Application of the Extended Technology Acceptance Model to Picture Archiving and Communication Systems in Dental Hospitals

Objective: With the rapid growth of picture archiving and communication systems (PACS) in the healthcare industry, this article describes the users’ satisfaction with PACS by employing functional PACS features and the two concepts of perceived ease-of-use (PEOU) and perceived usefulness (PU), based on the extended technology acceptance model (TAM). Methods: A cross-sectional survey was conducted with dentists in 25 dental hospitals which were cluster sampled from the national registry of 132 dental hospitals. Of the 204 respondents (response rate 81.6%), the data of 159 PACS users were analyzed using the structural equation modeling method. Results: The fitted model showed significant relations between the technical components and the TAM variables, via the following three significant paths: hardware to PEOU, and software to PEOU and also to PU. Moreover, the critical path of TAM variables was observed: PEOU→PU→SAT. Therefore, the model produced three significant routes: hardware→PEOU→PU→SAT, software→PU→SAT, and software→PEOU→PU→SAT. Conclusion: Contrary to expectations, the direct effect of PEOU on user satisfaction was not significant. The final model provided critical paths from technical components to user satisfaction, by utilizing PEOU and PU as intermediary, latent factors. (Journal of Korean Society of Medical Informatics 15-3, 265-272, 2009)