Successfully introducing a new technology in a healthcare setting is not a walk in the park. Many barriers need to be overcome, not only technical and financial but also human barriers. In this study, we focus on the human barriers to health-care information systems' implementation. We monitored the acceptance of a Picture Archiving and Communication System (PACS) by radiologists and hospital physicians in a large Belgian university hospital. Hereto, questionnaires were taken pre-implementation (T1) and 1 year after the radiology department stopped printing film (T2). The framework we used to perform the study was the Unified Theory of Acceptance and Use of Technology. Main findings were that both groups were positive toward PACS prior to the introduction and that each group was even more positive at T2 with extensive PACS experience. In general, the ratings of the radiologists were higher than those of the physicians, as the radiologists experienced more of the benefits of PACS and had to use PACS throughout the day. Two factors were salient for predicting users' intention to use PACS: the usefulness of PACS (performance expectancy) and the availability of support of any kind (facilitating conditions). The results show that our approach was successful. Both radiologists and physicians give evidence of an excellent level of user acceptance. We can conclude that the implementation of PACS into our hospital has succeeded.

The aim of this work was to investigate MR‐based polymer gel dosimetry as a three‐dimensional (3D) dosimetry technique in conformal radiotherapy. A cylindrical container filled with polymer gel was placed in a water‐filled torso phantom to verify a treatment plan for the conformal irradiation of a mediastinal tumor located near the esophagus. Magnetic resonance spin‐spin relaxation rate images were acquired and, after calibration, converted to absorbed dose distributions. The dose maps were compared with dose distributions measured using radiographic film. The average root‐mean‐square structural deviation, for the complete dose distribution, amounted to less than 3% between gel and film dose maps. It may be expected that MR gel dosimetry will become a valuable tool in the verification of 3D dose distributions. The influence of imaging artifacts arising from eddy currents, temperature drift during scanning, and B1 field inhomogeneity on the dose maps was taken into account and minimized. Magn Reson Med 43:116–125, 2000. © 2000 Wiley‐Liss, Inc.

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The implementation of PACS has succeeded. At T 1 the physicians were welcoming PACS and this was confirmed at T 2. Experience with PACS led to an overall improved attitude toward PACS. The key factors for physicians' intentions to use PACS were the usefulness of PACS (at T 1 and overall) and the availability of support (at T 2).

This article outlines the strategy used by our hospital to maximize the knowledge transfer to referring physicians on using a picture archiving and communication system (PACS). We developed an e-learning platform underpinned by the cognitive load theory (CLT) so that in depth knowledge of PACS' abilities becomes attainable regardless of the user's prior experience with computers. The application of the techniques proposed by CLT optimizes the learning of the new actions necessary to obtain and manipulate radiological images. The application of cognitive load reducing techniques is explained with several examples. We discuss the need to safeguard the physicians' main mental processes to keep the patient's interests in focus. A holistic adoption of CLT techniques both in teaching and in configuration of information systems could be adopted to attain this goal. An overview of the advantages of this instruction method is given both on the individual and organizational level.