To help alleviate anxiety and, most importantly, to reduce the need to sedate fidgety pediatric patients, Dr. Robert Min, chairman of radiology at Weill Cornell Medical College and president of Weill Cornell Imaging at NewYork-Presbyterian Hospital, has helped create the pioneering program in collaboration with Siemens Healthcare.
"As a parent, I can tell you that many times it is not the fear of the MRI but the fear of the sedation that causes people to avoid a test they may need, or go through with it with a lot of anxiety," Min said. "Particularly in the pediatric population, there also are concerns about ionizing radiation and the effect on young children who need serial exams."
Dr. Robert Min (middle) joined Iron Man (left) and Captain America (right) to launch the MRI Heroes Kit last October in New York City. All images courtesy of Siemens Healthcare.
After much contemplation on how to solve these issues, Min decided that educating young patients before their MRI scans would help eliminate their trepidation, and the best way to hold a child's attention is to make the learning fun and entertaining.
So he approached Siemens at the RSNA 2013 meeting with an idea: Show superhero patients successfully confronting and completing their own MRI scans. The result was the MRI Heroes Kit, a collaborative effort between Siemens, Weill Cornell, NewYork-Presbyterian, and Marvel Custom Solutions (part of Marvel Comics).
Now available through Siemens, the kit includes 100 copies of an educational comic book, 100 superhero-themed capes, 100 Captain America and Iron Man plush toys, an educational DVD, and a toy model of a Siemens MRI scanner.
"We wanted to provide a much more child-friendly educational program that was real for kids and that they can relate to," Min said. "I think everyone can benefit by education, but I think there was something missing for the pediatric population."
At the kid's level
Siemens worked with child life specialists at NewYork-Presbyterian to create a 6.5-minute video that details what children and parents should expect during their visit. Instead of making a traditional instructional video with a physician, hospital staff, or parent, the presentation features a 10-year-old girl recounting her experience with her MRI exam.
Child life specialists helped with "how the language should be spoken, what words we should use, and techniques to convey to the patient and the parent something of emphasis," said Linda Tait, Siemens MR product manager.
The program encourages parents to sit and watch the video with their kids before coming to the hospital for the scan. "When they come into the facility, they realize [the MRI scan] is not going to hurt, there will be loud sounds, and this is what to expect," Min said. "When there are no surprises, kids absolutely take to it far better than what we might think."
"The pediatric patients feed off of their parents," Tait added. "If the parent is misinformed or anxious, that translates down to the patient. So we needed to make sure we kept [the video] fun, informative, and on the level a pediatric patient would understand, yet capture those things that really make the parent comfortable."
The small mock-up of a Siemens MRI scanner sits in the patients' waiting room and mimics the sound of a real system in operation. A Weill Cornell child life specialist or staff member prepping the young patient uses a doll to show how the patient will go through the scanner and come out, Tait explained.
Comic book heroes
Siemens also took advantage of its partnership with Walt Disney, which owns Marvel, to create a comic book featuring Captain America, who undergoes an MRI for nagging shoulder pain after a battle with evil.
The message to the child is if Captain America can lie still during a MRI exam, so can you.
The Marvel comic book shows kids how Captain America underwent his MRI.
"Like pediatric patients, he, too, feels anxiety and does not want to get the scan, but because he is empowered by a little girl who just came out of an MRI scanner, we show the real-life reality that it is OK to be nervous, anxious, or scared," Tait said. "You are your own superhero, just like Captain America, and you can get through an MRI experience."
The young patients can hold a Captain America or Iron Man plush toy during the exam to help them relax and to bring the comic book characters to life. After the scan, the patients receive a superhero cape as a reward for their courage and cooperation.
Word spreads fast
Since its launch last October, it hasn't taken long for the novelty and potential benefits of the program to reach beyond Weill Cornell. Just before the holidays, Min received a call from a mother in Denver whose 17-year-old son has a form of autism and needs MRI scans on a regular basis.
The teen read about the program on Marvel's website and told his mom about it. She, in turn, contacted Min to obtain an MRI Heroes Kit. Min gladly obliged.
"She told me that if she can get [her son] the kit, he is convinced that he can go through the MRI scan without sedation," Min said. "We are seeing older children, for a variety of reasons, who might benefit from a program like this. We have our own success stories, but I would like to see this [program] catch on throughout the country."
Siemens plans to make the MRI Heroes Kits available to other facilities with the purchase of the company's MRI equipment. Two pediatric hospitals already have committed to the program, Tait said.
"We have seen a lot of international interest, so we will have those discussions on how we can make this available for all children across the world," she added. "That is our next step."
To further promote the program, Siemens is thinking about attending Comic-Con in 2015, the annual convention for comics enthusiasts.
With all the fun the program has provided so far, Min emphasized that avoiding sedation for these young patients remains the paramount goal.
"We think children who are 4 years old and older have the potential to avoid sedation now," he said. "Do I believe there are many reasons why some children will still need sedation? Absolutely, but we are hoping to get word out to people who routinely refer these children" for MRI scans.
To get a better handle on how to reduce sedation, Weill Cornell reviewed its records for the last half of 2014 for cases where sedation possibly could have been avoided in kids 4 to 12 years old.
"It is a fairly large number, and the feeling is that if even 50% of those [MRI scans] can be accomplished without sedation, that is obviously a huge benefit to patients first and foremost, and a huge benefit to healthcare in general, because we are driving down costs significantly," Min said.
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