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Challenges of Implementing Picture Archiving and Communication System in Multiple Hospitals: Perspectives of Involved Staff and Users

  • Systems-Level Quality Improvement
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Abstract

Today, despite the advantages of the PACS system, its implementation in some healthcare organizations faces many challenges. One of the important factors in the successful implementation of a PACS system is identifying and prioritizing the challenges from the perspectives of involved staff and user of this system. Therefore, the aim of this study was to determine and compare the challenges of implementing PACS from perspectives these users in educational hospitals. This study was conducted on all IT and medical equipment staff, and radiology residents (n = 140) in Kerman University of Medical Sciences (KUMS) and Shiraz University of Medical Sciences (SUMS) in 2016. The data were collected through two researcher-made questionnaires. Their validity was approved by radiologists, IT staff, and medical informatics specialists and their reliability through calculation of Cronbach’s Alpha (0.969 and 0.795). We used Multivariate Analysis of Variance (MANOVA) to compare the scores given by three groups of participants in the challenges and Univariate Analysis of Variance (ANOVA) to compare the scores in two universities. The participants believed that technical challenges were more important than other challenges (x̄=3.74, SD = 0.7). IT experts (x̄=3.87, SD = 1) and radiology residents (x̄=3.95, SD = 0.9) gave the higher scores to the “shortage of high quality monitors” factor and medical equipment experts (x̄=4.26, SD = 0.87) to the “low speed of communication networks” factor among all technical challenges. The mean scores given to technical (x̄=76.1, SD = 13.5) and managerial (x̄=16, SD = 5.9) challenges in SUMS were more than the scores of the same challenges in KUMS (x̄=69.9, SD = 15.7) and (x̄=11.9, SD = 6.4) (p < 0.05). The technical challenges are the most common challenges to PACS implementation, and different universities experience different levels of technical challenges. Eliminating implementation challenges can reduce the risk of failure in the utilization process. Based on the results of this study, providing necessary infrastructures such as appropriate monitors and upgraded IT equipment can prevent many of the PACS implementation challenges.

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References

  1. Prevedello, L. M., and Khorasani, R., IT tools can help "harvest" clinical case material from your PACS. J. Am. Coll. Radiol: JACR. 9(8):543–544, 2012.

    Article PubMed  Google Scholar 

  2. Fridell, K., Aspelin, P., Edgren, L., Lindsköld, L., and Lundberg, N., PACS influence the radiographer's work. Radiography. 15(2):121–133, 2009.

    Article  Google Scholar 

  3. Kapoor, D., Picture archiving and communication systems (PACS) – A new paradigm in healthcare. Apollo Med. 7(3):181–184, 2010.

    Article  Google Scholar 

  4. Markonis, D., Holzer, M., Baroz, F., De Castaneda, R. L., Boyer, C., Langs, G. et al., User-oriented evaluation of a medical image retrieval system for radiologists. Int. J. Med. Inform. 84(10):774–783, 2015.

    Article PubMed  Google Scholar 

  5. Benjamin, M., Aradi, Y., and Shreiber, R., From shared data to sharing workflow: Merging PACS and teleradiology. Eur. J. Radiol. 73(1):3–9, 2010.

    Article PubMed  Google Scholar 

  6. Faggioni, L., Neri, E., Castellana, C., Caramella, D., and Bartolozzi, C., The future of PACS in healthcare enterprises. Eur. J. Radiol. 78(2):253–258, 2011.

    Article PubMed  Google Scholar 

  7. Shakeshaft, J., Picture archiving and communications system in radiotherapy. Clin Oncol (R Coll Radiol). 22(8):681–687, 2010.

    Article CAS PubMed  Google Scholar 

  8. Armbrust, L. J., PACS and image storage. Vet. Clin. North Am. Small Anim. Pract. 39(4):711–718, 2009.

    Article PubMed  Google Scholar 

  9. Mildenberger, P., Brüggemann, K., Rösner, F., Koch, K., and Ahlers, C., PACS infrastructure supporting e-learning. Eur. J. Radiol. 78(2):234–238, 2011.

    Article PubMed  Google Scholar 

  10. Hurlen, P., Borthne, A., Dahl, F. A., Ostbye, T., and Gulbrandsen, P., Does PACS improve diagnostic accuracy in chest radiograph interpretations in clinical practice? Eur. J. Radiol. 81(1):173–177, 2012.

    Article PubMed  Google Scholar 

  11. Faggioni, L., Neri, E., Cerri, F., Turini, F., and Bartolozzi, C., Integrating image processing in PACS. Eur. J. Radiol. 78(2):210–224, 2011.

    Article PubMed  Google Scholar 

  12. Mahadeva, D., Dias, R. G., Deshpande, S. V., Datta, A., Dhillon, S. S., and Simons, A. W., The reliability and reproducibility of the Neer classification system – Digital radiography (PACS) improves agreement. Injury. 42(4):339–342, 2011.

    Article CAS PubMed  Google Scholar 

  13. Varajão, J., Cunha, M., Bjørn-Andersen, N., Turner, R., Wijesekera, D., Martinho, R. et al., CENTERIS 2014 - conference on ENTERprise information systems / ProjMAN 2014 - international conference on project MANagement / HCIST 2014 - international conference on health and social care information systems and technologies exploring the determinants of PAS, EDMS, and PACS adoption in European hospitals. Proc. Technol. 16:1502–1509, 2014.

    Article  Google Scholar 

  14. Montgomery, R. A., Hresko, M. T., Kalish, L. A., Gold, M., Li, Y., Haus, B. et al., Spondylolisthesis: Intra-rater and inter-rater reliabilities of radiographic sagittal spinopelvic parameters using standard picture archiving and communication system measurement tools. Spine Deformity. 1(6):412–418, 2013.

    Article PubMed  Google Scholar 

  15. Stromatia, F., and Tzovara, I., Study of the replacement-update of the PACS/RIS system in the medical imaging department of the IASO general hospital. Phys. Med. 30(Supplement 1):e109–ee10, 2014.

    Article  Google Scholar 

  16. Yu, T.-Y., and Ho, H.-H., The design and development of a physician-oriented PACS for the enhancement of e-hospital facilities. Int. J. Med. Inform. 77(12):836–847, 2008.

    Article PubMed  Google Scholar 

  17. Kuo, Y.-T., Chu, H.-C., Hsieh, T.-J., Chiang, I. C., Liu, G.-C., Hwang, S.-J. et al., Effect of filmless imaging on utilization of radiologic services with a two-stage, hospital-wide implementation of a picture archiving and communication system: Initial experience of a fee-for-service model. Kaohsiung J. Med. Sci. 19(2):62–66, 2003.

    Article PubMed  Google Scholar 

  18. Bellon, E., Feron, M., Deprez, T., Reynders, R., and Van den Bosch, B., Trends in PACS architecture. Eur. J. Radiol. 78(2):199–204, 2011.

    Article PubMed  Google Scholar 

  19. Ribeiro, L. S., Costa, C., and Oliveira, J. L., Clustering of distinct PACS archives using a cooperative peer-to-peer network. Comput. Methods Prog. Biomed. 108(3):1002–1011, 2012.

    Article  Google Scholar 

  20. Morgan, M. B., Branstetter Iv, B. F., Clark, C., House, J., Baker, D., and Harnsberger, H. R., Just-in-time radiologist decision support: The importance of PACS-integrated workflow. J. Am. Coll. Radiol. 8(7):497–500, 2011.

    Article PubMed  Google Scholar 

  21. Savoie, B., and Nagy, P., PACS and the potential for medical errors. J. Am. Coll. Radiol. 9(10):756–758, 2012.

    Article PubMed  Google Scholar 

  22. Pandit, R. R., and Boland, M. V., Impact of digital imaging and Communications in Medicine Workflow on the integration of patient demographics and ophthalmic test data. Ophthalmology. 122(2):227–232, 2015.

    Article PubMed  Google Scholar 

  23. Weatherburn, G., Bryan, S., Nicholas, A., and Cocks, R., The effect of a picture archiving and communications system (PACS) on diagnostic performance in the accident and emergency department. J Accid Emerg Med 17(3):180–184, 2000.

    Article CAS PubMed PubMed Central  Google Scholar 

  24. MacDonald, D., and Neville, D., Evaluating the implementation of picture archiving and communication systems in Newfoundland and Labrador—A cost benefit analysis. J. Digit. Imaging 23(6):721–731, 2010.

    Article PubMed  Google Scholar 

  25. Kalyanpur, A., Singh, J., and Bedi, R., Practical issues in picture archiving and communication system and networking. Indian journal of radiology and imaging. Ind. J. Radiol. Imaging. 20(1):2–5, 2010.

    Article  Google Scholar 

  26. Mansoori, B., Erhard, K. K., and Sunshine, J. L., Picture archiving and communication system (PACS) implementation, integration & benefits in an integrated health system. Acad. Radiol. 19(2):229–235, 2012.

    Article PubMed  Google Scholar 

  27. Rohaya MN. Medical imaging trends and implementation: Issues and challenges for developing countries. J. Health Inform. Dev. Count. 2011 May 30;5(1).

  28. Alalawi, Z. M., Eid, M. M., and Albarrak, A. I., Assessment of picture archiving and communication system (PACS) at three of ministry of health hospitals in Riyadh region–content analysis. J. Infect. Public Health. 9(6):713–724, 2016.

    Article PubMed  Google Scholar 

  29. Tan, S. L., and Lewis, R. A., Picture archiving and communication systems: A multicentre survey of users experience and satisfaction. Eur. J. Radiol. 75(3):406–410, 2010.

    Article PubMed  Google Scholar 

  30. Pare, G., and Trudel, M. C., Knowledge barriers to PACS adoption and implementation in hospitals. Int. J. Med. Inform. 76(1):22–33, 2007.

    Article PubMed  Google Scholar 

  31. Tolle, S., Primo, H., Harris, T., and Morgan, J., Overcoming today's PACS/RIS challenges. Health Manag Technol. 33(5):16–17, 2012.

    PubMed  Google Scholar 

  32. Hussein, R., Engelmann, U., Schroeter, A., and Meinzer, H. P., DICOM structured reporting: Part 2. Problems and challenges in implementation for PACS workstations 1. Radiographics. 24(3):897–909, 2004.

    Article PubMed  Google Scholar 

  33. de Souza, R. F., Westphall, C. B., dos Santos, D. R., and Westphall, C. M., Challenges of operationalizing PACS on cloud over wireless networks. In: The ninth international conference on wireless and Mobile communications, 2013, 265–270.

    Google Scholar 

  34. Jabbari, N., Lotfnezhad, A. H., Zeinali, A., Feizi, A., and Sheno, A. K., Problems and obstacles in implementation of picture archiving and communication system (PACS) in Urmia imam Khomeini hospital. J. Hosp. 10(4):45–52, 2012.

    Google Scholar 

  35. Heydari, M., Saghafi, F., and Khansari, M., Effective factors for implementing PACS in Iran regard to future technology trends. J. Med. Council Iran. 31(3):201–210, 2013.

    Google Scholar 

  36. Collin, S., Reeves, B. C., Hendy, J., Fulop, N., Hutchings, A., and Priedane, E., Implementation of computerised physician order entry (CPOE) and picture archiving and communication systems (PACS) in the NHS: Quantitative before and after study. Bmj. 337:1–8, 2008.

    Article  Google Scholar 

  37. Hartman, D. J., Pantanowitz, L., McHugh, J. S., Piccoli, A. L., OLeary, M. J., and Lauro, G. R., Enterprise implementation of digital pathology: Feasibility, challenges, and opportunities. J. Digit. Imaging 30(5):555–560, 2017.

    Article CAS PubMed PubMed Central  Google Scholar 

  38. Berkowitz, S. J., Wei, J. L., and Halabi, S., Migrating to the modern PACS: Challenges and opportunities. RadioGraphics. 38(6):1761–1772, 2018.

    Article PubMed  Google Scholar 

  39. Handayani, P. W., Hidayanto, A. N., and Budi, I., User acceptance factors of hospital information systems and related technologies: Systematic review. Inform Health Soc Care. 43(4):401–426, 2018.

    Article PubMed  Google Scholar 

  40. Esmaeilzadeh, P., Sambasivan, M., Kumar, N., and Nezakhati, H., Adoption of technology applications in healthcare: The influence of attitude toward knowledge sharing on technology acceptance in a hospital. InInternational conference on U-and E-service, science and technology 2011 Dec 8 (pp. 17-30). Springer, Berlin. Heidelberg.

    Chapter  Google Scholar 

  41. Lakbala, P., and Dindarloo, K., Physicians’ perception and attitude toward electronic medical record. Springerplus. 3(1):63, 2014.

    Article PubMed PubMed Central  Google Scholar 

  42. Ward, R., The application of technology acceptance and diffusion of innovation models in healthcare informatics. Health Policy Technol. 2(4):222–228, 2013.

    Article  Google Scholar 

  43. Moore, G. C., and Benbasat, I., Development of an instrument to measure the perceptions of adopting an information technology innovation. Inf. Syst. Res. 2(3):192–222, 1991.

    Article  Google Scholar 

  44. Sezgin, E., and Yıldırım, S. Ö., A literature review on attitudes of health professionals towards health information systems: From e-health to m-health. Proc. Technol. 16:1317–1326, 2014.

    Article  Google Scholar 

  45. Abdekhoda M, Salih KM. Determinant factors in applying picture archiving and communication systems (PACS) in Healthcare. Perspectives in health information management. 2017;14(Summer).

  46. Crivianu-Gaita, D., Babyn, P., Gilday, D., O’Brien, B., and Charkot, E., User acceptability—A critical success factor for picture archiving and communication system implementation. J. Digit. Imaging 13(1):13–16, 2000.

    Article CAS PubMed PubMed Central  Google Scholar 

  47. Zahiri Esfahani, M., Farokhzadian, J., Bahaadinbeigy, K., and Khajouei, R., Factors influencing the selection of a picture archiving and communication system: A qualitative study. Int. J. Health Plann. Manag.:1–14, 2019.

  48. Odhiambo-Otieno, G. W., Evaluation criteria for district health management information systems: Lessons from the Ministry of Health, Kenya. Int. J. Med. Inform. 74(1):31–38, 2005.

    Article PubMed  Google Scholar 

  49. Ahmadian, L., Khajouei, R., Nejad, S. S., Ebrahimzadeh, M., and Nikkar, S. E., Prioritizing barriers to successful implementation of hospital information systems. J. Med. Syst. 38(12):151, 2014.

    Article PubMed  Google Scholar 

  50. Nematolahi, M., and Abhari, S., Assessing the information and communication technology infrastructures of Shiraz University of Medical Sciences in order to implement the telemedicine system in 2013. Int. J. Virtual Learn. Med. Sci. (IJVLMS). 5(2):44–51, 2014.

    Google Scholar 

  51. Hiss, S. S., Understanding radiography. Charles C Thomas Publisher, 2003.

  52. Kifle M, Mbarika V, Tan J. Telemedicine Transfer Model in Sub-Saharan Africa: Investigating Infrastructure and Culture. Proceedings of the 9th International Conference on Social Implications of Computers in Developing Countries; 2007 May 10–12; São Paulo, Brazil.

  53. Gemmill, J., Network basics for telemedicine. J. Telemed. Telecare 1(11):71–76, 2005.

    Article  Google Scholar 

  54. Almalki, M., Al-fleit, S., and Zafar, A., Challenges in implementation of information system strategies in Saudi business environ-ment: A case study of aBank. Int. J. Comput. Trends. Technol. 43(1), 2017.

    Article  Google Scholar 

  55. Li, K. C., Marcovici, P., Phelps, A., Potter, C., Tillack, A., Tomich, J., and Tridandapani, S., Digitization of medicine: How radiology can take advantage of the digital revolution. Acad. Radiol. 20(12):1479–1494, 2013.

    Article CAS PubMed  Google Scholar 

  56. Fernández-Alemán, J. L., Señor, I. C., Lozoya, P. Á., and Toval, A., Security and privacy in electronic health records: A systematic literature review. J. Biomed. Inform. 46(3):541–562, 2013.

    Article PubMed  Google Scholar 

  57. Haas, S., Wohlgemuth, S., Echizen, I., Sonehara, N., and Müller, G., Aspects of privacy for electronic health records. Int. J. Med. Inform. 80(2):e26–e31, 2011.

    Article PubMed  Google Scholar 

  58. Sittig, D. F., and Singh, H., Electronic health records and national patientsafety goals. N. Engl. J. Med. 367(19):1854–1860, 2012.

    Article CAS PubMed PubMed Central  Google Scholar 

  59. Van Roessel, I., Reumann, M., and Brand, A., Potentials and challenges of the health data cooperative model. Publ. Health Genom. 20(6):321–331, 2017.

    Article  Google Scholar 

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Acknowledgements

The authors would like to thank all the IT administrators, medical equipment experts and radiology residents for their participation in this study.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study resulted from research project No. 96.10.60.301 funded by the Medical Informatics Research Center, Kerman University of Medical Sciences.

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Authors and Affiliations

  1. Medical Informatics Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

    Reza Khajouei

  2. Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran

    Reza Khajouei

  3. Health Service Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Haft-bagh Highway, 7616911320, Kerman, Iran

    Maryam Eslami Jahromi

  4. Department of Health Information Sciences, Faculty of Management and Medical Information Sciences, Kerman University of Medical Sciences, Kerman, Iran

    Arefeh Ameri

  5. Medical Informatics Research Center, Institute for Future Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

    Arefeh Ameri

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  1. Reza Khajouei

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  2. Maryam Eslami Jahromi

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Correspondence toMaryam Eslami Jahromi.

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The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Research Involving Human Participants - Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

The study was approved by the Research Ethics Committee of Kerman University of Medical Sciences (Code of Ethics: IR.KMU.REC.1396.1343).

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Informed consent was obtained from all individual participants included in the study.

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Khajouei, R., Jahromi, M.E. & Ameri, A. Challenges of Implementing Picture Archiving and Communication System in Multiple Hospitals: Perspectives of Involved Staff and Users.J Med Syst43, 182 (2019). https://doi.org/10.1007/s10916-019-1319-0

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