Abstract
The quality of service (QoS) can be treated as a set of concepts whose satisfaction/dissatisfaction generates a global positive/negative vision about the service provided by any application. The different nature of the services and its features require an analysis of the factors that have the greatest influence on the users’ opinion and, therefore, measuring the quality of service in each application requires a specific instrument. This paper will introduce an instrument to measure the QoS offered to users by a general Web application for Electronic Health Records (EHRs). The collection of opinions from a pilot sample and the performance of an explanatory factor analysis will bring together the factors that best sum up the quality of an EHRs application. Subsequently, a confirmatory factor analysis will be performed to make the study reliable and, as its name suggests, to confirm that indeed the structure of the instrument developed measures the QoS in accordance with the requirements of the users.



Similar content being viewed by others
References
Phillippi, J. C., and Buxton, M., Web 2.0: Easy tools for busy clinicians. J. Midwifery Womens Health 55(5):472–476, 2010.
Taylor, P., Evaluating telemedicine systems and services. J. Telemed. Telecare 11:167–177, 2005.
Otieno, G. O., Hinako, T., Motohiro, A., Daisuke, K., and Keiko, N., Measuring effectiveness of electronic medical records systems: Towards building a composite index for benchmarking hospitals. Int. J. Med. Inform. 77(10):657–669, 2008.
Karagiannis, G. E., Stamatopoulos, V. G., Rigby, M., Kotis, T., Negroni, E., Munoz, A., and Mathes, I., Web-based personal health records: the personal electronic health record (pEHR) multicentred trial. J. Telemed. Telecare 13:32–34, 2007.
Mäkelä, K., Virjo, I., Aho, J., Kalliola, P., Koivukoski, A. M., Kurunmäki, H., Kähärä, M., Uusitalo, L., Valli, M., Vuotari, V., and Ylinen, S., Electronic patient record systems and the general practitioner: An evaluation study. J. Telemed. Telecare 11:66–68, 2005.
Hira, A. Y., et al., Web-based patient records and treatment guidelines in paediatric oncology. J. Telemed. Telecare 11:53–55, 2005.
Yoon, D., Chang, B. C., Kang, S. W., Bae, H., and Park, R. W., Adoption of electronic health records in Korean tertiary teaching and general hospitals. Int. J. Med. Inform. 81(3):196–203, 2012.
Schenarts, P. J., and Schenarts, K. D., Educational impact of the electronic medical record. J. Surg. Educ. 69(1):105–112, 2012.
Argüello, M., Des, J., Fernández, J., Pérez, R., and Paniagua, H., Executing medical guidelines on the web: Towards next generation healthcare. Knowl.-Base. Syst. 22(7):545–551, 2009.
Huang, E. W., Hsiao, S. H., and Liou, D. M., Design and implementation of a web-based HL7 message generation and validation system. Int. J. Med. Inform. 70(1):49–58, 2003.
Veselý, A., Zvárová, J., Peleška, J., Buchtela, D., and Anger, Z., Medical guidelines presentation and comparing with Electronic Health Record. Int. J. Med. Inform. 75(3–4):240–245, 2006.
Esper, G. J., Drogan, O., Henderson, W. S., Becker, A., Avitzur, O., and Hier, D. B., Health information technology and electronic health records in neurologic practice. Neurol. Clin. 28(2):411–427, 2010.
Byrne, B. M., Structural equation modeling with AMOS. Basis concepts, applications and programming. Multivariate application book series. pp. 107–141, 2001.
Sweeney, J. C., and Lapp, W., Critical service quality encounters in the Web: An exploratory study. J. Serv. Market. 18(3):276–289, 2004.
Zeithaml, V. A, Parasuraman, A., Malhotra, A., A conceptual framework for understanding e-service quality: Implications for future research and managerial practice. Marketing Science Institute, 2000.
Jun, M., Yang, Z., and Kim, D., Customers’ perceptions online retailing service quality and their satisfaction. Int. J. Qual. Reliab. Manag. 21(8):817–840, 2004.
Vincent, S. L., and Honglei, L., Technology acceptance model for internet banking: An invariance analysis. Inf. Manage. 42(2):373–386, 2005.
Liu, C., Du, T., and Tsai, H., A study of the service quality of general portals. Inf. Manage. 46:52–56, 2009.
Barnes, S., and Virgen, R., An evaluation of cyber-bookshops: The WebQual method. Int. J. Electron. Commerce 6(1):11–30, 2001.
De la Torre-Díez, I., et al., Choosing the most efficient database for a Web-based system to store and exchange Ophthalmologic Health Records. J. Med. Syst. 35(6):1455–1464, 2011.
De la Torre-Díez, I. et al., Performance evaluation of a Web-based system to exchange Electronic Health Records using queueing model (M/M/1). J. Med. Syst., 2010. (In press). doi: 10.1007/s10916-010-9555-3.
Bernstein, I. H., Likert scale analysis. University of Texas, Arlington, Arlington, 2005.
Acknowledgements
This work has been partially supported by the Instituto de Telecomunicações, Next Generation Networks and Applications Group (NetGNA), Portugal, by National Funding from the FCT—Fundação para a Ciência e a Tecnologia through the PEst-OE/EEI/LA0008/2011 Project.
Conflict of Interest
The authors declare that there is no conflict of interest with the contents of this manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
de la Torre-Díez, I., López-Coronado, M. & Rodrigues, J.J.P.C. How to Measure the QoS of a Web-based EHRs System: Development of an Instrument. J Med Syst 36, 3725–3731 (2012). https://doi.org/10.1007/s10916-012-9845-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10916-012-9845-z