DIP was first produced in the early 1990s by a group of medical imaging specialists based in Perth, Western Australia, namely:

  • Richard Mendelson, a full-time public sector radiologist at Royal Perth Hospital (RPH) 
  • Anita Bourke, a full-time public sector radiologist at Sir Charles Gairdner Hospital with a special interest in breast imaging, and later a member of various DIP expert panels
  • Martin Blake, a medical imaging specialist working part-time in the public sector (SCGH and RPH) and the private sector, and later a member of various DIP expert panels

Aware of the prevalence of inappropriate requests for diagnostic imaging, they produced a booklet containing guidelines and recommendations primarily for medical students, junior doctors and General Practitioners to assist them when referring patients for diagnostic medical imaging. In its final iteration, the booklet contained 56 guidelines addressing common imaging problems, grouped in seven organ systems. It also contained information about common imaging procedures. Richard Mendelson progressively assumed the role of Chief Editor of the booklet, then Editor of the DIP website.

The onset of the metamorphosis of the booklet into a substantial online publication was fortuitous and was triggered and enabled by an administrative reorganisation of clinical services at RPH.

In 1996, the Division of Imaging Services was established for the devolved management of the Department of Radiology and the Department of Nuclear Medicine. The inaugural Director of the Division was Turab Chakera, a full-time public sector radiologist. He supported the development of DIP beyond the initial booklet, and the submission of funding applications for various associated projects, effectively assuming the role of Executive Sponsor. 

Coincident with the appointment of a Director was the creation of a full-time Business Manager who reported to the Director. The inaugural appointee was Phillip Bairstow. He had an academic background and experience in health service management. Supported by the Director, he restructured the staff establishment to create a Support Services Section without reducing front-line clinical staff. The section included:

  • an Information Technologist - justified by the need for specialist IT support and the predicted introduction of a Picture Archiving and Communication System (PACS)
  • a Quality Coordinator -  justified by the documented symbiotic relationship between quality and efficiency of services and the predicted introduction of national accreditation schemes

In 2002, as the core of the Support Services Section was being established, the HDWA announced the availability of seed funding for 12 months to support ‘quality initiatives’, a serendipitous event. Knowing about the DIP booklet and its objective to improve the effectiveness and efficiency of diagnostic imaging services, Phillip Bairstow worked with Richard Mendelson on a joint application, supported by the Executive Sponsor.

The budget included funds for a full-time, fixed-term (12 months) Research Registrar to assist with reviewing the literature and updating the DIP pathways. Annual ‘quality initiative’ funding from the HWDA enabled the appointment of a succession of fixed-term full-time Research Registrars (link to registrars). With the support of the Executive Sponsor, the supernumerary full-time position of Research Registrar was established permanently in 2007, removing the need to apply annually for funds and providing certainty that the clinical and academic content of DIP would be continuously reviewed, updated and expanded. 

Notably, in the year following their tenure, all Research Registrars were successful in their application for RANZCR approved training programmes, which led to their becoming a Fellow of RANZCR, with the exception of Daniel Wong who embarked on a career as a pathologist . The value to the public health sector of having fully qualified radiologists with significant insight, interest and experience in evidence-based clinical practice cannot be underestimated. 

With the agreement of Executive Sponsors (link), permanent staff in the Division of Imaging Services including the Business Manager, Information Technologist, particularly Robert Long and staff under his supervision (especially Frederick Valton), the Quality Coordinator, particularly Natalie Gray and Sue Alexander, Barbara Taylor and Harriet Wong, contributed significantly to the development of DIP and associated projects.

When funds became available for special projects, mainly from the HDWA through competitive application to advertised quality initiatives, Project Officers were recruited for fixed-term appointments and Contractors (link) were appointed. Neil Lynch in the HDWA was particularly helpful in providing non-partisan advice and guidance in application processes.

As the work became more complex, involving external organisations, accreditation by national and international entities, and funding for a range of projects, a governance structure evolved including a Steering Committee, Editorial Panel (link), Expert Panels and other ad hoc groups required for special projects, all of which ultimately reported to the Executive Sponsor.

Membership of the Editorial Panel (link) was honorary. It was multidisciplinary and consisted mainly of imaging consultants with subspecialty interests, medical and surgical specialists, and general practitioners, all participating voluntarily. Membership also included a consumer representative.

The Editor and members of the Editorial Panel ensured that Expert Panels (convened when pathways were created, or reviewed and advised) included and consulted with appropriate Clinical Advisors (link) (subspecialty imaging specialists, subspecialty referring specialists and general practitioners) by networking with local, national and international colleagues for expert advice from qualified personnel who were willing to participate voluntarily.