PACS Administrator Roundtable: Lots of ideas, but not enough chairs

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If it's any indication of how the field continues to grow in numbers and enthusiasm, the PACS Administrator Roundtable (or tables plus many chairs and standing-room listeners) was almost literally bursting out the doors this morning at the Society for Imaging Informatics in Medicine (SIIM, formerly SCAR) annual meeting in Austin, Texas. Apparently the session at last year’s SCAR was in a much smaller room and there was little trouble fitting everyone. Not this year. They could barely fit all the folks in this early morning session.
   
Over breakfast, a series of PACS admin hot topics were mulled over by professionals in the field from all over the country, over half of whom were radiology technologists (RTs) by training, while the rest come equipped with information technology (IT) backgrounds.
   
The first topic on the agenda was quality assurance (QA) of images as they are generated and then sent through a PACS and archived. Many opined that since the technologist was the one to make the error, all images with issues should in the end be sent to the technologist to rectify. Another PACS administrator believed that there was a distinction between before and after archiving. If it is before the archive, then a technologist should address imaging errors. If the image is in the archive and part of a medical record, PACS administrators do not and should not have access.
   
It also was suggested that vendors could go a long way to helping the situation by developing systems that could designate privileges for a variety of users to streamline the QA process.
   
Another topic discussed was the dilemma faced by many radiology departments concerning the importing of images from CD and DVDs. An assortment of administrators in attendance viewed this as very problematic because the images raise a slew of problems relating to ownership of the images. Does the hospital archive images that were acquired by another facility? What are the legal ramifications? What does HIPAA demand that facilities do? And, beyond that, there seem to be problems with reading images from proprietary systems. There were no universal conclusions as to how to confront these issues.
   
Yet one idea put forward seemed to rise above the other concerns: having prior images benefits patient care and gives radiologists and doctors more information in order to treat them more effectively. This, a few suggested, made all the headaches worthwhile.