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
