The effect of PACS on the practice of orthopaedic surgeons

When new information and communication technologies are implemented there are organizational effects. Picture Archiving and Communication Systems (PACS) have been implemented not only within radiology but also within the orthopaedic context. We studied the impact of PACS on the work practice and professional role of orthopaedic surgeons in relation to radiologists. Qualitative interviews were performed with 15 surgeons at two hospitals. The interviews were transcribed, analysed and then coded using grounded theory. Three main categories were defined: professional role, diagnostic practice and technology used. There was a shift in orthopaedics from a single to a mixed profession, and from a relatively static practice in interpreting images to a more flexible practice, where every orthopaedic surgeon could view and access images from anywhere at any time, including three-dimensional imaging. It was easier for surgeons to see and interpret the images, and their diagnostic skills became accessible to everyone. The use of PACS also improved the dialogue with patients, according to the respondents. This was necessary in order to explain the treatment options for the patient or the details of the disease. PACS therefore acts as an information and communications technology and users required new knowledge and skills.