What you need to know to be a PACS administrator

July 30, 2001

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

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.


During an upgrade, a solid understanding of the network will be required so that backup plans may be developed and put in place prior to the upgrade. This too should be worked out with the vendor.

DICOM and HL7


The more thorough the understanding of DICOM and HL7, the better off the PACS administrator will be. Period. This cannot be stressed enough. Neither of these is a plug-and-play standard. Given the fact that these two standards are integral to the deployment of ANY diagnostic imaging network, the more the PACS administrator can learn about them, the more effective that person will be. The understanding of these standards is critical, as they pertain to the functionality of just about every single device on the network in both in imaging and IS. As the DICOM and HL7 standards continue to evolve, this understanding is going to become more complicated.


Every year, we see more effective use of these standards at the Integrating the Healthcare Enterprise (IHE) demonstrations at the RSNA and Healthcare Information and Management Systems Society meetings. It will be the responsibility of the PACS administrator to understand what is a DICOM function and what is not. It will also be the administrator's responsibility to know what vendor can provide the functionality necessary for "your" network -- where and when to print, where and when to store, store what?


Although almost everyone expects to be able to download patient demographics directly into an imaging device, this is not possible without the necessary DICOM 3.0 functionality in the "right" place at the right time. Imaging devices provide the ability to review their respective DICOM information files if they are configured properly by the vendor. The PACS administrator will need to know how to read these files from the devices in order to collaborate with IS in solving functional and integration issues.

Workflow, QA, and Other Real Stuff


Above all, the PACS administrator must know how the department works. This is where the administrator gets into solving everyday issues of what is wrong with this workstation and why aren't the images matched with the reports? This everyday stuff, along with the necessary policies and procedures and "housekeeping" maintenance, frequently must be addressed. Often, just the housekeeping chores take the better part of a day. Fixing files and exams is a daily task: The patient ID does not match the file generated by the imaging device on a John or Jane Doe, or an exam from the new multislice CT is broken up into three exams -- head, abdomen, pelvis. Are we having fun yet?


The PACS administrator must keep his or her senses and maintain a genuinely positive personality while dealing with the questions of IS, the physicians, the technologist staff, the administrative director, and the clients of radiology or cardiology -- those people who actually ordered the exams in the first place.


The PACS administrator is a well-informed director of imaging network activities who must know where to point the finger and when.


(SG&A Consulting is introducing the PACS Administrators Training School at the upcoming AHRA in Las Vegas. Classes will be held beginning in September. Contact SG&A Consulting at 817/277-2558 or http://www.sgaconsulting.com for further information.)


For more from the PACSweb archives on PACS administration: