Probably the single most asked question in our PACS consulting services from clients is, "What are the requirements of a PACS administrator?" The next most frequently asked is, "Where can we find one?" These questions are then usually followed by, "What is the job description?" Having been involved in the deployment of PACS and various forms of diagnostic imaging networks since we started Merge Technologies, we have heard most of these concerns and worked to address and eliminate them.

A PACS administrator must be a jack-of-many-trades, perhaps a master of one or two, with a personality that can deal with anyone and the patience of Job. It is often suggested or even requested that the PACS administrator have one skill set or the other -- clinical, coming with a radiology technology background, or information systems, coming from the IS department. One thing is very clear: the PACS administrator must have a thorough understanding of the "working" clinical environment, or in other words, the sense of urgency.

The PACS administrator must have the ability to take charge and manage a situation and needs to understand the following:

• networking concepts


• DICOM and HL7


• inner workings of his or her own institution:
  
  -- workflow of the department and its clients
  
  -- Q/A
  
  -- needs of physicians
  
  -- policies and procedures
  
  -- framework of the network including its affiliates
  


• HIPAA


• project management (even if the PACS is already installed)

Other issues and areas to be addressed vary by institution and are more site specific. The impact and deployment of voice recognition is an example: How will it affect the flow of the department, and what issues must be addressed?

Most of this is fairly obvious, except perhaps the need for project management expertise. A basic understanding of how to deploy anything involving the PACS will make the life of a PACS administrator easier and help ensure the successful launch of an upgrade or a whole new system. Radiology departments often begin a PACS procurement/upgrade using the same process as that for replacing an existing piece of imaging equipment. They then encounter difficulties for no apparent reason. Usually, this is an IS project with radiology or cardiology applications, and the IS people have very well defined methods of doing just about anything.

Networking concepts

It's not necessary to have a certified network engineer as your PACS administrator, but the ability to understand what the engineers are saying without being intimidated is a big plus. The PACS administrator will get involved with the network, most often basic troubleshooting, and should give direction to the engineers as accurately as possible. This usually means the ability to go to the switch closet or a workstation and determine network viability.

During a new system deployment, the learning curve is easier, as everyone, including IS, is actively involved in the connections and building of the network. The integration testing schemes should be worked out together with IS and the vendor with the participation of all parties.