John Kildea, PhD, MCCPM

John Kildea (photo)

Medical Physicist
McGill University Health Centre

Assistant Professor
Department of Oncology,

McGill University

Associate member
Medical Physics Unit, McGill University
Department of Physics, McGill University
Department of Biomedical Engineering, McGill University


Medical Physics Unit

Cedars Cancer Centre, DS1.7141 
1001 boul Décarie
Montréal, Québec 
H4A 3J1
Canada

john.kildea at mcgill.ca

514 934-1934 ex 44154

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Clinical Work

My clinical medical physics duties include radiotherapy treatment support, treatment plan quality control, brachytherapy treatment planning and quality assurance of radiotherapy equipment. I also lead the risk management committee in radiation oncology at the MUHC, perform certain radiation safety duties as part of the Medical Physics radiation safety committee, and lead various software projects for the Cedars Cancer Centre.

When I learn new things in the clinic I write them down so that I don't forget. You can find my clinical notes here.


Clinical Training and Certification

On completion of my M.Sc in medical physics in February 2010, I undertook a two-year on-the-job residency training at the McGill University Health Centre. In 2012 I passed the membership exam of the Canadian College of Physicists in Medicine.


Clinical Software Support

In addition to my day-to-day clinical duties, I provide significant software support for the Division of Radiation Oncology at the Cedars Cancer Centre. This varies from developing and maintaining database query reports for the clinical team (currently over 100 such reports are in use) to developing major software projects to support patients and staff. Examples include a document management suite for healthcare institutions (Depdocs), a waiting room management software system (WORMS) and an interface to automatically send documents between two different clinical information systems (ATS).

My software projects often fall into the category of translational research; they involve new and innovative algorithms that aim to improve radiation oncology practice. For more details on my various software projects please see my software page.


Quality, Patient Safety and Risk Management

Treatment quality and patient safety are major preoccupations in medical physics and radiation oncology, as they are and should be in all areas of medicine. Over the past five years, patient safety in radiation oncology reached a new level of urgency as a number of major radiotherapy accidents were highlighted in the popular press (see for example this New York Times article). Following from the publicity, a number of major initiatives were developed worldwide to learn from errors so to prevent their recurrence. In Canada, the Canadian Partnership for Quality Radiotherapy has taken the lead in developing the National System for Incident Reporting - Radiation Treatment. The NSIR-RT system incorporates a taxonomy of incident reporting nomenclature to help radiation medicine professionals to report and categorize radiotherapy incidents in a standardized manner.

SaILS
SaILS - Safety and Incident Learning System

At the MUHC I am leading an effort to implement the NSIR-RT taxonomy into clinical practice. With funding support from the CPQR, my graduate student Logan Montgomery has updated the SaILS (Safety and Incident Learning System, developed originally by Randle Taylor at the Ottawa Hospital Cancer Centre) to use the NSIR-RT taxonomy. With the support of our multi-professional risk management committee, we are incorporating the NSIR-RT taxonomy into our day-to-day clinical workflow. More information on SaILS is available on my software page.

In addition to SaILS, I proposed and developed a software tool to automatically audit patient electronic charts in radiation oncology at the MUHC to search for patient records that stand out as different from the norm. Each patient is unique but in a database of thousands of patients there are many clusters of similar patients. Similar patients with similar diseases should receive similar treatments. If they do not, something may be amiss with the prescription or treatment plan. Our software tool, called AEHRA (automated electronic health record auditing) is designed to run nightly on the electronic medical record database and flag patient treatments that stand out from the norm for their cohort. Initial funding for this ongoing project was provided by the Canadian Patient Safety Institute. Our technical report on the project can be found here. More information on AEHRA is provided on my software page.


Patient Partnership

I am a strong advocate for full patient participation in their own treatments and in hospital decision-making committees. Patients themselves know best how they feel, they are best placed to report their own outcomes, and they gain valuable experience during their treatments that can inform the treating team, hospital committees and future patients. My interest in patient participation has come from my experience working with a patient researcher as a full and equal partner in the Health Informatics Group and from the Canadian Winter School in Quality and Safety in Radiation Oncology that I directed (2015 and 2016). At the 2015 Winter School in Kelowna, BC, keynote speaker Jan Davies and patient researcher Laurie Hendren were both very clear that patients should be full partners in their treatments. Please see the article I wrote about Laurie's presentation here.

It might seem unlikely at first sight but patients have a lot to offer the field of medical physics. Patient-reported outcomes, coupled with aggregated dosimetric data offer great potential for evidence-based improvements in radiation oncology outcomes. The Oncospace project at Johns Hopkins is a excellent example of what can be achieved. Medical physicists too have a lot to offer patients. We understand and we can explain to patients and family members how radiation is produced and how it interacts with tissue. We often underestimate the usefulness of our knowledge and our role in reassuring patients that their treatments are safe. The UCLA medical physics team letter to patients is a nice example of direct communication with patients.

Radiotherapy educational booklet
Radiotherapy patient education booklet

I am personally involved with two clinical initiatives that directly involve patients. The first was production of an educational booklet and video for radiotherapy patients at the MUHC. I proposed, co-led and developed the booklet and video with collaborators at the Jewish General Hospital and St Marys Hospital Centre. Funding was provided by a grant from the Rossy Cancer Network. The second is Opal, the Oncology patient application for mobile phones and the web that I am developing with my colleagues in the Health Informatics Group that I co-founded. Opal will provide MUHC radiation oncology patients with direct access to their medical records, appointment schedules, wait times, lab results and educational material. We are currently working with two patient focus groups to finalize the core features of Opal to be included for release in the Spring of 2016. A demo version is available now at depdocs.com/opal.




Maintained by John Kildea
Last updated: 30 November 2020