A new model of healthcare
Read time: 9 mins
The Centre for Integrated and Advanced Medical Imaging solves clinical, educational and research challenges through deep institutional partnerships.
The new Centre for Integrated and Advanced Medical Imaging (CIAMI) will provide desperately needed MRI services in Hamilton, educate in demand MRI technologists through hands-on learning, foster innovation and new research discoveries.
Developed through a partnership between Mohawk College, McMaster University and affiliated hospitals, Hamilton Health Sciences (HHS) and St. Joseph’s Healthcare, CIAMI serves as a model for a new generation of healthcare.
It’s more than a place, CIAMI is an approach to improving MRI services in the community that addresses backlogs, educates the next generation of MRI technologists and conducts critical research.
Located at the Mohawk-McMaster Institute of Applied Health Sciences (IAHS) building on the university’s main campus, CIAMI includes a newly installed GE Healthcare Signa 3T advanced MRI suite, only the second of its kind in Canada.
Long-time partnership
CIAMI builds on a long tradition of partnership in healthcare education between McMaster and Mohawk College that includes the province’s first collaborative degree in Nursing, the IAHS facility itself, which opened in 2000, and the first fully integrated diploma-degree program in Medical Radiation Sciences in 2004.
“Those early years of the Mohawk-McMaster partnership paved the way for exceptional successes in education and research. CIAMI is a great example of how strong partnerships and meaningful collaborations can succeed in amazing ways,” says Mohawk College President and CEO Ron J. McKerlie.
“Both Mohawk and McMaster are committed to moving the region forward,” says David Farrar, President of McMaster University. “Individually, we have great capacity in that regard, but together we have massive power.”
According to Wendy Lawson, Associate Vice President Academic & Dean of the School of Health & Community Services at Mohawk College, CIAMI will revolutionize medical imagine training, discovery and care in the community.
“We envision a future in which front-line allied health professionals are actively engaged in research and one in which teams of clinicians, radiologists, academic researchers an technologists work together to solve problems and propel technological advances in the expanding field of diagnostic imaging,” she says. “Above all, we envision a future in which specialists collaborate across disciplines to train the healthcare professionals of the future, make exciting research discoveries, and provide better healthcare for all.”
Mohawk College’s commitment to producing Future Ready graduates through experiential learning, applied research and interprofessional education will flourish at CIAMI, says Lawson.
The joint purchase of an MRI and the creation of CIAMI, as a centre of excellence in the field, will provide game-changing opportunities for our students and offers an entirely novel approach to community patient care.
City-wide collaboration
The partnership behind CIAMI is a true citywide collaboration, says Leslie Gauthier, Vice President of Clinical Support Services and Surgery at HHS.
“This will have a huge impact. It’s a different way of thinking about education and clinical needs.”
Launching this initiative – which has been about 10 years in the making – has taken the input of 19 working groups, more than 100 people and hundreds of meetings.
“With CIAMI, we are being responsive to community needs and we have connected with community partners on a level that is unprecedented,” says Laura Thomas, Associate Dean of Allied Health and Medical Radiation Sciences at Mohawk College. “
MRI: Standard of care
MRI provides a more in-depth anatomical picture than other forms of diagnostic imaging and is especially useful for imaging of the spine, joints and organs, such as the kidneys, liver and ovaries.
“There was just one MRI in Hamilton when I trained. It’s now a proven technology that many doctors rely upon for diagnosis,” says Dr. Karen Finlay, Chief of Diagnostic Imaging and Nuclear Medicine at HHS. Hamilton is now home to 10 MRIs, including the one at CIAMI.
But the need is much greater. Non-urgent patients are waiting up to a year to get an MRI.
The lack of health human resources, the most limiting factor, has long been one of the biggest challenges.
Under supervision of registered technologists, students get real-world training on clinical cases and the site will offer a space where existing healthcare staff in the city can train to add MRI to their skill set.
Mohawk College’s accelerated training for upskilling healthcare professionals – within the Centre for Professional Advancement – has already helped 82 existing diagnostic imaging staff fast-track their paths to learning MRI.
As well, Mohawk College’s first MRI technologist post-graduate certificate program launched this fall with a cohort of 24 students.
Improving efficiencies
The whole idea for CIAMI came about when Mohawk College Chief Operating Officer Paul Armstrong, then Dean of Health Sciences, met McMaster University professor Mike Noseworthy for a coffee more than a decade ago. They hashed out a dream for an MRI at IAHS that would combine clinical, educational and research functions.
“It was a crazy idea but I’m elated to see what it’s become,” says Noseworthy, who is Director of Medical Imaging Physics and Engineering at St. Joseph’s Healthcare and a professor in McMaster’s Department of Electrical & Computer Engineering. “This is a unique model. McMaster and Mohawk College have a special relationship that has allowed this to happen.”
He’s been working MRIs for 35 years and always wished there was a dedicated MRI that could be used for research and education.
Noseworthy says the last piece of the concept came from radiologist Dr. Julian Dobranowski, who suggested the MRI should focus on nonurgent cases.
Dobranowski was chief of radiology at St. Joseph’s Healthcare and is now Chief of Medical Imaging at Niagara Health. He is also chair of medical imaging at McMaster University and an adjunct professor at Mohawk College. He serves as the provincial lead at Ontario Health for cancer imaging and for access to care for MRI and CT. His mission is to improve efficiencies and cut wait times.
The system has been under pressure for years. It’s not simply an equipment issue—it requires creative solutions.
The relevance of CIAMI is that it will cut wait times while still giving space for training and research.
“It’s important that CIAMI is outside the hospital system,” says Dobranowski. “The hospital is taking care of ICU, ER, ward patients and outpatients coming in for MRIs. We now have an option for lower acuity patients. When we take them out of the hospitals, it leaves more spaces for acute patients.”
The new MRI – a 3 Tesla unit that features a magnet 60,000 times more powerful than the magnetic pull of the Earth – has enhanced artificial intelligence features, an audio system, and a monitor that can stream television or a movie for patients who have to stay completely still up to an hour. It also features a wider bore that accommodates larger patients, along with those with claustrophobia.
When it’s in research mode, engineers and scientists can access the back end of the operating system to study and improve its operation and output, as well as design new components.
The MRI will be used to assess physiological processes such as muscle and brain activity or the behaviour of diseases. Researchers will be able to investigate new efficiencies within the MRI magnet as well as design hardware to support patient diagnosis.
Proof of concept
St. Joseph’s Healthcare’s MRI, which had been primarily used for medical research through the hospital’s Imaging Research Centre (IRC), stepped in to take clinical cases under the CIAMI program beginning in 2022.
“St. Joseph’s Healthcare was instrumental in the implementation of the proof of concept for CIAMI,” says Cheryl Livingston, Chief of Diagnostic Services at the hospital. “We worked out what patients would be suitable, the gains that could made through this model and the benefits to the overall hospital sector.”
By extending the working hours of the MRI and staff, St. Joe’s took on 1,500 to 2,000 hours of clinical MRI work a year or about 6,000 MRI scans under the CIAMI program, targeting those who had been waiting the longest.
As MRI proves to be increasingly useful as a clinical tool, that research directly leads to the growing demand for MRI services that far outstrips capacity and leads to long wait times. Dobranowski believes CIAMI will serve as a model of care for other communities struggling to manage demand.
“The mindset here was our institutions coming together to do the right thing to solve a problem. All affiliations were just left at that door. There’s no reason this can’t be replicated across the country.” 