Ghent University Hospital, Radiology and Medical Imaging, Belgium.
Int J Med Inform. 2012 Feb;81(2):88-97. doi: 10.1016/j.ijmedinf.2011.10.007. Epub 2011 Nov 8.
The purpose of this study is to gain a better insight into the reasons why hospital physicians accept and use a Picture Archiving and Communication System (PACS). Two research questions are put forward, pertaining to (1) factors that contribute to physicians' acceptance of PACS, and (2) whether these factors change as physicians gain experience in using PACS.
Questionnaires were administered at three moments in time during the PACS implementation process in a private hospital: just before its introduction (T1), four months later (T2), and about fifteen months after the introduction of PACS (T3). The Unified Theory of Acceptance and Use of Technology was chosen as the theoretical framework for this study. Hence, the following scales were measured: performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, and self-reported frequency of use.
Forty-six usable responses were obtained at T1, 52 at T2 and 61 at T3. Three variables directly influenced PACS acceptance (measured as behavioral intention and use of PACS): effort expectancy, performance expectancy, and social influence; and their influence evolved over time. Effort expectancy was of particular importance at T1, whereas performance expectancy influenced acceptance at T2 and T3; social influence was the only consistent predictor of PACS acceptance at all times. Variance explained in behavioral intention ranged from .26 at T1 to .58 at T3.
In this setting, the main motivation for physicians to start using PACS is effort expectancy, whereas performance expectancy only becomes important after the physicians started using PACS. It is also very important that physicians perceive that their social environment encourages the use of PACS.
本研究旨在深入了解医院医生接受和使用影像归档与通信系统（PACS）的原因。提出了两个研究问题，涉及（1）促使医生接受 PACS 的因素，以及（2）随着医生使用 PACS 经验的增加，这些因素是否会发生变化。
在一家私立医院的 PACS 实施过程中，在三个时间点进行了问卷调查：引入前（T1）、四个月后（T2）和引入 PACS 约十五个月后（T3）。本研究选择了统一的技术接受和使用理论作为理论框架。因此，测量了以下几个方面：绩效预期、努力预期、社会影响、促进条件、行为意图和自我报告的使用频率。
T1 时获得了 46 份可用回复，T2 时获得了 52 份，T3 时获得了 61 份。有三个变量直接影响 PACS 的接受度（以行为意图和 PACS 的使用来衡量）：努力预期、绩效预期和社会影响；而且它们的影响随时间而变化。在 T1 时，努力预期尤为重要，而在 T2 和 T3 时，绩效预期影响了接受度；社会影响是所有时间 PACS 接受度的唯一一致预测因素。行为意图的解释方差范围从 T1 的.26 到 T3 的.58。
在这种情况下，医生开始使用 PACS 的主要动机是努力预期，而只有在医生开始使用 PACS 后，绩效预期才变得重要。医生认为他们的社会环境鼓励使用 PACS 也非常重要。
