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Fundamental to the smooth operation of an echocardiography laboratory are its leaders,
the Medical and Technical Directors. The Organization section of The ICAEL Standards (Part I, Sections 1.1 and 1.2) outlines the requirements and responsibilities of each. This article focuses on the function of the Technical Director and explains the specifics of selecting a Technical Director who is in compliance with The Standards.

Qualification to be Technical Director

A Technical Director must possess either the Registered Diagnostic Cardiac Sonographer (RDCS) credential from the American Registry for Diagnostic Medical Sonography (ARDMS), or the Registered Cardiac Sonographer (RCS) credential from Cardiovascular Credentialing International (CCI). There are no alternatives to this requirement; however, first-time applicant laboratories may be eligible for a provisional grant. (See the sidebars on provisional grants and earning credentials.)

Choosing the Technical Director

The sonographer who is considered the “chief” or “lead” sonographer in the laboratory
should be named the Technical Director. This person must perform echocardiograms in the laboratory, and along with the Medical Director, must ensure compliance to The ICAEL Standards and delivery of quality patient care. As part of the leadership role, the Technical Director is responsible for technical training, maintenance of the equipment and the daily operations of the laboratory.

It is not required that the Technical Director directly supervise other sonographers or ancillary staff; often a laboratory has a non-technical “administrative manager” in a supervisory position. However, this type of manager does not qualify to be a Technical Director.

If there is only one sonographer in the laboratory, that person must be listed as the Technical Director.

When an Interpreting Physician may be the Technical Director

A physician may serve as the Technical Director only if there are no sonographers and the interpreting physician(s) perform all of the echocardiograms. If physicians and sonographers share the scanning, one of the sonographers must be named as the Technical Director.

A physician serving as the Technical Director must meet certain eligibility requirements. In addition to meeting the training and experience requirements as a medical staff member (or Medical Director), the physician Technical Director must hold a sonographer credential (RDCS or RCS), or must demonstrate Level II or III training (or equivalent, if trained before 1990) in echocardiography. The article footnoted in Part I, Section 1.2.1 of The ICAEL Standards (“ACC/AHA Clinical Competence Statement on Echocardiography”, Quinones et al, Journal of the American College of Cardiology, Vol. 41, No 4, 2003, February 19, 2003:687-708) describes the documentation required to prove such training, or its equivalent. Note that certification from the National Board of Echocardiography (NBE) establishes that a physician meets the training and experience requirements to serve as the Technical Director.

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