Factors affecting the acceptance and meaningful use of picture archive and communication systems by referring clinicians in private practice

A Picture Archive and Communication System (PACS) is a health information technology that facilitates the electronic storage, transmission, presentation and processing of digital medical-imaging datasets. The benefits of PACS have been well-documented. It provides a means to replace traditional film-based workflows and their inherent limitations. Referring clinicians’ acceptance is a critical factor in the overall success of a PACS implementation; and given the financial implications of project failure, research into physician acceptance and meaningful use is crucial. Very few PACS acceptance studies have focused on the referring clinicians, and even less in the context of the private sector. Therefore, the problem that this research aims to address is: There is a lack of understanding on which factors influence PACS acceptance and the meaningful use thereof by referring clinicians in private practice. This explorative study follows an embedded mixed methodology approach in order to meet the research objectives, favouring a qualitative method of inquiry with the support of a quantitative strand. Electronic questionnaires were distributed to private practice referring clinicians to probe the aspects related to PACS acceptance and its meaningful use. The conceptual framework, as devised by Paré and Trudel (2007), was used as a theoretical lens to categorize and discuss the research results in terms of Project, Technological, Organizational and Behavioural factors that affect PACS acceptance and its meaningful use. The findings showed good acceptance rates, which is in line with other research conducted in this field, including research done in the public sector. Technical and Organizational factors were the most prevalent. An extension of the above-mentioned theoretical framework was proposed to assist in maintaining positive results after the project Implementation phase has been completed. This research expands the Information Technology PACS body of knowledge – by identifying both the technical and the non-technical factors that are crucial in private practice referring doctor acceptance and meaningful use. By addressing these factors, institutions can improve the likelihood of PACS project success in private practice settings. Maximising referring doctor acceptance and meaningful use could also give private practices a competitive advantage over their competitors

A Filmless Radiology Department in a Full Digital Regional Hospital: Quantitative Evaluation of the Increased Quality and Efficiency

Reggio Emilia hospital installed Picture Archiving and Communications Systems (PACS) as the final step towards a completely digital clinical environment completing the HIS/EMR and 1,400 web/terminals for patient information access. Financial benefits throughout the hospital were assessed upfront and measured periodically. Key indicators (radiology exam turnaround time, number of radiology procedures performed, inpatients length of stay before and after the PACS implementation, etc.) were analyzed and values were statistically tested to assess workflow and productivity improvements. The hospital went “filmless” in 28 weeks. Between the half of 2004 and the respective period in 2003, overall Radiology Department productivity increased by 12%, TAT improved by more than 60%. Timelier patient care resulted in decreased lengths of stay. Neurology alone experienced a 12% improvement in average patient stay. To quantify the impact of PACS on the average hospital stays and the expected productivity benefits to inpatient productivity were used a “high level” and a “detailed” business model. Annual financial upsides have exceeded $1.9 millions/year. A well-planned PACS deployment simplifies imaging workflow and improves patient care throughout the hospital while delivering substantial financial benefits. Staff buy-in was the key in this process and on-going training and process monitoring are a must

The organizational implications of medical imaging in the context of Malaysian hospitals

This research investigated the implementation and use of medical imaging in the context of Malaysian hospitals. In this report medical imaging refers to PACS, RIS/HIS and imaging modalities which are linked through a computer network. The study examined how the internal context of a hospital and its external context together influenced the implementation of medical imaging, and how this in turn shaped organizational roles and relationships within the hospital itself. It further investigated how the implementation of the technology in one hospital affected its implementation in another hospital. The research used systems theory as the theoretical framework for the study. Methodologically, the study used a case-based approach and multiple methods to obtain data. The case studies included two hospital-based radiology departments in Malaysia. The outcomes of the research suggest that the implementation of medical imaging in community hospitals is shaped by the external context particularly the role played by the Ministry of Health. Furthermore, influences from both the internal and external contexts have a substantial impact on the process of implementing medical imaging and the extent of the benefits that the organization can gain. In the context of roles and social relationships, the findings revealed that the routine use of medical imaging has substantially affected radiographers’ roles, and the social relationships between non clinical personnel and clinicians. This study found no change in the relationship between radiographers and radiologists. Finally, the approaches to implementation taken in the hospitals studied were found to influence those taken by other hospitals. Overall, this study makes three important contributions. Firstly, it extends Barley’s (1986, 1990) research by explicitly demonstrating that the organization’s internal and external contexts together shape the implementation and use of technology, that the processes of implementing and using technology impact upon roles, relationships and networks and that a role-based approach alone is inadequate to examine the outcomes of deploying an advanced technology. Secondly, this study contends that scalability of technology in the context of developing countries is not necessarily linear. Finally, this study offers practical contributions that can benefit healthcare organizations in Malaysia

Information Technologies for the Healthcare Delivery System

That modern healthcare requires information technology to be efficient and fully effective is evident if one spends any time observing the delivery of institutional health care. Consider the observation of a practitioner of the discipline, David M. Eddy, MD, PhD, voiced in Clinical Decision Making, JAMA 263:1265-75, 1990, . . .All confirm what would be expected from common sense: The complexity of modern medicine exceeds the inherent limitations of the unaided human mind. The goal of this thesis is to identify the technological factors that are required to enable a fully sufficient application of information technology (IT) to the modern institutional practice of medicine. Perhaps the epitome of healthcare IT is the fully integrated, fully electronic patient medical record. Although, in 1991 the Institute of Medicine called for such a record to be standard technology by 2001, it has still not materialized. The author will argue that some of the technology and standards that are pre-requisite for this achievement have now arrived, while others are still evolving to fully sufficient levels. The paper will concentrate primarily on the health care system in the United States, although much of what is contained is applicable to a large degree, around the world. The paper will illustrate certain of these pre-requisite IT factors by discussing the actual installation of a major health care computer system at the University of Rochester Medical Center (URMC) in Rochester, New York. This system is a Picture Archiving and Communications System (PACS). As the name implies, PACS is a system of capturing health care images in digital format, storing them and communicating them to users throughout the enterprise

Factors affecting the acceptance and meaningful use of picture archive and communication systems by referring clinicians in private practice

A Picture Archive and Communication System (PACS) is a health information technology that facilitates the electronic storage, transmission, presentation and processing of digital medical-imaging datasets. The benefits of PACS have been well-documented. It provides a means to replace traditional film-based workflows and their inherent limitations. Referring clinicians’ acceptance is a critical factor in the overall success of a PACS implementation; and given the financial implications of project failure, research into physician acceptance and meaningful use is crucial. Very few PACS acceptance studies have focused on the referring clinicians, and even less in the context of the private sector. Therefore, the problem that this research aims to address is: There is a lack of understanding on which factors influence PACS acceptance and the meaningful use thereof by referring clinicians in private practice. This explorative study follows an embedded mixed methodology approach in order to meet the research objectives, favouring a qualitative method of inquiry with the support of a quantitative strand. Electronic questionnaires were distributed to private practice referring clinicians to probe the aspects related to PACS acceptance and its meaningful use. The conceptual framework, as devised by Paré and Trudel (2007), was used as a theoretical lens to categorize and discuss the research results in terms of Project, Technological, Organizational and Behavioural factors that affect PACS acceptance and its meaningful use. The findings showed good acceptance rates, which is in line with other research conducted in this field, including research done in the public sector. Technical and Organizational factors were the most prevalent. An extension of the above-mentioned theoretical framework was proposed to assist in maintaining positive results after the project Implementation phase has been completed. This research expands the Information Technology PACS body of knowledge – by identifying both the technical and the non-technical factors that are crucial in private practice referring doctor acceptance and meaningful use. By addressing these factors, institutions can improve the likelihood of PACS project success in private practice settings. Maximising referring doctor acceptance and meaningful use could also give private practices a competitive advantage over their competitors

Managing technological change in a military treatment facility: a case study of medical diagnostic imaging support (MDIS) system

Picture archiving and communication system (PACS) represents an enormously expensive technological innovation in digital imaging which has the potential to alter the way in which radiology is practiced. The purpose of this thesis is to provide a better understanding of the requirements for PACS technology and the implementation of information systems in medical facilities. The objective of PACS technology is to improve access to radiographic images and reports throughout medical facilities while decreasing the cost of image production and storage. Medical Diagnostic Imaging Support (MDIS) system is the military tri-service project to install PACS in selected U.S. military medical treatment facilities (MTF) in an attempt to create a totally filmless environment. This thesis includes a case study of the implementation of the MDIS system at Madigan Army Medical Center and the change management issues that surround the introduction of an information system in a health care organization. The issues brought forth in this study are derived from two change models in the implementation of information systems.http://archive.org/details/managingtechnolo1094542869U.S. Navy (USN) authorApproved for public release; distribution is unlimited

New technology in radiological diagnosis: An investigation of diagnostic image quality in digital displays of radiographs

Digital radiology is undergoing rapid evolution. Its objectives can be summarized as the creation within the modern radiology department - and indeed within the entire hospital - of a harmonious, integrated, electronic network capable of handling all diagnostic radiological images, obviating the need for conventional film-based radiology. One of the limiting factors in the introduction and exploitation of digital technology is the issue of image display quality: if electronic display systems are to be widely used for primary radiological diagnosis, it is essential that the diagnostic quality of the displayed images should not be compromised. From the perspective of the practising radiologist, this study examines the performance of the first two commercially available digital radiological display systems to be purchased and installed in a British hospital. This work incorporates an extensive observer performance investigation of image quality from existing 1024- and 1280-line display systems, and suggests that displayed images digitized at a pixel size of 210?m show a significant reduction in diagnostic performance when compared with original film. Such systems appear to be unsuitable for primary radiological diagnosis of subtle lesions. Some of the physical properties of such systems, some relevant methodological issues, and the relationship between image quality and other factors influencing the development acceptance and implementation of digital technology, have also been investigated; the results are presented. This is a controversial subject, and conflicting views have been expressed in the British literature concerning the issue of whether or not the technology is now ready for total system implementation; the view of this author is that careful testing of display systems, and of every other component of digital networks, should precede their entry into clinical use

Curriculum guide to teach computed radiography at El Camino College

The purpose of the project was to design a curriculum guideline for educators to teach computed radiography. This project can be used as a stand-alone course, or integrated into existing radiologic technology courses