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National healthcare services (NHS) is the management policy of healthcare services affairs that deals with the issues of long-term healthcare, disease prevention, and generic health services at the national level. It can be considered as a large scale application that can influence the well-being of people from different social levels. In the U.S., the healthcare expenditure consumed 16% ($1.9 trillion) of the nation's gross domestic product (GDP) in 2004; and is further projected to grow to 17.7% by 2012 (Bhattacherjee, Hikmet, Menachemi, & Kayhan, 2007; Smith Cowan, Heffler, & Catlin, 2006). In the U.K., £12-£20 billion was spent on the national programme for IS to facilitate the applicability of global healthcare and the performance of NHS (Avison & Young, 2007). Investment in IS for handling NHS affairs is prevalent in developed countries.
Likewise, in terms of the developing countries, for improving the quality and effectiveness of the national services to their citizens, the governments in most countries are raising a modern administration to conduct national information exchange (Ndou, 2004). The government in Taiwan, also, has invested a huge amount in NHS from 2000 to 2004, and the expenditure rapidly increased from $569,236 to $664,698 (in millions) (Bureau of Health Promotion, 2006). However, for governing such huge national healthcare expenses, the lack of IS assistance has caused many kinds of troublesome management issues (Avison & Young, 2007; Khoumbati, Themistocleous, & Irani, 2006).
Despite the information system having been commonly applied in many areas, with many failed applications, its development is relatively slow and difficult in the management of NHSS (Avison & Young, 2007; Hendy, Reeves, Fulop, Hutchings, & Masseria, 2005). National healthcare services systems (NHSS) is a type of e-Government information system in modern administrative practices for providing information needed by public healthcare workers, and helping the managers in NHS have better control (Jeffcott & Johnson, 2002; Khoumbati et al., 2006). Recently, there have been vast amounts of research concerning traditional admin/business IS and healthcare information systems (HIS) (Chang, Chang, Ho, Yen, & Chiang, 2011; Lee & Shim, 2007), but few of them focus on NHSS. To understand and measure the factors affecting the success of NHSS is becoming increasingly important for managing the government’s national healthcare services affairs, and it is thus necessary to conduct research on this issue. Yet, measuring NHSS success is a complex and difficult task because the implementation of NHSS has the characteristics of user heterogeneity and inter-organizational features at different levels of public healthcare centers.
The development of NHSS is driven by the needs of public healthcare workers and the impact of complex organizational functions. Numerous studies suggest that the D&M model has become a prevalent and popular mean for measuring IS success (DeLone & McLean, 2003; Iivari, 2005; Wu & Wang, 2006). From the viewpoint of quality perspective, the DeLone and McLean IS success model (D&M model) seems to be a sound framework and the basis of measuring NHSS success. However, the implementation of NHSS is different from other IS in business and distinct from HIS in common hospitals since it possesses the NHSS feature of user heterogeneity and inter-organizational collaboration. Therefore, the assessment of NHSS success is more than the story of evaluation from a system characteristics, the ability of the updated D&M model in explaining the complex factors of NHSS success is questionable.