| 4. In which ways is the initiative creative and innovative?
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Carefully, Prof. Dr. Athasit Vejjajiva pointed out the need to have an advanced diagnostic imaging center in his medical school. However, the equipments to equip the imaging center were very expensive, thus they should be exploited as much as possible. The crucial strategy to success was to set the center to be managed as a private organization to support the public university hospital. The most important factor that he needed to have was to find a potential person who was very new to the conventional public service system. He got Dr. Jiraporn Laothamatas, a young passionate neuro-radiologist, who had just come back from the U.S.A. to carry on his vision.
Dr. Athasit mitigated the sluggishness of the public administration system in establishing a new organization by getting a financial loan from Ramathibodi Foundation, a nonprofit organization to help underprivileged patients in medical issues. Dr. Jiraporn knew that to get the center to survive and to grow, she needed qualified and avid staff to run the center. She recruited nearly all of her staff from the outside of the public hospital. Most of them were young and just graduated. The most important thing was that she had to devotedly work hard for the young and new organization. That was the model for the new young staff. She managed to make sure that her staff would get monthly monetary compensations as high as those in private sectors, even the base salaries were not high. Those could be done with professional compensation and longer hours of work.
Dr. Jiraporn implemented ‘24/7 working system’ to the center. Without office hours, the center has always opened to serve patients. Some sections can be closed at night to cut down the expenses, but patient servicing sections and the expensive equipments operate all the time, 24 hours a day, 365 days a year. This strategy has made the center be able to serve patients as if it is 4 times bigger in size. The additional working hours from the policy can increase the incomes of the center staff. Most importantly, the increased incomes of the center could pay back monetary investment in a short period of time as well as could make huge profits, and thus the typical long-waiting-time for MRI and CT scanners was solved. When a patient gets her needed MRI/CT examination fast, she or the country will indirectly pay less in the healthcare expenses for her disease!
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| 5. Who implemented the initiative and what is the size of the population affected by this initiative?
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Prof. Dr. Athasit Vejjajiva and the administrative board of Mahidol University Faculty of Medicine Ramathibodi Hospital in 1993 initiated the challenging policy. Ramathibodi Foundation gave investment loans to found the advanced imaging center. Dr. Jiraporn Laothamatas has managed the center as if she has been the mother of the center.
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| 6. How was the strategy implemented and what resources were mobilized?
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Ramathibodi Foundation, a nonprofit organization to help underprivileged patients, gave the first loan of 66 million Baht to found the advanced imaging center, while Mahidol University Faculty of Medicine Ramathibodi Hospital rented out a place for the center in its university hospital. Most of the loaned money was spent on acquiring an MRI scanner, while some was used in building the center office. Later when the center expanded to the present size (4 MRI/CT scanners), the foundation also gave a new loan for the center. All loans and interests have been paid back to the foundation.
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| 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
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The center’s most proud success is that it can serve a lot of patients of a very large university hospital to have diagnostic and following-up examinations in a very short waiting time with a few expensive equipments. Indirectly, this will save the country’s expenditures on health care. Moreover, the center can extend its advanced medical diagnostic services to patients from all over the country.
The center has just received ‘Excellent Agency of the Nation Award’, given by the office of prime minister. The picture of the center director receiving the award from Her Royal Highness Princess Sirindhorn is at the center’s website: http://AIMC.mahidol.ac.th
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| 8. What were the most successful outputs and why was the initiative effective?
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Continuously, the center has arranged trimester meetings. The reports on waiting-time-to-be-MRI-and-CT-scanned, financial situation, human resource, and risk management are presented by the center staff. Then they will be discussed and suggested by the center administrative board. Anyhow, there is monthly meeting of section heads with the center director.
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| 9. What were the main obstacles encountered and how were they overcome?
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Because of the 24/7 patient servicing without the hospital boundary policy, there are too many MRI/CT imaging data of patients to be served by sub-specialty radiologists of Mahidol University Faculty of Medicine Ramathibodi Hospital. The center director came up with the solution of hiring sub-specialty radiologists from other medical schools and private hospitals to help. Their monetary compensations are nearly as high as those in private imaging centers and hospitals. Thanks to the internet and information technology era, those sub-specialists can work from their homes and offices.
Of course, the hardest obstacle was to have a private-like patient servicing organization in a public hospital. Laws and regulations must have been adjusted with transparency.
Human resources and sufficient financial compensations for the center staff are crucial. Even being associated with a public university and hospital, the center has been able to keep imaging center staff including highly-sought technologists by supporting them to get higher education and continuing education, setting up professional compensations, and giving them chances to work extra hours to earn more incomes.
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