Knowledge barriers to PACS adoption and implementation in hospitals.
OBJECTIVE
Drawing on the classical theory of diffusion of innovations advanced by Rogers [E.M. Rogers, Diffusion of Innovations, 4th ed., Free Press, New York, NY, 1995] and on the theory of barriers to innovation [P. Attewell, Technology diffusion and organizational learning: the case of business computing. Organ. Sci. 3 (1992) 1-19; H. Tanriverdi, C.S. Iacono, Knowledge barriers to diffusion of telemedicine. Proceedings of the 20th International Conference on Information Systems, Charlotte, NC, 1999, pp. 39-50; S. Nambisan, Y.-M. Wang, Roadblocks to web technology adoption? Commun. ACM, 42 (1) (1999) 98-101], this study seeks a better understanding of challenges faced in PACS implementations in hospitals and of the strategies required to ensure their success.


METHODS
To attain this objective, we describe and analyze the process used to adopt and implement PACS at two Canadian hospitals.


RESULTS
Our findings clearly demonstrate the importance of treating any PACS deployment not simply as a rollout of new technology but as a project that will transform the organization. Proponents of these projects must not lose sight of the fact that, even if technological complexity represents a significant issue, it must not garner all the project team's attention. This situation is even more dangerous, inasmuch as the greatest risk to the implementation often lies elsewhere. It would also appear to be crucial to anticipate and address organizational and behavioral challenges from the very first phase of the innovation process, in order to ensure that all participants will be committed to the project.


CONCLUSIONS
In order to maximize the likelihood of PACS success, it appears crucial to adopt a proactive implementation strategy, one that takes into consideration all the technical, economic, organizational, and human factors, and does so from the first phase of the innovation process.
Paré
Guy
G
Canada Research Chair in Information Technology in Health Care, HEC Montréal, 3000 Côte-Ste-Catherine Road, Montréal, Que., Canada H3T 2A7. guy.pare@hec.ca
Trudel
Marie-Claude
MC
D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D002170:Canada; D007722:Health Knowledge, Attitudes, Practice; D006739:Hospital Administration / Q000379:methods*; D015279:Organizational Culture; D009936:Organizational Innovation; D011873:Radiology Information Systems / Q000458:organization & administration*