Our PACS team consists of 2 seniors and a deputy and we stand as part of Radiology. There are currently whispers of us being absorbed into the digital dept. We have worked closer with them recently for software upgrades and the move towards OrderComms these process’ have been made smoother with the help of digital.
Should PACS remain under radiology management? Are there any other PACS teams that lie within digital and if so what is your experience?
Many thanks, Andy
Hi Andy,
I’ve written about PACS team structures in the Clark’s PACS book and also carry out the annual workforce assessments which look at banding and structures in imaging informatics positions across the UK healthcare systems (I started collecting PACS JD’s as the jobs came up almost 2 decades ago now!)
The general consensus (and of course both opinions are valid) is that a Radiology led PACS team is more efficient and able to respond to the direct clinical challenges of service provision.
That said, many well known and ‘great’ PACS managers fall under I.T. departments and so it really depends on how flexible and clinically focused the particular I.T. department is as to whether a move will be successful.
Some sites have lost PACS from Radiology as there simply was no one able or willing to fill the role.
Some sites chose to move PACS from Radiology for budgetary reasons or to combine Cardiology/Pathology system management with Radiologys (usually after being sold a VNA). One fairly famous site which was one of the first to move the PACS team is almost constantly advertising for their vacant PACS posts over in I.T.
Looking at the positions across the UK, those in I.T. departments are banded lower on average (some Band 5’s, many Band 7’s, a few Band 8a’s), whereas Radiology PACS teams average a Band 8a for PACS Managers, with 8c being the highest.
I do not have the figures in front of me right now, but remember about 10%-15% of Trusts in England have PACS Teams not in Radiology (1 is led by a Physiotherapist and a couple in Clinical Engineering so not all these will be in I.T.).
Generally, if the move to I.T. is due to costs, it will be more a challenge. If it is due to lack of personnel, it could go either way. Clinical training will basically end though once in I.T…
Hope this helps, good luck!
Al.
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Hi Andy
Our PACS team currently consists of 2 x band 7, 2 x band 5 and 0.5 band 6. We cover Radiology, Pathology, Cardiology, Endopscopy, Medical Photography and Obstetrics! There has been some chat over the past years, particularly when the specialties outside of radiology were brought onboard, over where the PACS resource should sit.
We also work closely with our digital department and we use their project manager resource to help with some of our bigger projects that take up so much time. Currently they are assiting with the introduction of the outside ologies into PACS, providing admin support for our AI pilot audit and coordinating some new workstations going out! While I absolutely appreciate their support and they are definately a massive perk in our Trust, both they and I agree that that the benefit that both they and I get from the relationship works best when we are separate.
I get the obvious benefit of being able to bring in additional support when required and they get an ‘in’ with the services where we can help them with introductions and ‘back channels’. We both worried that if the PACS team were absorbed into the greater digital world, the expertise would be diluted and we would end up being pulled into other activities to the detriment of the PACS.
It helps that I have great support within the Radiology Service and managers who understand my role (sort of!). I should mention that although I have some responsibility for Pathology, the 0.5 band 6 is the other team member that sits outside of our structure. Their workflow are much more unique and we felt required dedicated knowledge. They sit within the labs team.
No easy answers to this one and look forward to hearing how other teams are operating!
Louise
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Thank you Alex, that’s really helpful. I’m actually reading your Clark’s book at the moment. And thanks too Louise. Personally, I feel that the move wouldn’t be a positive one. Standing within radiology we, I think, we are allowed to develop a rogue mentality which lends itself very well to the job and to be restricted and fenced in by a dept that doesn’t appreciate the nuances of a radiology dept could be quite oppressive.
Maybe if it’s inevitable, a very descriptive ‘stay in your lane’ policy can be created!
We do work closely with digital currently, and as you mentioned Louise, it has great benefit to both parties. We currently only deal with radiology, although pathology can use our RIS and PACS, but this is rare and they only needed help in the original set up.
As contracts expire and vendors now routinely receive other Ologies, maybe the loss of the uniqueness of DICOM will strengthen the argument towards amalgamation as ‘outsiders’ will see PACS purely as an image sharing platform with no appreciation for the intricacies of the PACS manager role.
Many thanks, Andy
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Andy,
We’re a team of eight covering five London hospitals at the higher end of the band range mentioned by Alex. Up until a few years ago we sat within Imaging but reorganisation led to a transfer to IT management.
Before, we found Imaging services often didn’t appreciate the technical challenges a PACS Team are faced with (not their fault of course), and we were badly under resourced from a staffing perspective.
Now we are closer to the IT teams we rely on: EUC, Server, Networks etc and fortunately have a management structure above that understands what is and isn’t possible, and also has a strong understanding of Imaging workflows. We do have to be sure governance channels are in place so Imaging service needs are addressed, but this change has been a positive move for diagnostics at our Trust.
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We transitioned the PACS and even CRIS management services away from Radiology around 4 years ago and moved into digital to sit within Clinical Informatics. This move has proved beneficial for both Radiology and digital services. There was concern initially from Radiology that support would diminish but this has been far from the case.
The support, acknowledgement, and awareness of Radiology workflows across the digital services have helped us to transform workflows and there is an appetite now to develop and invest in solutions, which would have previously been more difficult working alone in Radiology.
I transitioned the service as a single resource as PACS Manager (the system admins remained under radiology management for political reasons), looking after services across 4 different sites. The team now consists of a Digital Imaging Lead, PACS/CRIS Manager, a 0.6 wte Band 6 and 3x PACS/Digital Imaging Administrators. This growth I do not believe would have been possible within Radiology alone. We have also been able to be involved with digital solutions outside of Radiology where our input has been invaluable in identifying what workflows would/wouldn’t work. In summary, for us the transition has been a hugely positive one both for Diagnostics and Clinical Informatics.
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Following up on this topic to add two further points for thought after a few questions were raised at a recent PACS Managers event:
- PACS are classified as medical devices. Medical devices require suitably qualified individuals to install, maintain and administer them. A ‘pure’ I.T. service may be less likely to meet this definition if it evolves to include only non-clinically qualified staff - this is very rare and of course it would be a completely individual assessment.
- HCPC registered Radiographers will need to find ways to undertake at least some clinically oriented CPD (to ensure their CPD variety covers the required breadth of professional practice) if they are not employed within a clinical department and also do not undertake clinical examinations.
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