Abstract
The paper uses the example of PACS (Picture Archiving and Communication System) in Austria (where some of the earliest large PACS projects were realised and led to a high penetration with state-wide networked PACS installations) to discuss success criteria and success factors of medical information systems. The paper describes the development of digital imaging in medicine and classifies the impact of systems according to their first or second order effects on patient care. The historic goals of PACS and the technical infrastructure in the eighties are shortly described. The paper then outlines the early PACS projects in Austria and their different approaches as well as the present state of PACS in Austria. After giving a definition of success, success criteria (which allow to decide whether a system is in fact a success or not) are discussed in general--the final criterion being routine use--and in detail and it is concluded that PACS in Austria was and is indeed successful. The analysis of success factors shows a multitude of influences but the most decisive ones are the practical ability of the system to deliver a real service to health care and the ability to support the (key) users in their work and goals.
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