Effect of picture archiving and communication system on diagnosis accuracy in CT and radiography examinations in emergency departments.

Abstract

Picture archiving and communication system (PACS) affects the radiologists' and physicians' performance. We aimed to evaluate the effect of implementing PACS on the emergency department (ED) physicians' accuracy compared to a radiologist's diagnosis in Iran. We retrospectively collected data for three six-month periods before and after the implementation of PACS on CT scan and radiography examinations. We compared ED physicians' diagnoses of CT scan and radiography images with a radiologist's interpretations for the same images. We compared 374 CT scans and 346 radiography examinations before implementing PACS (July 2015 to December 2015); 507 CT scans and 480 radiography examinations immediately after PACS (July 2016 to December 2016); and 870 CT scans and 1137 radiography examinations one year after PACS (July 2017 to December 2017). We found that diagnosis accuracy of ED physicians on CT scans increased from 75.9 % before implementing PACS to 84.4 % immediately after PACS and 94.9 % one year after PACS (p-value < 0.0001). Diagnosis accuracy for radiography images increased from 63.0 % before implementing PACS to 80.2 % immediately after PACS and 93.1 % one year after PACS (p-value < 0.0001). Implementation of PACS technology increases ED physicians' diagnosis accuracy.