PACS influence the radiographer's work

Abstract 

Radiological departments are changing rapidly due to the implementation of digital images and PACS (Picture Archiving and Communication Systems).

The introduction of new technology seems to dissolve boundaries between the professions in the work environment where the technology is introduced. This process tends to change the organization and its routines.

The aim of this qualitative study is to explore changes in radiographers' work with regard to skills, work practice and technology. The study used open-ended interviews to explore the radiographers' perceptions of such changes, and to identify problems and solutions pertaining to work practice. Inspiration is taken from grounded theory to explain the changes in work that were found. Respondents were selected from a total of 133 potential participants as a theoretical or purposive sample.

The changing trends within the professional role indicated that radiographers, as image producers, shifted their focus from the ability to set the optimal exposure parameters in order to obtain the optimal image for diagnosis to become expert in exposure parameters, projection techniques and diagnostic practice, having multifaceted skills, as being the jack of all trades. When implementing PACS there was an obvious change in image production. At the start there were visions of new routines, and therefore the radiographers became early adopters to the new technology; in practice the organization was stacked in old routines, as the routines were inflexible and PACS work was pushed into old work routines. Although inflexible, this does not mean that they cannot change, and obviously in 2006 new routines had been implemented making it possible for the radiographers in finding new ways for collaborating with colleagues. The new technology immediately created a vision of improved service to the clinicians. In order to optimize the service the radiographers developed an insight into the need for a more comprehensive change in work using a new PACS technology and digital workflow. Using PACS technology, together with an adjustment to the new system workflow, the experience among radiographers was that the production of images increased and as a result the stress in work increased as well. Using PACS technology, medical staff had little control over the organization of image production and its workflow, so that radiographers experienced PACS as a more technical deterministic system allowing small human control in the organization of work.

Keywords: PACS, IT systems, Professional roles