Imaging in Lithuania

Transcription

1 Imaging in Lithuania Jurate Dementaviciene Assoc.prof. Vilnius university President of Lithuanian radiologists association MIR 2009, Riga, Latv

2 Content Geography Short history Praesent situation in imaging Future perspectives

3 Geography

4 Historical scetches 1896 first presentation at Vilnius society of medical doctors A.Gershun 1896 first x-ray examination laboratory F.Dembovski 1947 Radiology society V.Krotovas scientific theses at Moscow university D.Kuncevic, K.Ambrozaitis 1957 Radiology chair at Kaunas university of Medicine 1960 first scientific theses at Vilnius university D.Kuncevic 1967 established radiology chair at Vilnius university 2007 joined EAR 2009 MIR, Riga, Latvia

5

6 Human resources 467 licensed radiologists 353 working as radiologists 107/ working as sonoscopists 8as interventional radiologists LRA members ( Honorary members), technicians

7 Human resources Age groups: <40y.o (30%) 41-60y.o (40,5%) >61y.o (29,5%) 30% 30% <40y.o >61y.o <40 y.o >60 y.o. No.radiologists 40%

8 The problem Advanced age Emigration No radiology physicists at the hospitals Too little radiologists are involved in IR. Vascular IR performed by IC, and nonvascular - by surgeons No adequate education for radiology technicians

9 Radiological equipment 427 conventional x-ray machines, including 129 fluosroscopy units 13/ Mammografy units 20 Angiography units 0,6/ CT (6 16 slices, 1 64 and slices) 1,5/ MR (6-1,5T) 0,42/ NM departments

10 State/private sectors Rapid increase in advanced technologies ½ MR machines and 1/3 CT instalations are at private centers

11 The problem Increasing availability of the imaging Not enough of trained specialists Quality control becomes more complicated

12 Statistics No. of radiology examinations: ,1/ resident 24% Including: for out patients in private centers Inpatients Outpatient 10% 76% State Private 90%

13 IR MRI CT Othe Statistics CT examinations (85870 for outpts) 5,58/ MRI examinations (20359 for outpts) 1,46/ IR procedures 1% 1% ~ NM procedures 5% 93%

14 Limitation Statistical information is unrelieble, data are missing Statistical questions are widely interpreted, so data are not comparable Data is incomplete, interpretation is misleading

15 Financing The source of budgeting for radiology equipment government, municipalities, private sector Health care Ministery provide financing by two ways : Directly for radiology equipment For special clinical specialities development programms, that cover also diagnostic requirements

16 Financing Healthcare system got 4,6 % out of total budget in 2008 and 4,3% in 2009 The programm of radiology service optimisation: Year Amount in LTL Amount in EUR

17 The problem Funds are spread not according to the health care requirements Radiologists are not involved in decision making process In fear of health care reorganization, hospitals compete to purchase more equipment, usually unnecessary

18 The problem Social insurance doesn t cover the real cost According to present income not adequate estimation of the radiologist qualification

19 E-Health Ministry of Health implemented project ehealth services in 2005 Establishment and development of an electronic health record (EHR) is one of the most important development directions This project includes the implementation of base Hospital information systems in three regional healthcare institutions Radiology is not on the agenda yet.

20 The problem It is neccesary to make imaging an integral part of e-health system The solution shoud come from a good RIS, that will support web based PACS systems, that will become an integral part of electronic patients record....

21 The problem RIS does not exist PACS local instalations, the viewing and workstations inefficient, slow transfer of images, bad providing with computers and radiological work stations

22 E Health European projects altic ehealth ( ) R-Bay project (ended at 31st May 2009) Cross border Pilotproject of Teleradiology Network Development among hospitals in Latvia and Lithuania

23 Education Vilnius university Medical Faculty Kaunas university of Medicine Scientific personell: 2 Professor, 6 Assist. Prof. Fellows 11 Residency (for 4 years) 14 residents each year

24 Continuous education Refresher courses at VU and KMU Educational lectures, conferences, cources by LRA International cources (MRI school, RSNA visiting professors programm) Training courses are partialy covered at local universities by physicians society for two weeks once in five years

25 Research Finansing provided by clinical research projects including imaging purposes Sites for research: Vilnius university, Kaunas university of Medicine and Vilnius oncology institute

26 Research Main research topics imaging in cardiology, oncology, neuroradiology Scientific results per year : Scientific theses, presentations at Lithuanian, Baltic, international conferences 3 textbooks, 11 articles in ISI journals

27 Lithuanian radiologists association Lithuanian radiologists society founded in members in 2008 (347 in 2007), including 33 Honorary memebrs Main tasks: Continuous education International cooperation Training in new techniques Sharing experience, introducing novelties Cooperation with universities cooperation with health care officials inefficient

28 Ist Baltic Congress of radiology

29 Future perspective Establishing team for imaging service: radiologist, medical physicist, radiology technician Training teachers for future Unification statistical information in imaging Taking more iniciative of association in education, research, quality control, financing of speciality, management

30 Future perspective Involvement and cooperation with government should enhance, based on the experience of other european countries Trying to mobilise public opinion and the media towards radiology services Increase role in creating the imaging solutions for e-health project in Lithuania Extending international cooperation Introducing e-education by sharing cases, teaching files

31 Future perspective Common efforts would help to easier achieve progress in Lithuanian radiology THANK YOU VERY MUCH!