With ubiquitous digitisation throughout healthcare in 2021, informatics is an important speciality within radiology and oncology. We are often asked for guidance and advice regarding career pathways for radiographers in informatics.
There are many routes an individual can take and they are fairly similar to other specialities in radiology. In this article we summarise typical progression. To aid standardisation, the various levels were identified as tiers 1-5 ascending in seniority.
Tier 1: The entry-point to the profession.
Tier 2: Clinical system support (those working within the PACS team or in IT supporting other clinical systems - PAS, EPR, LIMS etc). At this stage, mostly in-house training including PACS training via a vendor is available. Self-study materials on platforms such as eLearning for Health and via professional bodies are widely available.
Tier 3: This is the main tier providing the ‘branch points’ where areas of personal interest can be explored. Some individuals prefer to focus on one area where their skills are easier to develop, whereas others choose to take on a greater breadth of learning early on. This generally is influenced by the individual, their learning style and capacity, together with career aspirations and the opportunities afforded to them by the employer.
The main focus areas on Tier 3 comprise:
Professional and Technical Development (mainly IT topics) – including networking and interconnection courses such as the Cisco Certified Network range (CCNA, CCNP) and the Microsoft range of accreditations (MCP, MCITP). There will also be more in-depth training courses from vendors along with local database administration training or experience.
Management and Leadership Development (mainly how to manage people and projects rather than technology) – these include nationally standardised project management structures (PRINCE2), similarly standardised helpdesk operation frameworks (ITIL) as well as standardised programme and risk management frameworks (P3O, MSP and MoR) as well as general clinical area administration techniques.
Speciality Development (technical specifics) – Imaging Informatics has an array of comparatively specialist skills. These include the specifics of HL7 + DICOM (imaging communication standards), integrations with EPRs and wider hospital systems, areas of legislation of concern (GDPR etc), companion guidance such as IHE / XDS workflows, information security and general skills such as those needed for system replacements, procurements or migrations.
Training in this area has been offered by RIG members for many years nationwide on a non-profit basis. The ‘Level 1 Fundamentals of Radiology IT Training Course’ (www.learnpacs.com), attended by several thousand radiographers over the years, contains a good overview for those wanting to round their knowledge.
The intermediate Level 2 course focuses more on the specifics of HL7 + DICOM, EPR and integrations, with both Level 2, and the Level 3 Advanced sessions having moderated assessments available on conclusion. Other similar courses of interest include the GDPR basics for Radiology short course, IHE / XDS and a few other specialised sessions on PACS migrations and crisis management in informatics, originally designed for the WannaCry type outbreaks.
Information Science Development (the theories and structures around data processing, storage and retrieval): many formal, longer, courses are run in universities across the UK, and this strand covers the pursuit of Certificate or Diploma of Higher Education levels of study and the theoretical knowledge these impart to underpin the informatics profession more broadly.
At this stage in the career, and due to the constantly developing nature of the IT industry, members are encouraged to keep up to date with developments to avoid their skills becoming stale or outdated. This can happen quickly in the profession and does require a far more involved commitment to seeking out new knowledge.
Tier 4: When working on a daily basis in informatics, this stage builds on the breadth of knowledge gained previously. Here we move further into the self-development and autonomous practice phase. Standard Higher Academic Qualifications such as an MSc in Clinical Informatics or Information Management are commonplace as they allow individuals to research areas of interest while still retaining some supervision. Local leadership begins here.
Tier 5: Moving deeper into the Expert phase, teaching or research qualifications such as a postgraduate doctoral degree (PhD) or a Master of Research or Philosophy are important here as autonomous practice now includes greater involvement at the forefront of the profession more widely outside of the local or even national area.
This tier is differentiated from Tier 4 by the extension of practice into the assessment of upcoming and potential influences to the informatics profession as a whole. Principally ‘future-gazing’, informing regional and national practice as to what’s on the horizon and how this will come to affect existing ways of working. A more systemic viewpoint, along with broader knowledge and opinion sharing, is expected at this professional leadership level.
PACS or Radiology Systems managers are expected to be well rounded in their knowledge. Be aware that interviewers should be challenging candidates on a wide variety of topics because the position of PACS manager is similar to a CT or MR Superintendent – they are in charge of a critical department, a team and responsible for a budget in the hospital. PACS itself is generally an expensive and vital system, resulting in strong competition for positions at the higher levels.
In our experience, many recruiters for PACS positions at the lower end of Bands 6 and 7 look for attendance on the Fundamentals course (Level 1) or for similar experience. Some will look for Level 2 training, but these may be at higher bands. It is a competitive market and thousands of practitioners have taken the courses. If applicants have gained enough shadowing experience and knowledge of the fundamental portions of the trade (HL7 + DICOM, XDS, terminology, workforce management etc) that may be sufficient.
Overall, when progressing through the tiers it must be remembered that in the speciality of informatics there are plentiful opportunities for those with the right skills and qualifications to develop a career either in or outside of radiography.
Further detail on progression through the various levels of PACS (or Systems) Management, including samples of AfC banding, are set out in Chapter 17 of the textbook: Clark's Essential PACS, RIS & Imaging Informatics (www.pacsbook.com). This book was written specifically for those interested in a primer to ‘PACS’ (or Systems) Management as a profession and can help identify which areas of the profession you are knowledgeable on, and those in which further research or experience may be needed.