Everywhere I go, my clients and their committees ask me for information on what to do about a PACS administrator (PA). For example, they want to know, “Who should I hire?” and “When and/or where do I find the appropriate resource and skill set?”

Recently, we at the Thomas Group Ltd (Anaheim, Calif) conducted a nine-question, unscientific survey of some of our current and former clients to obtain feedback on this very important aspect of a PACS project. Some clients were not surveyed?those who have engaged us to either validate or audit an existing vendor selection and system design versus team objectives or are replacing an existing PACS. The results in most cases, while not conclusive, seem to support my hypothesis that every facility discovers a great many variables, along with pluses and minuses to each, in finding a solution that best matches their needs and environment. In addition to the standard requests for position description and salary expectations, the Thomas Group wanted to obtain some actual data to compare and contrast against what we typically see from our clients.

Question 1: When did you hire your PA?

Most clients responded the same way: It depends. Apparently, timing had more to do with the project’s strategic strength than considering how PACS administration would be handled. Three out of four PAs were hired before the project’s funding was approved. This information means a couple of things: 1) The initiative already could have been started and/or restarted one or more times in the recent past; or, 2) The organization had committed the budget dollars for the project. It is usually not good idea to hire a PA before having the budget for the project?no budget, no job for the PA. When the uncertainty of the budget dollars for your project has been overcome, it is very beneficial to have your PA participate in any or all vendor-selection activities. This provides the background and experience for which vendor is selected and why. The team’s commitment to your selection and consensus is critical to project success and stakeholder satisfaction. Your PA’s knowledge of what was done and why becomes especially important if any short-term tradeoffs had to be made to make the system purchase affordable, and what that tradeoff would mean at the go-live date or to certain workflows.

Question 2: How difficult was the hiring process?

Surprisingly, almost 90% reported that the process was either “As expected” or “Easier than expected.” My feeling on this data is that respondents expected the process to be difficult; therefore, they were not left frustrated by what they encountered and, in some cases, were pleasantly surprised when it was easier. In the case of finding the process easier, some clients already had one or more predetermined candidates in mind for the position.

Question 3: Where did you find your PA?

About half of the respondents’ PAs were existing hospital employees, and almost all of those were found within the radiology department. The other 50% of respondents hired their PAs through a mix of advertising and recruiting efforts. As mentioned previously, in several cases, clients identified candidates in advance. Additionally, sometimes several existing employees believed they had the skill set required for the position, and the radiology administrator selected the best candidate.

Question 4: What was your PA’s background?

No surprise here?almost 90% selected someone with a radiology background, either a technologist or a person with biomedical/radiology experience. Since the position is very heavily loaded to supporting radiology workflow, the ability to “speak radiology” cannot be underestimated. Generally, 95% of the job is working with, interfacing with, or discussing radiology workflow and imaging dynamics.

Question 5: What was your PA’s experience?

A little more than 60% had some previous PACS experience, while, interestingly, the rest had no PACS experience before the facility’s project. Again, these findings reflect some of the data from Question 4 about the PA’s background. Although we are not sure of the connection between experience and employee, this information seems to reinforce the theory that clients can identify key skill sets and then grow an existing staff member into the PA position. It is very probable that each client had an employee who had exhibited the skill set and strengths required of a PA before the employee transferred into the PA position.

Questions 6 and 7: What are a PA’s most and least important job skills?

These questions provided an interesting contrast. More than 60% identified knowledge of radiology as the most important job skill needed, and computers, software, and networking were noted in about 25% of answers. However, half identified the same computer, software, and networking knowledge as the least important job skill. As previously noted, the responses to these questions reflect the strong radiology background required or the ability to quickly acclimate to radiology terminology and workflow.

Question 8: What were your PA’s salary expectations?

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Most responded with “As expected,” and 25% claimed expectations were “Higher than expected.” These findings definitely reflect the background, experience, and origin of the PA applicants. Typically, outside applicants will have higher expectations; however, an existing hospital employee already will know and understand the salary structure and will have set his order expectations accordingly. (For more details on current salaries in the field, see the results to Medical Imaging’s first-ever salary survey.)

Question 9: On reflection, what is the one thing you would do differently?

In a nutshell, almost everyone would have done at least some things differently. In fact, the feedback alone on this question is a subject for an entire column of its own. As most of us know, upon reflection, we rarely would do everything over exactly the same way. Stay tuned for more to come on this subject.

Michael Mack is VP of business development at the Thomas Group Ltd (Anaheim, Calif). Having more than 20 years of experience in the medical imaging industry, Mack now specializes in PACS planning and implementation.