# Knowledge, Utilisation, and Challenges of Medical Doctors Using Picture Archiving and Communication Systems at a Tertiary Academic Hospital in the Eastern Cape, South Africa

## TL;DR

This study explores how well medical doctors in a South African hospital use PACS, finding moderate knowledge and significant challenges like internet issues.

## Contribution

The study provides insights into PACS usage and challenges in a rural South African hospital, highlighting areas for improvement.

## Key findings

- Most doctors (63.7%) showed moderate to good knowledge of PACS.
- Internet connectivity and mobile PACS were major challenges.
- A majority (83.3%) have used PACS for years, but usage could be improved.

## Abstract

Despite the investments in the picture archiving and communication system (PACS) in the South African health facilities, it is unclear whether clinicians in the rural tertiary hospitals are using this tool maximally. This study determines the level of knowledge, utilisation, and challenges associated with the use of PACS among doctors in a rural tertiary hospital in the Eastern Cape Province. In this cross-sectional descriptive study, a total of 66 medical doctors drawn from different departments completed a structured questionnaire at the Nelson Mandela Academic Hospital, Mthatha. Relevant items on knowledge and use of PACS, including challenges experienced, were obtained. The mean age of the respondents was 36 (± standard deviation 9.58) years. The majority of the doctors (n = 42; 63.7%) demonstrated moderate to good knowledge of PACS. Similarly, a substantial majority (n = 55; 83.3%) have used PACS for years, for both images and reports (49.2%). The highest proportion of the respondents had at least 1 year of PACS experience (63.5%). Though there was no association between the sociodemographics and level of knowledge, the duration of use (p = 0.025) and frequency of use (p = 0.025) were significantly associated with moderate to good knowledge of PACS. Internet connectivity and mobile PACS were the major challenges identified. The study found moderate to good knowledge of PACS among the final sample of 66 clinicians. A substantial majority of the clinicians had used PACS for years; however, there is considerable room for strengthening and expanding the use of PACS in the study setting.

The online version contains supplementary material available at 10.1007/s10278-025-01526-2.