OBJECTIVE: An application service provider (ASP) is a business that provides computer-based services to customers over a network. The need for ASPs has developed due to increasing costs of information systems, which have far exceeded the price-range of small to medium sized businesses. The ASP could be considered as a potential strategy in hospital information systems (HIS). This study investigates significant factors influencing the adoption of an ASP in hospitals. METHODS: Two survey instruments were developed for information technology (IT) experts in hospitals and IT companies, respectively, and a total of 101 responses were analyzed using SAS, version 9.1. Respondents' characteristics were presented using descriptive statistics, while factor analyses were performed for ASP characteristics and influencing factors for ASP adoption. Regression analyses enabled the understanding of relationships between factors and attitudes toward ASP adoption. RESULTS: Nine factors were derived: efficiency, availability, responsiveness, security, resistancy, service quality, attitude toward information-oriented work of CEO or IT experts, environment, and user attitude. Except for responsiveness and CEO or IT experts' attitude, the seven factors had significant effects on the adoption of an ASP in hospitals. In particular, security and user attitude showed negative effects on ASP adoption. There were variations in the subsystems of HIS. CONCLUSION: For adopting ASP in hospitals, efficiency, availability, security, resistancy, service quality, environment, and user attitude need to be considered, especially security and user attitude. This study allowed the understanding and comparative analysis of user (hospitals) and supplier (IT companies) perspectives of information systems in terms of ASP adoption in hospitals.
Adoption ; Commerce ; Hospital Information Systems ; Information Systems ; Phenothiazines ; Viperidae ; Surveys and Questionnaires

OBJECTIVE: Mid-sized hospital websites were assessed to examine how their attributes influence outcome indicators as a potential marketing strategy. Specifically, the website attributes considered were accessibility, content sufficiency, and layout design, while outcome indicators were evaluated, based on satisfaction with the website, intention to revisit the website, and intention to recommend the hospital. METHODS: Five representative websites were selected according to their ranks derived from major ranking sites. The diversity of the websites were emphasized. Then, a questionnaire survey was conducted on 74 respondents. Collected data was analyzed, using frequency, correlation, and repeated measures analysis of variance. RESULTS: All three attributes were related to satisfaction with the website; in addition, both content sufficiency and layout design were significantly related to the intention to revisit. As for the intention to recommend the hospital, only the content sufficiency was significant. In particular, the sufficiencies on 'disease or symptoms' and 'question and answer' were important to all three outcome indicators. CONCLUSION: The websites serve as a marketing tool in managing mid-sized hospitals. Well-designed websites containing sufficient contents facilitate visitor's satisfaction and intention to revisit the website, as well as furthering their intention to recommend the hospital.
Surveys and Questionnaires ; Hospital Administration ; Intention ; Internet ; Marketing ; Personal Satisfaction

BACKGROUND/AIMS: To suggest a lexicon for liver ultrasonography and to identify radiologic features indicative of benign or malignant lesions on surveillance ultrasonography. METHODS: This retrospective study included 188 nodules (benign, 101; malignant, 87) from 175 at-risk patients identified during surveillance ultrasonography for hepatocellular carcinoma. We created a lexicon for liver ultrasonography by reviewing relevant literature regarding the ultrasonographic features of hepatic lesions. Using this lexicon, two abdominal radiologists determined the presence or absence of each ultrasonographic feature for the included hepatic lesions. Independent factors associated with malignancy and interobserver agreement were determined by logistic regression analysis and kappa statistics, respectively. RESULTS: Larger tumor size (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.06-1.183; P<0.001), multinodular confluent morphology (OR, 7.712; 95% CI, 1.053-56.465; P=0.044), thick hypoechoic rim (OR, 5.878; 95% CI, 2.681-12.888; P<0.001), and posterior acoustic enhancement (OR, 3.077; 95% CI, 1.237-7.655; P=0.016) were independently associated with malignant lesions. In a subgroup analysis of lesions <2 cm, none of the ultrasonographic features were significantly associated with malignancy or benignity. Interobserver agreement for morphology was fair (κ=0.36), while those for rim (κ=0.427), echogenicity (κ=0.549), and posterior acoustic enhancement (κ=0.543) were moderate. CONCLUSIONS: For hepatic lesions larger than 2 cm, some ultrasonography (US) features might be suggestive of malignancy. We propose a lexicon that may be useful for surveillance US.
Acoustics ; Carcinoma, Hepatocellular* ; Humans ; Liver ; Logistic Models ; Retrospective Studies ; Ultrasonography*