Original Research

Reasons for Picture Archiving and Communication System (PACS) data security breaches: Intentional versus non-intentional breaches

Tintswalo B. Mahlaola, Barbara van Dyk
Health SA Gesondheid | Vol 21 | a966 | DOI: https://doi.org/10.4102/hsag.v21i0.966 | © 2016 Tintswalo B. Mahlaola, Barbara van Dyk | This work is licensed under CC Attribution 4.0
Submitted: 10 October 2017 | Published: 11 October 2016

About the author(s)

Tintswalo B. Mahlaola, Department of Medical Imaging and Radiation Sciences, Faculty of Health Sciences, University of Johannesburg, South Africa
Barbara van Dyk, Department of Medical Imaging and Radiation Sciences, Faculty of Health Sciences, University of Johannesburg, South Africa

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Background: The Picture Archiving and Communication System (PACS) has led to an increase in breached health records and violation of patient confidentiality. The South African constitution makes provision for human dignity and privacy, virtues which confidentiality seeks to preserve. Confidentiality thus constitutes a human right which is challenged by the use of technology. Humans, as managers of information technology, constitute the weakest link in safeguarding confidentiality. Nonetheless, it is argued that most security breaches are nonintentionally committed by well-meaning employees during routine activities.

Objective: The purpose of this article is to explore the nature of and reasons for confidentiality breaches by PACS users in a South African context.

Methods: A closed-ended questionnaire was used to collect quantitative data from 115 health professionals employed in a private hospital setting, including its radiology department and a second independent radiology department. The questionnaire sought to explore the attitudes of participants towards confidentiality breeches and reasons for suchbehaviour.

Results: Breach incidences were expressed as percentage compliance and classified according to the nature and reasons provided by Sarkar's breach classification. Cross tabulations indicated a statistical significance (p < 0.00) between the expected and observed confidentiality practices of participants and also the adequacy of training, system knowledge and policy awareness.

Conclusion: Our study supports previous findings that, in the absence of guidelines, most security breaches were non-intentional acts committed due to ignorance. Of concern are incidents in which sensitive information was intentionally shared via social media.


Intentional breaches; Patient confidentiality violation; PACS; Unintentional breaches


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Crossref Citations

1. Limitations in and Solutions for Improving the Functionality of Picture Archiving and Communication System: an Exploratory Study of PACS Professionals’ Perspectives
Mona Alhajeri, Syed Ghulam Sarwar Shah
Journal of Digital Imaging  vol: 32  issue: 1  first page: 54  year: 2019  
doi: 10.1007/s10278-018-0127-2