Another quandry - X-ray



I have come around to a clearer understanding of why we should consider alternatives to the X-ray package.  Splitting the PACS system off to do later makes sense to me if it is doable and brings the price of the X-ray machine proper to within our grasp.

Kikoti and Chota are driving to Mbeya tomorrow to see two installations and get a first-hand take on Dominic’s company support. I asked if this could be via email, however, Benjamin did not think so, being too easy to disregard an email.

Questions of course include what it would take to switch horses in this stream and how far back this would set us by getting more bids, site visits and other social as well as financial investments. I assume the new visits after those a year ago will satisfy the recurrent need for more information, hence, what would it take to spoil the deal now? The prices will doubtless trend upward regardless with more time spent.

We will need to know from Valdi the consequences of the new direction. With Kikoti gone tomorrow and our leaving next Friday before the weekly Rotary meeting I have had no opportunity to meet with them, which at this point might only muddy the waters more anyway.

If I was reading between the lines correctly, ILH is getting a little static from some sources, presumably the government, but possibly from others as well about how long this is taking. We need to get this project done!

A note of good news: we have a technician! George is skilled at X-ray, US and CT. I told Kikoti the CT scanner would not be this year…. 
George is personable and speaks English well trained at Muhimbili, born in Mwanza.

Bruce Burnett has been looking at the US, which is made by a good company, but it needs a different transducer for color doppler for blood flow studies. He will, with the help of George and Sovelo, get the info. The device would be about $2000 USD, though I am not sure where that would come from.
 ILH has a discrepancy between patients seen and diagnoses submitted; 69,000 patients were “registered” (which I believe correlates with charges submitted), but only 15,000 diagnoses were submitted to the government. This cost ILH 22M/= (nearly $10,000 USD). A great QI project for sure, with rapid potential gains. Laura Chaffee has done a little looking at the process which is not clean. From what little I saw, clinicians are not helped well in the process by the computer to make the right thing the easy thing.

I have seen the clinic computers now. They are hardwired, but to where, I do not know as yet.

Ken

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