volunteers = 49 • Activity: suspended March 2013 (contact left) • Future: via a platform, being tested • Disadvantage: our main client is non-functional for now • Advantage: start with new platform = Doctors refer specific cases = more realistic reporting (like MSF)

25. Médecins Sans Frontières • All 3 readers reported: since July 2012 • Sources: Tajikistan; CAR; Cambodia; Malawi • Savvas Andronikou: 43 reports • Kieran McHugh: 15 reports • Arzu Kovanlikaya: 21 reports

26. New outreach movement • Simplified ultrasound • ACR/Haiti: follow up • India: Cicero Silva • Liberia: Aadil Ahmed • RAPED/Mozambique: ?

27. Participation in the European TB Network reveals a need for radiologists as partners • Impact on diagnosis using radiology in low resource areas • Collect material regarding TB imaging in children and host on website as a reliable resource • Support facilities and activities in Africa, Asia, Latin America and Europe – second opinion / volunteer tele-reading / targeted education and training • Initiate and participate in pediatric TB research

29. How to Create a TB network • Announce formation • LOGO and Catch-phrase • Volunteers: • Education materials • Visits • Communicate intent to partners - (see letter) • Agree to projects • Request funding • Newsletter: CHIT-chat CHIT Children’s Imaging in Tuberculosis

30. Partners? Already in communication For future communication ACR Philippe Devred: SFIPP & MSF France Francis Brunelle: UNITAID Arnaud Laurent, ESTHER (big HIV UNITAID project) RAD-AID RAD PED (Alexandra Monteiro) and WHO's Regina Ungerer Desmond Tutu Foundation Clinton Foundation The Union • ISR/TB Steering group - Eric Stern • WHO: Dr Matteo Zignol, Stop TB Strategy Unit • Baylor College of Medicine • UNICEF: Dr Ruslan Malyuta • European PTBNET: President, Prof Beate Kampmann • Imaging the World, Prof Gara and Kara-Lee • MSF: Myrto Schaeffer / Marylinne Bonnet Epicentre • Doctors for Africa CUAMM - Ezia Ruga

31. CHIT Children’s Imaging in Tuberculosis TB Network: Activity TB outreach Impact diagnosis volunteer reporting / opinion TB clinics: MSF; Khayelitsha Advocate improved Dx Imaging Participate in global forums Affect guidelines Research execution Imaging the World • Group expertise • Education and training • Literature collection • Online lectures [Dr. Laya] • Outreach visits [Haiti / Ethiopia / Baylor / Khayelitsha] • Communications • Newsletter • Other networking • Research development: • Imaging the world • CDC • Baylor etc. • Consultation: • expert panel

32. Volunteers please: • Africa • Asia • Pacific • North America • Latin America • Europe • Eastern Europe: SIGN UP on www.wfpiweb.org

33. Cross-cutting issuesChild Imaging Safety, Telecommunications

34. Child Imaging Safety

35. Child Imaging Safety • Radiation Exposure • Image Gently has agreed to work with WFPI • Its International Group, presided by Kimberly Applegate, has WFPI representatives – Erich Sorantin (ESPR),is co-chair. Other Regional representatives? • There are many areas we can work on, volunteers needed

36. TelecommunicationsErich Sorantin, MDChair, Telecommunications Committee

37. Telecommunications Global reach = exorbitant costs OR use of virtual technology (web tools) • WFPI’s education & outreach strategy depends on the internet (online education and training, expert opinions via tele-reading: platform) • Website – the WFPI hub • Communications tools (workboards, forums) • Online meetings (GoToMeeting)

38. Telecommunications Committee • Contributes to strategic discussions and implementation strategies • Identifies and tests tools • Provides technological back up and support • Is critical to the WFPI’s success! (As such, a webpage being developed to render its contributions more visible)

39. Institutional performanceInes Boechat, MD & Wendy Lam, MDFounding President & Secretary

40. Institutional performance (1) • Laying the foundations: step by step, “big picture” to project- specific • Through working groups (bylaws committee, strategic framework), then the Council • Underpinned by staff support

41. Institutional performance (2) Governance • Bylaws – June 2012 • Council formed – September 2012 • Council working tools (meeting & web) – ready • Strategic Framework – August 2012 • External strategic advice – Mailman School of Public Health, Columbia University, NY, USA • Legal considerations on bylaws, tele-reading, incorporation – addressed • Meetings: Council (BA, online) & open (RSNA 2012)

42. Institutional performance (3) Council composition President: Ines Boechat, SPR Secretary: Wendy Lam, AOSPR Treasurer: Gloria Soto, SLARP Vice Secretary: Dorothy Bulas, SPR Membership Secretary: Tim Cain Representative Directors: AfSPI (Africa): SavvasAndronikou AOSPR: Abrah Hayat, Bernard Laya ESPR: Erich Sorantin, Michael Panuel SLARP: Pedro Daltro, Celia Ferrari SPR: James Donaldson, Rebecca Stein-Wexler

43. Institutional performance (4) Project oversight & steering • Committee frameworks (objectives, approach) • Education, Outreach - ready, • Patient Safety and Telecomms – in progress • Tools • Education webpages – ready, need webmaster • Lower resource (needs assessment, volunteer registration & data base) - ready • Project frameworks – ready

44. Institutional performance (5) Visibility • Website – launched • Newsletters – 3 this year • Articles & presentation posters/slides – produced on demand Fund raising • Capital injections • Reporting on funds received to date: delivered • Phase II (external) funding plans – ready • TB project formatted for grant applications – ready • Private fund raising – planning underway • Grant & partnership prospection - underway

45. Mailman School of Public Health • Columbia University Situation Analysis Jasmina Bogdanovic, Jennifer Chiu, Inqu Haile, Cole Manship, Sunitha Reddy

46. Agenda • Background of Pediatric Radiology • WFPI • History • Organizational structure • Internal Culture • External Environment • Global Societies • Childhood Disease Burden • Medical Equipment Manufacturers • Challenges • Opportunities • Problem Redefined

47. Challenges 1. Uneven representation and participation among members 2. Increasing communication between the societies 3. Maintaining adequate staffing, resources and funding 4. Overcoming political and language barriers to improve access to care 5. Expanding representation from countries around the world

48. Treasurer’s ReportGloria Soto, MD & Timothy Cain, MDTreasurer & Acting Vice Treasurer

49. “Snapshot”May 1 2012 – April 30 2013 • Not yet incorporated so reporting periods in limbo, some fusion with SPR • To be aligned depending on future organization and legal framework • Gives an overview of WFPI income and expenditures between two WFPI meetings: San Francisco (May ‘12) and San Antonio (May ‘13) • Differentiates between actual and promised sums

50. Income 2012-13(1) CURRENT ASSETS • SPR R&E Foundation pilot award 50 k • ESPR website initiation costs 1.8 k • Member society fees + AOSPR top up 1.3 k • Individual AOSPR member donation 0.5 k NON-CURRENT ASSETS • Balance, SPR contribution, staff costs 1.6 k • SPR Capital injection 2013 25 k TOTAL = $US 80.2 k