User Centred Design and Implementation of Useful Picture Archiving and Communication Systems for Effective Radiological Workflows in Public Health Facilities in Zambia

Radiological workflows in public health facilities in The Republic of Zambia are performed using manual processes. With a broad spectrum of stakeholders—physicians, radiographers and radiologists in volved in radiological workflows, the efficiency of health service provision is drastically reduced, subsequently compromising clinical care. While there are a number of software platforms that are used in radiological workflows, Picture Archiving and Communication System platforms are important as they are primarily used to store, manage and facilitate access to Medical Images. This paper outlines the user-centred design and implementation of a Picture Archiving and Communication System for storing, managing, and facilitating access to medical images in pub-
lic health facilities in Zambia, in order to demonstrate the feasibility of automating manual medical imaging workflows in public health facilities. Semi-structured interviews were conducted with two (2) radiologists and four (4) radiographers in order to understand medical imaging workflows in public health facilities. A Picture Archiving and Communication System was designed and implemented using Dicoogle as the base platform and, subsequently evaluated—using the TAM 2 questionnaire—in order to assess its perceived usability and usefulness. The interviews conducted provide insight into the extent towards which manual workflows are employed, with DICOM viewers used as the main technology in the workflow. The impementation and evaluation of the Picture Archiving and Communication System demonstrates the feasibility of implementing these platforms in public health facilities and their potential usefulness, respectively.