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When a complex reality as the Department of Diagnostic Imaging and its staff is aimed at the provision of a service, it may be extremely difficult to identify all present correlations and in turn, correlate them with the final goal. The relationship between human and technical resources, between organization and environment are of the utmost importance in planning the structure design. It should be kept in mind that "the person" is the pivot of any innovation for change. Participation by all members, a more flexible, structure, is required. In education and teaching, the global network we are heading for, could become the determining factor in a continuing training process and multispecialized research, facilitating the circulation of information in an interactive, formative dialogue.

It is well-known that while RIS allows the management of all input and output data of a Radiology service, PACS plays a major role in the management of all radiologic images. However, the two systems should be closely integrated: scheduling of a radiologic exam requires direct automated integration with the system of image management for retrieval of previous exams and storage of the exam just completed. A modern information system of integration of data and radiologic images should be based on an automated work flow management in al its components, being at the same time flexible and compatible with the ward organization to support and computerize each stage of the working process. Similarly, standard protocols (DICOM 3.0, HL7) defined for interfacing with the Diagnostic Imaging (D.I.) department and the other components of modules of a modern HIS, should be used. They ensure the system to be expandable and accessible to ensure share and integration of information with HIS, emergency service or wards. Correct RIS/PACS integration allows a marked improvement in the efficiency of a modern D.I. department with a positive impact on the daily activity, prompt availability of previous data and images with sophisticated handling of diagnostic images to enhance the reporting quality. The increased diffusion of internet and intranet technology predicts future developments still to be discovered.

One of the major and demanding problems in the management of a modern department of Radiology is undoubtedly the organization of a radiologic archive. Its management has been increasingly difficult in last years both for the increase in procedures and the number of radiologic exams. At the Radiology department of UCSC, since some years, this problem has been tackled. Major objectives have been identified in focusing on responsibilities, global management and planning of radiologic film retrieval and archiving integrated with health care activities (scheduling of admissions and exam appointments, reporting, discharge). Based on these assumptions, the archive has been divided into 3 sections, each dynamically integrated with the others. The 3 archives should be integrated with RIS and supported by information technology. RIS is considered the starting point of the process. In fact the system ensures communication to the archiving workstation and to the radiology room of patient admission and consequent execution of the exam which involves image production. This user-friendly procedure enables consistent information between RIS and archiving system and correct association of images to the patient medical report, for subsequent consultation.