Historically, CSI models have been used at macro levels where the satisfaction of customers at the national level or the level of an enterprise was the matter of concern.
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The ECSI model consists of 9 latent construct variables, which are measured by a series of measure or manifest variables. The American Customer Satisfaction Index improved the Swedish version, and then the European Customer Satisfaction Index (ECSI) enhanced the American version. The original CSI model was introduced in Sweden. There are at least three versions of CSI widely being used. At the same time, it impacts lagging indicators such as user loyalty. There, the satisfaction construct is affected by leading indicators such as perceived quality. The Customer Satisfaction Index (CSI) model family places the satisfaction construct at the core of their path structures. There are also models, whether novel or customized from the mainstream, that are specific to a smaller context such as health information systems. Some of these models have largely been employed in diverse contexts. Researchers have tried to capture and demonstrate through the models how success, acceptance, or satisfaction are created by constructs such as perceived quality, perceived expectation, ease of use, and other variables. Below this layer of top indicators, there exist sets of constructs and relationships that cause success, acceptance, or satisfaction. For an overall evaluation of these systems, one might measure how well these information systems succeed, how these technologies are accepted by users, or how the customers of these systems, patients, or professionals are satisfied with these products. Each of these keywords reminds us how a health information system inherits traits from its conceptual ancestors, that is, the information system, technology, and product. The normative evaluation of health information systems is articulated through a frequently used set of keywords such as acceptance or adoption, success, and satisfaction. For the next step, 2 partial least squares structural equation modeling (PLS-SEM) path models were developed using the quality and satisfaction measure variables and the latent construct variables that were suggested by the UVON method. The results were analyzed using Kendall correlation coefficients matrices, incorporating the quality and satisfaction aspects. In the questionnaires, the user was asked if the system has improved the specified qualities and if the user was satisfied with the system.
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Moreover, 2 similar questionnaires for 87 patient users and 31 health professional users were elicited from the ontology. The ontology included and unified the required qualities of those systems together with the aspects suggested by the Model for ASsessment of Telemedicine apps (MAST) evaluation framework. The eHealth apps were deployed across 7 EU countries. The Unified eValuation using ONtology (UVON) method was used to construct an ontology of the required qualities for 7 electronic health (eHealth) apps being developed in the Future Internet Social and Technological Alignment Research (FI-STAR) project, a European Union (EU) project in electronic health (eHealth).