Monitoring the PACS Implementation Process in a Large University Hospital—Discrepancies Between Radiologists and Physicians

Abstract

Successfully introducing a new technology in a healthcare setting is not a walk in the park. Many barriers need to be overcome, not only technical and financial but also human barriers. In this study, we focus on the human barriers to health-care information systems' implementation. We monitored the acceptance of a Picture Archiving and Communication System (PACS) by radiologists and hospital physicians in a large Belgian university hospital. Hereto, questionnaires were taken pre-implementation (T1) and 1 year after the radiology department stopped printing film (T2). The framework we used to perform the study was the Unified Theory of Acceptance and Use of Technology. Main findings were that both groups were positive toward PACS prior to the introduction and that each group was even more positive at T2 with extensive PACS experience. In general, the ratings of the radiologists were higher than those of the physicians, as the radiologists experienced more of the benefits of PACS and had to use PACS throughout the day. Two factors were salient for predicting users' intention to use PACS: the usefulness of PACS (performance expectancy) and the availability of support of any kind (facilitating conditions). The results show that our approach was successful. Both radiologists and physicians give evidence of an excellent level of user acceptance. We can conclude that the implementation of PACS into our hospital has succeeded.

Do hospital physicians’ attitudes change during PACS implementation? A cross-sectional acceptance study

“…In PACS, medical images are collected from the imaging modalities, stored with their corresponding reports, and distributed to the referring physicians. Unlike many other clinical information systems, PACS can be considered a success story [11]; its benefits are considerable [12] and tangible on different levels, going from patients to management [13]. Yet, between the moment when the implementation is considered, and implementation success, there are four threats for a PACS-implementation project [14]:…”

“…Eleven relevant studies are retrieved and from these studies we learn that just as in business settings CIS-acceptance [13, 23-nor importance [13,23,26]. Although physicians have a large degree of professional autonomy and are considered to independently make technology acceptance decisions, some studies have found that social influence is positively associated with CIS-acceptance [13,26,31], whereas other studies found no effect of social influence [28][29][30].…”

“…Although physicians have a large degree of professional autonomy and are considered to independently make technology acceptance decisions, some studies have found that social influence is positively associated with CIS-acceptance [13,26,31], whereas other studies found no effect of social influence [28][29][30]. Constructs relating to 7 facilitating conditions were also important predictors of CIS-acceptance, either directly [13,[26][27][28][29][30] or indirectly through perceived usefulness [24,[28][29][30] or perceived ease of use [25].…”

“…-only very few PACS acceptance studies have been conducted: we identified four studies reporting on PACS acceptance in two university hospitals situated in Canada [32] and Belgium [13,26,27]. This limited body of research contrasts with the widespread use of the system; -the most frequent format in the literature is a one-shot approach, in which CISacceptance is typically assessed on only one moment in time.…”

The Acceptance Level of Picture Archiving and Communication System amongst Radiographers

“…Kebanyakan pengkaji bersetuju terdapat banyak faktor yang mempengaruhi kejayaan sistem PACS dalam sesebuah organisasi (Duyck et al, 2010;Hama, 2002;Seyed Jamaledin et al, 2011;Top, 2012). Faktor tersebut termasuk pengurusan dan pengstrukturan sistem, teknikal dan kelakuan terhadap PACS.…”