Only at SIIM can we look at topics such as PACS workflow within the imaging center, IT infrastructure within the imaging center environment, and Avoiding the imaging center island, and literally be excited, states Dr. James Whitfill from Scottsdale Medical Imaging.

As the implementation of medical imaging informatics takes off, radiologists, radiologic technologists and other imaging professionals face many challenges.

Focusing on the outpatient aspect Dr. Whitfill, along with a leading panel of experts in medical imaging informatics, discussed the unique challenges that are frequently met in imaging centers and their potential solutions.

"Imaging centers are a heterogeneous group," states Whitfill. In the US, over 70 per cent of imaging centers perform about 75,000 exams a year and still the majority of them do not have PACS.

Unlike the larger medical institutions, PACS as well as associated purchases often come out of the radiologist's salary. Outpatient imaging centers as well as larger institutions are still suffering from the "curse of the stand alone workstation"; expensive purchases with no integrative workflow capabilities. We can see why, in some cases, outpatient imaging based radiologists may have a different tune when it comes to large purchases. "Larger institutions are less sensitive to the impact of a PACS purchase decision," and we can honestly say: "when it comes to big purchases, size does matter," Dr. Whitfill adds.

The panel agreed that today's radiological technologists are often faced with pressure from outpatient imaging center radiologists. Having to customize reading workflow for the reading and referring physician, RTs often fall into the trap of becoming "a medical imaging concierge".

"See one, do one, teach one does not work in medical informatics side of radiology." Imaging Informatics professionals are constantly challenged and there are mass training requirements for successful practice integration. "An inpatient modeled workflow cannot be dropped into an outpatient environment and expected to work".

"Implementing a robust IT infrastructure insures quality service," states Jefferson Radiology IT expert, Arne Meis. In order to guarantee the success of an outpatient imaging center, "Priority number one needs to be IT infrastructure, not modality," he adds. With the increase in diagnostic imaging the panel concluded that it will be important to have standardized leverage and vendor partnerships. With proper networking, multi site remote access and local peer support, we will be able to avoid creating the 'imaging center island'.

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