It's a nightmare scenario for any PACS-enabled hospital: the image management system crashes and thousands of studies disappear into the Ethernet. Experts say damage control in the event of such a disaster would be optimized if standardized training and testing existed for PACS administrators. Luckily, formal credentialing is right around the corner, promising more security for hospitals seeking qualified candidates in image management and upward career mobility for those involved in managing PACS.

As early as September 2007, a new Certified Imaging Informatics Professional (CIIP) exam will be available to candidates from a range of backgrounds, including radiology technologists and IT specialists. The certification program was hatched by the Society for Imaging Informatics in Medicine (SIIM) and will be administered through a partnership with the American Registry of Radiologic Technologists, which has with the American Registry of Radiologic Technologists, which has expertise in managing computerized testing centers.

"Certification is a manifestation of the maturing of PACS markets," said Dr. Elliot Siegel, chief of radiology and nuclear medicine at the Veterans Administration in Baltimore.

Currently, employers find it difficult to determine if candidates have the wherewithal to undertake a job based on resumes alone, because up to 20 different descriptions are used to define the role of PACS administrators. Certification will define minimum requirements and create more uniformity in the marketplace. PACS administration will not just be an ancillary position done in a person's spare time, but a new profession in its own right, Siegel said.

The CIIP exam is not the first test for PACS managers. Another organization, the PACS Administrators Registry and Certification Association (PARCA), already offers four levels of certification and recently introduced a standardized exam to test core competencies.

The rise of credentialing in imaging informatics partly reflects growing penetration of PACS. Precise figures are hard to come by, but experts estimate that 35% of departments across the country, including group practices and academic sites, are reading more than 90% of studies in a soft-copy format. PARCA estimates that there are 3000 to 4000 PACS administrators in the U.S., a figure likely to quadruple in the next five years.

Harris Methodist Fort Worth Hospital in Texas was the one of the first in its area to launch PACS. Now, there are six hospitals with PACS within walking distance, increasing competition for PACS administrator talent, said Don Jollota, director of clinical information systems and a member of PARCA's advisory board.

Typically, PACS administrators have been homegrown and trained on the job. As PACS become more pervasive, it will be harder for prospective employers to get assurances that they are not hiring someone else's castoffs, or alternatively, to know whether a new homegrown fledgling will fly, Jollota said.

"How do we validate meaningful experience or training? A defined degree offers some assurance," Jollota said.

Those who forego credentialing are unlikely to suffer in the short term, because PACS administrators are so much in demand, said Leonard Avicella, vice president of SG&A Consulting in Arlington, TX, which runs a school for PACS administration. The number of inquiries about training has risen 30% in the last six months. One of the challenges for training and testing is that professionals in the field are very diverse, drawing people from radiology, IT, and biomedical engineering. Professional preparation is not uniform because candidates have gaps in different areas.

The CIIP exam will create a need for educators, including universities and training companies, to prepare candidates for the program. Clarkson College in Omaha launched one of the first college-based medical degrees for imaging informatics in June 2005. For the new candidates, certification will provide a defined career path in digital imaging. Some say it can also be used as a bargaining chip for a higher salary.

Whatever the reasons, people have taken notice of the effort, according to Anna Marie Mason, SIIM executive director. Within a month of the announcement, the organization had received more than 500 inquiries about the program.

"This exam will elevate the position of the profession, defining core competencies needed to do the job in a safe manner," Mason said.