IIPBoot Cover 2012.Psd

ImagingInformaticsProfessionalBootcamp

Wednesday,June6,2012OrlandoWorldCenterMarriott

Orlando,FL

TrainingManual

SocietyforImagingInformaticsinMedicine19440GolfVistaPlaza,Suite330

Leesburg,Virginia20176Phone:7037230432Fax:[email protected]

EducationManagerNicoleSmithMedinaDirectorofMeetingsAndreaSarisExecutiveDirectorAnnaMarieMasonTheSIIM2012ImagingInformaticsProfessionalBootcampisindependentoftheImagingInformaticsProfessional(IIP)certificationprogram,whichrequiresaseparateapplication.TheImagingInformaticscertificationprogramisgovernedbytheAmericanBoardofImagingInformatics(ABII),anindependentcertifyingbodyandorganization.ABIIanditsstaffaresolelyresponsibleforthepoliciesandadministrationoftheIIPcertificationprogram,includingapplicationdeadlineandeligibilityrequirements.TolearnmoreaboutABIIIIPcertification,visitwww.abii.org.QuestionsabouttheIIPBootcampandotherSIIMIIPeducationalresourcesshouldbedirectedtoSIIMatiip@siimweb.org.Copyright2012SocietyforImagingInformaticsinMedicineAllrightsreserved.Thisbookisprotectedbycopyright.Nopartofthisbookmaybereproducedinanyformorbyanymeans,includingphotocopying,orutilizedbyaninformationstoragesystemwithoutwrittenpermissionfromthecopyrightowner.

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TableofContents

IIPBootcampSchedule.................................................................................. 4SIIMPositionStatementonIIPEducationandtheABIICertification............ 5ContinuingMedicalEducationInformationandSpeakersDisclosures......... 8CourseObjectives.......................................................................................... 10TheSIIMIIPEducationAdvisoryNetwork(EAN)LearningObjectives........... 11SuggestedReferencesandResourcesfortheImagingInformaticsProfessional................................................................................................. 22PresentationSlides

CommunicationandTraining........................................................................ 34PACSProcurement&ProjectManagement................................................... 64PACSOperations............................................................................................ 97InformationTechnology................................................................................ 130ClinicalEngineeringandMedicalInformatics................................................ 165SystemsManagement................................................................................... 246ImageManagement....................................................................................... 289SIIM2012IIPBootcampPracticeTestQuestions..........................................

355

CourseEvaluation.......................................................................................... 369ContinuingEducationVerificationofAttendanceForms.............................. 376SIIM2012AnnualMeetingIIPRoadmap. 381

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ImagingInformaticsProfessionalBootcampSchedule

Wednesday,June6,2012

8:00AM6:00PMOrlandoWorldCenterMarriottOrlando,FL

SagoPalmsBallroom

RegistrationandBreakfast7:00am8:00am

Welcome&Introduction

CommunicationandTraining(1.0hr)AnnL.Scherzinger,PhD,CIIP

PACSProcurement&ProjectManagement(1.0hr)

ScottShannon,RT(R),PMP,CIIP

Break10:00am10:15am

PACSOperations(1.0hr)JohnGriffith,RT(R,MR,CT),CIIP,CRA

InformationTechnology(1.0hr)

RichardSkipL.Kennedy,MSc,CIIP

LunchPotomacBallroomD12:15pm1:15pm

ClinicalEngineering(0.5hr)MedicalInformatics(1.0hr)

DavidE.Brown,BSCS,CNMT,CIIP

SystemsManagement(1.0hr)CraigA.Bryant,RDMS,CNMT,CIIP

Break

3:45pm4:15pmImageManagement(1.0hr)EliotL.Siegel,MD,FSIIM

PanelDiscussionandTestQuestionReview(.75hr)

AllPresenters

Conclusion6:00pm

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SIIMPositionStatementonIIPEducation

andABIICertification

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TheSocietyforImagingInformaticsinMedicine(SIIM)PositionStatementon

ImagingInformaticsProfessional(IIP)EducationandtheAmericanBoardofImagingInformatics(ABII)Certification

TheSIIMpositionstatementtakesintoaccountthefollowingbasicprinciplesonImagingInformaticsProfessionaleducationandcertification:

TheABIIIIPcertificationprogramprovidesapropercredentialforIIPstoenhanceprofessionaldevelopment,stimulatecareergrowth,andofferobjectivevalidationofIIPexperience.

SuccessontheABIIIIPcertificationexamwillbetheresultofexperience,education,andacquiredknowledge.ItwillcrossthespectrumofimaginginformaticsknowledgeasdescribedintheIIPexamTestContentOutline.

NoeducationalcoursecanguaranteethatitscontentwillrepresentthequestionsontheABIIIIPcertificationexamination.

TheABIIIIPexamTestContentOutlinewillserveasthebasisfortheSIIMEducationAdvisoryNetwork(EAN)todevelopthebodyofknowledgeforIIPeducation.

WhentheEANcompletesthedevelopmentoftheEANcorecurriculum,SIIMwillconsiderrecommendingtheEANcontentastherecommendcourseofstudyinIIPeducation.

IIPeducationalprogramsofferedbySIIManditsEANparticipantsareindependentoftheABIIIIPcertificationprogram.

SIIMhasrecommendedtoABIIthatindividualswhoserveintheleadershipofABIIorwhoparticipateinthedevelopmentoftheIIPexamshouldnotteachcertifiedimaginginformaticsprofessional(CIIP)reviewcourses.

SIIMdefinesanImagingInformaticsProfessionalasanindividualwhoapplieshisorhereducation,clinical,andITexpertisetomanagingenterprisewidePictureArchivingandCommunicationSystems(PACS)andotherdigitalmedicalimagingsystems.TheprimaryroleoftheIIPistoevaluate,analyze,implement,andrenderinformedopinionsaboutthedeliveryofhealthcareusingimaginginformaticssystems.ThepracticeofIIPadministrationpredatesanyspecialtyorganization,trainingprogram,orcertificationbody.IIPsentertheprofessionwithavarietyofeducationalbackgroundsandpracticalexperiences.ManyIIPshaveacquiredknowledgeandexpertisefrominformalguidanceoronthejobtraining.SpecificeducationisnotaprerequisitetothepracticeofIIPadministration.ImagingInformaticsProfessionalEducationToday,agrowingnumberofeducationalopportunitiesareavailabletoIIPswhowishtobecomeCIIPs.Whileformaltraininginimaginginformaticsisnotrequiredtopractice,manyIIPsmaybenefitfromaformalintroductiontotheprofessionaswellasfromopportunitiesforlifelonglearningandprofessionaldevelopmentinthisrapidlyevolvingfield.EachindividualIIPisbestabletodeterminewhicheducationalprogramsmaymeethis/herneedsandgoals.WhileatthistimeSIIMdoesnotrecommendorendorseparticularprograms,thefollowingcriteriashouldbeconsideredinassessingIIPeducation.

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InstitutionIIPeducationisofferedbyuniversities,colleges,communitycolleges,forprofitbusinesses,andnotforprofitorganizations.Inassessingthevalueoftheseprograms,thereputationoftheorganizationandpotentialconflictsofinterestofthesponsoringinstitutionshouldbeconsidered.CurriculumTheprimaryfocusofIIPeducationshouldbetobuildonpreviouseducationandclinicalexperienceandtoprepareIIPstofunctioninthemedicalimagingenvironmentacrossvendorsystems.Inevaluatingaparticularprogram,itsmissionandpurposeshouldbecomparedtothisstandard.TheSIIMEANisdevisingamodelcurriculumthatcanserveasastandardagainstwhicheducationalprogramscanbecompared.Coursesofstudybasedonthiscurriculumwillvaryinlengthandscope.IIPsareencouragedtochooseacourseofstudythatmeetspersonalneedsandprofessionalgoals.ProgramdirectorsandinstructorsIIPeducationprogramsshouldbedevelopedandpresentedaspartofacore,standardbodyofknowledgebyexperiencedandprofessionaleducators.Ingeneral,programsdevelopedandtaughtbyexperiencededucatorswhoareexpertsinthefieldofimaginginformaticsand/orpracticingIIPsarerecommended.TheSIIMImagingInformaticsProfessionalEducationAdvisoryNetwork(EAN)TheEANisasubcommitteeoftheSIIMEducationCommitteeandiscomposedofSIIMmemberswhoareeducatorsfromthroughouttheUnitedStatesandCanada.IthasbeencreatedinresponsetotheincreasingprofessionaldevelopmentneedsofIIPs.WhiletheEANgroupsfocusiscompletelyeducationalanddistinctfromtheCIIPexaminationprocess,theeffortsofthiscommitteetocreatecurriculumdevelopmentresourceswillsupportthosepursuingpathwaystowardcertification.TheEANperspectivewillhelptoelaboratetheCIIPtestcontentoutline(TCO)andassureanobjectiveunderstandingoftheknowledgerequirementsthatarelikelytobenecessaryforCIIPcertification.StandardizationoftheknowledgebasewillhelpeducatorsandcertificationcandidatesfocusontheessentialcontentthatreflectsthefunctionalroleoftheCertifiedImagingInformaticsProfessional.VariationsintheIIProlewillcontinuetoevolvebutthebaselinecontent,asdefinedbytheCIIPtestcontentoutline,willensureongoingessentialcompetenciesrequiredoftheIIParepresentedineducationalprogramsandinstructions.IIPprofessionalsareencouragednotonlytomeetthecurrentcompetenciesoftheCIIPprofession,butalsotoengageinlifelonglearning,sharingofbestpractices,andothermechanismsforprofessionaldevelopment.CertificationforImagingInformaticsProfessionalsTheAmericanBoardofImagingInformatics,Inc.(ABII)isanonprofit,independentcertifyingbodythatsponsorstheImagingInformaticsProfessionalCertificationProgramandawardstheCertifiedImagingInformaticsProfessional(CIIP)designationtoqualifiedcandidates.FoundedbytheSocietyforImagingInformaticsinMedicine(SIIM)andtheAmericanRegistryofRadiologicTechnologists(ARRT),ABIIoffersanationalcertificationprogramthatestablishesastandardfordemonstratedknowledgeandcompetenceinmedicalimaginginformatics.

Approved:November26,2007

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ContinuingMedicalEducationInformationTheImagingInformaticsProfessionalBootcampisjointlysponsoredbytheSocietyofInterventionalRadiology(SIR)andtheSocietyforImagingInformaticsinMedicine(SIIM).Physicians:ThisactivityhasbeenplannedandimplementedinaccordancewiththeEssentialsandStandardsoftheAccreditationCouncilforContinuingMedicalEducation(ACCME)throughjointsponsorshipofSIRandSIIM.SIRisaccreditedbytheACCMEtoprovidecontinuingmedicaleducationforphysicians.SIRdesignatesthiseducationalactivityforamaximumof8.0AMAPRACategory1Credits.Physiciansshouldonlyclaimcreditcommensuratewiththeextentoftheirparticipationintheactivity.Technologists:CategoryACEcredithasbeenapprovedbytheAmericanSocietyofRadiologicTechnologists(ASRT)fortheSIIMImagingInformaticsProfessionalBootcamp.MedicalPhysicists:AnapplicationhasbeenapprovedbytheCommissiononAccreditationofMedicalPhysicsEducationPrograms(CAMPEP)toprovideMedicalPhysicsContinuingEducationCredit(MPCEC)fortheSIIMImagingInformaticsProfessionalBootcamp.IIPCertificateofAttendance:CertificateofAttendancewillbeavailableforImagingInformaticsProfessionals(IIP)totrackcontinuingeducationeligibilityrequirementsfortheABIIforboththeSIIMAnnualMeetingprogramandtheIIPBootcamp.___________________________________________________Presentersatthiscoursewilldiscloseanyconflictofinterestortheirintentiontodiscussofflabeluse,ifapplicable,inaccordancewithACCMEStandardsandFDArequirements.SpeakerDisclosureofVestedInterestislistedbelow.Speakersarealsoencouragedtodiscloseverballyanyconflictofinterestortheirintentiontodiscussofflabeluseatthebeginningoftheirpresentations.SpeakerDisclosureofVestedInterestFacultyName: DavidE.Brown,BSCS,CNMT,CIIP PresentationTitle: ClinicalEngineeringandMedicalInformaticsConflictofInterest: NoneFacultyName: CraigA.Bryant,RDMS,CNMT,CIIPPresentationTitle: SystemsManagementConflictofInterest: NoneFacultyName: JohnL.Griffith,RT(R)(MR)(CT),CRA,CIIPPresentationTitle: PACSProcurementConflictofInterest: None

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ContinuingMedicalEducationInformation(Continued)FacultyName: RichardSkipL.Kennedy,MSc,CIIPPresentationTitle: InformationTechnologyConflictofInterest: NoneFacultyName: AnnL.Scherzinger,PhD,CIIPPresentationTitle: ProgramIntroduction

CommunicationsandTrainingConflictofInterest: StockholderandboardmemberofTolTech,Inc.FacultyName: ScottShannon,RT(R),PMP,CIIP PresentationTitle: PACSProcurement&ProjectManagementConflictofInterest: NoneFacultyName: EliotL.Siegel,MD,FSIIM PresentationTitle: ImageManagementConflictofInterest: OnMedicalAdvisoryBoardofFovia,McKesson,CarestreamHealth,MedRad,

TeraRecon,andMercuryComputerSystems;onboardofdirectorsofCarestreamHealth;OnSpeakerBureauforSiemens;receivesgrant/researchsupportfromGEMedicalSystems,EvolveTechnologies,RedRickTechnologies,EXBIXSystems,Steelcase,Inc.,AnthroCorporation,Barco,IntelCorporation,DellCorporation,HermanMiller,Inc./SonareTechnologies,VirtualRadiology,andAnatomicalTravelogue

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ImagingInformaticsProfessionalSubcommitteeoftheSIIMEducationCommittee

AnnL.Scherzinger,PhD,CIIPChairUniversityofColoradoHealthScienceCenterDenver,CODavidE.Brown,BSCS,CNMT,CIIPKaiserPermanenteInformationTechnologyLosAngeles,CACraigA.Bryant,RDMS,CNMT,CIIPSharpHealthcareSanDiego,CARichardSkipL.Kennedy,MSc,CIIPKaiserPermanenteMedicalGroupSacramento,CAVictoriaMyers,BSRT(R),CIIPScottsdaleHealthcareScottsdale,AZSalvadorO.Tejeda,RT(R)(CT)(MR),A+,Network+,CDIA+,HL7Certified,CIIPAgfaHealthcareLakeland,FL

CourseLearningObjectivesAttheconclusionofthiscourse,theparticipantwillbeableto:

ExplaintherangeofrolesrequiredfortheImagingInformaticsProfessional(IIP)andthesupportingtasksandknowledgerequirementstoensureasuccessfulPACSimplementationandoperation

Describethecomplexityofimaginginformaticsadministrationinthemedicalimagingenvironmentacrossvendorsystems

IdentifyareaswheremoreeducationandunderstandingisneededforthoseinterestedinpursuingIIPcertification

Exploretheblendofessentialcompetenciesrequiredforimaginginformaticsadministrationasdescribedinthe10domainsoftheIIPcertificationtestcontentoutline

DifferentiatebetweentheABIIcertificationeffortsandSIIMIIPeducationgoals

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TheSIIMIIPEducationAdvisoryNetwork

(EAN)

LearningObjectives

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TheSIIMImagingInformaticsProfessional(IIP)EducationAdvisoryNetworkLearningObjectives Acompetentimaginginformaticsprofessionalshouldbeableto:I. Procurement

A. Determineorganizationreadinessfortheelectronicenvironment.o SynthesizethefinancialaspectsofpurchasingaPACS.o Identifykeystakeholderswithinandoutsidetheorganizationandtheirexpectations.o DiscusstheobjectivesandelementsofaformalPACSStrategicPlandocument.o IdentifythefunctionalrequirementsassociatedwithPACSforfactorsaffectingthe

organizationsbusinesspractices.o Appraisetherelevanceofexistingequipmentandsystemsinventoryinpurchasinga

PACS.o Differentiateamongthecommonneedsanalysisstrategies.o Understandtheneedforlifecycleanalysis.o IdentifythemembersneededforaPACSSteeringCommittee.o Listkeyelementsthatmustbeconsidered(plannedfor)insitepreparationthatare

notincludedinthevendorsPACSpurchaseprice.o LearnhowtodevelopaPACSMigrationStrategy.o IdentifytheimpactofPACSimplementationoncurrentandfutureworkflow.

B. Establishandimplementaprocessforvendorselection.o DiscusstheobjectivesandelementsofaformalRFPdocument.o Compareandcontrastvendorresponseanalysistools.o Interpret,evaluate,andcomparevendorproposals.o DevelopinformationcollectiontoolsdesignedtoassistwithPACSselection,including

sitevisits,referencechecks,etc.o RelatethedifferencebetweenaRequestforProposal(RFP),aRequestforSolutions,

andaRequestforInformation.o Discussthecommonstandardscomplianceissues.

C. Negotiatecontractswithvendors.o Listthestandardcomponentsofacontract,suchaspricing,implementationsupport,

training,service,functionality,acceptancecriteria,financingoptions(ASP,capital,leasing),penalties,etc.

o Describenegotiationstrategiesastheyrelatetothecontractcomponents.o Recognizetheneedtocomplywithfederalregulations.o Understandhowtoresearchfederalstandardsforprotectedhealthcareinformation.o Describedifferentdatamigrationstrategiesandhighlightpossiblepitfalls.

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II. ProjectManagementA. Identifythegoals,scope,risks,andkeymembersofprojectteam.

o Useprojectclarificationtechniquessuchasscatterdiagramsandfishdiagrams.o DefinetherolesoftheProjectManager,ProjectSponsor,andotherkeyindividualson

aproject.o CreateaProjectCharter.o Identifyandmanagethemostcommonprojectrisks.

B. Evaluatethefeasibilityofaproject.o Performworkflowanalysistogaugetimeandresourceallocationfornewandexisting

systems.o Describehowtousequalitativeassessmentmethods(i.e.,focusgroups)

andquantitativeanalysis(i.e.,comparisonstudies)tozeroinonsystemissues.o Assesscurrentoperatingcostsoftheexistingsystem.o Assesstotalinvestmentofanewsystemtoincludeallpertinentfactorssuch

ashardware,software,training,etc.o Evaluatedifferentreturnoninvestment(ROI)models.o DeterminetheROIbyassessingreductioninoperatingcostthatoffsetsinvestmentin

newsystem.o Identifysignificantbarriersandobstaclesthatmayhaltprojectimplementationsuch

asfundinglimitations,politicalconsiderations,managementconcerns,andorganizationalresistancetochange.

C. Utilizethecommonprojectmanagementtools.o BuildaProjectWorkPlan,includingschedules,resourceallocations,andbudgets.o Createactivitynetworks(i.e.,PERT,Gantt,andCPM)andothertoolsfor

communicatingprojectscopeandactivities.o Createcriteriaformonitoringandreportingprogress,includingmilestonecharts,

projectactivity,andcostreports.o Usecommonfinancialcalculationtoolsforprojectmeasurement.o Explainhowaprojectisdocumented.o ManageexternalPACS/RISvendorsandconsultantseffectively.o Determineandanticipatechangesthatoccurduringprojectexecution.

III. Operations A. Designandimplementqualityimprovement(QI)procedures.

o ExplainthephilosophicalbasisofQI(i.e.,popularmethodsandbackground).o Identifyandusetoolsforproblemidentificationandanalysis.o Determinetargetareasforimprovementbaseduponanalysis.o Evaluateissuesthroughgapanalysismodel.o Recommendaproposedcourseofaction.o CreateprocessmappingofredesignedQIprocedures.

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o Document,formalize,administer,execute,evaluate,andmonitorQIproceduresandestablishQIaccountability.

o Establishcompetencybasedapplicationstrainingforallendusergroups.o Developprotocolsforgrantinguserprivilegesandusertraining.

B. Developandimplementpoliciesandprocedures.o Referenceandverifyexistingpoliciesandprocedures.o Evaluateexistingprocesses.o Identifyworkflowpointsoffailure.o Recommendprocessimprovements.o Constructpoliciesandprocedures.o Administerpoliciesandprocedures.o Developandimplementcontingencyplans.o Communicatepoliciesandprocedureswithinandoutsideoftheimagingdepartment.o Develop,implement,monitor,andregulatepoliciesandprocedures,andestablish

accountability. C. EnsurecompliancewithFederalregulations.

o DefinecriterionforcompliancewithfederalregulationssuchasFDA,JCAHO,HIPAAandMQSA.

o Assembletoolsforcomplianceprocesses.o Designcomplianceproceduresandprocesses.o Presentcomplianceprocedures.o Regulatecompliance.

IV. Communications A. Recognizerolesandrelationshipsinhealthcaresettings.

o Comprehendorganizationaltheoryandhowitappliestotypicalhospitalorganizationalstructures,includingaffiliates,management,departmentsandstaff,andtheirindividualroles.

o Comprehendrolesandrelationshipsinthepatientcareprocess,especiallytheroleandfunctionofmedicalspecialties.

o AnalyzePACSservicemetricswithrespecttobasiccustomerservicetenets.o Integratecommunicationstrategiesintoserviceprocedures.o AppraisetheroleofInformationTechnology(IT)inrelationtotheorganizational

structure.o DeterminetheneedsforaPACS/RISteam.

B. Communicatewithhealthcareprofessionalsusingappropriatemedicalterminology.o Explainappropriatemedicalterminology(i.e.,anatomy,physiology,andpathology)as

itrelatestomedicalimages.o Useappropriatepositioningterminologyasitrelatestoimaginginmedical

informatics.

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o Relatetheterminologytoitsuseinthestandards,suchasDICOMandIHE,andtheimpactondisplayparameters,suchasdeterminingthehangingprotocols.

o RecognizetherolesandusesofICDandCPTcodinginrelationtoPACSworkflowandbilling.

o Recognizeprocedurenamesandclinicalfindingsassociatedwithspecificmodalities.C. Alertclinicalstaffaboutissuesregardingsystemavailability

orchanges.o Definetheaudienceaffectedbydowntimes,upgrades,andchangesinworkflow.o Definetheprocessesforsuitablecommunicationstrategiestoreachmedical,allied

health,andtechnicalprofessionals.o Createdocumentationdescribingthecommunicationofdowntimeprocedures.

D. Providedecisionmakers(businessunits,CIO,etc.)with informationaboutsystemchanges.o Provideanassessmentofchangeenhancementthatisconsistentwithorganizational

objective.o ProvideanevidencebasedassessmentofPACSROIforstrategicplanning.

E. Developuserfeedbackmechanisms.o Evaluateexistingassessmentandfeedbacktoolsandtechniques,bothoperational

andtechnical.o Developresponsestrategies.

V. TrainingandEducation A. Performaneedsassessmenttodeterminetrainingneeds.

o Distinguishthedifferentlearningtypologiestoapplyinahealthcareenvironment.o Createaneedsassessmentbasedoncompositionofstaffandworkflow.o Determinethestaffneededtosupportandapproveoftrainingplans.o Createoutcomesorevidencebasedobjectives.

B. Evaluateandselecttrainingprogramsaccordingtouserneeds.o Incorporatethecharacteristicsofadultlearningandadulttrainingmethodsinto

teachingstrategies.o Developorselectfromavailableinstructionalresourcesthatareconsistentwiththe

instructionalneedsassessmentresults. C. Implementtrainingoreducationalprograms.

o Defineadeliveryprocessforthoseresourcesthataccommodatetheorganizationsstaffing,schedules,specialneeds,andavailableresources.

o Analyzeandsuggestworkflowmodificationsthatarerequiredduringtraining.

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D. Evaluateeffectivenessoftraining.o Developmethodsforlearningandtrainingprogramperformanceassessmentand

reporting.o Createprocessesforfollowuptrainingifneeded.o Createprocessesforperiodicretrainingofstaff.

VI. ImageManagementA. Managethedesignoftheenvironmentforviewingandinterpretingimages.

o ApplytherecommendationsoftheHumanFactorsandErgonomicsSocietytoworkstations.

o Identifykeyconsiderationsfordesigningthesoftcopyreadingenvironment.o Assesstheroomlayoutdesign,incorporatingbothphysicalandworkflow

considerations.o Listtheergonomicconsiderationsnecessaryforanoptimalreadingenvironment.o Developpoliciesandproceduressurroundingimaginginformationaccessrequests.

B. Evaluatethehumancomputerinterface.o Evaluate,implement,support,andmanagetheapplicationsand/orinterfaces

necessaryforinterpretations.o EvaluatetherequirementsforseamlessinterfacingofEMR/RIS/PACS/otherhealth

informaticssystems,andidentifywhatIHEprofilesmustbeavailable.o Developtheprocessesandpoliciesformonitorcalibrationandrecyclingofimaging

devices.o Developthecommunicationsprotocolsforexceptionsresolution.o EstablishtherelationshipbetweenDICOMandmediaexchange.o UsethesoftwaretodemonstratehowthePACSsystemvieweroperates.o Explainhowtousethewebbrowser.o Explorethefunctionsavailablewiththesoftware.o UnderstandthefunctionandstandardimplementationofKeyImagesand

Annotations.o ExplainwhatfunctionsPACSadministratorsmightuse.o Describethefunctionsthatthetechnologistsandradiologistswoulduse.

C. Determineoptimalimageflowandimplementprocessesthatensuredataintegrity.o Recognizeanddevelopprotocolsandproceduresfordataandworkflowintegrity.o Classifyanddocumentallactionsdirectlyrelatedtomanualinterventionswithdata

integrity.o Analyzedatatoidentifytrendsinproblemsolvingissuessurroundingequipment,

training,andworkflowpointsoffailure.o Classifyanddocumentallactionsrelatedtoworkflowintegrity.o Developprotocolsandproceduresforactivatingsupportofimaginginformation

systems.o Identifytechnologicalchallengeswithimageviewingandlargedatasetsinrelationto

imageaccessibilityacrosstheenterprise.17

o Developworkflowcontingenciesforsinglepointsoffailureandsystemsfailures.o Explorethepurposeofteachingfiles.o Identifyimagestorage,acquisitionprotocols,andstandardsimplementation(DICOM)

forteachingfilesandclinicaltrials.o Determinecompressionrequirementsappropriateforspecificmodalityimagessets.o Determinecompressionrequirementsforappropriateimagedisplayforradiologists,

technologists,andreferringphysicians.o EvaluateIHEinrelationtoimageintegrityandteachingfiles.o Explaintherelationshipbetweensoftcopy/hardcopyimagingpipelineandaPACS

environment.o EvaluatetheissuesassociatedwithimagecompressionandPACS.

D. ImportandexportoutsidestudiesintoaPACS.o Implementandprioritizeimaginginformationmanagementpoliciesandprocedures

forclinical,research,nighthawk,andteleradiologyservices.o Facilitateanddocumentworkflowprocesses,policies,andproceduresassociatedwith

imageintegration.o DetermineviewingprivilegesandstoragerulesforimportingstudiesintothePACS.o EstablishworkflowprocessesandprotocolsforexportingstudiesfromthePACS.o Understandthepolicyandimplementation,asdescribedbytheIHE,specificallyPDI

andIR.o Understandthestandardsoffileexchange.o Recognizetherecordinganddigitizingtechnologyusedforimageintegration.

VII. InformationTechnologyA. Assessstorageandarchiveneedsanddetermineappropriatearchitecture.

o Examinestorageandarchiveneedsassociatedwithmedicalimaging.o Reviewcurrentarchivearchitecturesandsolutions,suchasDAS,SAN,NAS,andgrid

storage.o Understandstorageprotocols,suchasfilebased,blockbased,andmetafileheader.o Distinguishamongthedifferentarchivemedia(tape,MOD,spinningdisk)andidentify

whenandhowtheyareused.o Establishstoragemanagementandretentionpolicies.o Calculateperformanceandcapacityneeds.

B. Designandspecifynetworkarchitecture.o Examinenetworkingneedsgeneratedbyimaging.o Reviewnetworkarchitectureandsolutions.IncludeLAN,WLAN,MAN,andWAN.o Understandfaulttoleranceandloadbalancingimplementation.o Understandnetworkandtransmissionprotocolswithcorrespondingperformance

parameters.o ComprehendtheOSIreferencemodel.o Distinguishnetworkhardwareandsoftwarecomponents.o Understandbasicnetworkingconfigurationparameters.o Distinguishinterpretationnetworkmetricssuchasbps,servicelevel,collisions,etc.

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C. Implementandmaintainappropriateserverhardwareandsoftware.o Examinehardwareandsoftwarerequirementsforimagingservers.o Differentiateamongdifferentserverarchitectures.

D. Retrieveinformationfromdatabasesforoperations,qualityassurance,andplanningpurposes.o Differentiateamongthedifferentdatabasedesignsandunderstandthe

implementationbasics.o Executesimpledatabasequeries.o Understandbasicdatabasemanagementandperformancemeasurementtools.

E. IdentifyandimplementITstandards.o IdentifyITcommunicationsstandards.o IdentifyITnetworkmanagementstandards.o DemonstrateknowledgeofITsecurityaspects.

F. Developappropriatereplacementschedules.o Definethelifecycleofeachsoftwareandhardwarecomponent,includingMoores

Law.o Explaintechnologyobsolescenceandobsolescenceplanning.o Describetheprocessofdatamigration.

G. PACSarchitecture.o IdentifykeycomponentsofPACSarchitecture,includingservers,diagnostic

workstations,andsoftwareapplicationarchitectures.o Explainhowcomponentsareconnected,includinganyrelevantinterfacesand

approachestointegratedHIS/RIS/PACS/VR.o DifferentiateamongcommonPACSarchitectures,suchaswebbasedviewing,

integratedwebservers,multipletierarchives,theroleofspecialtyworkstations,andmodalities.

o DistinguishPACSarchitecturefromotherITarchitectures(i.e.,similaritiesanddifferences).

VIII. SystemsManagementA. Determinetherequirementsforoptimal,costeffectivesystemcapacityand

throughput.o Developamodelforcalculatingarchivecapacityrequirements.o Describevariousmethodsthatvendorsuseforlicensingsoftware.o Usetoolstomonitorsystemperformance.o Describethemetricsusedtomeasuresystemperformance,suchasonlineresponse

time.

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o Evaluatealternativestrategiesforenterprisewideperformanceimprovementandcosteffectiveness.

o EvaluateimpactofnewtechnologiesonPACSinfrastructure.B. Plandisasterrecovery(DR)andbusinesscontinuity(BC)strategies.

o DifferentiatebetweenBCplanningandDRplanning.o CreatepoliciesandproceduresforDR.o DescribetheHIPAArequirementsforsystemsmanagementwithrespecttoDR.o TestDRandBCplans.o EvaluateDRandBCplansandmodificationsperiodically,asrequired.

C. Useproblemmanagementandsystemavailabilitytoolsandstrategies.o Createpoliciesandproceduresforsystemsperformancemonitoringand

troubleshooting.o Defineproblemescalationprotocols.o Analyzeproblemsandsolutionsforperformanceimprovement.o Identifyanduseappropriatemonitoringandtroubleshootingtools.o Createshorttermdowntimestrategies.

D. Planandevaluatedatamigrationprocedures.o Developandexecuteadatamigrationprocedureforcurrent,aswellasfuture,

migrations.o Identifyissueswithdatamigrationstrategiesanddescribetheimplications: Accuracy Dataintegrity Efficiency Workproduct(KON,annotations,PS)migration

o Determinecostsofdatamigrationstrategies.o Developacutoverstrategythatminimizesimpactontheusers.

E. Maintaindatasecurityandindividualprivacy.o Create,monitor,andenforcedatasecurityandprivacypolices.o DescribetheHIPAArequirementsforsystemsmanagementwithrespecttoprivacy.o Describestrategiesforprovidingdatasecurity.o Identifytoolsandtechniquesforprovidingdatasecurity.

IX. ClinicalEngineering A. Assessimagingmodalitycapabilities.

o Describeanddifferentiateamongallimagingmodalities: Basicoperatingprinciples Typicalclinicalapplications Imageformatsandappearances Datavolumesandfilesizes

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Interpretiveconsiderations Typicalexamprotocols

B. Supervisemodalityintegration.o Manageandcoordinateintegrationactivities.o Comprehendapplicabletechnicaldocumentation,suchasnetworkdiagrams,

conformancestatements,andintegrationprofiles.o Usethetechnicalskillsneededforintegrationsuchas: Networking AppropriateDICOMTransferSyntaxes Standards Tools

C. Establishaprogramforimagedisplayqualitycontrol.o ExplainwhatismeantbycompliancewiththeGrayscaleStandardDisplayFunction

(GSDF).o DiscusstheimpactofGSDFondisplayandhardcopyconsistency.o Describetheuseofrecommendedtools,procedures,andtestpatternsforimage

displayconsistency.o Listanddescribeallinfluencesintheimagingchainthatshouldbeevaluatedand

monitoredforoptimalimagedisplay. D. Recognizehazardsspecifictothehealthcareenvironment.

o Recognizetheoccupationalsafetyhazardsassociatedwitheachmodality,suchasinfectionandbiohazards.

o Recognizethepatientsafetyhazardsassociatedwitheachmodality,suchaselectricalsafety,ionizingradiation,andmagneticfields.

X. MedicalInformatics A. Identifyandimplementmedicalimagingstandards.

o Understandthecommunicationprotocolsanddataformatsofimaginginformaticsstandards,suchasDICOMandHL7.

o Understandtheimagequalitystandards,recommendations,andregulations.o Understandcodingandnomenclaturestandardswhichimpactimageinterpretation

andworkflow. B. ApplyappropriateIHEguidelines.

o SpecifyandinterpretapplicableIHEintegrationprofiles.o InterpretanIHEintegrationstatementandconnectathonresults.

C. Integrateimagearchitectureintoorganization'slongrangeplan.o Understandhowmultipleimagingdisciplinescanuseacommonenterprisearchive.

21

o Appreciatethechallengesofusingmultiplepatientidentifiers(MPI)andhowMPIcanhelp.

o Understandinformationsharingconceptsandtherequirementsassociatedwithregionalandnationalhealthcaredeliverysystems.

o Appreciatetheuniqueworkflowsandrequirementsassociatedwithallimagingspecialties.

22

SuggestedReferencesandResourcesfortheImagingInformaticsProfessional

23

S I IM KNOWLEDGE CENTER

www.siimcenter.org

The SIIM Knowledge Center is your Imaging Informatics content resource.

Anytime, Anywhere Access to Practical, Essential Imaging Informatics Knowledge

"Need to Know" Series ePub The SIIM Need to Know (NTK) Series provides up-to-date, expert views on key Imaging Informatics topics. The series kicks off with two online publications: Displays and Archiving.

Education SIIMs Webinars, eTutorials, and Live Learning Center offer professional development, information exchange, and continuing learning in the field of Imaging Informatics all year long. SIIM members and SIIM 2012 full-registrants free access to select audio synchronized PowerPointTM presentations, and listen to SIIM 2012 sessions in MP3 format on your mobile device for education on the go!

24

YourComprehensiveGuidetoStudytheFundamentalToolsinImagingInformatics

PracticalImagingInformatics:FoundationsandApplicationsforPACSProfessionalsISBN:9781441904836 $59.95SIIMmembers $89.95nonSIIMmembers

PickUpYourCopyattheSIIM2012AnnualMeetingSpringerBooth708

ExhibitHallCypressBallroomFrom theworldrenownexpertsatSIIMan indispensible reference for thepracticing IIP,thosestudying foracertificationexam,andanyprofessionalwhoneedsquickaccess to thenutsandboltsofimaginginformatics.PracticalImagingInformaticsdescribesthefoundationsofinformationtechnologyandclinicalimagemanagement,detailstypicaldailyoperations,anddiscussesrarercomplicationsandissues.Thebookincludessuggestedresources,personalexperiences,keyconcepts,andanextensiveglossary of imaging informatics terms, as well as stepbystep outlines and checklists forimportant tasks. Each of 26 chapters includes pearls (key points) and selfassessmentquestionstohelpyoutestyourknowledgeandprepareforcertification.

Orderyourcopytoday!www.siimweb.org/pii

SIIMPublicationSales

19440GolfVistaPlaza,Suite330,Leesburg,VA20176Phone:703.723.0432Fax:703.723.0415www.siimweb.org/[email protected]

25

SuggestedResourcesandReferencesforImagingInformaticsProfessionalsSIIMResources www.siimweb.orgSIIMIIPEducation www.siimweb.org/IIPEducationSIIMIIPEducationalAdvisoryNetwork www.siimweb.org/EANSIIMResourcesforIIPs www.siimweb.org/IIPSIIMKnowledgeCenter www.siimcenter.org SIIMImagingInformaticsResources www.siimweb.org/imagingSIIMAnnualMeeting www.siimweb.org/meetingsSIIMPublications www.siimweb.org/publications

JournalofDigitalImaging(JDI) www.siimweb.org/jdi

OnlineAbstracts/FullTextforSIIMMembers

PracticalImagingInformatics: www.siimweb.org/piiFoundationsandApplicationsforPACSProfessionals

SIIM/SCARUniversityPrimerSeries www.siimweb.org/primers SecurityIssuesintheDigitalMedicalEnterprise,SecondEditionArchivingIssuesintheDigitalMedicalEnterpriseQualityAssurance:MeetingtheChallengeintheDigitalMedicalEnterpriseElectronicReportingintheDigitalMedicalEnterpriseDecisionSupportintheDigitalMedicalEnterprise

SIIMPosition/WhitePapers www.siimweb.org/whitepapers

IrreversibleCompressionofMedicalImagesAddressingtheComingRadiologyCrisis:SCARTRIPInitiativeTransformingMedicalImaging:TheFirstSCARTRIPConference

SIIMeLearning www.siimweb.org/elearningSIIMExpertHotline www.siimweb.org/experthotlineSIIMTechnicalResources www.siimweb.org/resourcesSIIMOpenSourceResources www.siimweb.org/openSIIMImagingInformaticsResources www.siimweb.org/imagingSIIMTopTen www.siimweb.org/toptenSIIMImagingInformaticsMarketplaceRFI www.siimweb.org/index.cfm?id=7742SIIM/ACRJoinPracticeGuidelinesDevelopment www.siimweb.org/index.cfm?id=243

NEW

26

SuggestedResourcesandReferencesforImagingInformaticsProfessionalsSIIMshareBlog www.siimshare.orgSIIMJDIBlog http://blogs.springer.com/jdiSIIMLinkedIn www.linkedin.comSIIMTwitter@SIIM_Tweets https://twitter.com/#!/SIIM_TweetsSIIMFacebook http://www.facebook.com/pages/

SocietyforImagingInformaticsinMedicineSIIM/64297426586

27

Resources and ReferencesBooks**CourseRecommendedReadingsAdvancesinHealthCareOrganizationsbyM.WernerandK.Jones(Publishedby

JosseyBass,2003)TheArtofProjectManagement(TheoryofPractice)byScottBerkun(PublishedbyPearsonEducation,2001)BareBonesProjectManagement:Whatyoucan'tnotdobyBobLewis(ISSurvivorPublishing,2006)TheDemingManagementMethodbyM.Walton(PublishedbyPerigee,1986)TheDesignofEverydayThingsbyD.Norman(PublishedbyCurrencyDoubleday,1988)DICOMBasics,3rdEditionbyH.Oosterwijk(PublishedbyOTech,Inc.,2005)Don'tMakeMeThink:ACommonSenseApproachtoWebUsabilitybyS.Krug(PublishedbyNewRiders,2000)EffectiveProjectManagementbyR.Wysocki(PublishedbyWiley,2000)TheEssentialPhysicsofMedicalImagingbyJ.Bushberg(PublishedbyLippincott,Williams&Wilkins,2002)ToErrisHuman:BuildingaSaferHealthSystembyCommitteeonQualityofHealthCareinAmerica,Institute

ofMedicine(PublishedbyNationalAcademyPress,2000)EvaluatingTrainingPrograms:TheFourLevelsbyD.L.Kirkpatrick(PublishedbyBerrettKoehler,1994)FinancialManagementinRadiologybyS.Sferrella,M.Allen,andM.Reitter(PublishedbyAmericanHealth

RadiologyAdministrators,2004)AGuidetotheProjectManagementBodyofKnowledge(PMBOKGuide)FourthEdition(PublishedbyProject

ManagementInstitute,2008)HighAvailabilitybyF.Piedad(PublishedbyPrenticeHall,2001)ITProductionServicesbyH.Kern,R.Schiesser,andM.Muniz(PublishedbyPrenticeHall,2004)ITSystemsManagementbyR.Schiesser(PublishedbyPrenticeHall,2002)ManagerialBreakthroughbyJ.Juran(PublishedbyMcGrawHill,1995)ManagingHealthCareInformationSystemsbyK.A.Wager,F.W.Lee,andJ.P.Glaser(PublishedbyJohnWiley&

Sons,2005)

NationalCouncilonRadiationProtectionandMeasurements(2004).RecentApplicationsofthePublicDoseLimitRecommendationforIonizingRadiation,NCRPStatementNo.10(NationalCouncilonRadiationProtectionandMeasurements,Bethesda,Maryland)

28

Resources and ReferencesPACS:AGuidetotheDigitalRevolution,SecondEditionbyK.Dreyer,D.Hirschorn,A.Mehta,andJ.Thrall

(PublishedbySpringer,2005)PACSandImagingInformatics:BasicPrinciplesandApplications,SecondEditionbyH.K.Huang(Publishedby

JohnWiley&Sons,2010)PERLforSystemAdministrationbyD.BlankEdelman(PublishedbyOReilly,2000)**PracticalImagingInformatics:FoundationsandApplicationsforPACSProfessionalsbyB.F.Branstetter,D.L.

Rubin,D.S.Griffin,andD.L.Weiss(Eds)(PublishedbySpringer,2009)ThePracticeofSystemandNetworkAdministrationbyT.Limoncelli(PublishedbyPearsonEducation,2001)PrinciplesofAnatomyandPhysiologybyG.J.TortoraandS.R.Grabowski(PublishedbyHarperCollinsCollege

Publisher,1996)RitaMulcahy'sPMPExamPrep,SeventhEditionbyRitaMulcahy(PublishedbyRMCPublications,2011)

QualityisFreebyP.Crosby(PublishedbyMcGrawHill,1979)ReviewofRadiologicPhysics,ThirdEditionbyW.HudaandR.Sloan(PublishedbyLippincott,Williams&

Wilkins,2010)TheSixSigmaBookforHealthcare:ImprovingOutcomesandReducingErrorsbyR.Barry(PublishedbyHealth

AdministrationPress,2002)ATaxonomyforLearning,TeachingandAssessingbyL.AndersonandD.R.Krathwohl(Eds)(Publishedby

AddisonWesleyLongman,2001)UNIXSystemsAdministratorHandbookbyE.Nemeth(PublishedbyPearsonEducation,2000)UsabilityEngineeringbyJ.Nielsen(PublishedbyMorganKauffman,1993)WhoMovedMyCheese?byS.Johnson(PublishedbyPenguin,2000)Windows2000AdministrationbyG.Spalding(PublishedbyMcGrawHill,2002)WritingEffectivePoliciesandProceduresbyN.Campbell(PublishedbyAmacom,1998)

29

Resources and ReferencesJournalArticlesAAPM/RSNAtutorialonequipmentselection:PACSequipmentoverview:generalguidelinesforpurchasingand

acceptancetestingofPACSequipmentbyE.Samei,J.A.Seibert,K.Andriole,et.al,Radiographics,Vol23,(313334),2004

AninnovativeoutcomesbasedmedicaleducationprogrambuiltonadultlearningprinciplesbyHPMcNeil,

MedicalTeacher,Vol28,(527534),2006ChangesintechnologistproductivitywithimplementationofanenterprisewidePACSbyB.Reiner,E.Siegel,

andM.Scanlon,JournalofDigitalImaging,Vol15:1,(2226),2002ThenewRADadministratorbyG.Wiley,DecisionsinImagingEconomics,Vol18:8,(1518&54),2005DefiningtheroleofaPACStechnologistbyA.Cabrera,JournalofDigitalImaging,Vol15Suppl1,2002DefiningthePACSprofession:aninitialsurveyofskills,training,andcapabilitiesforPACSadministratorsby

P.Nagy,G.Bowers,B.Reiner,andE.Siegel,JournalofDigitalImaging,Vol18:4,(252259),2005DevelopingPACSpoliciesandprocedures,byB.Gaytos,JournalofDigitalImagingVol.14:2,2005EducationtechniquesforlifelonglearningbyJ.Collins,Radiographics,Vol24,(14831489),2006Filmlessradiologydepartmentinafulldigitalregionalhospital:quantitativeevaluationoftheincreasedquality

andefficiency,byA.Nitrosi,et.al.,JournalofDigitalImaging,Vol20:2,(140142),2007Howmanypeopledoesittaketooperateapicturearchivingandcommunicationsystem?byR.Honea,

JournalofDigitalImaging,Vol14Suppl1(4043),2001HowtoeffectivelyuseconsultantsbyW.N.Bridgewater,N.Johnson,andG.Garofolo,JournalofDigital

Imaging,Vol13Suppl1,2000ImpactofdigitalinformationtechnologiesonradiologictechnologistproductivitybyJournalofDigital

Imaging,SpecialIssue,Vol15:3,2002InternalITsupportcrucialtosuccessinfilmlessdepartmentbyY.Y.ShiehandG.H.Roberson,Diagnostic

Imaging,(6162),2000ImagingInformaticsAdministration,JournalofDigitalImaging,SpecialIssue,Volume19,Supplement,2006

AninnovativeoutcomesbasedmedicaleducationprogrambuiltonadultlearningprinciplesbyH.P.McNeil,

MedicalTeacher,(527534),Vol28(6),2006OptimizingphysiciansinstructionofPACSthroughelearningcognitiveloadtheoryappliedbyP.Devolder,

et.al.,JournalofDigitalImaging,Volume22,(2533)2009AnoverviewofadultlearningprocessesbyS.S.Russell,UrologicNursing,Vol26:5,2006ManagementofthepicturearchivingandcommunicationssystemarchiveatTexasChildren'sHospitalbyM.E.

Blado,JournalofDigitalImaging,Vol14Suppl1,(8488),2001

30

Resources and ReferencesPACSadoptionbyJ.HoneymanBuck,SeminarsinRoentgenology,(256269),2003Physicianacceptanceofnewmedicalinformationsystems:thefieldofdreamsbyN.W.Treister,Journalof

DigitalImaging,(2024),1998PlanningforPACS:AComprehensiveGuidetoNontechnicalConsiderationsbyM.D.Cohen,L.L.Rumreich,

K.M.Garriot&S.G.Jennings,JAmCollRadiol,Vol2,(327337),2005ProactivelymonitoringdepartmentalclinicalITsystemswithanopensourceavailabilitysystembyC.

Toland,C.Meenan,M.Warnock,P.Nagy,JournalofDigitalImaging,Vol20Suppl1(119124),2007Radiologists'productivityintheinterpretationofCTscans:acomparisonofPACSwithconventionalfilmby

B.Reiner,E.Siegel,F.Hooper,S.Pomerantz,A.Dahlke,andD.Rallis,AmericanJournalofRoentgenology,Vol176,(861864),2001

Radtracker:AwebbasedopensourceissuetrackingtoolbyP.Nagy,M.Warnock,M.Daly,J.Rehm,K.

Ehlers,JournalofDigitalImaging,Vol15Suppl1,2002Reinventingradiologyinthedigitalage,PartI,thealldigitaldepartmentbyJamesH.Thrall,Radiology,Vol

236,(382385),2005Reinventingradiologyinthedigitalage,PartII,newdirectionsandnewstakeholdervaluebyJamesH.Thrall,

Radiology,Vol237,(1518),2005Reinventingradiologyinthedigitalage,PartIII,facilities,workprocesses,andjobresponsibilitiesbyJames

H.Thrall,Radiology,Vol237,(790793),2005ResourcebasedrelativevalueunitsbyS.JohnsonandW.Newton,FamilyMedicine,Vol34:3,(17276),2002ThegoalofmedicalimagingbyB.Sanders,RadiologyManagement,Vol24:2,(1214),2002TheimportanceofaPACSmanagerforlargescalePACSinstallationsbyL.C.Beird,JournalofDigitalImaging,

Vol12Suppl1,(37),1999Useracceptabilityacriticalsuccessfactorforpicturearchivingandcommunicationsystemimplementation

byD.CrivianuGaita,P.Babyn,D.Gilday,B.O'Brien,andE.Charkot,JournalofDigitalImaging,Vol13Suppl1,(1316),2000

UserquestionnairetoevaluatetheradiologicalworkspacebyP.vanOoijen,A.Koesoema,andMOudkerk,

JournalofDigitalImaging,Vol19Suppl1,(5259),2006

EfficiencyMetricsforImagingDeviceProductivity.ByM.Hu,WPavlicek,PLiu,MZhang,SLanger,SWang,VPlaceRMiranda,TWu.Radiographics.31:603616,2011.

SurveyofModernFluoroscopyImaging:FlatPanelDetectorsversusImageIntensifiersandMore.ENickoloff.

Radiographics.31:591602,2011.AnInformationModeloftheDICOMStandard.ByCKahnJr,CLanglotz,DChannin,DRubin.Radiographics.

3:295304,2011.

31

Resources and ReferencesApplicationofFailureModeandEffectAnalysisinaRadiologyDepartment.EThornton,OBrook,M

MendirattaLala,DHallett,JKruskal.Radiographics31:281293,2011.AnatomyandPathophysiologyofErrorsOccurringinClinicalRadiologyPractice.OBrook,AOConnell,E

Thornton,REisenberg,MMendirattaLala,JKruskal.Radiographics.30:14011410,2010KeyPerformanceIndicatorsforMeasuringandImprovingRadiologyDepartmentPerformance.HAbujudeh,R

Kaewlai,BAsfaw,JThrall.Radiographics30:571583,2010.DepartmentScorecard:ATooltoHelpDriveImagingCareDeliveryPerformance.LDonnelly,KGessner,J

Dickerson,BKoch,AToebin,TLehkamp,JMoskovitz,ABrody,CDumoulin,BJones.Radiographics30:20292038,2010.

32

ResourcesandReferencesOnlineResources

ACRPracticeGuidelinesandStandards http://www.acr.org/accreditation/FeaturedCategories/GuidelinesStandards.aspxAHRAContinuingEducationOnline

http://www.ahraonline.org//AM/Template.cfm?Section=Online_InstituteFreetomembersofAHRA.Costtoothers

AmericanAssociationofPhysicistsinMedicine(AAPM)ReportsTaskGroup18:AssessmentofDisplayPerformanceforMedicalImagingSystems

http://www.aapm.org/pubs/reportshttp://www.aapm.org/pubs/reports/OR_03.pdf

AmericanBoardofImagingInformatics

http://www.abii.orgAMAComplianceCoding https://commerce.amaassn.org/store/AuntMinnie(ActivePACSbulletinboard)

http://www.auntminnie.com

BloomTaxonomyoftheCognitiveDomainhttp://www.edpsycinteractive.org/topics/cogsys/bloom.htmlhttp://www.coun.uvic.ca/learning/exams/bloomstaxonomy.html

CareersinMedicine https://www.aamc.org/students/medstudents/cim/specialties/CDC(JobHazards)

http://www.cdc.gov/niosh/docs/88119/

Cohen,Rumreich,Garriot&Jennings(2005).PlanningforPACS:AComprehensiveGuidetoNontechnicalConsiderations.JAmCollRadiol,2:327337.Retreivedfrom:

http://www.jacr.org/article/S15461440(04)003783/abstractConflictResearchConsortiumUniversityofColorado

http://conflict.colorado.edu

CPT(CurrentProceduralTerminology)http://www.amaassn.org/ama/pub/physicianresources/solutionsmanagingyourpractice/codingbillinginsurance/cpt.shtml

CustomerService

http://marketing.about.com/od/relationshipmarketing/a/crmtopten.htmhttp://www.joelonsoftware.com/articles/customerservice.html

DCM4JBOSS

http://www.dcm4che.org/33

ResourcesandReferencesDefinitionofMedicalSpecialties

http://www.healthadvantage.org/body.cfm?id=66DICOMInformationandStandard

http://dicom.nema.orghttp://www.dclunie.com

TheDICOMStandardhttp://www.cabiatl.com/mricro/dicom/index.html

DICOMValidationToolkit(DVTK)

http://dvtk.org/GeneralRadiologyInformation

http://www.radiologyinfo.org

HealthcareInformationTechnologyProcurementhttp://www.otpedia.com/entryDetails.cfm?id=351

HealthcareInformationTechnologyProjectManagement

http://www.otpedia.com/entryDetails.cfm?id=353HealthcareStandards

http://www.iso.org/iso/home.htm(searchhealthcare)

HealthImaginghttp://www.healthimaging.com

HIMSS

http://www.himss.orgHIPAACompliance

http://www.cms.hhs.gov/HIPAAGenInfo

HL7Browserhttp://nule.org/wp/

HL7InformationandStandardshttp://www.hl7.org/Library/standards.cfm

IAChttp://www.intersocietal.org/intersocietal.htm

ICD9CMhttp://www.cdc.gov/nchs/icd.htm

34

ResourcesandReferencesIHEDocuments

http://www.ihe.nethttp://www.himss.org/ASP/topics_ihe.asphttp://www.ihe.net/Technical_Framework/index.cfm#radiologyhttp://sumo.irisa.fr/con_result/Cardiologyhttp://www.ihe.net/Technical_Framework/index.cfm#cardiology

ImagingEconomics

http://www.imagingeconomics.comImagingEconomics:KeystoaSuccessfulPACSImplementationhttp://www.imagingeconomics.com/issues/articles/MI_200505_06.asp

InstituteforHealthcareImprovementhttp://www.ihi.org/ihi

JointCommission2012NationalPatientSafetyGoals

http://www.JointCommission.org/PatientSafety/NationalPatientSafetyGoals/

LeapfrogGroupforPatientSafetyhttp://www.leapfroggroup.org

MagneticResonanceSafetyhttp://www.mrisafety.com

MedicarePhysicianPaymentSchedule(RBRVS)http://www.amaassn.org/ama/pub/physicianresources/solutionsmanagingyourpractice/codingbillinginsurance/theresourcebasedrelativevaluescale.shtml

MQSAGuidancehttp://www.fda.gov/RadiationEmittingProducts/MammographyQualityStandardsActandProgram/default.htm

MedicalImaging&TechnologyAlliance(MITA),adivisionofNationalElectricalManufacturersAssociation(NEMA) http://www.nema.org/prod/med/NHINNationalHealthcareInformationNetwork

http://healthit.hhs.gov

OccupationalSafetyhttp://www.radiologyinfo.org/en/safety/index.cfm

OnlineResourceGuidetoProjectManagement

http://quickbase.intuit.com/articles/onlineresourcesguidetoprojectmanagementPrinciplesofAdultLearners

http://honolulu.hawaii.edu/intranet/committees/FacDevCom/guidebk/teachtip/adults2.htm

ProjectManagementhttp://management.about.com/cs/projectmanagement/a/PM101c.htm

35

ResourcesandReferencesProjectManagementInstitute http://www.pmi.orgProjectManagementVideos

http://www.youtube.com/user/projectmanagervideosPublicationTopics

http://www.prepressure.com

RadiologyManagementhttp://www.ahraonline.org/AM/Template.cfm?Section=About_Radiology_Management1&Template=/CM/HTMLDisplay.cfm&ContentID=16704

RadLexBrowserhttp://www.radlex.org/http://www.rsna.org/Informatics/radlex.cfmhttp://bioportal.bioontology.org/ontologies/42161http://www.searchradiology.com/RadLex/radlextutorial/RadlexTutorial.ppt

RHIOSRegionalHealthcareInformationOrganizationshttp://www.himss.org/asp/topics_rhio.asp

SANS(SystemAdmin,Audit,Network,Security)InstituteReadingRoomhttp://www.sans.org/reading_room

Security

http://web.mit.edu/security

SixSigmahttp://www.isixsigma.com/http://www.isixsigma.com/topic/sixsigmanewbie/

SNOMEDTerminologyhttp://www.nlm.nih.gov/research/umls/Snomed/snomed_main.html

SNOMEDCT

http://www.ihtsdo.org/snomedctSNOMEDCollegeofAmericanPathologists

http://www.cap.org/apps/cap.portal?_nfpb=true&_pageLabel=snomed_page

SPSSSurveyTips http://www.wu.ac.at/imm/student_platform/research_information/statistics/survey_tips.pdfStorageNetworkIndustryAssociation(SNIA)TechnicalTutorials

http://www.snia.org/education/tutorials

SystemAdministratorsGuild(SAGE)http://sageweb.sage.org

36

ResourcesandReferencesVHDissector4.5.1

http://www.toltech.netWebMD

http://www.webmd.comWikipedia

http://en.wikipedia.org/wiki/Computer_storagehttp://en.wikipedia.org/wiki/Hard_disk_drivehttp://en.wikipedia.org/wiki/RAIDhttp://en.wikipedia.org/wiki/Satahttp://en.wikipedia.org/wiki/SCSIhttp://en.wikipedia.org/wiki/Serial_attached_SCSIhttp://en.wikipedia.org/wiki/Iscsihttp://en.wikipedia.org/wiki/Network_File_System_(protocol)http://en.wikipedia.org/wiki/Dicomhttp://en.wikipedia.org/wiki/Ishikawa_diagram

YahooPACSMailingList

[email protected]

http://groups.yahoo.com/search?query=osirixNIHImagesoftware

http://rsb.info.nih.gov/nihimage/

37

Communicationsand

Training

AnnL.Scherzinger,PhD,CIIPAssociateProfessor

DepartmentofRadiologyUniversityofColoradoHealthSciencesCenter

38

Communications&Training Scherzinger

SIIM2012IIPBootcamp

ImagingInformaticsProfessionalBootcampCommunicationandTraining

AnnScherzinger,PhD,CIIPAssocProfRadiology,UColorado

BoardMember,ToLTech,Inc

ImagingInformaticsProfessional2011TopTrendsinImagingInformatics Dosematters...: RadiationDose Weneedtoknow: BusinessAnalytics Cloudywithachanceofimages: CloudComputing Youcan'tmeasureitifyoudon'thavetheunits: SIIMWorkflowProject Shareandsharealike: ImageSharing Aradiologistwitharulerisaradiologistintrouble: QuantitativeImaging Stampofapproval: FDAApprovalProcess

A i di lit P l H lth R d Animpendingreality: PersonalHealthRecords Innovatorsonthemove:MobileTechnologies "Mr.Watson comehere Iwanttoseeyou...": AIApplicationsinMedicinehttp://www.siimweb.org/index.cfm?id=7728

39


SIIM2012IIPBootcamp

CIIPTestContentOutlinehttps://www.abii.org/TestContentOutline.aspx

Procurement ProjectManagement Operations Communications

Imagemanagement InformationTechnology SystemsManagement ClinicalEngineering

TrainingandEducation MedicalInformatics

SIIMEducationalAdvisoryNetwork Subcomittee oftheSIIMEducationCommittee

Createeducationallearningobjectivesforeachofthe10ABIItestingdomains

Completedin2008p AvailableontheSIIMwebsite

http://www.siimweb.org/EAN

40


SIIM2012IIPBootcamp

TCOA. Recognize roles and relationships in A. Recognize roles and relationships in

EAN

TCOversusEANCommunications

A. Recognizerolesandrelationshipsinhealthcaresettings.1. Organizationalchart2. MedicalSpecialties3. Organizationaltheory4. Customerservicemethods

A. Recognizerolesandrelationshipsinhealthcaresettings.

Comprehendorganizationaltheoryandhowitappliestotypicalhospitalorganizationalstructures,includingaffiliates,management,departmentsandstaff,andtheirindividualroles.

Comprehendrolesandrelationshipsinthepatientcareprocess,especiallytheroleandfunctionofmedicalspecialties.

Analyze PACS service metrics with respect toAnalyzePACSservicemetricswithrespecttobasiccustomerservicetenets.

Integratecommunicationstrategiesintoserviceprocedures.

AppraisetheroleofInformationTechnology(IT)inrelationtotheorganizationalstructure.

DeterminetheneedsforaPACS/RISteam.

CommunicationsandTraining Communications

Organizational structure what you should knowOrganizationalstructure whatyoushouldknow ITsupportfunctionsinimaginginformatics Medicalterminology:anatomy,positioning,studydescription

andbilling.DICOMandIHEcoveredbylaterpresentations. ServiceandQAmetrics. Systemavailability,businessmetricsandprocurement:covered

bylaterpresentations. TrainingTraining

A.Needsassessment B.Selectionoftrainingprogramsforadultlearners C.Implementationoftraining D.Evaluationofprogramandneedsforretraining.

41


SIIM2012IIPBootcamp

CommunicationsOrganizationalStructure

Traditional Current Thought Traditional Administrationontop. Managementbydepartmentor

service(Nursing,Radiology,Medicine).

Decisionsslow,musttraveluphierarchytotop.

CurrentThought Organizationisbasedonstrategic

initiativesandmarketneeds(WomensHealth).

Managersintheservicehaveauthorityandaccountability.Flattenedmanagementstructure Collaborationbetween

departmentsinvolvestopmanagement.

Goalsofdepartmentmaydifferornotmeshwiththoseoforganization.

structure.

Decisionsmadewithinthecollaborativegroup.Canadaptmorequickly.

Oftenrequiresduplicationofservices.

CommunicationsOrganizationalStructure

Typically combinationofthetwostructures Duplicationofservicesisexpensiveintime,personnelandp p p

equipment. Radiologymayexistinsomebutnotallcentersandtherestillisa

department. Managementcanbeaproblembecausepersonnelinthecenter

reallyworkforthedepartment. Centeranddepartmentgoalsmaynotalwaysbealigned. PACSexpertiseiseasilyexpandedtosupportthecenter.

ORTHOPEDICS

WOMENS HEALTH

CARDIOVASCULARED

MAINRADIOLOGY

NEUROSURGERY

42


SIIM2012IIPBootcamp

CommunicationsWhatyoushouldknowaboutyourorganization

Missionandstrategicinitiativesofyourorganization.g y gAdvancing healthcare for our patients and their

families through healing, discovery and education.

PoliciesandProcedures waytoachievemission Radiation Protection Policy: automated tracking of individual examRadiationProtectionPolicy:automatedtrackingofindividualexam

doseandlifetimedosetopatient Utilizationcontrol:Standardizedimagingprotocolswhichenable

appropriateuseofimagingresources.


AccreditingbodiesthatyourorganizationanswerstoJoint Commission (JC) Information management Standards JointCommission(JC)InformationmanagementStandards.

HIPAAprivacyandsecurityrequirements Criticalresultreporting,timelyaccesstoinformation Limiteduseofabbreviations Documentauthentication

JCSafety correctpatient,resultturnaroundtimes ACRinitiatives workwithyourMedicalPhysicist

Radiologyserviceaccreditation:MAM,CT,MRI,US,NM,PET ImageGently:reductionofdoseinchildrensexams ImageWisely:dosereductionforadults Radiationdosemonitoring Standardsforelectronicimaging

43


SIIM2012IIPBootcamp


Howpatientsaccesstheirownmedicalrecord


Benchmarking ACR,SCARD,UHC Physicianproductivity PressGaney PatientSatisfaction.y CMS ClinicalIndicators.

Qualityandstandardsinitiatives ACRappropriatenesscriteriafororders ACRRADPEERandotherpeerreviewtools RSNA StandardizedTemplates

ProcessImprovement organizationsprocess FOCUS PDCAandSixSigmaarecommon. Improvementanalysis:Flowcharts,Ishikawa,Pareto

Purchasing Itemstomeetcentralfacilityneeds Technologytosupportimaging:DICOM,IHE

44


SIIM2012IIPBootcamp

ParetoChart16 100%

Hou

rs

8 50%

WORKFLOW

CO CompletedexamONPACS SenttoPACSTREV TechapprovedRREV ResidentreviewedAREV AttendingreviewedSO Si d ff

TREV-R

REV

RR

EV-AREV

CO

-ON

PACS

ON

PAC

S-TREV

AR

EV-S

OSO Signedoff

CommunicationsITDepartment Leadroles

CIO:leadstheITdepartment canbeamemberoftheboardorreporttotheCOOp

CTO:responsibleforITstandardsandevaluationanduseofemergingtechnologies.DoesyourPACSarchitecturematchthatofthehospitaldatacenterorthatofexistingstandards?

CSO:responsibilitytoimplementaneffectivesecurityplanDothesecurityfeaturesofPACSmeetthehospitalstandards?

CMIO:aphysicianchampionforclinicalinformationsystemswhoservesunderCIOtodriveISintegrationwithexistinghospitalworkflowControlofPACSmaydependonwhetheryouareasinglevendororabestofbreedinstitution.

45


SIIM2012IIPBootcamp

CommunicationsITDepartment

RoleofITinHealthcare CreationofanITplanandstrategy.Updateofplanandstrategy

withchangeintheorganizationanditsneeds Acquisitionordevelopmentandimplementationofnew

applications

Dailysupportofsystemusers Infrastructuremanagement,includingservers,networkand

interfaces

Evaluatingtheuseandrelevanceofnewtechnologies Looksfamiliar!!

PatientPatient

CommunicationsYourDirectSupportCustomers

CliniciansCliniciansRadiologistsRadiologists

GoodOutcomeGood

Outcome

EfficientWorkflowEfficientWorkflowTrainingTraining

StaffStaffTechnologistsTechnologists

TimelySupportTimelySupport

AccurateData

AccurateData

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SIIM2012IIPBootcamp

CommunicationsEfficientWorkflow

Beknowledgeableofworkflowduringprocurementphasep p

Beproactiveinmonitoringsystemandimprovinguserexperience. Utilizeasystemdashboard Makesureyouknowwhen

vendorsareupgradingmodalitysoftwarey

ReviewrecommendationsofSCARTripinitiative

Shadowstaffforwaystomaketheirworkflowbetter

Nagy PG. etal. RadioGraphics, 29, 1897-1906, 2009.

SIIM2012*LEARNINGTRACK8MaximizingEfficiency&QualitythroughAdvancedEnterpriseWorkflow

CommunicationsMedicalSpecialties specialworkflowneeds

EmergencyMedicine:STATreads,24/7coverage,HIRES.OrthopedicSurgery:HIRESbone,CTsurgicalplanning,Jointreplacementtemplatesoftware.CardiovascularDisease(Cardiology):CT/MRIlargestudies,3Dandotheranalysisandprocessing.Neurology/Neurosurgery:CT/MRIlargestudies,3Danalysisandprocessing;surgicalplanningandlocalization.ObstetricsandGynecology:USvideo,coloredDoppler,structuredreporting.

Oncology:CT/MRIstudycomparisonsandmeasurements.LargePETandPET/CTimagingstudies.Mammography,CAD,clinicaltrials.

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SIIM2012IIPBootcamp

CommunicationsMedicalSpecialties specialworkflowneeds

PulmonaryDisease:CT/MRIlargestudies,analysisandprocessing.RadiationOncology:CT/MRIstudiestoimportfortreatmentplanning.Mayhaveownequipment.SportsMedicine:HIRESbone,CT/MRIforjointsandsofttissue.Surgery:Accesstoimagingandimagesduringsurgery.Gastroenterology:Fluoroscopy,video.Foralistanddescriptionoftheseandotherspecialtiesgoto:https://www.aamc.org/students/medstudents/cim/specialties/

SIIM2012*LEARNINGTRACK5SolvingEnterpriseImaging

CommunicationsQualityandTimelySupport

Makesurethatyourserviceisquality Hiregoodpeople.Givethemapathtoadvancement.Recognizeall

rolesasimportant. Whensomethinggoeswrong,fixitandmakeaplantohaveitnot

happenagain.Haveyourhelpdeskemployeesinteractwithtechnicalsupport.

Staffneedtokeepcurrentinfield,attendmeetingsandusergroups. Providereasonableexpectations;deliverearlyifpossible. Trackissues,provideamethodforfollowup

Customer may not always be right but should be treated with Customermaynotalwaysberightbutshouldbetreatedwithrespect. Dontroutinelypointoutshortcomings Taketheblamewhenyoumakethemistake Ifcustomersroutinelymakeamistake,maybethereisasystemic

problemthatcanbeaddressed

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SIIM2012IIPBootcamp

CommunicationsMeasureCustomerServiceQuality

Customerservicesurveys Abilityofpersonneltoquicklyunderstandtheirproblem.

Ability of personnel to resolve problem or direct user to another Abilityofpersonneltoresolveproblemordirectusertoanotherappropriatesource.

Professionalismofpersonnel.Knowledgeandsupportoforganizationsstrategicplan

Effectivenessofalertsregardingnewapplications,changesanddowntime.

SPSSSurveyTips:http://www.wu.ac.at/imm/student_platform/research_information/statistics/survey_tips.pdf

Supportstatistics dashboardforservice Averagetimebetweensupportcallandresolutionofproblem Percentageproblemsresolvedin24hours Percentageofcallsthatarerepeatcallsonsameproblem

CommunicationsDataqualityaccuracy

Qualityassurancemeasures Discrepanciesindemographic

and exam information RIS toandexaminformation,RIStoPACS

Missingimages,technologistQAprotocol

Timebetweenworkflowsteps Communicateresults,both

goodandbadg IndicationsforaQAeffort Patientcareconsequencesare

motivationforchange LackofQAisexpensive

Requiresknowledgeofmedicalterminologyand

procedures

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SIIM2012IIPBootcamp

AnatomicSystemsandRegionsSkeletal SystemBones, cartilage, and joints

Cranial cavityj

Pelvic cavity

Lower Extremities

Upper ExtremitiesThoracic cavity

DiaphragmAbdominal cavity

Thigh

Knee

Leg

MusculoskeletalSystemCervical Vertebrae (C1- C7)Skull

( )

Thoracic Vertebrae (T1 - T12)

Lumbar Vertebrae (L1- L5)Sacral Vertebrae (S1 - S5)

An arthrogram is an x-ray of a

includes the skeletal system and attached muscles.

An arthrogram is an x ray of a joint after the injection of contrast

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SIIM2012IIPBootcamp

NervousSystem

C i l N (C1 C7)Brain

B hi l Cervical Nerves (C1- C7)

Thoracic Nerves (T1 - T12)

Lumbar Nerves (L1- L5)Sacral Nerves (S1 - S5)

BrachialPlexus

SpinalCord

includes the brain, spinal cord, peripheral nerves, vision, hearing, taste and smell.

RespiratorySystem

Pulmonary refers to the lungs.

Thoracentesis is the removal of fluid or air from the pleural space surrounding the lungs.

Larynx and pharynx

includes the nasal cavity, sinuses, pharynx, larynx, trachea, bronchi, and lungs.

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SIIM2012IIPBootcamp

CardiovascularSystemincludestheheart,bloodandbloodvessels.

Carotid vessels

HeartAbdominal aorta and vena cava

Carotid vessels

Angiogram, MRA and CTA are images of vessels.

The Circulatory or Vascular System includes blood and blood vessels.

DigestiveSystemSialogram is a contrast x-ray

includes the mouth, esophagus stomach large

Cholangiogram is a contrast x-rayof the gall bladder and bile ducts.

Hepatic refers to the liver.

of the salivary gland.

esophagus, stomach, large and small intestines, liver, gall bladder, and pancreas.

The gastrointestinal (GI) system includes the stomach, large and small intestines.

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SIIM2012IIPBootcamp

EndocrineSystem

Thyroid

PancreasAdrenal glands

includes the pituitary, thyroid, parathyroid, and adrenal glands, pineal body, gonads, and pancreas.Testicle

UrinarySystem

includes the kidneys,includes the kidneys, ureters, bladder and urethra.

Renal refers to the kidneys. A NM GFR study measures kidney function. A nephrostomy is a procedure to insert a tube, stent, or catheter into the kidney.

Cystography is a contrast study of the bladder.

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SIIM2012IIPBootcamp

ReproductiveSystemincludes in women, the ovaries, fallopian tubes uterus cervix and vagina

includes in men, the prostate, testes, and penis.

A hysterosalpingogram is a contrast study of the uterus and fallopian tubes.

tubes, uterus, cervix, and vagina.

The genitourinary (GU) system includes the urinary system plus the reproductive system

DirectionalTerms

Midli i l li

Midline Midline:centerverticalline

thatdividesthebodyintoleftandright

Lateral:fartherfromthemidlineofthebodyorstructure

Medial: nearer to the midlineMedial:nearertothemidlineofthebodyorstructure

Medial LateralLateral

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SIIM2012IIPBootcamp

DirectionalTerms

Superior Superior:towardtheheador

upperpartofastructure Inferior:towardthefeetorlower

partofastructure Anterior:nearertooratthefront

ofthebody Posterior:nearertoorattheback

f h b d

Superior

ofthebody

PosteriorAnterior

Inferior

ImageOrientationAP/PAandLAT

PA Vi P iti L L t l Vi P iti

R L A P

PA View Position L Lateral View Position

Imagetakenorviewedfromposteriortoanterior

Imagetakenorviewedfromoneside(L)ofthebody

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SIIM2012IIPBootcamp

SpecialOrientations

R Lateral SwimmersOdontoid

Swimmers: Arm is raised to avoid overlap with spine.Odontoid: Image through open mouth or have patient raise head.

ImagePlanes AxialA

R L

Transverse or Axial image is viewed from the inferior (feet) of patient. Patients RIGHT is on the LEFT.

P

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SIIM2012IIPBootcamp

ImagePlanesS S

R L

I

A P

ICoronal or Frontalimage is viewed from the anterior (front) of patient.

Midsagittal is a slice through the central axis A to P.

Parasagittal is a slice hat is parallel to midsagittal.

Both are also called sagittal.

PlanarImaging

Orientation: AXIAL CORONAL SAGITTAL

(0008,0060) Modality: MR(0018,0015) Body Part: Brain(0020,0060) Laterality: U(0008,1030) Study Description: Non-contrast Brain

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SIIM2012IIPBootcamp

ImagePlanes Oblique

Series: Coronal LOCIO: 1\0\0\0\0\ 1

Coronal PD7\ 6\0\0\0\ 1

LR

+XIO: 1\0\0\0\0\-1 .7\.6\0\0\0\-1

(0020,0037) Image Orientation: direction cosine of first row and column (xr\yr\zr\xc\yc\zc) with respect to patient*

* See DICOM PS 3.3 - 2009, C.7.6.2.1

ProcedureCodes Medicaltermsusedto

define Procedure Codes RADLEX http://www radlex org/defineProcedureCodes

Schedulestudies ModalityWorklist Imagingprotocols Worklistfilters Relevantpriors Body parts associated

http://www.radlex.org/

Bodypartsassociated Dictationtemplates Billingcodesandcharges

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SIIM2012IIPBootcamp

CommunicationsCodingandBilling

ICDClassificationScheme UsedtocodeinpatientdiseasesandproceduresintheUS.p p UsedbyhospitalstodeterminetheDRGthatapatientisassignedasthebasis

forreimbursement. ITcanuseencodersbasedonICDcodestodeterminetheDRGand/orthe

accuracyofthecoding.


CPT CurrentProceduralTerminology AMAdevelopedschemeforcodingprocedures.p g p MajorcomponentoftheHealthcareCommonProceduralCoding

Scheme(HCPCS). Standardforphysiciansoffice,outpatientandambulatorycarecoding

forreimbursement.

CPT Code Example

https://commerce.amaassn.org/store/

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SIIM2012IIPBootcamp


IHE ChargePosting IP HL7 TransactionPostingIP

RAD35ChargePostedTransaction

IHE Profile

ICD Code


RBRVU/RVU ResourceBasedRelativeValueUnit AssignedtoaCPTcodeasameasureofwork(timeandeffort)required

bycliniciantoperformorinterpretaprocedure assignedbyAMA. Intenttoshiftpaymenttoprimarycarephysicianwhospentmoretime

withpatientandtodiscourageuseofspecialties. RVUisadjustedforgeographiclocationandsomepracticeexpenses. CPTcodingdeterminestheRVUandthusthereimbursement.

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SIIM2012IIPBootcamp

WorkforceTrainingNeeds NewSystemsandUpgrades.N P NewProcesses.

NewUsers. RetrainingoftenrelatedtoaQAissue. Wearenotlookingforingenuity.

Never tell people how to do things. Tell them what to do and they will

surprise you with their ingenuity."George S. Patton, War As I Knew It

Get your workflow ducks in a row.

CharacteristicsoftheAdultLearner

Autonomousandselfdirected. Haveaccumulatedafoundationofexperiences

andknowledge. Goaloriented. Relevancyoriented. Practical.

N d t b t t d ith t Needtobetreatedwithrespect.From: Knowles MS. The modern practice of adult education: andragony versus pedagogy. New York, NY: Association Press, 1970

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IshikawaorFishboneDiagram

Add to chart:

http://en.wikipedia.org/wiki/Ishikawa_diagram

Add to chart:

NOISECrowded areas

Slow ResponseLong dropdown list

AdultLearningStyles

Teaching Strategies

AuditoryLearner Rememberswhatotherssay. Remembersbestthroughverbalrepetitionanddiscussions. Findsitdifficulttoworkquietlyforlongperiods.

TeachingStrategies Rephrasepointsandquestionsinseveraldifferentways. Incorporatemultimedia. Varyspeechtocreateinterestingauraltextures. Ensurethatstudylocationhasadequateacoustics.

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SIIM2012IIPBootcamp

AdultLearningStyles VisualLearner

Preferswritteninstructionsandillustrations. Remembersthroughuseofchartsand

diagrams.

Wellorganized,studiesbyoutliningnotes. TeachingStrategies

Providewithavarietyoforganizedvisualpresentations and handoutspresentationsandhandouts.

Useavarietyofvisualtechnologies.Cheat Sheets

From: Russell SS. An Overview of Adult-Learning Processes. Urologic Nursing. Vol 26 (5), October 2006.

AdultLearningStyles KinestheticLearner

Remembersbestbygettingphysicallyinvolved.Enjoyshandson.

Hastroublestayingstillforalongtime. Hasgoodmotorcoordination.

TeachingStrategies Providelotsoftactilekinesthetic

activitiesinclass. Permitfrequentbreaks. Incorporatemultimediaandstudent

presentations.

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Curriculum

LearningObjectives Training goals > Measurable objectives.Traininggoals >Measurableobjectives. EXAMPLE:Afterattendingthiscourse,thestudentwillbeableto

scheduleaninpatientexamaccurately. http://www.coun.uvic.ca/learn/program/hndouts/bloom.html

http://www.edpsycinteractive.org/topics/cogsys/bloom.html

Trainingmaterials Translationtablesfromoldtonewsystems.Buildoncurrent

knowledge. Cheatsheets specifictoyourworkflow. Practicecases basedonyourfacility. Remembertoaddressallofthelearningstyles. Expecttoupdateduringthetraining.

TrainingImplementationScenarios

TrainthetrainersSuperusers are trained by vendor staff They then train other staff Superusersaretrainedbyvendorstaff.Theythentrainotherstaff.

Superusersarethenavailableaftergolivetoprovidesupportandtrainnewusers.Requiresextraworkonpartofsuperusers.

Oneonone Vendorstafftrainsusersindividually. Normallyforradiologistsandtechnicalstaff,3rdpartyapplications.

Vendortrainsallusers Mayworkforminorupgrades. Vendorsareconcernedthattheyhaveresponsibilityforworkflow.

ElectronicMedia Usefulifyouhavealearningmanagementsystem(LMS). DevolderP,etal.J.DigitalImagingOnlineFirst:Nov2007.

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SIIM2012IIPBootcamp

TrainingImplementation Schedulewellinadvance trainingrooms,vendors,users.

Dontforgeteveningandweekendstaff. Communicationplanforchanges.

Createanappropriatelearningenvironment Decreaseworkloadduringtraining hospitalbuyinthatthis

trainingisimportant. Training systemshouldmimicreal system. Explainorganizationaladvantage,roadmapforchange/upgrade. Explainexpectationsandtestingmethods.

Createopportunitiesforpracticeandongoingsupportuptogolive.

TrainingEvaluationMaterialsforevaluation

Evaluation strategies Evaluationstrategies Formativeassessment:evaluateduringlearningtoupdateprocess. Summativeassessment:evaluateatfinishtomeasuresuccess.

Considerations Evaluationsconsistentwithlearningobjectives. Assessmentcanincludestudentreaction,attainedskills,businessprocessimprovements,cost/benefitoftrainingprogram.

Materials. Surveys seewebsite:http://www.wu.ac.at/imm/student_platform/research_information/statistics/survey_tips.pdf.

Multiplechoice answercomesfromperformingthetask. Onthejobskilltesting.Performanceevaluations.

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CommunicationsCustomerSupportConcepts

References CustomerSupport Toland C,Meenan C,WarnockM,NagyP.ProactivelyMonitoring

DepartmentalClinicalITSystemswithanOpenSourceAvailabilitySystemJDI:Vol 20,Suppl 1,2007:pp119124.

NagyP,WarnockM,DalyM,Rehm J,EhlersK.Radtracker:AWebBasedOpenSourceIssueTrackingToolJDI:Vol 15,Suppl 1,2002.

http://marketing.about.com/od/relationshipmarketing/a/crmtopten.htm

http://www.joelonsoftware.com/articles/customerservice.html Nitrosi Aetal.JDI:Vol 20(2):140148,2007. VanOoijen P,etal.JDI:Vol 19(Suppl1):5259,2006.

AdditionalReferences

Branstetter IV,B(ed.) PracticalImagingInformatics. SIIM,Springer,2010. http://www.isixsigma.com/ Tortora GJ,GrabowskiSR:PrinciplesofAnatomyandPhysiology.New

York:HarperCollinsCollegePublisher,1996. VHDissector4.5.1:www.toltech.net WebMD:www.webmd.com JohnsonS,NewtonW.ResourcebasedRelativeValueUnits.Fam Med

2002;34(3):1726.2002;34(3):172 6. CollinsJ:EducationTechniquesforLifelongLearning.Radiographics 2006,

24:14831489. Haugen,H(11/2007)."Acceleratingadoption.Whenitcomestogetting

everyoneonboardwithRISandPACS,sometimesanewmodelisallthat'sneeded".Healthcareinformatics(10509135),24(11), p.67.

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AdditionalReferences McNeilHPetal.:Aninnovativeoutcomesbasedmedicaleducation

programbuiltonadultlearningprinciples.MedicalTeacher1006,28:527534.D ld P t l O ti i i Ph i i I t ti f PACS Th h Devolder Petal.OptimizingPhysicians InstructionofPACSThroughELearning:CognitiveLoadTheoryApplied JDIOnlineFirst:Nov2007.

WagerKA,LeeFW,GlaserJPManagingHealthCareInformationSystems.JosseyBassSF:JohnWileyandSons,2005.

WernerM,JonesK.AdvancesinHealthCareOrganizationTheory.JosseyBass,2003.

KirkpatrickDL.EvaluatingTrainingPrograms:TheFourLevels. Sanp g g gFrancisco,CA:BerrettKoehler,1994.

JointCommissionIM:http://www.jcrinc.com/JointCommissionRequirements/Hospitals/#IM

67

PACSProcurement&

ProjectManagement

ScottShannon,RT(R),PMP,CIIPProjectManagerEnterpriseImagingSystems

BarnabasHealth

68

PACSProcurement&ProjectManagement Shannon

SIIM2012IIPBootcamp

ImagingInformaticsProfessionalBootcamp

PACSProcurement&ProjectManagementScottT.Shannon,RT(R),PMP,CIIP

PROCUREMENT

Procurementistheacquisitionofgoodsandservicesatthebestpossiblecost,intherightquantityandquality,attherighttime,andintherightplacefordirectg pbenefitoruse.Source:OTpedia.com

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PROCUREMENT

NEED

SELECTION

NEGOTIATION

PROCUREMENT

Determineorganizationreadinessforelectronicenvironment. Organization strategic plan and policiesOrganizationstrategicplanandpolicies Keyreadinessfactors Methodsofneedsanalysis

Establishandimplementaprocessforvendorselection. InformationcollectiontoolsandtheRequestForProposal Vendorresponseanalysistools

Negotiate contracts with vendors Negotiatecontractswithvendors. Standardcomponentsofcontracts Negotiationskills;howtoreadacontract

Source:ABIIsTestContentOutline

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PROCUREMENTREADINESSNEED

IdentifyStakeholders StrategicPlanandPolicies ReadinessFactors NeedsAnalysis

PROCUREMENTREADINESSIdentifyStakeholders

VendorSelectionCommittee Radiology IT AdministrationPh i i Physicians

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SIIM2012IIPBootcamp

PROCUREMENTREADINESSStrategicPlanandPolicies

MissionStatementShouldbeareflectionoflongtermgoals

PatientSatisfactionIncrease IncreaseServicesScope Decrease Report Turn Around Time DecreaseReportTurnAroundTime EliminateFilmLoss IncreaseServicestoPhysicians

PROCUREMENTREADINESSStrategicPlanandPolicies

CompetitiveAnalysis EnvironmentalScanningandForecasting InternalOrganizationalAnalysis EstablishLongandShortTermObjectives Identify Strategic Alternatives IdentifyStrategicAlternatives StrategyEvaluationandSelection StrategicControlSystems

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SIIM2012IIPBootcamp

PROCUREMENTREADINESSReadinessFactors

OrganizationalSupport OperationalandFunctionalNeeds

ProjectChampion/Sponsor FromAdministration NotaTECHIE

PROCUREMENTREADINESSReadinessFactors

NetworkInfrastructure ITSupport OutsourceorInHouse Training

Interfaces Space Power ReadingRooms

Personnel Security

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PROCUREMENTREADINESSNeedsAnalysis

DeterminethePresentCondition DefineJob RanktheGoalsinOrderofImportance IdentifyDiscrepancies DeterminePositiveAreas SetPrioritiesforAction

VENDORSELECTIONPROCESS

Request for Proposal (RFP) RequestforProposal(RFP) RFPAnalysis InformationCollectionTools(SiteVisits, Reference Checks, etc)Visits,ReferenceChecks,etc)

RFI,RFPandRFSDifferences

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VENDORSELECTIONPROCESSRequestforProposal(RFP)

MissionStatement Objectives HospitalCharacteristics Type/Size ClinicalScenarios Departments,IP,OP,etc Timeline GrowthPotential ComponentRequirements

VENDORSELECTIONPROCESSRequestforProposal(RFP)

Migration ListofModalities DICOMandHL7Standards PerformanceStandards CompressionStandards FaultTolerance SystemIntegration

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SIIM2012IIPBootcamp

VENDORSELECTIONPROCESSRFPAnalysis

Limitto3to5FinalCandidates AssignImportanceValueforEachRequirement

CalculateaTotalPerformanceScore

VENDORSELECTIONPROCESSRFPAnalysis

NumberofYearsinBusiness UnderstandingofNeeds PriceofLifeCycleCost TechnicalAbility QualityofPastPerformance AbilitytoCompleteWorkonTime

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VENDORSELECTIONPROCESSInformationCollectionTools

ReferenceChecks SiteVisits OnSiteDemonstrations SpeaktoOtherUsers

VENDORSELECTIONPROCESSRFI,RFPandRFSDifferences

RFIisaRequestForInformation RFPisaRequestForProposal RFSisaRequestForSolution

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SIIM2012IIPBootcamp

VENDORSELECTIONPROCESSRequestforInformation

UsedatBeginningStagesofaProjecttoDetermineWhichVendorswillReceiveRFP

LeastFormal MakestheSmallestCommitmentaboutWhatYouIntendto

DoattheEndoftheProcess Collect Information from a Vendor with No Commitment to CollectInformationfromaVendorwithNoCommitmentto

EngageinAnyParticularProject NoProjectDetailswouldNeedtobeProvided FocusesontheVendorCapabilities,SkillsandExperience

VENDORSELECTIONPROCESSRequestforProposal

FocusesonSpecifyingaScopeofWorkthatNeedstobePerformed

SolicitsinResponseaProposalfromtheVendorDescribingHowtheyWouldgoAboutExecutingtheProject IncludingPricingInformation

The RFP Requires You to Know More About What you Want inTheRFPRequiresYoutoKnowMoreAboutWhatyouWantintheProject

SpecifiestheRequirementsfortheVendortoaSufficientDetailsotheycanDevelopanApproachtotheProject

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VENDORSELECTIONPROCESSRequestforSolution

IsUsedWhenTryingtoFindaSuitableVendortoSolveanInstitutionsUniqueRequirements

IstobeUsedWhenSupportfromITisRequiredsuchasEnhancements

VENDORCONTRACTNEGOTIATIONS

ContractComponents ContractNegotiation

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VENDORCONTRACTNEGOTIATIONSContractComponents

Agreement Purchaseorder GeneralConditions Specifications InstructionstoVendors ArchitecturalDrawings RFPAddenda TechnologicalAdvancements

VENDORCONTRACTNEGOTIATIONSContractComponents

ComponentDeterioration DisputeSettlement ServiceAfterInstallation OperatorandServiceTraining OperatingandMaintenanceInstructionsandManuals GuaranteeandWarranty WarrantyExtension

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SIIM2012IIPBootcamp

VENDORCONTRACTNEGOTIATIONSObjectives

ObtainaFairandReasonablePrice DevelopaGoodRelationshipwiththeSeller

VENDORCONTRACTNEGOTIATIONSItemstoNegotiate

Scope Schedule Price

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VENDORCONTRACTNEGOTIATIONSOtherItemstoNegotiate

Responsibilities Authority SupportAgreements System Upgrades

ApplicableLaws PaymentSchedule InterfacesMi ti SystemUpgrades

Warranties Migration

VENDORCONTRACTNEGOTIATIONSContractNegotiation

GetOutsideLegalExpertise NegotiatewithTwoVendors DontbeAfraidtoWalkAwayfromtheTable

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VENDORCONTRACTNEGOTIATIONSNegotiationTactics

Attacks GoodGuy/BadGuy LimitedAuthority FairandReasonable

Delay ExtremeDemands Withdrawal Deadline

VENDORCONTRACTNEGOTIATIONSMigration

NegotiateMethodandTimeFrame WhoisResponsibletoManage ReconciliationAgainstRISP f f S f l Mi ti ProofofSuccessfulMigration

DataAvailabilityatGoLive

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PROJECTMANAGEMENT Identifygoals,scope,risks,andkeymembersofprojectteam.

Clarification techniquesClarificationtechniques Commonrisksforprojects

Evaluatethefeasibilityofaproject. Needsassessment Financialviability

Utilizecommonprojectmanagementtools. Forms for documentation of initiating planning executing Formsfordocumentationofinitiating,planning,executing,monitoringandclosingprocesses

Budget,costschedule,resource,qualityandprocurementplan

Source:ABIIsTestContentOutline

DEFINEAPROJECT

PMIdefinesaProjectasatemporaryendeavorundertakentocreateauniqueproduct,service,orresult.

Source:PMBOK,4th ed.,PMI,2008

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DEFINEPROJECTMANAGEMENTPMIdefinesProjectManagementasthe

li ti f k l d kill t l dapplicationofknowledge,skills,tools,andtechniquestoprojectactivitiestomeettheprojectrequirements.ProjectManagementisaccomplishedthroughtheappropriateapplicationandintegrationofthe42logicallygroupedprojectmanagementprocessescompromisingthe5ProcessGroups.Source:PMBOK,4th ed.,PMI,2008

DEFINEPROJECTMANAGEMENTPROCESSGROUPS

Initiation Planning Executing MonitoringandControlling Closing

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DEFINEPROJECTMANAGEMENTInitiation

Thoseprocessesperformedtodefineanewprojectoranewphaseofanexistingprojectbyobtainingauthorizationtostarttheprojectorphase.


DEFINEPROJECTMANAGEMENTPlanning

Thoseprocessesrequiredtoestablishthescopeoftheproject,refinetheobjectives,anddefinethecourseofactionrequiredtoattaintheobjectivesthattheprojectwasundertakentoachieve.


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DEFINEPROJECTMANAGEMENTExecuting

Thoseprocessesperformedtocompletetheworkdefinedintheprojectmanagementplantosatisfytheprojectspecifications.


DEFINEPROJECTMANAGEMENTMonitoringandControlling

Thoseprocessesrequiredtotrack,review,andregulatetheprogressandperformanceoftheproject;identifyanyareasinwhichchangestotheplanarerequired;andinitiatethecorrespondingchanges.


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DEFINEPROJECTMANAGEMENTClosing

ThoseprocessesperformedtofinalizeallactivitiesacrossallProcessGroupstoformallyclosetheprojectorphase.


DEFINEPROJECTMANAGEMENTProjectLifeCycle

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TripleConstraintsPROJECTSCOPEANDGOALS

PROJECTSCOPEANDGOALS ProjectClarificationTechniques RolesofIndividualsonaProject ProjectCharter ProjectRisks

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PROJECTCLARIFICATIONTECHNIQUESFishboneDiagramorIshikawaDiagram

PROJECTCLARIFICATIONTECHNIQUESScatterDiagram

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PROJECTSCOPEANDGOALSRolesofIndividualsonaProject

Project ManagerProjectManager ProjectSponsor RadiologyRepresentatives

ChiefRadiologist RadiologyDirector ChiefTechnologistg

InstitutionalRepresentatives Physicians CIO ITServicesRepresentative

PROJECTSCOPEANDGOALSProjectCharter

Adocumentissuedbytheprojectinitiatororsponsorthatformallyauthorizestheexistenceofaproject,andprovidestheprojectmanagerwith the authority to apply organizationalwiththeauthoritytoapplyorganizationalresourcestoprojectactivities.

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PROJECTSCOPEANDGOALSProjectRisks

CostOverRun TimeOverRun NetworkInfrastructureIssues LackofTraining NoRollBackPlan LackofCommunication

PROJECTFEASIBILITY NeedsAssessments FinancialAssessments

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PROJECTFEASIBILITYNeedsAssessments

DeterminePresentState DefinetheJob RankGoals IdentifyDiscrepancies DeterminePositiveAreas SetPrioritiesforAction

WorkflowAnalysisPROJECTFEASIBILITY

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PROJECTFEASIBILITYFinancialAssessments

ReturnonInvestment,orROI PersonnelTimeSavings RepeatRateReductionEli i ti f C i EliminationofCopies

PROJECTMANAGEMENTTOOLS

ToolsandWhenTheyareUsed ImplementationForms FinancialDocumentation

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PROJECTMANAGEMENTTOOLSToolsandWhenTheyareUsed

GanttCharts PERT RACIDiagram RunCharts ProjectWebSite

PROJECTMANAGEMEN

IIPBoot Cover 2012.Psd

Documents

Transcript of IIPBoot Cover 2012.Psd