Challenges of Implementing Picture Archiving and Communication System in Multiple Hospitals: Perspectives of Involved Staff and Users

Khajouei, Reza; Jahromi, Maryam Eslami; Ameri, Arefeh

doi:10.1007/s10916-019-1319-0

Cited by 12 publications

(21 citation statements)

References 50 publications

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“…This was echoed by reported outcome on the implementation of a DICOM-compatible workflow in an ophthalmology clinic, which showed ≥50% reduction in need to enter or edit patient information into the testing device, and reduced need to manage misfiled images by 76% in a survey among technicians 14 . Limitations identified in our study involving technical aspects, such as unsatisfactory login time, were similar to those reported in radiology, for example, low speed of network 18 . Same as physicians, 5 training was a challenge in our hospital, with nearly half of the respondents reporting a lack of time to seek technical support.…”

Section: Discussionsupporting

confidence: 63%

“…14 Limitations identified in our study involving technical aspects, such as unsatisfactory login time, were similar to those reported in radiology, for example, low speed of network. 18 Same as physicians, 5 training was a challenge in our hospital, with nearly half of the respondents reporting a lack of time to seek technical support. On the other hand, certain limitations of PACS identified in our study were not shared among radiologists or physicians.…”

Section: Discussionmentioning

confidence: 99%

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Survey-based Evaluation of the Use of Picture Archiving and Communication Systems in an Eye Hospital—Ophthalmologists' Perspective

Lam

Lok

Lin

et al. 2022

Asia-Pacific Journal of Ophthalmology

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Purpose: Picture archiving and communication system (PACS) is a medical imaging system for sharing, storage, retrieval, and access of medical images stored. Our study aimed to identify ophthalmologists' views on PACS, with the comparison between 3 platforms, namely electronic patient record (ePR), HEYEX (Heidelberg Engineering, Switzerland), and FORUM (Zeiss, US), following their implementation in an eye hospital for common ophthalmic investigations [visual field, optical coherence tomography (OCT) of retinal nerve fiber layer and macula, and fluorescein/indocyanine green angiography (FA/ICG)]. Methods: An online survey was distributed among ophthalmologists in a single center. Primary outcome included comparison of PACS with paper-based system. Secondary outcomes included pattern of use and comparison of different PACS platforms. Results: Survey response rate was 28/37 (75.7%). Images were most commonly accessed through ePR (median: 80% of time, interquartile range: 50 to 90%). All systems scored highly in information display items (median scores !7.5 out of 10) and in reducing patient identification error in investigation filing and retrieval during consultation compared to paper (score !7.0). However, ePR was inferior to paper in "facilitating comparison with previous results" in all investigation types (scores 3.0 to 4.5). ePR scored significantly higher in all system quality items than HEYEX (P < 0.001) and FORUM (P < 0.022), except login response time (P ¼ 0.081). HEYEX scored significantly higher among vitreoretinaluveitis members (VRU) for information quality items for OCT macula and FA/ICG [VRU

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Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Survey-based Evaluation of the Use of Picture Archiving and Communication Systems in an Eye Hospital—Ophthalmologists' Perspective

Lam

Lok

Lin

et al. 2022

Asia-Pacific Journal of Ophthalmology

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“…The systems being studied in the present research have different capabilities including, measurement of lesions, ability to measure Hounsfield units, ability to make visual changes such as brightness, contrast, images resolution, and zooming in and out, viewing images in different slices, archiving images on database or CD, communicating images with workstations at the centers and ability to retrieve images on workstations. There are also studies concerning the challenges and issues in implementing PACS [ 28 , 29 ], factors affecting its use, successes and failures of this system [ 16 , 30 , 31 ], evaluation of usability [ 32 , 33 ] and investigating the impact of its implementation [ 11 ]. However, according to our knowledge, no study has been conducted in Iran to assess physician satisfaction with PACS.…”

Section: Introductionmentioning

confidence: 99%

Investigating the satisfaction level of physicians in regards to implementing medical Picture Archiving and Communication System (PACS)

Abbasi

Jabali

Khajouei

et al. 2020

BMC Med Inform Decis Mak

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Background: User satisfaction with PACS is considered as one of the important criteria for assessing success in using PACS. The objective of this study was to determine the level of user satisfaction with PACS and to compare its functional features with traditional film-based systems. Methods: This study was conducted in 2017. Residents at three large university hospitals in Kerman filled-out a selfadministered questionnaire consisting of three parts: demographic information of participants, user satisfaction with PACS, comparing features of the two digital and traditional imaging systems. The validity of this questionnaire was approved by five medical informatics, radiology, and health information management specialists and its reliability was confirmed by Cronbach's alpha (86%). Data were analyzed using descriptive statistics and the Spearman, Mann Whitney U and Kruskal-Wallis statistical tests. Results: The mean of the participants' ages was 31.4 (±4.4) years and 59% of the participants were females. The mean of physicians' satisfaction with PACS' had no significant relationship with their age (P = 0.611), experience of using PACS (P = 0.301), specialty (P = 0.093), and percent of interpretation of images with PACS (P = 0.762). It had a significant relationship with the participants' computer skills (P = 0.022). Conclusions: The mean of physicians' satisfaction with PACS was at a moderate to a high level, yet there are still problems in the successful implementation of these systems and establishing interoperability between them. PACS has not fully met all the demands of physicians and has not achieved its predetermined objectives, such as allaccess from different locations.

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“…There are some non-technical issues to address as well. Deployment of PACS requires considerable financial resources that must be allocated for the hardware and software, as well as for support and training [ 19 ]. Systems are not flexible and force staff to adapt to the system requirements [ 20 ] or to develop in-house solutions [ 21 ].…”

Section: Introductionmentioning

confidence: 99%

Design and Implementation of a Cloud PACS Architecture

Kawa

Pyciński

Smoliński³

et al. 2022

Sensors

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The limitations of the classic PACS (picture archiving and communication system), such as the backward-compatible DICOM network architecture and poor security and maintenance, are well-known. They are challenged by various existing solutions employing cloud-related patterns and services. However, a full-scale cloud-native PACS has not yet been demonstrated. The paper introduces a vendor-neutral cloud PACS architecture. It is divided into two main components: a cloud platform and an access device. The cloud platform is responsible for nearline (long-term) image archive, data flow, and backend management. It operates in multi-tenant mode. The access device is responsible for the local DICOM (Digital Imaging and Communications in Medicine) interface and serves as a gateway to cloud services. The cloud PACS was first implemented in an Amazon Web Services environment. It employs a number of general-purpose services designed or adapted for a cloud environment, including Kafka, OpenSearch, and Memcached. Custom services, such as a central PACS node, queue manager, or flow worker, also developed as cloud microservices, bring DICOM support, external integration, and a management layer. The PACS was verified using image traffic from, among others, computed tomography (CT), magnetic resonance (MR), and computed radiography (CR) modalities. During the test, the system was reliably storing and accessing image data. In following tests, scaling behavior differences between the monolithic Dcm4chee server and the proposed solution are shown. The growing number of parallel connections did not influence the monolithic server’s overall throughput, whereas the performance of cloud PACS noticeably increased. In the final test, different retrieval patterns were evaluated to assess performance under different scenarios. The current production environment stores over 450 TB of image data and handles over 4000 DICOM nodes.

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Challenges of Implementing Picture Archiving and Communication System in Multiple Hospitals: Perspectives of Involved Staff and Users

Cited by 12 publications

References 50 publications

Survey-based Evaluation of the Use of Picture Archiving and Communication Systems in an Eye Hospital—Ophthalmologists' Perspective

Survey-based Evaluation of the Use of Picture Archiving and Communication Systems in an Eye Hospital—Ophthalmologists' Perspective

Investigating the satisfaction level of physicians in regards to implementing medical Picture Archiving and Communication System (PACS)

Design and Implementation of a Cloud PACS Architecture

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