Referring physician perceptions of picture archive and communication systems

The picture archive and communication system (PACS) is a digital radiographic system that is steadily replacing the older film-based radiographic records. Despite the various benefits associated with PACS implementation, it is not yet clear what referring physicians think of such systems. This article reviews their thoughts and perceptions, which were obtained via surveys that were completed by referring physicians with practices at private hospitals in Port Elizabeth. A critical analysis of the data collected indicated that most referring physicians perceive PACS to be beneficial.

Implementation of Filmless Hospital

A PACS has tremendous benefits (Bryan, Weatherburn, Watkins, Buxton, 1999) and values outside of radiology as well as internally. The biggest benefit derived from a PACS is breaking the physical as well as time barrier for information exchange. The other benefit from PACS implementation is not the decreased operating cost in Radiology. The radiology cost benefit, while significant, does not compare with the system wide benefits of networking images throughout the hospital and physician offices. All PACS implementations should start with a business plan. This is the summation of many small plans and also summarizes the global goal. The plan should be segmented into smaller separate plans for cost justification, risk assessment, capacity planning, and the last consisting of an implementation plan.

PACS Contribution to Hospital Strategy via Improved Workflow

This chapter investigates the adequacy of BSC for a holistic evaluation of the workflow impacts of a PACS implementation. It asks whether a theoretical model such as BSC adequately captures the reality of how such technology is used. The approach taken is radical in that it is built on a consideration of the fundamentals of hospital strategy. The BSC is then modified to incorporate qualitative themes rather than performance measures to reflect the fundamentally qualitative nature of the clinical values of hospital strategy. In so doing, this chapter develops a framework that is relevant to a hospital’s not-for-profit and clinical strategies.

A Theoretical Model of Observed Health Benefits of PACS Implementation

Picture Archiving and Communication Systems (PACS) is an important e-health application, playing a significant operational role within hospitals in electronically transmitting image-based data. Various authors have attributed a range of benefits to PACS, including diagnostic accuracy (Scott et al., 1995; Slasky et al., 1990), interpretation time savings (Kato et al., 1995), workflow (Gale, Gale, Schwartz, Muse & Walker, 2000) and user satisfaction (Philling, 1999). While there is general consensus that PACS brings some or all of these benefits, there is little agreement as to the mechanism through which these benefits are generated. The work of Delone and McLean (2003) provides a generalized model that attributes information systems success to benefits accruing from relationships between characteristics of the information system (e.g., information quality, system quality, service quality) and user intention to use and user satisfaction (see Figure 1). This chapter provides empirical evidence that the Delone and McLean (2003) model with modifications explains the source of PACS benefits. Not only do we suggest a new model, but we also recommend that each specific information system context may require specific modification of Delone and McLean’s (2003) model to explain the source of success.