Skip to main content

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

Abstract

Successfully introducing a new technology in a health-care 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.

This is a preview of subscription content, access via your institution.

Fig 1.
Fig 2.
Fig 3.

References

  1. Lapointe L, Rivard S: A multilevel model of resistance to information technology implementation. MIS Quarterly 29(3):461–491, 2005

    Google Scholar 

  2. Berg M: Implementing information systems in health care organizations: myths and challenges. Int J Med Inform 64(2–3):143–156, 2001

    Article  CAS  PubMed  Google Scholar 

  3. Pare G, Trudel MC: Knowledge barriers to PACS adoption and implementation in hospitals. Int J Med Inform 76(1):22–33, 2007

    Article  PubMed  Google Scholar 

  4. Kohli R, Kettinger WJ: Informating the clan: controlling physicians’ costs and outcomes. MIS Quarterly 28(3):363–394, 2004

    Google Scholar 

  5. van de Wetering RV, Batenburg R, Versendaal J, Lederman R, Firth L: A balanced evaluation perspective: picture archiving and communication system impacts on hospital workflow. J Digit Imaging 19:10–17, 2006

    Article  PubMed  Google Scholar 

  6. Reddy AS, Loh S, Kane RA: Budget variance analysis of a departmentwide implementation of a PACS at a major academic medical center. J Digit Imaging 19:66–71, 2006

    Article  PubMed  Google Scholar 

  7. Hayt DB, Alexander S: The pros and cons of implementing PACS and speech recognition systems. J Digit Imaging 14(3):149–157, 2001

    Article  CAS  PubMed  Google Scholar 

  8. Lepanto L, Pare G, Aubry D, Robillard P, Lesage J: Impact of PACS on dictation turnaround time and productivity. J Digit Imaging 19(1):92–97, 2006

    Article  PubMed  Google Scholar 

  9. Bryan S, Weatherburn GC, Watkins JR, Buxton MJ: The benefits of hospital-wide picture archiving and communication systems: a survey of clinical users of radiology services. Br J Radiol 72(857):469–478, 1999

    CAS  PubMed  Google Scholar 

  10. Nitrosi A, Borasi G, Nicoli F, Modigliani G, Botti A, Bertolini M, et al: A filmless radiology department in a full digital regional hospital: quantitative evaluation of the increased quality and efficiency. J Digit Imaging 20(2):140–148, 2007

    Article  PubMed  Google Scholar 

  11. Bauman RA, Gell G: The reality of picture archiving and communication systems (PACS): a survey. J Digit Imaging 13(4):157–169, 2000

    Article  CAS  PubMed  Google Scholar 

  12. Johnson KC, Dye JA: Ten steps to improve your chances for success with PACS. Radiol Manage 17(3):32–33, 1995

    CAS  PubMed  Google Scholar 

  13. Law MYY, Zhou Z: New direction in PACS education and training. Comput Med Imaging Graph 27(2–3):147–56, 2003

    Article  PubMed  Google Scholar 

  14. Devolder P, Pynoo B, Voet T, Adang L, Vercruysse J, Duyck P: Optimizing physicians’ instruction of PACS through E-learning: cognitive load theory applied. J Digit Imaging, in press doi:10.1007/s10278-007-9089-5

  15. Pilling J: Problems facing the radiologist tendering for a hospital wide PACS system. Eur J Radiol 32(2):101–105, 1999

    Article  CAS  PubMed  Google Scholar 

  16. Pare G, Lepanto L, Aubry D, Sicotte C: Toward a multidimensional assessment of picture archiving and communication system success. Int J Technol Assess Health Care 21(4):471–479, 2005

    Article  PubMed  Google Scholar 

  17. Davis FD, Bagozzi RP, Warshaw PR: User acceptance of computer-technology—a comparison of 2 theoretical-models. Manage Sci 35(8):982–1003, 1989

    Article  Google Scholar 

  18. Venkatesh V, Morris MG, Davis GB, Davis FD: User acceptance of information technology: toward a unified view. MIS Quarterly 27(3):425–478, 2003

    Google Scholar 

  19. Duyck P, Pynoo B, Devolder P, Adang L, Vercruysse J, Voet T: Do hospital physicians really want to go digital? Acceptance of a picture archiving and communication system in a university hospital. Rofo 180(7):631–638, 2008

    CAS  PubMed  Google Scholar 

  20. Duyck P, Pynoo B, Devolder P, Voet T, Adang L, Vercruysse J: User acceptance of a picture archiving and communication system—applying the unified theory of acceptance and use of technology in a radiological setting. Methods Inf Med 47(2):149–156, 2008

    CAS  PubMed  Google Scholar 

  21. Moore GC, Benbasat I: Development of an instrument to measure the perceptions of adopting an information technology innovation. Inf Syst Res 2(3):192–222, 1991

    Article  Google Scholar 

  22. Chau PYK, Hu PJH: Investigating healthcare professionals’ decisions to accept telemedicine technology. An empirical test of competing theories. Inf Manage 39(4):297–311, 2002

    Article  Google Scholar 

  23. Chismar WG, Wiley-Patton S: Does the extended technology acceptance model apply to physicians. Proceedings of the 36th Hawaii International Conference on System Sciences (HICSS). 2003; p. 160a

  24. Hu PJH, Chau PYK, Sheng ORL, Tam KY: Examining the technology acceptance model using physician acceptance of telemedicine technology. J Manage Inf Syst 16(2):91–112, 1999

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bram Pynoo.

Additional information

Primary authors: Prof. Philippe Duyck and Bram Pynoo contributed equally to this article.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Duyck, P., Pynoo, B., Devolder, P. et al. Monitoring the PACS Implementation Process in a Large University Hospital—Discrepancies Between Radiologists and Physicians. J Digit Imaging 23, 73–80 (2010). https://doi.org/10.1007/s10278-008-9163-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10278-008-9163-7

Key words

  • PACS
  • acceptance testing
  • computers in medicine
  • radiology workflow
  • UTAUT
  • attitude
  • university hospital