Investigating the Quality and Effectiveness of the Picture Archiving Communication System (PACS) at an Academic Hospital in South Africa

PACS is a valuable workflow tool within a hospital environment and specifically in radiology departments. PACS is increasingly adopted in the developing countries like South Africa and India. While there has been much enthusiasm about the potential for PACS, major challenges persists in PACS implementation which calls for continuous evaluation of this system. However a review of previous PACS research indicates fragmented evaluation attempts and as such lack of comprehensive assessment of PACS systems. In addition, due to this fragmented work, the significance of factors influencing PACS quality has not been established. The present study investigated more comprehensively the quality of PACS in an academic hospital in South Africa and determined the extent to which the initial objectives for its development were met. A single case study involving 52 participants involved in PACS implementation and utilisation was conducted and mixed methods were used to collect and analyse the data. The findings suggest that many of the project objectives were achieved. In particular, PACS supports work processes within the Radiology department; Clinicians obtain images immediately and their interpretations of the results were perceived to be fairly accurate. However major challenges relating to security and compliance, maintainability, reliability of the data still exist and require urgent attention. This is also confirmed by the regression analysis which reveals that security and compliance are the most significant factors influencing the quality of PACS implementation in this academic hospital.