Do We Need to Certify PACS Administrators?

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Widespread deployment of new technologies often creates jobs that must accommodate quick growth and new tasks; jobs which must integrate rapid advances and frequent changes in responsibility on a routine basis. These positions are frequently multidisciplinary in nature, often defined ambiguously or at least specified inconsistently. Such new roles are not supported widely by continuing education, and sometimes give rise to concerns about performance proficiency and professional qualification.

The position of PACS System Administrator (PSA) has evolved in response to the volume and breadth of tasks associated with the installation and running of a PACS, even in the relatively smaller and less complex facility settings to which the technology is currently migrating in ever-increasing numbers. Not only are the functions of a PSA varied from setting to setting, but effective performance may require certain knowledge exclusive to one clinical sector vs. another (e.g. radiology or orthopedics, vs. cardiology).

Emerging, multidisciplinary functions are never initially incorporated in academically based, structured educational pathways leading to degrees, or even to certificate awards. Validated, competency based continuing education is not feasible when functional analysis of the occupational role has not been conducted.

These limitations notwithstanding, the need for both continuing education and some evolving form of professional qualification is as needed for the PSA as it was decades ago for other, now-established allied health practitioners, such as radiographers or nurses. IT professionals, a group from which many PSAs originate, are very familiar with certification processes that support in bits, and successive content trainings and evaluations, their constantly-changing knowledge and expertise requirements. In addition, there is no lack of preparatory training and review workshops to support those credentialing processes.

How can those IT professionals in PACS management, or PSAs with a clinical background - often radiographers, CT or MRI technologists and sonographers - satisfy their continuing education needs, or demonstrate proficiency and accomplishment to employers for purposes of advancement or general performance assessment?

The state of things

Years ago, Stuart Gardner initiated one of the first training programs for PSAs. Since then, numerous other workshops and short courses have been created, meeting with varying degrees of success. The content of early programs was based on the real-world expertise of (primarily) PACS consultants and other industry players who routinely witnessed the management requirements that facilities faced following system deployment.

Consistent with the varied nature of the facilities themselves, the relatively gradual stabilization, and standardization of PACS features and capabilities, and the relative lack of consistency in position descriptions and functionality, all programs then, and now, are a best guess at what a PSA needs to know to perform effectively.

The lack to date of a job analysis - and therefore no universally accepted role specification - compromises the design of course content. Many believe that it is difficult for the IT professional to have sufficient understanding of radiology and its various modalities, and for the clinical professional to master adequately the IT concepts required to manage technical issues or communicate with computer and digital imaging specialists. Whilst not always true, disparity in background and preparation usually results in courses being effective for only part of the program, and for only a subset of the participants. One or the other group is compromised by the necessity to accommodate any and all backgrounds. This is the usual bain of continuing education - not very often is it structured with prerequisite requirements, or for successive learning experiences as are traditional degree programs.

The participation of manufacturers

Effectively all PACS vendors offer new-user training in one form or another, of varying duration. It may be in-house and/or on-site at the customer facility. In the current climate of increased expenses, narrowing margins, and overall cost consciousness, these efforts focus on system-specific knowledge. There is neither the time nor the motivation to address the more fundamental, core knowledge. Ironically, these constraints can preclude the effective translation of system operating principles into optimization