Rather than perpetuating the struggle, "who controls the PACS, Radiology or Information Technology (IT)," Community Hospital of the Monterey Peninsula (CHOMP) took the approach of incorporating IT support within the Radiology Department. CHOMP faced the challenge of staffing Radiology computer systems and networks by using a two-pronged approach; promoting and training clinical staff in IT functions and transferring an experienced IT person into the Radiology Department. Roles and responsibilities are divided. CHOMP's IT Department supports the Radiology Department's desktop devices, PCs, printers, and standard peripherals; while the department's DICOM print and archive network, specialized hardware (e.g., Merge DICOM interface computers), and applications are supported by the Radiology Department. The IT Department provides operating system support for multi-user VMS, Unix, and NT-based systems, e.g. Sun Solaris for the DICOM archive, and Windows NT for Mitra PACS Broker, the HL7/DICOM interface engine. IT also supports network communications, i.e., network electronics (routers, switches, etc.), TCP/IP communications, and network traffic analysis; and OS operations support for major Radiology systems, e.g. back-ups and off-site tape storage. Radiology staff provides applications support and troubleshooting, including analyst functions for RIS; and are the first point of contact with the Radiology systems vendors, e.g., GE Medical, or Siemens. The Radiology Department's senior IT person, the Clinical Technology Coordinator, transferred from CHOMP's IT Department after 7 years in that department. She performs analysis and design associated with Radiology's computer systems, coordinates development of the department's strategic plan, evaluates vendor proposals, and assists the department with product and application selection. Her IT experience and growing knowledge of Radiology's clinical tasks enhances communications between the Radiology and IT departments. Formal meetings between the two departments are held monthly; informal and project-related meetings and discussion are frequent and vital to the continued good relationship between them. When CHOMP either upgrades or replaces its DICOM archive, and Radiology becomes completely filmless, the vendor's contract will include an on-site vendor-supplied picture archiving and communications systems support person for at least 6 months after deployment, to insure a better knowledge transfer. Having an on-site support person would have reduced the number of technical challenges the Radiology Department has faced over the past 2 years. Finding and maintaining qualified staff versed in both IT and Radiology has been and will continue to be difficult. A blend of IT and Radiology support staff and open communication between the departments is working for CHOMP.
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