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Not knowing what you don't know constitutes biggest risk in growing field
By: Merlina Trevino and Douglas Page
The role of the PACs administrator has grown at the same rate as PACS, yet no precise job description exists.
"One specific challenge of PACS administration is that it now requires a skill set that bridges the domains of radiology technologist, information systems analyst, and radiology administrator," said Paul G. Nagy, Ph.D., director of the Radiology Informatics Lab at the Medical College of Wisconsin. Nagy spoke at a SCAR scientific session.
Hospitals implementing a new PACS face difficulties in defining what a PACS administrator should do and in finding someone qualified to do it. No curriculum or standards exist to delineate what a PACS administrator should know.
"Today, all knowledge about PACS is experimental and can be highly vendor- or site-dependent," Nagy said. "The adage about not knowing what you don't know being the highest risk is very true in PACS administration."
Nagy presented a staffing model that attempts to define PACS administration as a profession. Under each of three competencies (behavioral, business, and technical), he identified various roles in planning, implementing, and operating PACS. Under these roles, he listed tasks and topics for which proficiency would have to be demonstrated. He ended up with 127 tasks organized under 15 roles.
That framework will form the basis of a curriculum for training individuals who will fill these roles and become part of the PACS administration profession. The curriculum could also be used for administrators' self-assessment.
"For PACS to be successful, the tasks required for implementation and operation need to be firmly established in the framework of a professional discipline," he said.
Nagy also moderated a session at the SCAR conference called "Zen and the art of PACS administration," which addressed the role of PACS administrators and examined how the lack of a precise job definition adds to their stress levels.
Nagy and the session participants suggested that PACS administrators can alleviate some of that stress by making sure they are not the only department members on the PACS administration battlefront. Three PACS administrators with varying medical and information systems backgrounds described their experiences in the trenches.
"PACS administrators today have really had to be trailblazers. What we're trying to do here at SCAR is pave the road," Nagy said.
Pitfalls that new PACS administrators frequently encounter include a lack of relevant expertise and little to no PACS skills redundancy in the department. New administrators often have a clinical background but little technological experience (such as a technologist), or they may have a technical background with no relevant clinical experience (such as an information systems administrator) (see table). While learning the tricks of the trade, many have to go it alone in a job that requires 24/7 uptime. Budget constraints are usually behind this situation, according to Nagy.
Charles Socia, formerly an RT, had little technology experience when he took on his current position as PACS administrator at Baptist Health in Arkansas. While RTs may not have extensive knowledge of technology, he said, they do have the advantage of being known members of the radiology staff, and they understand the needs and problems of the department.
Former technologists also bring medical imaging experience to their jobs. And they fully appreciate the benefits of going filmless, according to Socia. But despite these advantages, PACS administrators must build a team to handle the many tasks, duties, and obligations of the job.
Steven Chechet, a PACS administrator at Appleton Medical Center in Wisconsin, said that administrators will burn out quickly if they try to do the entire job on their own.
"Nobody comes to this position with a full set of tools," he said.
Chechet recommends that PACS administrators get involved in the imaging equipment purchasing process. This will ensure that the current PACS can handle additional equipment and that the new equipment will be able to communicate with all existing pieces of the PACS.
Marc Deshaies, lead PACS service engineer with GE Medical Systems, listed several essential qualities for a PACS administrator: a service-oriented mentality, sense of humor, positive attitude, and high motivation.
All the speakers agreed that although the stress level for a PACS administrator can be extremely high, and 12-hour days and night and weekend work are often necessary, the chance to affect the hospital and community care makes it worthwhile.
"High-quality patient care is the ultimate goal," Deshaies said.
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