Journal:Users’ perspectives on a picture archiving and communication system (PACS): An in-depth study in a teaching hospital in Kuwait

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Full article title Users’ perspectives on a picture archiving and communication system (PACS): An in-depth study in a teaching hospital in Kuwait
Journal JMIR Medical Informatics
Author(s) Buabbas, Ali Jassem; Al-Shamali, Dawood Ameer; Sharma, Prem; Haidar, Salwa; Al-Shawaf, Hamza
Author affiliation(s) Kuwait University, Mubarak AlKabeer Hospital
Primary contact Email: ali.buabbas [at] hsc.edu.kw; Phone: 965 25319504
Editors Eysenbach, G.
Year published 2016
Volume and issue 4 (2)
Page(s) e21
DOI 10.2196/medinform.5703
ISSN 2291-9694
Distribution license Creative Commons Attribution 2.0
Website http://medinform.jmir.org/2016/2/e21/
Download http://medinform.jmir.org/2016/2/e21/pdf (PDF)
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Abstract

Background: The picture archiving and communication system (PACS) is a well-known imaging informatics application in health care organizations, specifically designed for the radiology department. Health care providers have exhibited willingness toward evaluating PACS in hospitals to ascertain the critical success and failure of the technology, considering that evaluation is a basic requirement.

Objective: This study aimed to evaluate the success of a PACS in a regional teaching hospital of Kuwait, from users’ perspectives, using information systems success criteria.

Methods: An in-depth study was conducted by using quantitative and qualitative methods. This mixed-method study was based on: (1) questionnaires, distributed to all radiologists and technologists and (2) interviews, conducted with PACS administrators.

Results: In all, 60 questionnaires were received from the respondents. These included 39 radiologists (75% response rate) and 21 technologists (62% response rate), with the results showing almost three-quarters (74%, 44 of 59) of the respondents rating PACS positively and as user-friendly. This study’s findings revealed that the demographic data, including computer experience, was an insignificant factor, having no influence on the users’ responses. The findings were further substantiated by the administrators’ interview responses, which supported the benefits of PACS, indicating the need for developing a unified policy aimed at streamlining and improving the departmental workflow.

Conclusions: The PACS had a positive and productive impact on the radiologists’ and technologists’ work performance. They were endeavoring to resolve current problems while keeping abreast of advances in PACS technology, including teleradiology and the mobile image viewer, which is steadily increasing in usage in the Kuwaiti health system.

Keywords: PACS evaluation, user perspective, IS success, imaging informatics, radiology

Introduction

The picture archiving and communication system (PACS) is a well-known imaging informatics application in health care organizations, specifically designed for the radiology department. A PACS could be defined as “an electronic information system (IS) used to acquire, store, transmit, and display medical images.”[1] Using a PACS in a hospital has innumerable benefits at various levels.[2] At the management level, this technology has direct implications for cost reduction, rendering the film production process redundant. At the departmental level, the technology enhances productivity, as all tasks are performed digitally and swiftly. And at the clinical level, image interpretation and diagnosis become more precise and accurate.[3] For these reasons, health care organizations are increasingly adopting the PACS in their clinical radiology departments, despite the high costs, to benefit from the full advantages of using the technology. PACSs are currently being applied in many medical imaging projects around the world, such as in the United States, the United Kingdom, and Asia. However, the available literature reveals gaps with regard to the systems’ effectiveness and efficiency concerning their intended use.

The existing literature abounds with studies evaluating the PACS.[4] However, these evaluations invariably had different focuses and objectives; for instance, there are studies on the PACS before and after the system’s implementation[5], users’ satisfaction[6], PACS acceptance[7], cost-effectiveness[8], and the system’s efficiency concerning its use and in saving time.[9] The most widely used form of the PACS evaluation concerns its impact on users.[4][10][11]

References

  1. ↑ Tzeng, W.S.; Kuo, K.M.; Lin, H.W.; Chen, T.Y. (2013). "A socio-technical assessment of the success of Picture Archiving and Communication Systems: The radiology technologist's perspective". BMC Medical Informatics and Decision Making 13: 109. doi:10.1186/1472-6947-13-109. PMC PMC3849362. PMID 24053458. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3849362. 
  2. ↑ Vest, J.R.; Jung, H.Y.; Ostrovsky, A. et al. (2015). "Image Sharing Technologies and Reduction of Imaging Utilization: A Systematic Review and Meta-analysis". Journal of the American College of Radiology 12 (12 Pt B): 1371-1379.e3. doi:10.1016/j.jacr.2015.09.014. PMC PMC4730956. PMID 26614882. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730956. 
  3. ↑ Duyck, P.; Pynoo, B.; Devolder, P. et al. (2010). "Monitoring the PACS implementation process in a large university hospital: Discrepancies between radiologists and physicians". Journal of Digital Imaging 23 (1): 73–80. doi:10.1007/s10278-008-9163-7. PMC PMC3043749. PMID 18956231. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043749. 
  4. ↑ 4.0 4.1 Hains, I.M.; Georgiou, A.; Westbrook, J.I. (2012). "The impact of PACS on clinician work practices in the intensive care unit: a systematic review of the literature". JAMIA 19 (4): 506–13. doi:10.1136/amiajnl-2011-000422. PMC PMC3384105. PMID 22323392. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384105. 
  5. ↑ Bryan, S.; Weatherburn, G.C.; Watkins, J.R.; Buxton, M.J. (1999). "The benefits of hospital-wide picture archiving and communication systems: A survey of clinical users of radiology services". The British Journal of Radiology 72 (857): 469-78. doi:10.1259/bjr.72.857.10505012. PMID 10505012. 
  6. ↑ Tan, S.L.; Lewis, R.A. (2010). "Picture archiving and communication systems: A multicentre survey of users experience and satisfaction". European Journal of Radiology 75 (3): 406–10. doi:10.1016/j.ejrad.2009.05.008. PMID 19523778. 
  7. ↑ Aldosari, B. (2012). "User acceptance of a picture archiving and communication system (PACS) in a Saudi Arabian hospital radiology department". BMC Medical Informatics and Decision Making 12: 44. doi:10.1186/1472-6947-12-44. PMC PMC3423046. PMID 22640490. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3423046. 
  8. ↑ Bryan, S.; Weatherburn, G.; Buxton, M. et al. (1999). "Evaluation of a hospital picture archiving and communication system". Journal of Health Services Research and Policy 4 (4): 204-9. doi:10.1177/135581969900400405. PMID 10623035. 
  9. ↑ Mackinnon, A.D.; Billington, R.A.; Adam, E.J. et al. (2008). "Picture archiving and communication systems lead to sustained improvements in reporting times and productivity: Results of a 5-year audit". Clinical Radiology 63 (7): 796-804. doi:10.1016/j.crad.2007.12.015. PMID 18555038. 
  10. ↑ van de Wetering, R.; Batenburg, R.; Versendaal, J. et al. (2006). "A balanced evaluation perspective: Picture archiving and communication system impacts on hospital workflow". Journal of Digital Imaging 19 (Suppl 1): 10. doi:10.1007/s10278-006-0628-2. PMC PMC3045172. PMID 16763932. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3045172. 
  11. ↑ Creswick, N.; Hains, I.M.; Westbrook, J.I. (2011). "Innovation in intensive care nursing work practices with PACS". Studies in Health Technology and Informatics 169: 402–6. doi:10.3233/978-1-60750-806-9-402. PMID 21893781. 

Abbreviations

CAD: computer-assisted diagnosis

HIS: health information system

ID: identification

IS: information system

PACS: picture archiving and communication System

RIS: radiology information system

Notes

This presentation is faithful to the original, with only a few minor changes to presentation. In several cases the PubMed ID was missing and was added to make the reference more useful.

Per the distribution agreement, the following copyright information is also being added:

©Ali Jassem Buabbas, Dawood Ameer Al-Shamali, Prem Sharma, Salwa Haidar, Hamza Al-Shawaf. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 15.06.2016.

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