Alternative in Remote Teleradiological Presence

However, when this is not feasible, off-site teleradiology presence can be considered a real alternative in many cases. Such a service can also support services delivered by on-site radiologists. In such teleradiology applications, there will be appropriate involvement of the off-site radiologists with the local department regarding operational matters, imaging protocols and consultations in addition to the reporting of studies.

 Radiographers and Imaging Technological

Medical radiographers will be appropriately qualified, according to the requirements of Tanzania standard. Relevant focused imaging training will also be provided especially when position is multifunctional, i.

e. covers more than one imaging modality. Within the context of digital radiology, radiographers can take on the role of PACS administrators and as such would require additional training to allow them to appropriately manage those aspects of the radiology service.

Medical Physicists

Large facilities will have full time medical physicists available. All practices should have access to a medical physicist; the level and extent of involvement of the physicist should be dependent on the complexity and number of the procedures undertaken.

A medical physicist with competence in diagnostic radiology will have primary responsibility for assuring the quality and consistency of most of the technical aspects of radiology, including equipment acquisition, quality assurance, dosimetry and calibration. This includes supervision of quality assurance programs, whether provided by the center as part of a service contract. Because of their technical backgrounds, medical physicists are often good resources to use in the conversion to digital imaging and implementation of PACS. Furthermore, the medical physicist would also act as a radiation protection officer, providing specialist expertise with respect to radiation protection of the patients and staff.

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Alternatively, the facility may have procured the services of a separate radiation protection officer.

IT Staff

IT is a key element of any digital radiology facility that intends to store, review and distribute images electronically. Even in facilities with digital acquisition systems that choose to store and distribute using hard copy, IT is still very important. Although much IT hardware is now commercialized, and imaging vendors provide specialised software and even some imaging system connectivity, any other electronic connectivity and networking requires some IT expertise for planning, deployment, testing and maintenance. Such support can range from solving simple printer problems to the design of complex networks and backup strategies. The complexity of the installation may determine the extent of IT expertise needed on-site. In general, large complex facilities usually require resident IT staff to ensure consistent and reliable operation of all facets of the imaging facility’s computing technologies. Smaller facilities usually need IT personnel to help plan and implement the technical aspects of the initial installation, undertake modality connections and assist in troubleshooting DICOM association setups, and assist where necessary with DICOM device mappings and configurations. IT expertise can also be accessed through off-site and remote support technologies for many tasks that do not involve hardware repairs. Such IT support should be seen separately from the management support of the digital radiology system, which really requires a different skill set.

PACS Management

Digital imaging facilities usually have a database to manage images, requests and reports. This is usually in the form of a PACS, often combined with a RIS, which can be used in a localized fashion within radiology, or be scaled to distribute images within the facility to clinical areas outside the radiology department, or off-site, for remote interpretation and consultation. These systems, despite best attempts and technologies, will accumulate problems requiring local administration to correct errors in data entry, incomplete studies and so on. The management of these problems is the role of the PACS administrator. This is an individual who has a detailed understanding of the PACS and any RIS, understands the radiology workflow and understands the clinical processes.