Because PACS administrators come from various backgrounds and a site may have multiple systems from various vendors, fixing problems in a timely fashion can be challenging. To address this concern, PACS administrators at the University of Maryland Medical System have designed a wiki to build a collaborative decision support and knowledge repository for supporting a PACS. A wiki is a website that allows visitors to add, remove, and edit content (the most famous being Wikipedia, an online encyclopedia). The PACS administrator's wiki at the University of Maryland has been especially helpful during night call, said Antoinette King, a registered technologist and one of the PACS administrators in the university's radiology department. "If you haven't dealt with a particular issue for awhile, the wiki can refresh your memory," King said during a scientific session. "It also helps us solve problems without waking up the system administrator or calling the vendor." Setting up a wiki is fairly easy. First, one must download the template. Next comes the most time-consuming but important aspect: customizing the wiki. Groups have to decide what they want on their index page and what links to include. "People don't want more than three clicks to get information," King said. The university's title wiki page, for example, links to contact information, system administration information, and product support, which has further links to vendor sites so PACS administrators such as King can get immediate information on a particular device. The bulk of the wiki contains support information, such as decision support, and troubleshooting instructions for multiple systems, but it also has contact information of team members and of internal and external customers. An inhouse survey found that the PACS administrators spend about an hour a week updating, editing, and contributing to the wiki. It also revealed that they spend an average of three hours a week using the wiki to address issues, more than half of that time during night call, King said.

The most important aspects for starting a wiki, according to King, are:

• Take the time to customize it;
• Design it as a team, because everyone has something to contribute; and
• Integrate current systems and tools into the wiki, such as a ticket management system and a project management tool.

One of the lingering challenges for King and her colleagues is updating the wiki in a timely manner.

"All our team members have good intentions, but if it isn't documented, it isn't shared," she said.

Brian Keys, a PACS administrators at Johns Hopkins University, told Diagnostic Imaging that he wants to design a wiki, indeed, several wikis. One reason is that he will be dealing more with outpatient imaging and he wants to have a repository of knowledge from specialists in CT, MR, and ultrasound, which he has not dealt with that much.

King recommends:

• Keeping the wiki simple
• Encouraging all team members to contribute
• Making it a repository for all support material, so it becomes a progressive and powerful tool