Monday, March 29, 2021

Leveraging PACS skills and expertise to broaden your career

Sjoerd van Schie
This is the first in a series looking at using PACS administrator skills and expertise to leverage career possibilities. For this article PARCA eNews spoke with Sjoerd van Schie, District Service Manager for precision diagnosis and image-guided therapy at Phillips Healthcare. As service manager for Hitachi, Europe before PACS were a thing, Sjoerd was introduced to DICOM and he became early expert and advocate for DICOM at the company. He served as technical consultant for Hitachi in Zurich and then Technical Director for Hitachi in The Netherlands, Belgium and Luxembourg That experience propelled him to becoming the DICOM specialist at Hitachi, America based in Ohio. He has since leveraged that experience to serve in a variety of management positions at Carl Zeiss x-ray Microscopy in San Francisco and now at Phillips Healthcare in Los Angeles.

Q. Tell me a little bit about how you got started in healthcare and then how you became kind of an IT connectivity and DICOM specialist?

Well, I can tell you my story. Just stop me if I go on too much. I started as a field service engineer for Hitachi, Europe and did that for about 10 years and then the company made a corporate decision to step away from the dealership structure they had, they wanted to set up a completely different structure. And they approached me and asked, “Do you want to become the service manager for this company?” And I said of course.

I became fully responsible for everything and also the DICOM card and I went to many facilities all over Europe and everywhere I went, I got these questions about DICOM and the DICOM conformance statement. This was years ago and there wasn't too much that could be found about DICOM and it was in the early days of the Internet as well. So I educated myself a little bit more and then for my hobby, I also trained myself.

I read the literature and looked for books about everything about computers. I talked to people who are from the computer industry and they taught me several things and I learned myself many things without being formally taught. I developed my IT skills at the same time, and it was all done from a hobby perspective.

Now I think maybe my situation was pretty exceptional. I had the opportunity to take what I learned on my own and directly apply it in my job. Because of the DICOM questions that were being asked I did a little bit more of a deep dive into what DICOM had to do with healthcare and the link with informatics.

So I became responsible for that part for 10 years after being an engineer for 10 years and then I built on that experience. At that point I then applied for the job with Hitachi in Ohio. That was in 2008 and they hired me as the DICOM specialist not so much as a manager, forget about management there was no management, they hired me as the go-to guy for any networking issues or DICOM-related issues.

Of course the first question I asked them when I joined Hitachi, Ohio was, where's your DICOM infrastructure? Where's your PACS server? and it didn't exist. So I put it all together for the company and it became such a great infrastructure because it wasn't only DICOM storage, it was also anonymization, and it helped everyone understand what DICOM was about. At that point I felt that I had to train myself even more. I didn’t want to stop with the knowledge that I gave myself.

I had been doing that and working for a vendor for nine years in Ohio, but I didn’t want to restrict myself from getting the knowledge about how DICOM works and how these MRIs CTs and all these modalities are connected to a hospital network. I wanted to know what's behind that wall, which is called the PACS server. From the moment you send it, I wanted to understand what the PACS server does with the data. I looked for a place for more formal education and I found OTech and Herman Oosterwijk.

Q. Could you back up just a little to when you're working as a manager in Ohio for Hitachi, they were or were not a PACS vendor?

My IT experience built up in Europe at the same time I was the service manager, so It was mandatory that I understood what I was talking about. So I educated myself when I moved to Ohio in 2008 there was nothing there in terms of a PACS except for a TeraRecon workstation a TeraRecon server that they called their PACS, but it wasn't a PACS. I said, okay, if we don't have a PACS here, then at least what I want to build out is an image server and that's what I did. and I needed that training about how PACS servers respond how does it work and all the details of a PACS system, and that's why I sought training with OTech.

I also wanted to know not only from a vendor point of view but also what the systems do. I knew the DICOM conformance statement, I knew how they operate, but what happens when I send an image to the PACS, what does the PACS do with it? Because they were complaining about the images on the PACS or the images on the fueling stations, I wanted to know because I knew that my images were correct, but how do these PACS servers deal with that data? What is it that they do?

I wanted to know the PACS ins and outs. I did many deep dives into the communications between the modality and the PACS server and I wanted to train myself and get myself educated. I built this image server infrastructure, which was a storage server for Hitachi, and I installed all the clients, all the field stations for all the employees. I think we had about 500 of these workstations that would read the data off this image server. I was responsible for that. I built it from the ground up. There was nothing when I joined the company I built the whole infrastructure.

Q. Wasn't that essentially a PACS or was it just it a storage server?

It was not really an PACS server. You can consider it as purely a storage server and you can store an image and retrieve it. You can query and retrieve it, but a PACS does more than that, right? PACS has the archiving element hence the “A” in PACS. It does a lot more than an image server. I wanted to figure out how the PACS worked on all these sites. I worked with many PACS administrators on the phone, and I got to be considered the PACS guy within Hitachi. I knew all about PACS. I was that go-to person if you had a DICOM problem, if the customer is calling tech support or applications, I got so many types of questions and the question was can you fix it?

Many times the problems were technical, but I would say the other part had to do with the DICOM conformance statement. What is it? How does the PACS operate in those facilities and many times I worked together with the PACS administrators to tell them what they had to do in order to fix a problem that I thought was the culprit.

Many times I even had a situation where they said, “Can you dial in into my PACS and take over,” or they asked me can you log in and take care of this problem and fix it?

Q. It sounds like you didn’t exactly map out a career plan to go from service into a PACS job, it looks more like you were just driven to self-educate and expand your skills and your expertise. Is that kind of the way you have operated all your career?

Yes, I would say I did not plan it, it was just the way the ball rolled. Yes I planned a couple of career changes, but I didn’t have a whole career planned out. It just happened.

Q. Why did you switch from IT manager consultant at Hitachi Europe to start teaching at ITT and then again teaching and consulting at Hitachi America?

Now don't laugh. I always had in my mind that I wanted to move to America, and I felt like I had been working for Hitachi at that point for a total of twenty years, that it was time to make change one way or the other. There was no room for me to become the director for all of Europe. I was managing a couple of countries, but only three in Europe, but I wanted to all of Europe but there was no opportunity.

I thought okay, I'm going to see what's beyond the horizon over in the United States and they said no. No, we don't need a manager in America, and I said, but I don't want to be a manager. I'm okay with that, I have a lot of IT experience on all these modalities, and I had all this knowledge of DICOM and PACS. So that's how I kind of rolled that into the DICOM world, but at the same time I was single point of contact on ultrasound equipment as well, because I had 20 years of experience working on ultrasound. So they made me the primary top end point consultant for ultrasound if there were any problems.

Q. What did you gain from those experiences? What were the things that you valued most?

If I look back over my shoulder what I valued most was the dedication to my job, the dedication of being that single point of contact that endpoint DICOM specialist and it doesn't matter if you call me that DICOM expert or a PACS administrator because I did exactly the same. I also did more than that. I spoke with R&D at Hitachi, Japan. They would ask me, what is it that we need to do, and they would listen, and they would make these modifications. Okay, a PACS administrator doesn't do that, but I loved the work and found my job satisfaction in dedication to my job. I was focused on doing that and I became the top level position for that within the organization and that is something you definitely need.

You cannot. and it's funny because you and I both had this interview years ago about the CDIP certification. And I said the same thing then, you cannot just do this (PACS administration) on the side. And I continued to hear that, I kept saying, no they can't do that on the side, and the proof is when I left Hitachi and upper management told another engineer who was an MRI specialist for this and they said why don't you do what Sjoerd did, I hear you can do it on the side. Then soon enough because I was still talking to this guy he would call me every once in a while for advice and he said now everybody understands that what you did takes a full commitment.

He said, I cannot do this on the side. I need to be dedicated and he was given the choice, do you want to go back to MRI technology being an MRI specialist or do you want to stick with DICOM. He loved it and I think because of how passionate I was about it he picked it up and he loves it; he was very enthusiastic about everything we talked about DICOM and PACS Administration and everything and I think he got stuck with the virus. So now he is the DICOM guy.

Q. What lured you away from Hitachi to Carl Zeiss X-ray microscopy?

I hope you are not going to laugh again, but it was my dream to go to California in particular and when I got the job interview in Ohio where the Hitachi, America headquarters was, they said, you know the job opportunity that you applied for (at Hitatchi) in San Diego California, we are not going to do that. We want you here at the headquarters. So I said okay, that's fine, but at the time I took the job in Ohio I did not know about all the snow in Ohio.

Every year (winter) again, I would say I can't take this anymore. So after nine years I spoke with leadership and I said, I really want to move to California and when they said we don't have a job for you in California. I said, okay, then I'm going to apply for another job elsewhere and we laughed, and I left, and in the end we split up and actually parted with pain in our hearts. I really enjoyed what I did at Hitachi, and they were really happy with me, but you know, it wasn't my passion anymore to stay in Ohio.

I applied for several jobs and I got hired by Carl Zeiss as the head of the global tech support for the X-ray microscopes and I asked them many times, “Why did you pick me,” because there were many people who applied, and the main reason was the management experience I had. I had been in management for 10 years with Hitachi in Europe. I said, but I've been working for nine years in Ohio and I wasn’t in management. They said, yes, but you manage your own projects, and you were responsible for everything that had to be done including hiring people. So I said yes, I'll take that job and they took care of me. They took care of my relocation and everything and I became the manager for tech support for all over the world on the X-ray microscopes.

Q. And that moved you into more of a service position?

Yes and no. It moved me out of service, because I wasn't the one fixing the problems anymore, I was managing a full service team and I found that was one of the things I really enjoyed doing, I had to hire people. Unfortunately occasionally, I had to let people go but these things happen. I was responsible for the complete service revenue for the global support, and I enjoyed it. My team would actually be on the phone with the customers and with the field service engineers and I would manage them but didn’t directly do service myself, not anymore. I was a true manager.

Q. Now you are at Phillips, how did that come about and what are you doing?

I was hired by Philips and I left Carl Zeiss as the head of Global Tech Support and I got this job with Philips Healthcare, which was in Los Angeles, but I was living in the Bay Area. They said that's fine for now, but the job is in LA, so as long as you eventually, say within a year, you will need to move out of the Bay area and go down south to LA because that's your work region.

I manage 24 very experienced engineers. I was hired based on of my experience being a manager with Carl Zeiss. They knew that I had lots of experience with PACS with IT with modalities and managing people in the healthcare field. Based on those reasons, they hired me.

This shows that my whole history of working on multiple modalities, understanding how they operate was extremely beneficial. Phillips said you know what an MRI does, you know what a CT is, you understand the modalities and with everything you've done the ownership you demonstrated in that position with Hitachi we want you to work at Phillips.

Q. So you are living in the Bay Area and you are managing the whole LA region? Or is it more broadly than that?

It is just the LA area, but it is a little bit confusing. The job was initially posted as in the Metro LA area. It wasn't the Metro LA area. It was downtown LA and on the west side of LA plus the central coast, so not Orange County and not Inland Empire.

Q. I noticed that you speak five languages?

(He speaks a few words in each language, and then laughs.) My Spanish is not too good. I don't even want to try.

Q. And that's the one language you could really use in LA.

Yes, I know. I tried a few words of Spanish with some of my new team and they began speaking back to me so fast, I couldn’t keep up.

Q. How many years have you been working in imaging and IT?

Funny you should ask, I just was summarizing that for the new job. I think it came down to 32 years.

Q. Most people would be ready to retire, but you're ready to start a new career.

I wish, I wish, but with all these switches it has not been good for my 401k. I did manage to build it up of course, but it is scattered all over the place, but close to retirement? No, not yet.

Q. What would your advice be based on your experience for PACS administrators who may be in middle management and are looking around and thinking of expanding their careers?

I think what PACS administrators have that is a big plus is the knowledge about all the modalities. They know exactly how the images look, what to expect and even if you don't know the technology of how the images are created by the new PET system or a PET CT or MRI, even if you don't have in-depth knowledge of the technology, you’re fine, as long as you understand what it does, what it is it that you're looking for, the anatomy of these images.

PACS administrators have that knowledge, and they know exactly what to look for in these images if they're bad. Now not necessarily troubleshooting problems but understanding what the imaging is about is a big plus for a PACS administrator.

If you want to move to management in the same industry, I suggest looking for the right position in the company that you are comfortable with. There are many companies in the healthcare industry selling modalities in all different flavors and tastes.

Look for the company, and if you want to look for a management position, you have to have certain understanding of leadership and of what matters in field service. If you have had that experience, like I had, ten years in Europe, that's a big plus that's definitely going to convince people because you've done it before.

What if you haven't done it before? As a PACS administrator, you can say that you understand what matters because you were responsible as a PACS Administrator to deliver service to the radiologists, to the nurses to the doctors to everybody. You have that service element understanding plus you understand what the modalities are about. You have to find that company that you are comfortable with and that sees the value of the tech and service aspects of being a PACS administrator.

I heard many times during my applications, “you don't understand this” and I can say all I want during that interview that I do, but if they are of that opinion, they just don't want to hire you period. Don’t take it personally, usually, they just want to hire someone else that they have their eyes on. It may be that interviewing candidates is just a formality. They had to post the job and interview some candidates.

So you have to find the right company where you feel good with the company and the job, and they have to see the value of what you do. They have to see that a PACS administrator, is not only the backside administrator, but that he or she delivers service, resolves problems that are pressing and recognizes that there is a time element in healthcare. You have to do it as quickly as possible and a PACS administrator knows that, and knows how to guide the people and manage that service. If you have the right mentality the right skill and the right drive you will get it.

No comments:

Post a Comment