title: Do hospital physicians' attitudes change during PACS implementation? A cross-sectional acceptance study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Ghent University Hospital, Radiology and Medical Imaging, Belgium. Bram.Pynoo@UGent.be
authors: Bram
authors: B
authors: Pynoo
authors: Pieter
authors: P
authors: Devolder
authors: Wouter
authors: W
authors: Duyck
authors: Johan
authors: J
authors: van Braak
authors: Bart
authors: B
authors: Sijnave
authors: Philippe
authors: P
authors: Duyck
mesh_terms: D001291:Attitude of Health Personnel; D001530:Belgium; D003430:Cross-Sectional Studies; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data*; D010820:Physicians / Q000706:statistics & numerical data*; D011873:Radiology Information Systems / Q000706:statistics & numerical data*