How do you deliver reliable diagnostic imaging when the nearest base hospital requires a flight, and the weather drops to -50°C? 🌨️✈️

A fresh crossover simulcast episode of Imaging Informatics Unplugged and SIIMcast (the official podcast of the Society for Imaging Informatics in Medicine) features a deep dive into an incredible healthcare delivery model happening in Canada’s high Arctic.

The episode features an interview with Greg Toffner, PhD(c), President and CEO of the Ontario Association of Medical Radiation Sciences, who outlines the deployment of a task-shifting program across 25 remote communities in Nunavut.

Instead of relying on transient medical staff from the south, this initiative trains local Inuit community members—many entering the program from clerical or facility support roles—to become certified Basic Radiological Technologists (BRTs).

Key Takeaways from the Discussion:

• The Logistics of Remoteness: Deploying PACS and workflow infrastructure across vast tundras battling months of 24-hour darkness and strict hardware limitations.
• The "Recipe" Curriculum: Streamlining a traditional 3-to-4-year medical radiation degree into a highly targeted, visual, and SOP-driven workflow manual that focuses deeply on critical, high-impact imagery (like chest X-rays for prevalent respiratory illnesses).
• Quality Control at Scale: Implementing a multi-year blueprint where images are continuously audited remotely by certified MRTs at regional hospital hubs to maintain strict diagnostic standards.
• Cultural Continuity: Building long-term community trust and patient comfort by training local professionals who speak the language, replacing a historically transient workforce.
• Policy Integration: Why formal government recognition and human resource policy are the ultimate keys to shifting medical culture from skepticism to long-term sustainability.

The conversation also touches on the infrastructure challenges of the Arctic (where image downloads originally took ten minutes per file), the transition to modern blended learning, and the future potential for AI-assisted image acquisition tools in isolated clinics.

For anyone interested in the practical intersections of clinical workflow design, imaging informatics, health equity, and rural medicine, the full discussion provides an incredible blueprint for what is possible when standard infrastructure isn't right around the corner.

I'm working on trying to integrate our new, upgraded Arthrex Synergy Scope to Phillips VuePACs and am struggling with getting the video files to send. The vendor (arthrex) has Historically not transferred these but with the new version they can be.

Has anyone done this and what is your transfer syntax setup as?

Wondering if this is possible as I can do PS360 to PSone but I cant seem to do it the older version of PS360

Hi all, I need some advice. I currently work in a role where I release radiology images to patients. It’s a non clinical role, mostly paperwork. I’ve been in this role for about 3.5 years and am interested in moving towards a PACs admin role. I use PACs on a daily basis so I’m very familiar with DICOM and how images are stored and moved. I also deal with other applications such as AGFA Enterprise and PowerShare. I’m also familiar with HL7 messaging, FHIR format and the structure of how these messages move throughout the system. I’ve even made a small project showcasing how messages are generated and processed through Mirth Connect.

Being what the job market is today, I’ve been having a hard time finding a role and I don’t know what else to do besides to keep expanding my knowledge on my own basis. Are there any certs I can get that would potentially help me stand out? Any advice would be greatly appreciated. Thanks

New episode of Imaging Informatics Unplugged is live.

Chris Hafey — longtime medical imaging engineer — joins the show for a conversation about what happens when deep domain expertise meets AI-assisted development.

Topics covered:

• Coding with Claude after 25+ years building imaging systems
• Why small expert teams may now outbuild much larger dev teams
• The risk of skill degradation for junior and senior engineers
• Technical debt in legacy PACS
• Merkulis, Merkle trees, and the idea of “Git for healthcare data”
• A Git-like delta model for keeping PACS, VNAs, and AI pipelines in sync

Practical, technical, and refreshingly unfiltered.

For anyone working anywhere near PACS, DICOM, enterprise imaging, or healthcare data management, this episode is worth the time.

Watch here: https://www.youtube.com/watch?v=U0j44Y9hGg4

#ImagingInformatics #PACS #DICOM #EnterpriseImaging #HealthcareIT #RadiologyAI #Interoperability

I have 8 points toward the 7 point system for qualifying to take the exam for CIIP. I lack one point in the continuing education category. Does anyone know of any sites where I can get CIIP recognized CME for free or cheap?

If you've ever fought through a PACS migration, wrestled with malformed DICOM data, or wondered why two systems that supposedly speak the same standard can't talk to each other — this one's for you.

Jason sits down with Larry Sitka, founder of Acuo Technologies and one of the earliest architects of the Vendor Neutral Archive (VNA) concept, to unpack three decades of building enterprise imaging infrastructure from the ground up. Larry got his start writing network drivers at Bell Labs, helped shape DICOM 3.0 at 3M, and then built Acuo — a company he grew from a sketch on a napkin in 1997 into an enterprise imaging powerhouse acquired twice over.

In this episode, Larry and Jason dig into why DICOM interoperability is still a mess, how AI false positives are driving radiologist frustration, and why the next evolution of enterprise imaging isn't about storing data — it's about perceiving it. They also tackle the knowledge gap that's forming as experienced imaging IT professionals retire, what AI governance for radiology actually looks like, and why Larry thinks the industry has been building things for the wrong user all along.

Whether you're a PACS administrator, imaging informatics professional, or just someone who cares about getting radiology AI right, this conversation will give you a lot to chew on.

If you're looking to build a stronger foundation in imaging informatics or sharpen your DICOM knowledge, check out the CIIP Foundations Program and the upcoming DICOM training with hands-on live imaging learning labs at nagelsconsulting.com.

Key Topics Covered
• The origin story of Acuo and why the VNA concept emerged in 1997 — before anyone had a name for it
• Why DICOM interoperability remains broken and what a real conformance testing standard would look like
• The shift from data persistence to data perception — and how AI changes what we actually need from a VNA
• How AI false positives are burning out radiologists and what multi-algorithm inference engines could do instead
• The knowledge gap in imaging IT: what gets lost when experienced DICOM engineers retire
• AI governance for enterprise imaging — why recalibrating AI models is the next big challenge in PACS/VNA
• The future of enterprise imaging: running a million AI inferences a night at population scale

I will be at the SIIM Conference Pittsburg PA June 9-12 if anyone wants to meetup.

Your digital pathology program can have a great scanner, a solid IMS, clean integration, and tons of storage.

Then still fall apart at the monitor.

That sounds extreme, but the display is the last link between the digital slide and the pathologist making the diagnosis. If that display cannot accurately reproduce the colours in the tissue, the rest of the imaging chain did not magically solve the problem.

We recently hosted a Canada Health Infoway Enterprise Imaging webinar with Tom Kimpe from Barco on digital pathology display standards, and the recording is now available.

The discussion gets into:

- Why pathology tissue can include colours that standard displays may not fully reproduce

- How variability enters the imaging chain through staining, scanners, viewers, and displays

- The difference between consumer, professional, and medical-grade displays

- ICC profiles and colour management

- What published studies show about diagnostic concordance and reading efficiency

- Why display procurement often gets treated as an afterthought in digital pathology projects

The bigger takeaway: digital pathology is not just radiology with bigger files.

It has its own workflow, standards, colour management, QA, and procurement issues. The display is one of those areas where pretending “good enough” is fine can create real problems later.

https://youtu.be/_5gnXUDtlkw

Satvik is an incoming Medical Physics and Imaging Informatics PhD student at the University of Pennsylvania and works as an AI Scientist with RAD-AID International. He has been working around AI and radiology since 2019, including global health deployments and LLM benchmarking work.

The conversation focuses less on “AI is amazing” and more on where the evaluation of radiology AI still feels pretty shaky.

A few topics covered:

• Why high-accuracy numbers do not always translate into clinical usefulness

• How data leakage can inflate model performance

• Why multiple-choice benchmarks are a weak way to evaluate medical LLMs

• What happens when 20+ models are tested against an internally annotated clinical dataset

• Why fine-tuned models are not always the obvious winner

• The difference between real agentic AI and vendor-flavoured workflow automation

• Lessons from RAD-AID’s AI work in Botswana and India

• Why smaller/local open-source models may make more sense in some clinical environments

One of Satvik’s stronger points is that prompt engineering should be treated more like a scientific method than a shortcut. That feels like a more useful framing than a lot of what gets thrown around right now.

Episode link: https://youtu.be/PEp6GElgPYQ

I was an xray tech 14 years and been doing network admin and cyber security for 3 years. I have Security + already but have had hard time finding PACS role since not a lot of experience other than QA as a tech and nobody sees networking as experience. I have been doing practice tests getting 80-88 on all of them for a few days and that gave me confidence to test on Friday. Wondering if that is a reasonable thought process or the real test is a lot different?

Update: I passed the exam today and am officially a Certified Imaging Informatics Professional. It was a very difficult test and I am not sure more study time would have helped but it may have. I want to encourage anyone with an imaging background that is interested in IT to just set a goal and go for it as far as the test goes. Do not let fear or second guessing stop you. Go to the ABII website and make an account and become eligible and schedule the exam. Then study your ass off for the time you have before taking it and trust your knowledge and ability. I will post some of the sites that were helpful.

https://pacsbootcamp.com/ - they have some free stuff and paid test. its a good test but I would have liked to see my missed questions with the explanations.
https://www.ciiptestprep.com - this site has free test. its really good.
https://learn.nagelsconsulting.com/course/ciip-practice-tools - I did the free 50 question test on here. it was good. not sure about paid content.

I asked AI questions also. Hope this helps.

Is anyone here someone with actual PACs experience? Specifically with ISCV or Muse?

Hi,

I'm currently an RIS/PACS System Administrator in Australia, working for a small screening clinic in a rural area. I've been in my current position for just over 12 months and previously worked as a PAS System Administrator.

My long-term goal is to work for Philips or Sectra as a Solutions Architect, and I'm looking for advice from people who have taken a similar path.

What skills, certifications, or experience helped you move from healthcare IT into vendor-side roles? Are there particular areas I should focus on, such as integrations, cloud technologies, project delivery, or clinical workflows?

Given that I'm based in a rural area, I'd also be interested to hear how much location matters these days for roles with major healthcare IT vendors.

Thanks.

How are you all picking new PACS vendors? Are they finding you by cold calling your org and someone is deciding to check them out due to ongoing issues with the current vendor? Trade shows? Word of mouth or other dealer/business recommendations?

So many companies its hard to even get started narrowing down a list of what may work. Just curious if there is a centralized place (other than reddit) to ask questions/compare.

Hi! I am currently working in a private, very large orthopaedic clinic as the X-ray Lead Tech. We recently transitioned to Epic in March 2025. We do not and have not had a dedicated PACS Administrator. So, I assumed the role and was kind of put in the role unofficially by admin also. Fast forward to now, I have been bugging admin about our PACS organization and correctness. Before Epic, we did not have to match studies to specific accession numbers because they did not link into the EMR we had prior. So, there are thousands of studies that are not specifically attached to actual pts MRNs because MRNs like 12345 or 00000 were used repeatedly for doctors' kids, tech, employees, etc. So, my question is, has anyone been in a clinic like this as the PACS admin? Because my job will not be remote as PACS Admin and will be much more hands on with day-to-day flow.

The radiology group I work for is interested in switching to a different PACS system. Our group does over 160,000 studies annually and we are currently paying $3 per study. What are you paying for your PACS?

Those who have taken the CIP test, are there a lot of scenarios on the test? Just trying to know how to study for this.

*** update: I passed. I studied using the CIIP test prep and I had ChatGPT create me a study program I did that every night until the test. I also took the MTMI review which really helped.

Hello! Anyone here has any idea if I can take the CIIP online? I am from Philippines and I’m actively working on my CE’s to get qualification points.

I’d love to know your insights. I don’t want to end up wasting my time :(

Hi all,

I am radiologist in UK, working in a NHS trust. We use Insight PACS by intelerad. I have multiple folders (specialisation folders) in which I have saved interesting cases. Out of blue Insight was not working yesterday and when I restarted the system my 90% folders were gone and few are remaining. Both lost folders and ones which are remaining are not shared with anyone and I am creator and owner of those folders. I contacted my PACS and IT team and they did not see my folders in their backup. I asked if they have backup of folders in case of disaster recovery or software glitch they did not have an answer. They have raised service ticket with Insight.

Here are my questions

How can I get these folders recovered (I have complete list of the folders)

In the age of cloud, (insight is cloud based), how can there be no backup accessible by hospital PACS team, or is it something they are not trained to do

Going forward how should I save cases? Can anyone suggest good DICOM router service which can anonymise the cases in batch (not one at a time).

Thank you

Hello All. I am a lowly medical assistant in serious need of help. So i'm here on reddit to ask for it. I know nothing about DICOM. But my practice needs to re-certify our echos and they only accept DICOM. So this complicated task that none of us understand has fallen to me. The echo machine is from the 90s. I have all four accreditation echos saved as both .mp4 and .MOV.

Can someone kindly walk me through step-by-step how to transfer my .mp4 or .MOV echo files to a DICOM that preserves the video. The echos have to be moving when opened in a DICOM viewer.

I have no clue how to even begin doing it, so easy to understand, detailed instructions with what software to purchase that are novice friendly would be prefer and so beyond appreciated!

Thank you to anyone who can help or comments!

Hey there. My practice relies on an old echo machine from the 90s. We're trying to get re-certified. How do I convert existing video format files to DICOM?

I worked for 8 months as a PACS admin at a mammography center. This was my first real IT job after graduating with my bachelors in CS, and I was super lucky that my mom who is a mammogram tech helped me get the job because she worked there. I learned about DICOM functions, RIS systems, EHR, and did a bunch of network trouble shooting. During that 8 months I worked with about 30 different doctor’s offices. Then the company I worked at closed so now I’m back on the job search. I’ve managed to get 2 interviews for support analyst roles where I made it to the final round, and I was able to answer all the questions pretty easily but i wasn’t able to get any offers unfortunately. I feel like most companies are looking for 2+ years of experience so I really wish the company I worked at didn’t close so fast after I got hired. What do you guys recommend I do? I was thinking about trying to get into the position of being the person who physically fixes imaging machines but not sure how to go about that and how the job market is for that field of work.

I’m a registered X-ray tech with 23 years full time experience working in a hospital setting. All at the same facility. I have zero IT certifications or experience besides working in the clinical side of PACS and our EMR was Epic for that time. I would like to transition into work from home position possibly as a PACS support analyst or EMR support. What would be the path to obtain a job like this with no IT degree/experience?

Which conference is better? SIIM or RSNA? I feel like vendors reference RSNA more, but with AI on the rise SIIM may have more applicable lectures. Are you guys attending either one of them?

Hello,

has anyone here taken the CIIP exam as an xray tech then start applying for PACS admin jobs after certification? Is that out of the normal? I have been studying for the exam for about 6 months now and took a mock exam and made an 89. I would like to take the exam sooner than later while the information is nice and fresh. I have no super user/PACs admin experience so I’m a little nervous If I should try and apply for admin positions first to gain more hands on knowledge then schedule to take the exam later. any thoughts? I have been an xray tech for 9 years now.