The adoption of PACS by radiology practices has added a new member to their executive committees: the CIO. “The core duties of the CIO in a practice that has acquired PACS ought to be to establish security of the PACS data for both the radiology group and its clients and to ensure the continuity and availability of the network at all times,” according to James List, director of informatics and advanced applications support at Consulting Radiologists Ltd in Minneapolis. Brian Hannon, director of IT for Salem Radiology, Salem, NH, adds another core duty. “Beyond all the technical responsibilities of keeping PACS up and running, keeping the communications network going, and making sure data reach all the right places and are accessible when requested, the CIO is also a pivotal player now in keeping the practice fiscally healthy,” he says. As Pete Higgins, CIO for Radiology Affiliates Imaging in Hamilton Township, NJ, puts it, the mission of the CIO today can be tied as much to sales as to anything technical. “PACS-RIS is now becoming a marketing tool,” Higgins says. “CIOs and their IT teams go out into the field to work with referring physicians on implementing and integrating those systems. In our group, we like being out in the field because that puts us in a position to gather good intelligence about customer wants and needs, so that we can look at new services we should be offering.” Hannon believes that the CIO should be taking the lead when it comes to recruiting new customers and negotiating contracts. “I go out and solicit new business, often through leads provided by imaging-modality vendors with whom we have good relationships,” he says. “Those vendors are willing to provide the leads because they know the group for which I work offers a valuable service that can benefit purchasers of their equipment.” The role of CIO can become rather complicated when that person wears multiple hats within the organization, as Robert Ortega, MD, owner of Alta Vista Radiology in Paradise Valley, Ariz, does. Like Hannon, Ortega recruits the new customers. That is not easy, however, because Ortega is a coverage provider. “I primarily perform my reads during hours when prospective customers are asleep,” he says, “so I must be more strategic about when I schedule my business interactions and prospecting. For people in the Western United States, I save phone calling for late afternoons only. For people on the East Coast, I call at the end of my night shift because, in the Eastern United States, it will be the start of the business day. This approach leaves me the mornings and early afternoons for sleep and a personal life. I also use my days off in the middle of the week to take care of business.” Hannon contends that the financial duties of the CIO in today’s PACS-outfitted practice can, and should be, consistent from one practice to the next, regardless of the practice’s size, because of the impact of Deficit Reduction Act reductions in reimbursements of upwards of 40% on some modalities.