PACS training skimps on workflow and troubleshooting

An indispensable ingredient to a successful PACS implementation is training. A review of PACS training, however, shows emphasis on the use of workstations comes at the expense of clinical workflow, IT and networking, and troubleshooting.

"There is an urgent need to implement PACS training programs beyond the viewing workstations," said Maria Y.Y. Law, an assistant professor of radiology at Hong Kong Polytechnic University.

Law proposes a PACS simulator connected to the clinical PACS to provide practical experience for trainees in a controlled environment (Comput Med Imaging Graph 2003;27:147-156).

Law's generic PACS simulator consists of:
? acquisition modality simulator (to simulate clinical imaging)
? DICOM gateway
? PACS controller
? workstations

"Using the simulator, trainees can observe clinical PACS operation component by component, trace image flow through each component, and query, retrieve, and review images at workstations," Law said.

The simulator teaches students how to handle common daily problems by allowing them to induce failure in components to observe its impact on PACS and identify network bottlenecks.

"Reliance on IT personnel will not be adequate to solve the many day-to-day minor operation problems," Law said.

By cutting power to the gateway or disconnecting the workstation from the network, students learn how to troubleshoot problems. Gaining more comprehensive training allows PACS users to communicate more effectively with IT personnel and vice versa, she said.

Two simulators described by Law are already in place. One, at Hong Kong Polytechnic University (PolyU), offers training for undergraduate technologists. The other is at the Image Processing and Informatics Laboratory at Children's Hospital Los Angeles/University of Southern California and was developed as a stand-alone training and research tool for radiologists, residents, technologists, and PACS administrators.

Facilities without all current imaging modalities can still benefit from the simulator.

"Since PolyU does not have CT or MR scanners, we have to rely on the modality simulator to generate those images for simulation," Law said.

Law said PACS training should not stop at the radiology department. The concept can be extended to other medical specialties that use images.

"A successful implementation of PACS requires a team effort not just of radiologists and technologists, but also of IT specialists, system engineers, clerks, nurses, and administrators," she said.