Effect of the Picture Archiving and Communication System Implementation on the Diagnosis Accuracy of Emergency Physicians in CT Scan Examinations

Introduction: Picture Archiving and Communication System (PACS) allows the processing, archiving, and sharing medical images electronically with different parts of the hospital, especially the emergency department. The aim of this study was to evaluate the effect of PACS on the diagnosis accuracy of emergency department physicians before and after its implementation.  Method: In this analytical study, the diagnosis of emergency physicians was compared with that of radiologists in each period. Eventually, the data obtained in the two periods were compared. In this study, 380 and 509 CT scans were analyzed before and after the PACS implementation, respectively. Data analysis and comparison of the accuracy and agreement of diagnosis in the pre- and post-PACS implementation periods were performed using Chi-square test, and statistical significance level was calculated using SPSS version 24.  Results: The accurate diagnosis of CT scan examinations increased from 284 examinations (75.9%) before PACS implementation to 428 examinations (84.4%). The diagnostic agreement also increased from 306 examinations (81.8%) before PACS implementation to 452 examinations (89.2%). Statistical significant level was considered at P<0.05. Conclusion: The accuracy and agreement of the diagnosis of emergency physicians in CT scan examinations in the post-PACS implementation period increased compared to the pre-PACS implementation period; as a result, the implementation of PACS increases the diagnostic agreement between emergency physicians and radiologists, followed by an increased diagnosis accuracy of emergency physicians.