Tag: it

Posted on by

Why A PACS Crash Can Be A Disaster!

pacs crash

Many of us have become numbed by the PACS crash. Yes, it can ruin our day and prevent us from completing our work. And, it can cause us to finish up work late. As well, we joke about it as just another technical glitch that we have come to expect. However, there are real-world ramifications to the PACs crash that we don’t discuss but should take a bit more seriously. For this reason, we should have vigorous backups and supports for the systems. Here are some of the potential tragic issues that patients, physicians, and radiologists can face.

Missing Findings

I don’t know about you. But, when I am in the zone, I use all my search patterns and am thorough, going through all the anatomy that I need. But, when the PACs crashes in the middle of a case, you lose track of where you were. Well, that’s when bad things happen. You lose your train of thought. Perhaps, you forget to look at the adrenal glands or the spleen. It is now that radiologists miss critical findings that can be detrimental to their patients.

Even worse, when the PACS crashes at nighttime, the ER can bombard you with loads of phone calls and prevent you from getting a wink of sleep. When you wake up the next day, you are barely awake. It’s a setup to missing even more findings!

Incomplete Information Leading To Bad Treatments

Unable to pull up priors or histories? Well, you know what they say: Garbage In. Garbage Out! That PACS crash can cause incomplete reports that won’t even answer the question that the clinician asked. This lack of information can lead to patient disasters and poor outcomes. How is the poor radiologist to know the diagnosis of the patient when there is no history anywhere?

Significant Loss Of Revenue For The System

If you can’t dictate, you can’t get paid. PACS crashes can lead to problems with demographics and matching patients to studies. And that’s only the beginning. Depending on the severity, it’s possible to lose tens of thousands of dollars with a long-term PACS crash. A PACS crash can cut the imaging center or hospital’s bottom line!

Angry Physicians And Patients

And then there is the ill will you build with the patients and clinicians. Who wants to return to an institution with delays and constant technical malfunctions. What’s the point when they can go to the institution down the street? It is tough to build back goodwill once it is lost.

Inability To Make Emergency Diagnoses

Hemorrhagic strokes, appendicitis, and more significant disease entities can cause morbidity and mortality. We, as radiologists, find these entities all the time. And every second counts. When you lose your PACS system, you lose those valuable seconds to save a life potentially.

Potential Legal Ramifications

Even when the system comes back up, everyone is on the hook. All the misses, delays, and anger can cause lawsuits and the potential for long hours with an attorney. Not to mention all the legal fees your practice can rack up when dealing with the misdiagnoses and angry patients you could not help because of a PACS crash.

Loss Of Confidence In The System

Finally, PACS crashes can cause lost confidence in the system. These systems can be a hospital, imaging center, or clinic. Anytime you lose information, you lose trust. These patients may never come back to your department again if the PACS system does not work. It can be a permanent loss!

A PACS Crash Can Be Devastating! 

Most tend to make fun of the ineptitudes of information technology and the folks staffing them. However, there is a real-world consequence when the PACS goes down. Patients can get hurt, and we have the potential to be at fault legally. Physicians and referrers struggle. And, the radiologists can look like fools. So, the next time your hospital looks for a PACS system, make sure to get involved and find a reliable and redundant system. The last problem we need is another PACS crash!

 

Posted on by

How Can I Prevent Low Imaging Volumes From Causing Me To Lose My First Job?

low imaging volumes

Question About Low Imaging Volumes:

Hi. I am an R2. I’ll most likely do a fellowship in body imaging (mostly because I haven’t felt a click with any particular specialty). I keep reading about practices firing radiologists because of low imaging volumes due to COVID. I’m concerned that this will affect me when I apply for jobs because I am only interested in private practice. I want to position myself with some advantages, and I need your advice on how to do this. I particularly enjoy the IT aspects of radiology (troubleshooting PACS, EMR, making software more efficient, automation, computer hardware). In my residency, there is a faculty member who is the “Director of IT.” And, I might be interested in a role like this.

My question is, do you think this is something that is even an advantage if you are seeking private practice? If so, how can I enter this space? Is there a course? Do I do research? If this is a bad idea, are there other things I can do during residency to give myself an advantage when it comes time to apply for a job in private practice? 

What should I do?

 

Answer:

Armaments To Prevent Job Loss

These are excellent questions, and I have a few answers! Let’s start with the first one about practices firing employees because of low imaging volumes. First of all, this Covid situation will most likely all but disappear by the time you graduate residency. Nevertheless, one of the best protection against getting canned is to become invaluable in whatever area that you practice. That niche can be informatics/IT. However, it all depends on the type of practice where you work.

If you aim to work at a small private practice somewhere, it will probably not help all that much. If you work for a larger institution or an academic center, it can help a lot, depending on what you do. In an educational sort of setting, if you are pumping out tons of papers and creating lots of programs/IT solutions for your colleagues, no one will want to let you go. Alternatively, if you are in charge of a massive corporate IT program, and the business cannot function well without your knowledge, they will not fire you. On the other hand, if the IT services you provide are just a little help, and the clinical work that you provide to the practice is not so much. Well, then you will not have the same job security.

At this stage of your career, work hard, and perform well in residency regardless of your fellowship. Learn about all aspects of radiology as much as you can so that you can establish a niche for yourself when you leave your residency. To repeat, most folks that are good at what they do will be the last to be fired.

How To Get Into Information Technology

Next, how can you enter this IT space? Well, some of it depends on how much experience you have in IT already. If you don’t have the knowledge that you would need to take over the IT at a practice, you would probably want to look into the Informatics fellowship. This fellowship will give you the basics of what you will need to know about IT for radiology practices. There, you can establish connections that you would need to find a career. Additionally, research in your area of specialty is never a bad idea during residency or fellowship, especially if you want to follow the more academic path.

Final Advice

So, there you have it. Work hard, learn as much as you can about radiology, consider an informatics fellowship (if that is what you want), and perform a niche in a practice that others have a hard time filling. These are the ingredients that will keep you in practice regardless of the Covid or any other unfortunate situation that may arise to lower imaging volumes for radiologists.

Good luck,

Barry Julius, MD