Investigating the satisfaction level of physicians in regards to implementing medical Picture Archiving and Communication System (PACS)

Intention to use picture archiving and communication system and its predictors among physicians and nurses at specialized teaching hospitals in Amhara region, Northwest Ethiopia

Background

Picture archiving and communication system is an innovation system in the health information that reduces costs, facilitates access to medical image, and improves workflow in radiology department. However, studies indicated that intention and usage of picture archiving and communication system is limited in middle-income and developing countries.

Objective

This study aimed to assess the intention to use picture archiving and communication system and its predictors among physicians and nurses at specialized teaching hospitals in Amhara region, Northwest Ethiopia.

Method

Institution-based cross-sectional study design was conducted from October 11 to November 12, 2023. Proportional allocation and a simple random sampling were used to select participants of the study. A self-administered structured English questionnaire was used, and a 5% pretest was performed. Data were entered into Epi data 4.6 and exported to SPSS 26 and AMOS 23. Descriptive and structural equation modeling analysis was performed. The hypothesis was tested using a path coefficient and a p-value <0.05.

Results

About 54.7% (95%: CI: 50.9-58.4) of the participant intended to use picture archive and communication system with a 90.38% of response rate. Performance expectancy (β = 0.146, p-value <0.05), perceived enjoyment (β = 0.397, p-value <0.001), and computer literacy (β = 0.191, p-value <0.001) had positive influence on intention to use picture archiving and communication system.

Conclusions

Overall, more than half of physicians' and nurses' intention to use picture archiving and communication system were at hopeful stage for future. Performance expectancy, perceived enjoyment and computer literacy had direct positive effect on intention to use picture archiving and communication system among physicians and nurses. The designers, developers, and managers of the picture archiving and communication system should consider these variables. Furthermore, using this system can improve quality of health service through change workflow in to digital image, clinicians evaluate image more quickly and saving resources.

Survey-based Evaluation of the Use of Picture Archiving and Communication Systems in an Eye Hospital-Ophthalmologists' Perspective

PURPOSE

Picture archiving and communication system (PACS) is a medical imaging system for sharing, storage, retrieval, and access of medical images stored. Our study aimed to identify ophthalmologists' views on PACS, with the comparison between 3 platforms, namely electronic patient record (ePR), HEYEX (Heidelberg Engineering, Switzerland), and FORUM (Zeiss, US), following their implementation in an eye hospital for common ophthalmic investigations [visual field, optical coherence tomography (OCT) of retinal nerve fiber layer and macula, and fluorescein/indocyanine green angiography (FA/ICG)].

METHODS

An online survey was distributed among ophthalmologists in a single center. Primary outcome included comparison of PACS with paper-based system. Secondary outcomes included pattern of use and comparison of different PACS platforms.

RESULTS

Survey response rate was 28/37 (75.7%). Images were most commonly accessed through ePR (median: 80% of time, interquartile range: 50 to 90%).All systems scored highly in information display items (median scores ≥7.5 out of 10) and in reducing patient identification error in investigation filing and retrieval during consultation compared to paper (score ≥7.0). However, ePR was inferior to paper in "facilitating comparison with previous results" in all investigation types (scores 3.0 to 4.5). ePR scored significantly higher in all system quality items than HEYEX ( P  < 0.001) and FORUM ( P  < 0.022), except login response time ( P  = 0.081). HEYEX scored significantly higher among vitreoretinaluveitis members (VRU) for information quality items for OCT macula and FA/ICG [VRU: 10.0 (8.0 to 10.0), non-VRU: 8.0 (6.75 to 9.25), P  = 0.042].

CONCLUSIONS

Overall feedback for PACS among ophthalmologists was positive, with limitations of inefficiency in use of information, for example, comparison with previous results. Subspecialty played an important role in evaluating PACS.

Determining the Effect of the Picture Archiving and Communication System (PACS) on Different Dimensions of Users' Work

The impact of the picture archiving and communication system (PACS) on healthcare costs, information access, image quality, and user workflow has been well studied. However, there is insufficient evidence on the effect of this system on different dimensions of the users' work. The objective of this study was to evaluate the impact of the PACS on different dimensions of users' work (external communication, service quality, user intention to use the PACS, daily routine, and complaints on users) and to compare the opinions of different groups of users about the PACS. This study was performed on the PACS users (n = 72) at Kerman University of Medical Sciences, including radiologists, radiology staff, ward heads, and physicians. Data were collected using a questionnaire consisting of two parts: demographic information of the participants and 5-point Likert scale questions concerning the five dimensions of users' work. Data were analyzed using descriptive statistics, ANOVA, and Pearson's correlation coefficient statistical tests. The mean of scores given by the PACS users was 4.31 ± 0.86 for external communication, 4.18 ± 0.96 for user intention to use the PACS, 3.91 ± 0.7 for service quality, 3.16 ± 0.56 for daily routine, and 3.08 ± 1.05 for complaints on users. Radiologists and radiology staff had a more positive opinion about the PACS than other clinicians such as physicians (P < 0.01, CI = 95%). Factors such as user age (P < 0.01, CI = 95%), job (P < 0.001, CI = 95%), work experience (P < 0.001, CI = 95%), and PACS training method (P=0.037, CI = 95%) were related to the impact of the PACS on different dimensions of users' work. This study showed that the PACS has a positive effect on different dimensions of users' work, especially on external communication, user intention to use the system, and service quality. It is recommended to implement PACSs in medical centers to support users' work and to maintain and strengthen the capabilities and functions of radiology departments.

Nurses' Acceptance of and Satisfaction With the Advanced Cardiac Life Support Electronic Information System in Emergency Departments and Critical Care Units

Emergency and critical care nurses perform an important role in documenting the resuscitation process. However, paper-based recording is labor intensive and complex and may result in incorrect recording of important parameters, which suggests the need for an appropriate electronic information system for emergency care. This cross-sectional descriptive study explores emergency and critical care nurses' acceptance of, and satisfaction with, the newly developed advanced cardiac life support electronic information system and examines whether paper-based recording and electronic recording approaches differ in the completeness of resuscitation records. Data were collected through a self-designed structured questionnaire and a retrospective review of medical records. Data were analyzed by descriptive statistics, independent sample t test, and one-way analysis of variance. The results indicated that novice nurses were more satisfied with the electronic information system than others. Emergency care nurses were significantly more satisfied than medical and surgical ICU nurses. The electronic information system improved the completeness of resuscitation recording by 23.5%, compared with the paper-based recording approach. Emergency and critical care nurses have a moderate to high degree of acceptance of, and satisfaction with, electronic information systems.

Clinicians' Perceptions of Picture Archiving and Communication System (PACS) Use in Patient Care in Eastern Province Hospitals in Saudi Arabia

Purpose

The picture archiving and communication system (PACS) is one of the most important tools used in patient care in many hospitals worldwide. It allows clinicians to remotely communicate and consult with other clinicians on patient cases and view diagnostic images from different angles, thus facilitating patient diagnosis and treatment. Several studies have been conducted in Saudi Arabia to evaluate different aspects of PACS use; however, no comprehensive study has been conducted in its Eastern Province. This study aimed to investigate clinicians’ perceptions of the advantages and disadvantages of the use of PACS in Eastern Province hospitals in Saudi Arabia and identify the factors that affect their perceptions and its use. In addition, it aimed to gather recommendations of clinicians for improving the system and its implementation.

Methods

A qualitative approach with grounded theory method was employed. A sample of 18 residents, radiologists, and consultants from three Eastern Province hospitals in Saudi Arabia participated in the study. Data were collected using semi-structured interviews over a period of 7 months.

Results

The perceived advantages of PACS included providing quality images and the ability to manipulate their resolution, whereas the perceived barriers included low-speed internet connections and technical problems. Participants recommended providing clinicians remote access to the system and implementing a mobile PACS application. The theory that emerged from the analysis revealed that demographic, system-related, and hospital-related factors affected participants’ perspectives of PACS and its use.

Conclusion

The results of this study and its theoretical model can help identify areas of improvement and inform policy and strategic planning for the effective implementation of PACS in patient care in Saudi Arabia.