Understanding Interaction and Organizational Issues in Radiology Information Systems: a Qualitative Study with Health Professionals

• Fábio Aparecido Candido da Silva Universidade Federal de Lavras https://orcid.org/0000-0002-7359-1804
• Marluce Rodrigues Pereira Universidade Federal de Lavras https://orcid.org/0000-0003-4277-9529
• André Pimenta Freire Universidade Federal de Lavras https://orcid.org/0000-0001-7894-9740

Resumo

Context. Interaction with information systems such as PACS and RIS/HIS have been increasingly important in medical practice in hospitals and clinics and are essential for health professionals to perform their activities. Problem. These systems can present usability problems, compromising the efficiency of the process, generating incorrect diagnoses, delays in service and results. Proposal. The aim of this study was to investigate interaction and organizational issues with the use of radiology information systems by health professionals. Theoretical Approach. This qualitative study concerns the work routine of radiology professionals, cognitive learning, interaction and usability problems with systems and other radiology software. Method. The paper presents an exploratory study with thematic analysis of semi-structured interviews with eleven radiology professionals recruited via social networks and e-mails. The interview guide includes the process, responsibilities and factors that interfere in the routine of radiology professionals. Results. Thematic analysis revealed 5 themes that indicate the factors that interfere in the user's routine and in the radiological context, namely: System characteristics affect user usability; Process situations affect user task characteristics; User's behavior in relation to his routine; User experience and knowledge; Users deal with system failures and data loss risks. Contribution and Impact on IS. The results show that the users’ routine and interaction with radiology systems are conditioned to hospital or clinical processes, limiting users. The analysis of this study contributes to highlight usability aspects and business processes that can be improved in (clinical contexts) for a better effectiveness of radiological information systems.

Palavras-chave: Health Information Systems, Radiology, Qualitative Study

Referências

Reza Abbasi, Monireh Sadeqi Jabali, Reza Khajouei, and Hamidreza Tadayon. 2020. Investigating the satisfaction level of physicians in regards to implementing medical Picture Archiving and Communication System (PACS). BMC medical informatics and decision making 20, 1 (2020), 1–8. 

Cesar Alferez-Padron, Aide Aracely Maldonado-Macías, Jorge García-Alcaraz, Liliana Avelar-Sosa, and Arturo Realyvasquez-Vargas. 2017. Workload assessment and human error identification during the task of taking a plain abdominal radiograph: a case study. In International Conference on Applied Human Factors and Ergonomics. Springer, Springer, Switzerland, 108–119. 

M. Alhajeri and S.G.S. Shah. 2019. Limitations in and Solutions for Improving the Functionality of Picture Archiving and Communication System: an Exploratory Study of PACS Professionals’ Perspectives. Journal of Digital Imaging 32 (2019), 54–67. 

Mirza Mansoor Baig, Hamid GholamHosseini, Aasia A Moqeem, Farhaan Mirza, and Maria Lindén. 2017. A systematic review of wearable patient monitoring systems–current challenges and opportunities for clinical adoption. Journal of medical systems 41, 7 (2017), 1–9. 

Seth J Berkowitz, Jesse L Wei, and Safwan Halabi. 2018. Migrating to the modern PACS: challenges and opportunities. RadioGraphics 38, 6 (2018), 1761–1772. 

Virginia Braun and Victoria Clarke. 2006. Using thematic analysis in psychology. Qualitative research in psychology 3, 2 (2006), 77–101. 

Camila Rodrigues Dias, Marluce Rodrigues Pereira, and Andre Pimenta Freire. 2017. Qualitative review of usability problems in health information systems for radiology. Journal of biomedical informatics 76 (2017), 19–33. 

Misagh Zahiri Esfahani, Reza Khajouei, and Mohammad Reza Baneshi. 2018. Augmentation of the think aloud method with users’ perspectives for the selection of a picture archiving and communication system. Journal of Biomedical Informatics 80 (2018), 43–51. 

Les R Folio, Laura B Machado, and Andrew J Dwyer. 2018. Multimedia-enhanced radiology reports: concept, components, and challenges. RadioGraphics 38, 2 (2018), 462–482. 

Ina Geldermann, Christoph Grouls, Christiane Kuhl, Thomas M Deserno, and Cord Spreckelsen. 2013. Black box integration of computer-aided diagnosis into PACS deserves a second chance: results of a usability study concerning bone age assessment. Journal of Digital Imaging 6 (2013), 698––708. 

International Standardization Organization ISO. 2011. ISO/IEC 25010:2011 - Systems and software engineering — Systems and software Quality Requirements and Evaluation (SQuaRE) — System and software quality models. https://www.iso.org/standard/35733.html

International Standardization Organization ISO. 2018. ISO 9241-11:2018 - Ergonomics of human-system interaction — Part 11: Usability: Definitions and concepts. https://www.iso.org/standard/63500.html

Fateme Rangraz Jeddi, Ehsan Nabovati, Reyhane Bigham, and Razieh Farrahi. 2020. Usability evaluation of a comprehensive national health information system: A heuristic evaluation. Informatics in Medicine Unlocked 19 (2020), 100332. 

Wiard Jorritsma, Fokie Cnossen, Rudi A Dierckx, Matthijs Oudkerk, and Peter MA van Ooijen. 2016. Pattern mining of user interaction logs for a post-deployment usability evaluation of a radiology PACS client. International Journal of Medical Informatics 85, 1(2016), 36–42. 

Wiard Jorritsma, Fokie Cnossen, Rudi A Dierckx, Matthijs Oudkerk, and Peter MA Van Ooijen. 2016. Post-deployment usability evaluation of a radiology workstation. International Journal of Medical Informatics 85, 1(2016), 28–35. 

Wiard Jorritsma, Fokie Cnossen, and Peter MA van Ooijen. 2014. Merits of usability testing for PACS selection. International Journal of Medical Informatics 83, 1(2014), 27–36. 

Wiard Jorritsma, Fokie Cnossen, and Peter MA van Ooijen. 2015. Adaptive support for user interface customization: a study in radiology. International Journal of Human-Computer Studies 77 (2015), 1–9. 

Dasueran Kim, Peter Kang, Jungmin Yun, Sung-Hye Park, Jeong-Wook Seo, and Peom Park. 2014. Study on User Interface of Pathology Picture Archiving and Communication System. Healthcare Informatics Research 20, 1 (2014), 45–51. 

Mark D. Kovacs, Maximilian Y. Cho, Philip F. Burchett, and Michael Trambert. 2019. Benefits of Integrated RIS/PACS/Reporting Due to Automatic Population of Templated Reports. Current Problems in Diagnostic Radiology 48, 1 (2019), 37–39. 

Dimitrios Markonis, Frederic Baroz, Rafael Luis Ruiz De Castaneda, Celia Boyer, and Henning Müller. 2013. User Tests for Assessing a Medical Image Retrieval System: A Pilot Study. In MEDINFO 2013. Studies in Health Technology and Informatics, Vol. 192. IOS Press, Amsterdam, Netherlands, 224–8. 

Dimitrios Markonis, Markus Holzer, Frederic Baroz, Rafael Luis Ruiz De Castaneda, Célia Boyer, Georg Langs, and Henning Müller. 2015. User-oriented evaluation of a medical image retrieval system for radiologists. International Journal of Medical Informatics 84, 10(2015), 774–783. 

Mary L McHugh. 2012. Interrater reliability: the kappa statistic. Biochemia medica 22, 3 (2012), 276–282. 

Steven McShane and Mary Ann Von Glinow. 2018. Organizational Behavior(4 ed.). McGraw-Hill Education, New York, NY. 

J. Nielsen. 2020. 10 Usability Heuristics for User Interface Design. Nielsen Norman Group(2020). https://www.nngroup.com/articles/ten-usability-heuristics

Kenneth Olbrish, Paul Shanken, Donna Rabe, Lorraine Steven, and Nicholas Irizarry. 2011. Four-year enterprise PACS support trend analysis. Journal of Digital Imaging 24 (2011), 284––294. 

Djalma de Pinho Rebouças de Oliveira. 2013. Sistemas, Organização & Métodos: Uma Abordagem Gerencial (21 ed.). Atlas, São Paulo, SP. 

Oronzo Parlangeli, Paul M. Liston, Enrica Marchigiani, Margherita Bracci, and Alessandra Giani. 2020. Perceptions and Use of Computed Tomography in a Hospital Emergency Department: Technicians’ Perspectives. Human Factors 62(2020), 5–19. 

Lizawati Salahuddin, Zuraini Ismail, Ummi Rabaah Hashim, Nor Haslinda Ismail, Raja Rina Raja Ikram, Fiza Abdul Rahim, and Noor Hafizah Hassan. 2020. Healthcare practitioner behaviours that influence unsafe use of hospital information systems. Health informatics journal 26, 1 (2020), 420–434. 

Sandro Luis F. F. C. Silva, Marcelo Fornazin, and Rodrigo Pereira dos Santos. 2020. Analysis and Modeling of Emergent Systems in the Health Information System Domain. In XVI Brazilian Symposium on Information Systems. 1–8. 

Marcílio Ferreira Souza-Júnior, Lívio Antonio Monteiro Amorim, Lucas Emanoel Paulino Silva Santos, Jorge Silva Correia-Neto, and Hugo Araujo Souza. 2019. Aprimoramento de Interfaces de Usuários de Sistemas de Informação em Saúde no Atendimento Pré-hospitalar na Ótica da Consciência Situacional. iSys-Brazilian Journal of Information Systems 12, 4 (2019), 98–116. 

John A Wagner and John R Hollenbeck. 2020. Organizational behavior: Securing competitive advantage (3 ed.). Routledge, New York, NY. 

Misagh Zahiri Esfahani, Jamileh Farokhzadian, Kambiz Bahaadinbeigy, and Reza Khajouei. 2019. Factors influencing the selection of a picture archiving and communication system: A qualitative study. The International journal of health planning and management 34, 2(2019), 780–793.