Avoiding the Imaging Center Island thru a Local PACS User Group - SIIM News Winter 2009

Victoria Myers, BS, RT(R), CIIP

Those of us working in either academic or community health care systems often take for granted the many opportunities for peer interaction and the implicit expectation for teamwork in our health care models. I doubt anyone would disagree with the statement that multi-faceted collaboration is fundamental to patient care, as well as to the success of any academic training program or research project. While these health care models have their differences, there remains a common theme of collegiality. As an imaging informatics professional (IIP), I, like others, reach beyond my local community to SIIM for the latest in informatics innovation, continuing education , and the opportunity to network with others who are also interested in PACS informatics.

For the IIP working in an outpatient imaging center, however, the opportunity to collaborate with one’s peers rarely reaches beyond the boundaries of the center. In fact, many imaging centers have limited resources, yet are responsible for multiple locations or remote sites. At the SIIM 2008 Hot Topic session on Imaging Center PACS, Dr. Jim Whitfill and Arne Meis introduced attendees to the diversity in outpatient imaging center IT architecture, workflow, and operations. We learned how the imaging center environment offers little time for, or emphasis on, collaborative problem solving. Due to the inherent isolation from the more traditional medical community, peer networking for the imaging center IIP may be limited to the once-a-year SIIM conference—at best. This leaves the imaging center IIP experiencing an “island of information” effect, where they have access to some information, but are still quite isolated. If an occasional conference and a few online communities are the only way the lone IIP interacts, they are missing out on a valuable opportunity.

At Scottsdale Healthcare, our community hospitals went live on PACS in 2000. The radiologists reading in the hospital also owned the 10-location outpatient-imaging center Scottsdale Medical Imaging (SMIL). It was not long after SMIL went live on PACS in 2003 that the lone SMIL PACS Administrator, Andrea Gold, developed a working relationship with our PACS team. We shared the same PACS vendor and frequently talked solutions; yet, the desire to expand our knowledge base and Andrea’s continued feeling that she was working on an island prompted us to talk about starting a local user group. Our model was simple: encourage diversity and communication, and avoid vendor influence. This is a good point to state that starting a user group requires enthusiasm, motivation, and a strong desire to reach out to others doing what you do—no matter how they do it.

The local PACS community realized that some version of PACS administrator certification was imminent, so there was curiosity about starting a local group; however, here is where the motivation piece needed to kick-in. We set a date and sent out invitations to attend the first AZPACS local PACS user group. The invite included all PACS Administrators, Radiology and IT directors, a couple of local PACS consultants, and our vendor field service staff. At the first meeting, we had about seven attendees. Today, over three years later, we have over 40 AZPACS members representing 15 organizations across Arizona. While those outside of the greater Phoenix area do not attend meetings, they stay linked to the rest of the membership via our Yahoo Groups AZPACS website.

The benefits of our local PACS user group are much the same benefits we gain from SIIM, only at a local level— relationships, resources, and education. It is not unusual to get an email or call from another member seeking input or assistance. An example of this was when I received a call from an AZPACS member across town with an urgent need to print some films and they are 100 percent filmless. We were able to assist them that day. This example of calling upon a cross-institution resource probably would not have occurred without AZPACS because we were not tapping into our local collective knowledge.

Andrea Gold, RT(R)(M), CIIP, SMIL (left) and Victoria Myers, BS, RT(R), CIIP, Scottsdale Healthcare

There are no wallflowers in this group; we want to hear from everyone because, as we all know, there is not a single way to implement and maintain a PACS. All our members are equally critical to the viability of our group; therefore, everyone is expected to contribute to group promotion, education, and networking. Our only “rules” are: everyone in attendance must participate, everyone must respect group dynamics, and vendor participants may not promote. We have learned that we share more common ground than differences, and that our technical and workflow issues are more deeply rooted in PACS scalability and functionality than in any organizational model.

I am constantly impressed with the diversity of knowledge and the ways that our membership addresses PACS problems and solutions. To add value to the meetings, we always have an educational component, which is member prepared and driven. We start with a draft suggestion of educational topics for the year; after which, members, or the occasional vendor, volunteer to prepare and present at our every other month meetings. Topics have included monitor calibration, databases, voice recognition, disaster recovery, downtime architecture, preparing for a site visit, data migration, IHE, and others.

There is an evolution to starting, growing, and maintaining a local user group. We have not needed dues, elected officers, or formal by-laws. On the other hand, we needed to consider group dynamics. For the organizational types like me, it was at first difficult to allow the group to engage in what I refer to as “PACS-chat.” We have learned both to permit and to encourage the unstructured discussions that reveal what the IIPs are working on, often leading to lively
discussion. This is the time when the group may tackle practical problems, disagree with each other, and work collectively on solutions. It is also when we really begin to see the benefit of our vendor- neutral local network.

We all benefit as SIIM welcomes diverse health care models and new “’ologies” into our membership. However, if this is the only time that an IIP interacts with colleagues, they are missing out on the resources and collegiality found in a local user group. I propose that members continue the same “conference high” we get from a SIIM annual meeting when we return to our local communities. The “island of information” effect is avoidable; in fact, both imaging center IIPs and those of us in larger health care systems benefit from new relationships, resources, and another source of education. While starting and maintaining a local user group might seem intimidating, all that is required is the motivation to reach out to others who share our interest in imaging informatics.

Victoria Myers is the IS PACS Project Manager at Scottsdale Healthcare, a three-campus acute-care community hospital system located in Scottsdale, AZ.

Editor’s note: This article is based on a Hot Topic session presentation at the SIIM 2008 Annual Meeting in Seattle.