Picture Archiving and Communication Systems (PACS) is an important e-health application, playing a significant operational role within hospitals in electronically transmitting image-based data. Various authors have attributed a range of benefits to PACS, including diagnostic accuracy (Scott et al., 1995; Slasky et al., 1990), interpretation time savings (Kato et al., 1995), workflow (Gale, Gale, Schwartz, Muse & Walker, 2000) and user satisfaction (Philling, 1999). While there is general consensus that PACS brings some or all of these benefits, there is little agreement as to the mechanism through which these benefits are generated. The work of Delone and McLean (2003) provides a generalized model that attributes information systems success to benefits accruing from relationships between characteristics of the information system (e.g., information quality, system quality, service quality) and user intention to use and user satisfaction (see Figure 1). This chapter provides empirical evidence that the Delone and McLean (2003) model with modifications explains the source of PACS benefits. Not only do we suggest a new model, but we also recommend that each specific information system context may require specific modification of Delone and McLean’s (2003) model to explain the source of success.
Key Terms in this Chapter
Viewing Environment: The characteristics of the workspace in which digital images are viewed.
Hospital Strategy: An integrated set of actions with a focus on increasing the long-term prosperity and strength of hospitals relative to its environment and (strategic) goals.
Strategy: A pattern of decision in a company that determines and reveals its objectives, purposes, or goals; produces the principal policies and plans for achieving those goals; and defines the range of business the company is to pursue, the kind of economic and human organization it is or intends to be, and the nature of the economic and noneconomic contribution it intends to make to its shareholders, employees, customers, and communities.
Service quality: The degree of inconsistency between customers’ normative expectations for the service and their perceptions of service performance (Parasuraman et al., 1985).
Information Quality: Concerned with such issues as the relevance, timeliness, and accuracy of information generated by an information system (Seddon, 1997).
Evaluation: The systematic acquisition and assessment of information using an overarching perspective to provide useful feedback about some sort of object/subject.
Information Systems: A system that comprises people, machines, and/or methods organized to collect, process, transmit, and disseminate data that represent information.
Not for Profit: The concept that the primary objective is to support some issue or matter of private interest or public concern for noncommercial purposes.
Environmental Training: Represents activities that teach staff how to better perform their present jobs in order to cope with environmental changes, such as changes in lighting, monitors, and so forth.
System Quality: Concerned with whether or not there are “bugs” in the system, the consistency of the user interface, ease of use, quality of documentation, and sometimes quality and maintainability of the program code (Seddon, 1997).