Performance evaluation of public hospital information systems by the information system success model

An integration of expectation confirmation model and information systems success model to explore the factors affecting the continuous intention to utilise virtual classrooms

Virtual classrooms have recently gained significant consideration in educational institutes and universities due to their potential to encourage and support students' learning activities. Although recent research has focused extensively on online learning, virtual classrooms and the factors affecting their continuous use have garnered little attention, especially in Arab Gulf countries such as Saudi Arabia. Thus, this study integrates the expectation confirmation model and the information systems success model to assess the factors affecting students' continuous intention to utilise virtual classrooms in higher education. We examined the effects of information quality, service quality, system quality, confirmation, perceived usefulness, and satisfaction on the continuous intention to utilise virtual classrooms. Data were collected from 441 students and analysed using structural equation modelling "SEM". SEM is a powerful multivariate approach used increasingly in empirical investigation for evaluating and testing casual relationships. The results revealed that the proposed model demonstrated high explanatory power in explaining students' continuous intention to utilise virtual classrooms (R2 = 0. 86). Additionally, information quality had a significant effect on confirmation and an insignificant effect on perceived usefulness. System quality affected perceived usefulness and confirmation. Contrary to our expectations, service quality had a significant negative effect on perceived usefulness and confirmation. Additionally, perceived usefulness and confirmation affected students' satisfaction with using virtual classrooms, and satisfaction affected students' continuous intention to utilise virtual classrooms. This study contributes to the literature by offering a holistic integrated model that increases the understanding of the factors influencing students' continuous intention to utilise virtual classrooms, hence aiding in increasing their utilisation. Furthermore, it provides practical implications for enhancing students' continuous intention to utilise virtual classrooms. Virtual classroom developers must focus on improving the system quality of virtual classrooms. According to our results, higher system quality led the students to perceive virtual classrooms as useful and confirmed their favourable experiences with virtual classrooms. Additionally, providing students with high information quality in virtual classrooms would enhance their confirmation experiences, leading to the continuous intention to utilise virtual classrooms.

Constructing and implementing a performance evaluation indicator set for artificial intelligence decision support systems in pediatric outpatient clinics: an observational study

Artificial intelligence (AI) decision support systems in pediatric healthcare have a complex application background. As an AI decision support system (AI-DSS) can be costly, once applied, it is crucial to focus on its performance, interpret its success, and then monitor and update it to ensure ongoing success consistently. Therefore, a set of evaluation indicators was explicitly developed for AI-DSS in pediatric healthcare, enabling continuous and systematic performance monitoring. The study unfolded in two stages. The first stage encompassed establishing the evaluation indicator set through a literature review, a focus group interview, and expert consultation using the Delphi method. In the second stage, weight analysis was conducted. Subjective weights were calculated based on expert opinions through analytic hierarchy process, while objective weights were determined using the entropy weight method. Subsequently, subject and object weights were synthesized to form the combined weight. In the two rounds of expert consultation, the authority coefficients were 0.834 and 0.846, Kendall's coordination coefficient was 0.135 in Round 1 and 0.312 in Round 2. The final evaluation indicator set has three first-class indicators, fifteen second-class indicators, and forty-seven third-class indicators. Indicator I-1(Organizational performance) carries the highest weight, followed by Indicator I-2(Societal performance) and Indicator I-3(User experience performance) in the objective and combined weights. Conversely, 'Societal performance' holds the most weight among the subjective weights, followed by 'Organizational performance' and 'User experience performance'. In this study, a comprehensive and specialized set of evaluation indicators for the AI-DSS in the pediatric outpatient clinic was established, and then implemented. Continuous evaluation still requires long-term data collection to optimize the weight proportions of the established indicators.

Improve the satisfaction of medical staff on the use of home nursing mobile APP by using a hybrid multi-standard decision model

OBJECTIVE

To identify critical satisfaction gaps in a home nursing mobile application (APP) using a systematic decision-making model.

METHODS

Initially, the decision-making trial and evaluation laboratory method was used to analyze the relationship structure and corresponding weights among the indicators. The Importance-Performance Analysis (IPA) method was used to identify the categories of all indicators and their corresponding strategic directions. Twenty-six home nursing specialists currently providing home nursing services were recruited for this study.

RESULTS

The IPA results revealed that "Assurance," "Reliability," and "Personal security protection" are critical satisfaction gaps. From the influence network and weight results, "information quality" and "system quality" were the critical quality factors in the home nursing mobile APP. The influence of the network relationship structure and weight demonstrated a 98.12% significance level, indicating good stability.

CONCLUSION

Continuous improvement in information and system quality is recommended to optimize the overall quality of the home nursing mobile APP. Additionally, user demands should be considered, and personal safety guarantee functions should be developed and integrated into the system to ensure the safety of home nursing workers.

Organisational Culture Research in Healthcare: A Big Data Bibliometric Study

Across international healthcare, organisational culture and work environment have become central to all patient safety. However, there is a lack of comprehensive overview to assess and track the evolution of the literature on organisational culture in healthcare. This study aims to describe the current situation and global trends in organisational culture research in healthcare. The methodology is based on bibliometric mapping using scientific visualisation software (CiteSpace and VOSviewer). The big data were collected from the Web of Science core citation database. After applying the search criteria, we retrieved 1559 publications, which have steadily increased over the last two decades. In addition, 92 countries and regions have published studies on organisational culture in healthcare. The United States has made significant contributions to this field. In particular, organisational culture occupies an important position in the quality management of different types of care and caregiving. At the same time, organisational culture in healthcare may be inadequately researched in terms of theoretical underpinnings, which in turn leads to a lack of widespread dissemination of practice, and research on organisational culture in healthcare through evidence-based medicine may remain a significant focus and hot topic throughout the research field in the coming years.

The role of institutional factors and cognitive absorption on students' satisfaction and performance in online learning during COVID 19

With the rise of the Covid-19 pandemic, there has been a severe negative impact on all aspects of life, whether it be a job, business, health, education, etc. As a result, institutions, schools, colleges and universities are being shut down globally to control the spread of Covid-19. Due to this reason, the mode of education has a dramatic shift from on-campus to online learning with virtual teaching using digital technologies. This sudden shift has elevated the stress level among the students because they were not mentally prepared for it, and hence their academic performance has been adversely affected. So, there needs to figure out the underlying process to make online learning more productive. Thus, to obtain this objective, the present study has integrated the modified Technology Acceptance Model (TAM), Task Technology Fit Model (TTF), DeLone and McLean Model of Information Systems Success (DMISM) and Unified Theory of Acceptance and Use of Technology (UTAUT) model. A sample of 404 students was obtained, where 202 students were from the top ten public sector universities, and 202 were from the top ten private sector universities of Punjab. Structural Equation Modelling (SEM) was used to analyze the hypothesized framework using AMOS. The results reveal that institutional factors positively impact students' performance mediated by user satisfaction and task technology fit. Similarly, institutional factors affect performance through mediation by user satisfaction and actual usage in sequence. Cognitive absorption was used as a moderator between institutional factors and user satisfaction. In the end, theoretical and practical inferences have also been discussed.

Evaluation of the Egyptian knowledge bank using the information systems success model

The appearance of the coronavirus pandemic had several implications on the educational process, which caused students, at all educational levels, to resort to digital libraries as the available educational opportunity in this challenging time. This study sheds light on the Egyptian Knowledge Bank (EKB) as one of the largest digital libraries in the world. It empirically evaluates the EKB, using the updated Information Systems Success (ISS) model proposed by DeLone and McLean (2003), among postgraduate business students in the context of Egyptian universities with a sample of 245 students. The results indicate that all nine hypotheses derived from the research model are supported and significant, contributing either directly or indirectly to the success of the EKB. Hence, the results confirm the validity of the ISS model in measuring the success of the EKB. These findings highlight as well the significance of investing more deeply in digital libraries as a coping mechanism for the educational recovery process from COVID-19 and the importance of creating awareness among students about digital libraries in order to sustain the learning process in a safe environment.

MEASURING THE SUCCESS OF ERP VIA ORGANIZATIONAL CLIMATE CONSTRUCTS

Agencies depend on enterprise resource planning (ERP) to achieve success. However, the factors that lead to the success and use of these ERP systems have not attracted the needed attention. This study investigates the factors that influence the success and use of an ERP system. The proposed model is based on a quantitative and a mixed-method case study (MM-CS). The results show that organizational climate has a positive effect on information quality, system quality, and service quality constructs of the DeLone and McLean IS success model. The quality constructs also affect user satisfaction negatively as compared to previous studies.

Students' Performance in Online Learning Environment: The Role of Task Technology Fit and Actual Usage of System During COVID-19

The 2019 Pandemic has forced students to take online classes, increasing their stress levels and negatively impacting their academic performance. This issue urges the development of a mechanism to make online learning more effective in this nerve-racking time. Therefore, the present study has integrated the task technology fit (TTF) model and the DeLone and McLean Model of Information Systems Success (DMISM) to address the stated issue. The data were collected from 330 and 326 students of top-ranked public and private universities of Punjab, respectively. The theoretical framework was analyzed with the help of structural equation modeling (SEM) using Analysis of Moment Structures (AMOS). The findings indicate that overall quality positively predicts performance through the mediating role of user satisfaction and TTF. The overall quality also positively elevates performance through the mediating role of user satisfaction and actual usage of the system. Moreover, perceived usefulness proved to be a moderator between overall quality and user satisfaction. Finally, the expected practical and theoretical implications have also been discussed.

Exploring the Outcomes and Satisfaction of Automated Physiological Monitoring Systems Among Nurses

Vital signs are central to the assessment of physiologic functions of patients and must be included in the electronic health record. The purpose of this retrospective and cross-sectional design study was to evaluate use of-and satisfaction with-automated physiological monitoring systems. Usage data from a hospital database were analyzed 3, 6, and 12 months after implementation of the automated system (June 2018 to May 2019). In addition, questionnaires were completed by 168 nurses, and 20 nurses were interviewed between August/September 2020 and October/November 2020, respectively. Results revealed that usage frequency of automated physiological monitoring devices increased steadily with user familiarity. Although respondents indicated general satisfaction with the devices, system downtime, sufficiency of the battery charge, and data transmission speed were identified as needing correction to smooth workflow and boost work efficiency. Although most interviewees considered devices easy to use, some mentioned transmission speed of the gateway, scanner sensitivity, and accuracy of the ear thermometer as needing improvement. For nurses to use automated physiological monitoring devices fully, a user-friendly design in functions and features is vital, and in-service training and a streamlined workflow are recommended to facilitate technology adoption.

A multivariate statistical evaluation of actual use of electronic health record systems implementations in Kenya

Background

Health facilities in developing countries are increasingly adopting Electronic Health Records systems (EHRs) to support healthcare processes. However, only limited studies are available that assess the actual use of the EHRs once adopted in these settings. We assessed the state of the 376 KenyaEMR system (national EHRs) implementations in healthcare facilities offering HIV services in Kenya.

Methods

The study focused on seven EHRs use indicators. Six of the seven indicators were programmed and packaged into a query script for execution within each KenyaEMR system (KeEMRs) implementation to collect monthly server-log data for each indicator for the period 2012–2019. The indicators included: Staff system use, observations (clinical data volume), data exchange, standardized terminologies, patient identification, and automatic reports. The seventh indicator (EHR variable Completeness) was derived from routine data quality report within the EHRs. Data were analysed using descriptive statistics, and multiple linear regression analysis was used to examine how individual facility characteristics affected the use of the system.

Results

213 facilities spanning 19 counties participated in the study. The mean number of authorized users who actively used the KeEMRs was 18.1% (SD = 13.1%, p<0.001) across the facilities. On average, the volume of clinical data (observations) captured in the EHRs was 3363 (SD = 4259). Only a few facilities(14.1%) had health data exchange capability. 97.6% of EHRs concept dictionary terms mapped to standardized terminologies such as CIEL. Within the facility EHRs, only 50.5% (SD = 35.4%, p< 0.001) of patients had the nationally-endorsed patient identifier number recorded. Multiple regression analysis indicated the need for improvement on the mode of EHRs use of implementation.

Conclusion

The standard EHRs use indicators can effectively measure EHRs use and consequently determine success of the EHRs implementations. The results suggest that most of the EHRs use areas assessed need improvement, especially in relation to active usage of the system and data exchange readiness.

A Systematic Review on Flood Early Warning and Response System (FEWRS): A Deep Review and Analysis

Flood is the major natural hazard in Malaysia in terms of populations affected, area extent, frequency, social–economic damage, and flood duration. This shows the importance of providing comprehensive and effective flood mitigation management, which requires government agencies to enhance their employment performance that involves technological innovation. A flood early warning and response system (FEWRS) is essential to ensure that all stakeholders receive the right information and are provided with necessary actions and response information to avoid loss of lives and property. It should have some effective usability features and success components of its strategic information access and display; existing FEWRS fail and often do not effectively provide information on flood disasters to reduce their impacts at a local level to save the population’s lives. The measurement of information system (IS) success remains a top concern for researchers, managers, and practitioners. Therefore, this study seeks to provide a systematic overview of the most successful model of employment-related technical advancement for the management of flood disasters to improve its employees’ performance. In addition, examined factors that affect the successful implementation of flood management approaches, based on a systematic literature review among IS, show interrelationship of success factors. Findings from the literature suggest that the DeLone and McLean (D&M) model is the most widely employed model, recorded in 28 studies (39%). Further description of the 28 studies indicates that the D&M was either adopted alone or integrated with other theories. Moreover, results suggest the D&M is has been applied alone 39% of the time and has been extended 29% of the time; in total, 68% of the time, D&M has been applied either alone or extended in the information system domain. Additionally, 22% of the time it has been integrated with other theories.

Assessment of success of financial information system in educational, health, and medical centers affiliated to Isfahan University of Medical Sciences

BACKGROUND

Financial information system is one of the subsystems in management information system that is very important in health institutions. The use of financial information system creating effective and efficient information flow will greatly assist the management in decision-making, so that it can achieve institutional goals easier. This study is endeavored to assess the success of financial information system in Isfahan University of Medical Sciences.

MATERIALS AND METHODS

This descriptive-correlational study was performed on the research population consisting of financial information system users in educational, health, and medical centers affiliated to Isfahan University of Medical Sciences during 2018 that were studied by the census method (n = 108) because of a small number of these users. The data were collected using a questionnaire. The content validity of questionnaire was confirmed by pooling the ideas of five academic members of the health information management and two financial information system users. The reliability of questionnaire was also estimated by Cronbach's alpha. Then, the AMOS software was used to analyze the gathered data.

RESULTS

The result shows that system quality was positively correlated to the use and user satisfaction whereas use and user satisfaction was positively correlated to net benefit (P < 0.05). Furthermore, the information quality was positively correlated to the user satisfaction (P < 0.05).

CONCLUSIONS

As per the finding of this study, to improve user's intention to use the financial information system and their satisfaction toward the system, managers need to develop useful, easy-to-understand, easy-to-learn, and easy-to-use information systems.

A Rough Hybrid Multicriteria Decision-Making Model for Improving the Quality of a Research Information System

Improving the quality of research information systems is an important goal in the process of improving the performance of research management in Chinese universities. Since the evaluation of information system (IS) quality is a multicriteria decision problem, it is critical to identify the interrelationships among the dimensions and criteria, and decide on the important criteria for proposed improvement strategies. This paper suggests a hybrid multicriteria decision-making (MCDM) model for improving the quality of a research information system. First, a rough method combined with the decision-making trial and evaluation laboratory and analytical network process (rough DANP) model is used to improve the objectivity of expert judgements. Additionally, the rough DANP can be used to construct an influential network relationship map (INRM) between research information system components to derive the criterion weights. The complex proportional assessment of alternatives with rough numbers (COPRAS-R) is applied to evaluate the performance of the research information system. A Chinese university research information system is chosen to illustrate the usefulness of the proposed model. The results show that efficiency, effectiveness, and user frequency have the highest priorities for improvement. Selected management implications based on the actual case study are supplied.

Perspective of Yemeni students on use of online learning

Purpose

Online learning has evolved into a necessary means of learning because of its capability to enhance the education quality with minimum resources and infrastructure. Nevertheless, while academics have studied the espousal and use of online learning in various settings, the effect of compatibility and transformational leadership (TL) still remains to be seen, with regards to the Yemeni context. The purpose of this paper is to forward the Delone and Mclean Information System (IS) success Model by integrating compatibility and TL constructs as precursors to user contentment and actual use for estimating performance of students.

Design/methodology/approach

The questionnaire technique was utilised for gathering primary data from 448 students in nine state-funded Yemeni universities. The six variables in the recommended framework were gauged utilising current scales. Data analysis was done by deploying structural equation modelling through SmartPLS 3.0.

Findings

The outcomes encompassed three key results: overall quality (data, system and service quality), compatibility and TL have a favourable effect on user satisfaction and actual use; actual use considerably estimates user satisfaction; and user satisfaction and actual use have a favourable effect on performance of students.

Research limitations/implications

Because the research populace comprised students from nine state-funded universities, it did not include administrative and academic staff. Furthermore, as the study was cross-sectional, it studied the variables at a single point of time. Attaining experience in utilising online learning would transform the convictions of students, and this cannot be traced through a cross-sectional scrutiny. Moreover, the research relies upon self-testified measures for ascertaining the recommended research model. The reason behind this is that obtaining objective information regarding performance was not likely because of the privacy concern.

Practical implications

Despite the fact that Yemen is a low-income emerging nation with inadequate resources (World Development Indicators, 2017), it can capitalise on online-based learning that provides the advantage of excellent education and that too with limited supplies (Dokhan and Akkoyunlu, 2016; Yang et al., 2016). Additionally, online learning can enhance administration and communication, empower learning anywhere and anytime, and endorse fairness of education.

Originality/value

This study supplements the existing studies on information systems by blending overall quality, compatibility, TL, actual use and client satisfaction for estimating the effect of online learning among students from nine state-funded Yemeni universities. Moreover, the recommended model’s predictive prowess has a higher capability to elucidate and estimate the performance effect as against those acquired from few of the previous studies.

The Effect of Barcode Technology Use on Pathology Specimen Labeling Errors

Pathology specimen labeling errors occur for a variety of reasons. We investigated the use of barcode technology as a method to improve the accuracy of pathology specimen labeling and patient safety. We also assessed nurses' perceptions of system quality, information quality, service quality, user satisfaction, and net benefits. Sixty-eight perioperative nurses who work in a teaching hospital in Taiwan completed the survey. Nurses scored net benefits as highly contributing to their satisfaction, whereas system quality contributed most to dissatisfaction. Further, we analyzed pathology specimen records before and after implementing the barcode system and found that specimen management errors significantly decreased. The use of a reliable barcode system could improve specimen labeling accuracy and enhance nurses' satisfaction with this technology.

Evaluation of a Barcode Medication Administration Information System

When a medication administration error occurs, patient safety is endangered. Barcode medication administration system usage has been implemented to reduce medication errors. The purpose of this study was to evaluate barcode medication administration system usage outcomes. A survey based on DeLone and McLean's model of information systems success was utilized. The questionnaire, composed of 27 items, explored system quality, information quality, service quality, user satisfaction, and usage benefits. It was completed by 232 nurses. User satisfaction received the highest average score, and quality of information was the most critical factor related to this result (r = 0.83, P < .01). Medication errors occurring before and after barcode medication administration use were collected, and the reasons for errors related to work process were explored. Medication errors decreased from 405 at preimplementation to 314 at postimplementation (t = 77.62, P < .001). The main reason for medication errors related to work process was "not following the standard procedure," followed by "other factors." While technology is deployed to support individual practice, organizational elements also remain important to technology adoption.

An extension of Delone and McLean IS success model with self-efficacy

Purpose

While many researchers have investigated the adoption and usage of online learning in different settings, one area that has yet to be examined thoroughly, particularly in the context of online learning in Yemen, is the self-efficacy role. The purpose of this paper is to extend the Delone and McLean information system success model by incorporating a self-efficacy construct as an antecedent to user satisfaction and actual usage to predict student performance.

Design/methodology/approach

Questionnaire survey method was used to collect primary data from 448 students in nine public universities in Yemen. The six constructs in the proposed model were measured using existing scales. The data analysed using confirmatory factor analysis and structural equation modelling via AMOS.

Findings

Three main results were revealed, namely that overall quality (system, information and service quality) and self-efficacy have a positive impact on user satisfaction and actual usage; that actual usage significantly predicts user satisfaction; and that both user satisfaction and actual usage have a positive impact on student performance.

Research limitations/implications

First as the study population were students from nine public universities, it excluded academics and administrative staff. Second, the study depends on self-reported measures to test the proposed research model. This is because getting objective data about the performance was not probable due to the issue of privacy.

Practical implications

The findings of this study can be a guideline for Yemeni higher education institutions to develop efficient and effective plans to improve the performance of education institutions, and train and develop student ability to use online learning. Additionally, it highlights the areas that university management needs to concentrate on, namely information systems (IS) tools that will contribute to higher student enrolment, address the lack of infrastructure and improve the quality of education outcomes, things which represent Yemen’s main challenges in the higher education sector.

Originality/value

This paper adds to the existing literature of IS by combining overall quality, self-efficacy, actual usage and user satisfaction to predict performance impact of online learning among students in nine public universities in Yemen. Furthermore, the predictive power of the proposed model has a higher ability to explain and predict performance impact compared to those obtained from some of the previous studies.

Cultural orientations and information systems success in public and private hostitals: preliminary evidences from Italy

Background

The effective adoption and use of digital and computerized systems and records in hospitals are crucial for increasing the overall quality, safety and outcomes of any national health community. Prior research found that hospitals’ dominant cultural orientation affects the adoption of new technology. However, the organizational culture of hospitals can greatly vary between public and private hospitals. Thus, the ownership type of the hospital is likely to affect, to some extent, the aforementioned relationship between culture and information system success. The present article focuses in detail on this issue and attempts to answer the following research question: which cultural orientations are promoting information system success in public and private hospitals?

Methods

The authors develop and test two hypotheses about this relationship via two regression approaches (single-level and multi-level). The authors collected data from 172 respondents—clinicians and non-clinicians—working in two (one public and one private) hospitals in Campania, one of the largest regions in Italy.

Results

The findings of this study show clear differences between private and public hospitals. First, a dominant cultural orientation that emphasizes flexibility values (clan and adhocracy cultures) positively influences information systems success in terms of individual impact. Second, the influence of a clan orientation on individual impact is stronger in the public hospital. Third, the influence of an adhocracy orientation is stronger in the private hospital. Overall, the type of ownership—either public or private—of these healthcare organizations affects the link between cultural orientations and IS success.

Conclusion

Managers of private hospitals should offer to their employees the opportunity to adopt and implement new information systems processes driven by openness towards the external environment in order to benchmark and learn from what was done previously in other organizations. Managers of public hospitals should set up human resource management practices, knowledge creation mechanisms, and internal communication capable of generating a friendly learning environment for their employees when adopting new technology.

Evaluation of an Academic and Student Administration System in its Post-Implementation Phase

The article seeks to evaluate the Academic and Student Administration System (ASAS) at the University of Botswana (UB) in order to determine whether the system was performing successfully in its post-implementation phase. It was guided by the Delone and Mclean IS success evaluation model. Three independent ASAS quality variables and one dependent variable (user satisfaction) were included in the study Model. The study also examined if the Model was appropriate for evaluating ASAS in the UB context. The study used quantitative approaches that included a questionnaire, and statistical tools such as reliability test, descriptive statistics, and paired samples t-test. The study found that: (1) users were satisfied with the ASAS performance; however, they felt that there was still room for improvement; (2) the Model was found to be credible for evaluating ASAS in the UB context. Areas that needed improvement were identified and recommendations were made on how to address them.

Evaluation of the unified model of information systems continuance (UMISC) in two hospital environments

CONTEXT

The deployment and long-term acceptance of clinical information systems (CISs) are faced with multiple difficulties. They include insufficient quality of the systems in place and resistance to the multiple changes they induce in care processes. Permanent evaluation of deployed solutions is a prerequisite to their continuous improvement.

OBJECTIVE

The purpose of this study was twofold: (1) To validate the post-adoption unified model of information systems continuance (UMISC) progressively developed at the Georges Pompidou University Hospital (HEGP) in Paris (internal validation); and (2) To compare, using the same evaluation model, the results observed at HEGP with those of the Saint-Joseph Hospital Group (HPSJ), another Paris acute care institution (external validation).

METHODS

The UMISC post-adoption model is built around nine dimensions: end-user characteristics, social norm (SN), IS quality (ISQ), facilitating conditions (FC), perceived usefulness (PU), confirmation of expectations (CE), profession-adjusted use (PAU), satisfaction (SAT), and continuance intention (CI). Two semi-quantitative evaluation surveys were performed at HEGP in 2014 and 2015, and one at HPSJ in 2015. Statistical analysis included multiple regression analysis and structural equation modeling (SEM).

RESULTS

The analysis concerned 459 responders, 264 at HEGP and 195 at HPSJ. UMISC indicators, with the exception of SN, are superior at HEGP than at HPSJ, which had a shorter CIS anteriority than HEGP. In SEM analysis, the UMISC model explained 25% and 40% of the CIS use, 92% and 93% of health professionals' satisfaction, and 72% and 71% of continuance intention at HEGP and HPSJ, respectively. Seventeen of the 21 tested UMISC hypotheses were supported in at least one of the two sites.

CONCLUSION

The UMISC evaluation model can be used as a comparison and explanatory model of CIS use, satisfaction and continuance intention in post-CIS adoption situations that become prevalent in current electronic hospitals.

Success or failure of hospital information systems of public hospitals affiliated with Zahedan University of Medical Sciences: A cross sectional study in the Southeast of Iran

INTRODUCTION

After implementation, evaluation of hospital information systems (HISs) is critical to ensure the fulfillment of the system goals. This study aimed to assess the success or failure of HISs in public hospitals affiliated with Zahedan University of Medical Sciences.

MATERIALS AND METHODS

A cross-sectional descriptive and analytic study was performed in 2016. The study population comprised IT and HIS authorities and hospital information system users. The sample consisted of 468 participants. The data were collected using two questionnaires and analyzed with the SPSS software using descriptive and analytical statistics.

RESULTS

The mean score of functional, behavioral, ethical, organizational, cultural and educational factors from the users' perspective was 3.14±0.66, 2.97± 0.60, 3.39±0.70, 2.96±0.642, 3.09±0.63, and 2.95±0.74, respectively. The mean score of organizational, behavioral, cultural, technological, educational and legal factors from IT and HIS authorities' perspective was 3.51±0.54, 3.35±0.45, 2.75±0.61, 3.58±0.32, and 3.96±0.59, respectively.

CONCLUSIONS

The evaluated hospital information systems were considered relatively successful in terms of functional, ethical, and cultural factors but were considered as a relative failure in terms of behavioral, organizational, and educational factors form the users' perspective. Only the legal factor showed success, while organizational, behavioral, technical and educational factors showed relative success and the cultural factor showed relative failure from HIS and IT authorities' perspective. Therefore, assessing the users' needs before implementing the system, involving them in various stages of implementation, training them, and improving their computer skills seem to be necessary to achieve a better level of system success.

Internet usage, user satisfaction, task-technology fit, and performance impact among public sector employees in Yemen

Purpose

The internet technology becomes an essential tool for individuals, organizations, and nations for growth and prosperity. The purpose of this paper is to integrate the DeLone and McLean IS success model with task-technology fit (TTF) to explain the performance impact of Yemeni Government employees.

Design/methodology/approach

Questionnaire survey method was used to collect primary data from 530 internet users among employees within all 30 government ministries-institutions in Yemen. The four constructs in the proposed model were measured using existing scales. The data analysis starts with initial exploratory factor analysis, then confirmatory factor analysis and lastly structural equation modeling via AMOS.

Findings

The results showed that the proposed integrated model fits the data well. Findings of the multivariate analysis demonstrate four main results. First, actual usage has a strong positive impact on user satisfaction, TTF, and performance impact. Second, user satisfaction has a great influence on performance impact. Third, TTF has a strong positive impact on user satisfaction and performance impact. Fourth, both user satisfaction and TTF mediate the relationship between the actual usage and performance impact.

Research limitations/implications

The public sector in Yemen contains three parts: Yemeni prime minister, Yemeni ministries, and government agencies. This study focuses only on the Yemeni employees among Yemeni ministries; hence the results are not necessarily generalizable. Moreover, there are biases when the researcher measures the actual Internet usage variable through asking a participant about their opinion regarding their usage because these are generally found to differ from the true score of system usage.

Practical implications

The findings should be very useful for the Yemeni Government in presenting the importance of information technology effects on individual efficiency and effectiveness. Therefore, the information from these findings should encourage and support the formation of future policy at the organizational level and national level. If the government utilizes these findings by setting up strategies to promote internet usage, this may, in turn, improve professional practice, personal development, and quality of working life.

Originality/value

This paper adds to the existing literature of information systems by combining actual technology usage, user satisfaction, and TTF to predict performance impact within the organizations. Furthermore, this study proposed a second-order model of performance impact in order to increase the power of explaining the output by the model, which contains four first-order constructs: process, knowledge acquisition, communication quality, and decision quality. The predictive power of the proposed model has a higher ability to explain and predict performance impact compared to those obtained from some of the previous studies.

Application of Queueing Theory to the Analysis of Changes in Outpatients' Waiting Times in Hospitals Introducing EMR

Objectives

This research used queueing theory to analyze changes in outpatients' waiting times before and after the introduction of Electronic Medical Record (EMR) systems.

Methods

We focused on the exact drawing of two fundamental parameters for queueing analysis, arrival rate (λ) and service rate (µ), from digital data to apply queueing theory to the analysis of outpatients' waiting times. We used outpatients' reception times and consultation finish times to calculate the arrival and service rates, respectively.

Results

Using queueing theory, we could calculate waiting time excluding distorted values from the digital data and distortion factors, such as arrival before the hospital open time, which occurs frequently in the initial stage of a queueing system. We analyzed changes in outpatients' waiting times before and after the introduction of EMR using the methodology proposed in this paper, and found that the outpatients' waiting time decreases after the introduction of EMR. More specifically, the outpatients' waiting times in the target public hospitals have decreased by rates in the range between 44% and 78%.

Conclusions

It is possible to analyze waiting times while minimizing input errors and limitations influencing consultation procedures if we use digital data and apply the queueing theory. Our results verify that the introduction of EMR contributes to the improvement of patient services by decreasing outpatients' waiting time, or by increasing efficiency. It is also expected that our methodology or its expansion could contribute to the improvement of hospital service by assisting the identification and resolution of bottlenecks in the outpatient consultation process.

Validation of the DeLone and McLean Information Systems Success Model

Objectives

This study is an adaptation of the widely used DeLone and McLean information system success model in the context of hospital information systems in a developing country.

Methods

A survey research design was adopted in the study. A structured questionnaire was used to collect data from 442 health information management personnel in five Nigerian teaching hospitals. A structural equation modeling technique was used to validate the model's constructs.

Results

It was revealed that system quality significantly influenced use (β = 0.53, p < 0.001) and user satisfaction (β = 0.17, p < 0.001). Information quality significantly influenced use (β = 0.24, p < 0.001) and user satisfaction (β = 0.17, p < 0.001). Also, service quality significantly influenced use (β = 0.22, p < 0.001) and user satisfaction (β = 0.51, p < 0.001). However, use did not significantly influence user satisfaction (β = 0.00, p > 0.05), but it significantly influenced perceived net benefits (β = 0.21, p < 0.001). Furthermore, user satisfaction did not significantly influence perceived net benefits (β = 0.00, p > 0.05).

Conclusions

The study validates the DeLone and McLean information system success model in the context of a hospital information system in a developing country. Importantly, system quality and use were found to be important measures of hospital information system success. It is, therefore, imperative that hospital information systems are designed in such ways that are easy to use, flexible, and functional to serve their purpose.

Diffusion of Electronic Medical Record Based Public Hospital Information Systems

Objectives

This study was conducted to evaluate the adoption behavior of a newly developed Electronic Medical Record (EMR)-based information system (IS) at three public hospitals in Korea with a focus on doctors and nurses.

Methods

User satisfaction scores from four performance layers were analyzed before and two times after the newly develop system was introduced to evaluate the adoption process of the IS with Rogers' diffusion theory.

Results

The 'intention to use' scores, the most important indicator for determining whether or not to adopt the IS in Rogers' confirmation stage for doctors, were very high in the third survey (4.21). In addition, the scores for 'reduced medication errors', which is the key indicator for evaluating the success of the IS, increased in the third survey for both doctors and nurses. The factors influencing 'intention to use' with a high odds ratio (>1.5) were the 'frequency of attendance of user training sessions', 'mandatory use of system', 'reduced medication errors', and 'reduced medical record documentation time' for both doctors and nurses.

Conclusions

These findings show that the new EMR-based IS was well accepted by doctors. Both doctors and nurses also positively considered the effects of the new IS on their clinical environments.