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J Med Syst (2014) 38:76 DOI 10.1007/s10916-014-0076-3 SYSTEMS-LEVEL QUALITY IMPROVEMENT Assessing the Relationship between Technology iness and Continuance Intention in an E-Appointment System: Relationship Quality as a Mediator Shih-Chih Chen Din Jong Min-Tsai Lai Received: 23 February 2014 /Accepted: 3 June 2014 # Springer Science+Business Media New York 2014 Abstract Numerous types of self-service technologies have Introduction prevailed due to innovations in network and information technology. To hospitals, patient intentions to continue to Advances in Information Technology (IT) have fostered the use the e-appointment system are crucial. Previous investiga- sp of network services. People’s lifestyle has changed tions discussed only the relationships between the technology because they can engage in Internet banking or shop iness of users and their continuance intentions, and ig- online, thus ing themselves from temporal and geograph- nored the most important mediator, relationship quality. This ical constraints. Numerous companies have devoted their study explored the relationships among technology iness, energies to cyberspace in an effort to increase their competi- relationship quality, and continuance intention. The research tive advantage. Even traditional industries such as medicine results demonstrated that both optimism and innovativeness including hospitals, have begun to incorporate IT into their significantly and positively influenced continuance intention services. E-appointment is a Hospital Outpatient Pre-register through the mediating effect of relationship quality. However, Appointment System that involves patients making appoint- discomfort