Once a radiology facility makes the decision to install PACS, it becomes necessary to marshal a team to oversee the filmless migration.

When installation is complete and the project team officially disbands, PACS still needs an overseer, an administrator, a champion — someone prepared to fight for it and to supervise training, expansion, maintenance, and upgrades.

Patricia Whelan is the PACS administrator at Massachusetts General Hospital (MGH). One thing in her life is certain.

"There's not enough time," she said. "Once referring clinicians realize all the possible applications and potential of digital radiological data, you can never go back. The phone rings off the hook."

Whelan lists her responsibilities:

?ensuring timely, efficient transmission and storage of PACS images;
?overseeing development of a PACS strategic plan for the radiology department;
?evaluating PACS products;
?managing beta agreement relationships;
?enforcing equipment service maintenance agreements;
?developing Web-based quality control systems; and
?participating in PACS research and development contracts.

"There is no typical day," she said. "Some days I leave on time at 5 p.m., but most days I leave between 6 p.m. and 7 p.m. I'm booked with department meetings and I'm booked with meetings with people outside the department."

Among the most constant and glaring issues Whelan faces are maintaining image quality control, improving retrieval times from the deep archive, and increasing image throughput to Web browsers. All this while system administrator tools designed to evaluate system performance, particularly speed, are persistently lacking.

Then there are the firefights.

"Most fights are among radiology division heads and center on who needs more workstations in their area," she said. "We have been fortunate that our IS department is more than helpful. We don't have any battles with them."

Whelan, who reports to the radiology department's senior manager and to the radiologist-in-chief, says she not only doesn't have enough time, she also doesn't have enough help. Presently, only one applications analyst reports to her.

"I need another FTE," she said. "I have a real-time remote network monitoring and notification system that pages me when (system degradation) thresholds are hit, but we have a mission critical system and there's no PACS administrator here in the evening, at night, or on weekends."