среда, 19 сентября 2012 г.

From nighthawking to bedside manner, PACS administrators dish.(INFORMATICS)(Picture archiving and communication system) - Medical Imaging

Munish Goel, director of IT and PACS/RIS administrator at TrueMetric Imaging Medical Group (Bellflower, Calif), described his responsibilities in nighthawking from three different perspectives during a session called 'What's My Job' at the recent meeting of SIIM, April 27-30, Austin, Tex. As network administrator, workflow manager, and PACS administrator, handling all three aspects is imperative for successful nighthawking and involves such tasks as network feasibility, setting up the virtual private network (VPN), and setting up the routing (as a network administrator); determining the proper workflow for transmitting images, setting up protocols for sending requisitions and images, training on requisitions and images, and defining the life cycle for a study (as a workflow manager); and setting up modalities, creating or modifying DICOM tags for clear identification, setting up transfer syntax and compression parameters for image transmission, and checking image quality for diagnostic reading (as a PACS administrator).

Some of the tough nighthawking issues that Goel faces are slow image upload and retrieval because of limited bandwidth, lost network connectivity, an unresponding DICOM receiver/sender, studies that are missing images, and reports that aren't making it to hospitals. To make his life easier, Goel explained, he provisions the proper hardware and software at hospitals, and he ensures that the proper resources are in place before he obtains contracts. He also tests workstation calibration before fielding, and he uses image-compression applications, such as JPEG2000.

'I love my job,' Goel admitted. 'I love that it's a constant learning process, and I love the everyday challenges.' What would make his job easier in the future? Goel said he wants a real-time dashboard of the PACS to adjust productivity of radiologists and modalities. He also would like a truly integrated PACS and RIS.

Next up was Lance P. Ford, IT director and PACS administrator at Arkansas Medical Imaging (Little Rock). 'This is a highly technical world,' Ford said, 'and a PACS administrator is expected to know everything with extreme knowledge and the bedside manner of a family doctor.' Some of Ford's recommendations for doing just that included knowing the linguistics--for example, when a radiologist says, 'The network is down,' what does it truly mean? Is the PACS not working? Is an image not loading? Or is it something else? Ford advised, 'Figure out who you are talking to and how they communicate. But be sure not to talk down to anyone or talk below his or her level.'

Ford advised remembering who the customer is, and that it's everyone from physicians and technologists to assistants and administrative personnel. He added, 'If you fix the customer, you fix the problem. Just keep in mind that the real customer is the patient.'

David R. Fox, MBA, CRA, director of radiology at Baptist Health Medical Center-Little Rock, spoke next. Fox explained that his responsibilities include day-to-day operations--'meaning hiring, firing, and counseling.' The day-to-day also includes fiscal, project, and human resources management; professional development; and marketing--'Be a difference maker!'

As the director of radiology at a nonprofit, community, faith-based hospital with 767 beds, Fox is a communication resource for radiology, which includes being available via e-mail, phone, and pager. Then, it's knowing who to rely on for informatics, which includes the chief information officer, the PACS/RIS administrator, and information-technology support. And then, it's knowing when to call on them, 'which is before the problem occurs,' Fox said. His job also entails knowing how to get things done. 'To do that, I must trust in the ability of the people I have,' he advised. 'To do that, I need to hire and promote the right people.'

Fox also was adamant about strategic planning. 'Build a support team, involve the team, nurture the team with positive encouragement, and, above all, listen,' he advised. 'Then, perform a look back and ask, 'Did we meet our goals?'' Then, make adjustments accordingly, he added. In short, Fox said, 'Radiology administration is work, but it is rewarding with the right team.'

Finally, Session Chair Charles W. Socia, RT(R)(CT)(QM), vice president of operations at Arkansas Medical Imaging, closed out the session. He noted a few trends in imaging informatics, including that educational opportunities are becoming more readily available, technologies and platforms are becoming standardized, developmental cycles are shortening, and imaging informatics is being recognized as a vital role in health care. In fact, some of the career opportunities for imaging informatics professionals (IIPs) now include positions within hospitals, imaging centers, application service providers, vendors (in support and in sales), research and development, consulting, project management, radiology/IT leadership, and government.

Socia, who spent 13 years as a CT technologist, is part of the Certification of Imaging Informatics Professionals (CIIP) program. (See 'SCAR Becomes SIIM, and Other Announcements from the Annual Meeting' on page 20.) He noted that for him, one of the goals of the certification is to have a minimum requirement of qualifications for the individuals he hires. Some current needs in imaging, he said, are the need for defined roles for IIPs, the need for university-based professional curricula, the need for a diverse skill set to be required, and the need for professional recognition. He added, 'This certification is one step.'