Test Content Outline

Approved Date: June 2018 Implementation Date: March 2019 Number of Scored Questions1 A. Procurement 6 B. Project Management 7 C. Operations 13 D. 10 E. Training and 6 F. Image Management 24 G. Information Technology 18 H. Systems Management 15 I. Clinical Engineering 14 J. Medical Imaging Informatics 17

The Test Content Outline lists the areas to be covered and the weightings reflecting their relative importance. Content outlines are developed by determining what imaging informatics staff at entry level are required to do on the job, and then defining the knowledge and skills necessary to perform those tasks.2

A detailed Test Content Outline continues on the following pages.

Note: The abbreviation “e.g.” is used in this document to indicate examples of the topics covered, but the examples are not a complete list.

1 Each exam includes an additional 20 unscored (pilot) questions. 2 A special debt of gratitude is due to the hundreds of professionals participating in this project as committee members, survey respondents, and reviewers.

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1. Internal dependencies A. Procurement (6) 2. External dependencies 1. Needs Assessment d. Quantifying and controlling risks a. Organization strategic plan and policies 2. Project Feasibility b. Procurement goals a. Needs assessment design c. Methods of needs analysis b. Needs assessment implementation and review d. Replacement or enhancement c. Financial viability analysis 2. Vendor Selection 3. Project Management Assessment a. Collection tools Tools 1. Request for information (RFI) a. Documentation of readiness, 2. Request for application (RFA) planning, initiating, executing, 3. Request for proposal (RFP) monitoring, and closing b. Vendor response analysis processes (e.g., PERT charts, c. Vendor demonstrations Gantt charts, milestones, time- and-task schedules) d. Vendor evaluation b. Budget, cost schedule, resource, 3. Vendor Contracts quality, and procurement plan a. Contract development 4. Project Completion Assessment 1. Acquisition and deployment a. Performance validation budget b. Documentation validation 2. Total cost of ownership (TCO) c. User acceptance testing 3. Return on investment (ROI) b. Standard components of C. Operations (13) contracts 1. Quality Improvement (QI) 1. Licensing and user fee Procedures models a. Philosophical basis of QI 2. Performance b. Process improvement strategies metrics/payment milestones (e.g., PDSA, Six Sigma, LEAN) 3. Uptime guarantees c. Problem identification analysis 4. Liability and tools (e.g., runchart, fishbone) 5. Obsolescence clauses 2. Policies and Procedures 6. Service level agreements a. System management (e.g., c. Contract evaluation downtime, incidents, back-up

d. Contract negotiation and recovery, privacy and B. Project Management (7) security) 1. Goals, Scope, and Risks b. User management (e.g., access, a. Identifying goals roles)

b. Identifying and limiting scope c. Compliance with Applicable Regulations (e.g., HIPAA, MQSA, c. Identifying common risks HITECH Act, radiation dose tracking)

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3. Operational Budgeting E. Training and Education (6) 4. Identifying and Reporting Ethical 1. Needs Assessment Issues a. for training 5. Systems Change Control and b. Types of learners ® Problem Tracking (e.g., Remedy , 1. styles ServiceNow®) 2. Characteristics of adult D. Communications (10) learners 1. Roles and Relationships in c. Measurement methods (e.g., Healthcare Settings surveys, task analysis) a. Organizational chart d. Instructional objectives b. Organizational theory 2. Training Programs c. Medical specialties (e.g., a. Instructional methods radiology, pediatrics, b. Instructional tools orthopedics, neurology) c. Educational resources d. Customer service methods d. Assessment of training 2. Medical Terminology F. Image Management (24) a. Anatomy, physiology, and pathology 1. Environmental Design for Viewing and Interpreting Images b. Common imaging positions a. Ergonomics c. Imaging planes b. Environmental factors d. Modality-specific terminology c. Room layout and physical e. Coding with: ICD, CPT®, considerations SNOMED, RADLEX™, LOINC 2. The Human-Computer Interface 3. System Availability Issues or Changes, Notifications to Business Units a. EMR/RIS/PACS/SR/LIS/dictation integration a. Change management communications (e.g., who, what, b. Key image selection and image when, why, how) annotation b. Notifications (e.g., downtime, c. Input devices upgrades, changes in workflow) d. Display devices c. Plans and techniques based on 3. Work Flow Processes user roles a. Postprocessing workflow 4. Strategic Planning and Reporting b. Compression a. Aligning department goals with c. Image workflow (e.g., hanging organizational strategic plan protocols, read-ready) b. Feedback mechanisms d. Teaching files 1. Reporting tools e. Clinical trials 2. Surveying methods f. Image acquisition and display terminology

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g. Reporting and results 2. Network Architecture a. Network protocols (e.g., h. Data integrity QC checks (e.g., Ethernet: Wireless, Bluetooth, storage commitment, OSI/ISO mode, TCP/IP) reconciliation, modality worklist) b. Transmission protocols (e.g., i. Workflow optimization DICOM, FTP, HTTP, SSH) j. Remote interpretations (e.g., c. Load balancing, fault tolerance, telehealth, ) and redundancy 4. Image Import and Export d. Network components and a. Policies and procedures hardware (e.g., hubs, switches, routers, gateways, trunks, CAT-5e, b. Workflow procedures (e.g., IHE, CAT 6, fiber) PDI) e. Network configuration (e.g., IP c. Data integrity address, LAN, WAN, VLAN, DNS, d. Digitizing technology ARP, NAT, firewall, SSL, ports) e. Standards of file exchange f. Network metrics/dashboard (e.g., f. Cross enterprise image exchange capacity, bandwidth, 5. Enterprise Imaging performance, cost) a. Visible light 3. Hardware and Software Components b. Radiology a. Hardware components c. Cardiology 1. Video card G. Information Technology (18) 2. CPU, GPU

1. Storage and Archive Technology and 3. Memory Architecture 4. Hard drive a. Architectures (e.g., NAS, SAN, 5. Network interface card DAS) 6. Motherboard connectivity b. Storage network protocols (e.g., (e.g., PCI, USB, SCSI, AGP) SCSI, fibre channel, ATA/SATA) 7. Removable media hardware c. Archive strategies (e.g., CD, DVD, MOD, flash) 1. Online b. Software components 2. Nearline 1. Operating systems 3. Data throughput 2. Mobile devices 4. Methods for storage 3. Browser management (e.g., 4. DNS virtualization, replication, 5. Group policy mirroring) 6. Remote management tools 5. Storage metrics (e.g., RDP, VNC, Bomgar®, d. Vendor Neutral Archives (VNA) WebEx®)

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7. Authentication mechanisms 5. Cloud a. Active Directory c. Impact of new technology (e.g., b. LDAP, LDAPS 256 slice CT, breast c. Kerberos tomosynthesis) d. Two-factor authentication d. Licensing models (e.g., c. Server architecture concurrent, per/named user) d. Virtual architecture (e.g., Citrix®, 2. Disaster Recovery Plans and VMware®) Business Continuity Strategies 4. Data Retrieval for Operations, a. Policies and procedures Quality Assurance, and Planning 1. Testing Purposes 2. Downtime a. Structured Query Language 3. Failover (SQL) 4. HIPAA compliance b. Data analytics and b. Data and system recovery (e.g., methods, statistics) 1. Offsite archiving c. Key performance indicators (e.g., utilization, performance, uptime, 2. Hardware and software capacity, exceptions, unread solutions exams, lost studies) 3. Applications Service Provider d. design, management, (ASP) and maintenance 3. System Problem Management 1. Relational versus hierarchical a. Availability monitoring and 2. Basic principles (e.g., keys, problem detection normalization, table joining, 1. Reporting procedures performance) 2. Automated monitoring (e.g., 5. Appropriate IT Standards dashboard) a. Data structures (e.g., XML, JSON) 3. Alerts b. File systems (e.g., CIFS, NFS) 4. SNMP 6. Obsolescence Planning b. Troubleshooting/problem a. Technology lifecycle diagnosis (e.g., Wireshark®, b. Moore’s Law DVTK) c. Root cause analysis H. Systems Management (15) 1. Bottlenecks 1. Requirements for Optimal and Cost- Effective System Capacity and 2. Single points of failure Throughput 3. Alternate pathways a. Study size calculations d. Status reports to management b. Scalability considerations 4. Data Migration Procedures 1. Database a. Strategies for migration 2. Storage b. Physical data transfer 3. Server considerations 4. Networking

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c. DICOM standardization and data d. Stereotactic imaging integrity e. Intraoperative imaging d. Work-product migration (e.g., f. Point of care imaging key images, annotations, g. Research imaging presentation states) 3. Modality Integration e. Cost and performance models a. DICOM configuration f. User impact 1. Configuration parameters 5. Data Security and Individual Privacy (e.g., AE title, port) a. Standards, policies, and 2. Modality worklist guidelines 3. Performed procedure step 1. HIPAA 4. Storage commitment 2. ACR-SIIM Practice guideline b. DICOM services for electronic medical information privacy and c. DICOM objects security d. DICOM validation 3. NIST e. DICOM transfer syntax b. Security strategies f. DICOM tools 1. Physical g. Other types of integration 2. System 4. Image Display Quality Control 3. Application a. DICOM Grayscale Standard 4. Encryption Display Function (GSDF) part 14 c. Privacy b. AAPM TG18 report 5. Clinical Awareness I. Clinical Engineering (14) a. Electrical hazards 1. Support for Imaging Modalities and Techniques b. Ionizing radiation and radiopharmaceuticals a. Radiography/Fluoroscopy/ Tomography c. Magnetic fields b. Breast imaging d. Infection/biohazards c. Magnetic resonance imaging e. Sterile field procedures (e.g., (MRI) operating room) d. Computed tomography (CT) J. Medical Imaging Informatics (17) e. Ultrasound 1. Medical Imaging Workflow Solutions f. Nuclear medicine a. Implementation g. Cardiology b. Evaluation/process improvement h. Radiation therapy 2. Systems Integration i. Interventional radiology a. HIS 2. Support for Ancillary Services b. RIS a. Oncology (e.g., tumor tracking) c. EMR b. Orthopedic templates d. PACS c. Surgical planning e. CAD (e.g., breast, lung, prostate)

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f. Dictation systems g. Postprocessing software or systems h. Radiation dose management i. Contrast dose management j. Modality content structured reporting (e.g., ultrasound, DXA) k. Decision support 1. order entry 2. exam protocols 3. interpretation, case comparisons l. Critical/urgent results communication m. Discordant findings notification n. Peer review o. Clinical analytics p. Integration methods (e.g., API, web services) q. Scanned documents 3. Medical Imaging Standards a. DICOM b. HL7 c. MQSA d. ACR e. AAPM, SIIM f. ICD, CPT®, SNOMED 4. Apply Appropriate IHE Guidelines (e.g., integration profiles, connectathon results) 5. Integrate Image Architecture into Organization’s Long-Range Plan a. Enterprise archiving b. Master patient index c. Regional Healthcare Information Organizations (RHIOs) d. Enterprise imaging specialties (e.g., cardiology, pathology)

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