he high-quality health service contributes to improving the health organization's reputation, and this helps it to survive and grow in a competitive environment. Al-Shatrah General Hospital is one of the governmental health organizations that provide health services for patients. Patients often review private sector hospitals instead of reviewing government sector hospitals. They perceive that private sector hospitals have health hardware, equipment, software, and human resources that help in accurate medical diagnosis. Therefore, the study of the impact of information and communication technology in improving the technical quality of health services with a view to diagnosing weaknesses and defects and providing solutions to increase patients' confidence in the health services provided in Al-Shatrah General Hospital. Edlund et al (2003) conducted a study to analyze the relationship between satisfaction and technical quality of care for common mental disorders.

The results of the study indicated an association between effect and quality between technical quality and patient satisfaction. The Al-Hassan et al. (2015) study was a statistical test to determine differences in health service perceptions from the service provider and the patient, as the study results showed that teaching patients to comply will help improve the technical quality of health services. Barr et al. (2017) study revealed that the success of information and communication technology depends on supporting social relations and technological organization. The goal of improving information and communication technology will improve the technical quality of health services. Omona and Odongo (2006) have studied the evaluation of the application of information and communications technology in accessing health information in Uganda, where it was interested in analyzing the current situation of information and communication technology applications and the cost of accessing medical information and literacy of information and communications technology. Healthy.

This study is the first of its kind in the Iraqi health sector as the effect of information and communication technology in improving the technical quality of health services have not been studied previously. Technical quality is one of the topics that has not been highlighted by researchers in the Iraqi environment, as it was studied for the first time in the field of Iraqi higher education by (Khaleel and Sayah, 2020), and this study is the second of its kind in terms of its study of the technical quality variable in general and the first in terms of its specialization In the Iraqi health sector.

Technology is a term consisting of two parts: the first Techno meaning practical application; The second is Logy, which means science, and therefore technology means "applied science" (Hasson, 2017). The interaction of technology with information was why the emergence of the term information and communication technology (acronym). It is intended to use modern techniques of computer science and technical analysis in organizing the amount of data and information related to all aspects of life (Alshahrabally and Dawood, 2017).

Apulu and Latham (2011) indicated that information technology and communication is a tool that facilitates communication, processing, information transfer, and knowledge sharing through electronic means. Binuyo and Aregbeshola (2014) referred to it as a wide range of computerized technologies that allow communication, electronic information capture, processing, and transmission. They identified it (Hasan et al., 2016) as a study; Design; Development; Implementation of; Support and management of computer-based information systems, especially software and computer applications. Gargvanshi and Kumar (2020) defined it as a general term that includes the various technologies that deal with information, processing, and presenting it to the people concerned. Information and communications technology can be defined as the systems and tools supporting communication and cooperation between people and organizations efficiently and effectively.

Information and communication technology is important in business strategies because it has a role in improving the competitive situation. It contributes at the industry level to changing its nature in which organizations compete through the integration of industry with computers and various other formations of flexible production. The emergence of information technology has created new opportunities for the top management of organizations. On the level of production economics, the organization's possession of information and communication technology contributes to reducing costs, reducing effort, and optimal use of available resources and highlights the importance of information and communication technology at the level of distribution and marketing activities. The organization's possession of information technology and a modern and advanced communications network enables it to control weaknesses in the market; helps her make the appropriate decisions in marketing (Hammadi et al., 2018;Saleem et al., 2020). Omona and Odongo (2006) pointed out that the importance of information and communication technology in health services lies in the following: Provide high-quality, up-to-date information and data;

? Avoid geographical boundaries, as people from all over the world have access to information;

Information and communications technology in health services is affected by the occupational or career conflict of roles, responsibilities, and cultures. As the absence of explicit rules governing behavior in how and when the communication process is conducted, information and communication technology can exacerbate the differences between cultures. The skills that the medical staff possess are one of the factors affecting information and communication technology, in which health institutions must adopt a continuing education curriculum; and create an appropriate job climate compatible with information and communication technology applications (Barr et al., 2017). Yassir and Dakhil (2016) They mentioned a group of factors that affect information and communication technology, as follows:

? Administrative decision: The administrative decision affects the role of information and communications technology and to facilitate the user's needs (customer, organization) of data. ? Computing: Computing is the factory of information technology and its developer. Political, economic, and security factors: These factors may affect study or training plans (related to information technology) that are set by countries. For example, fees or cancellations of many training programs are imposed due to economic conditions, which makes information technology weak and does not rise to the level of performance.

Most researchers agreed that (hardware, equipment, software, communication networks, human resources) represent the components of information and communications technology that depend on them for data collection, processing, and conversion into information that is published, distributed, stored, updated, and retrieved (Hammadi et al., 2018). Accordingly, the current study will address the components of information and communications technology as a measurement model that includes dimensions according to the following:

? Hardware and Equipment: This dimension focuses on the hardware and equipment needed to run the software. The computer may be the most obvious part of this dimension, and this dimension includes medical devices, imaging devices, data projectors, and data entry devices such as mouse and keyboard (Sittig and Singh, 2015). ? Software: Represents drivers guide the hardware components of hardware and equipment (Hammadi et al., 2018). This dimension includes system drivers and application software and is responsible for processing, storing, retrieving, and transmitting health data as needed (Sittig and Singh, 2015).

Networks: Communication technology is important and has a valuable content in information and communication technology and represents a group of computers and surrounding devices connected to allow users to exchange information (Abdul Hadi and Hadi, 2018).

? Human Resources: The most important aspect of information and communication technology because they that it is the decision-maker in determining the usefulness of information for adoption in the decision-making process, and they are the people who operate and manage information and communication technology (Hammadi et al., 2018).

The American Joint Commission on Accreditation of Hospitals (JCAH) defines the quality of the health service as the level of adherence to standards approved for good practice and the expected results of the health service or diagnosis or medical problem (Al Jazari et al., 2011). Quality should be available in the health services provided to patients according to predefined specifications and standards and presented at the required times in a manner that achieves patient satisfaction (Musleh, 2017).

Technical quality seeks to achieve customer satisfaction and gain and maintain their loyalty. The technical quality of health services depends on good diagnostic methods, information systems, and infrastructure and the skills of service providers (Mittal and Lassar, 1998). The technical quality of health services is defined as the knowledge and technology side. It represents the knowledge, skills, and experiences and the degree of scientific and technological progress available for medical care, techniques, and methods used in medical care (Al Jazari et al., 2011). While (Ghebremichael, 2019) defined it as customer perception of quality about the final (actual) result of the service. Al Hassan et al. ( 2015) defined technical quality in health services as the extent to which health services meet the standards Predetermined. Accordingly, the technical quality of health services can be defined as the final and actual result that patients receive. Al hassan et al., ( 2015) referred that the quality of health services is divided into two types, namely technical quality, and perceived quality. While (Edlund et al., 2003) referred that the quality of health services is classified into:

? Technical Quality: Relates to the extent to which the health service conforms to the standards previously determined by the service provider. ? Personal Quality: which represents the quality of medical personnel ? Patient comfort: It relates to the amenities that affect patients regarding the level of service.

It can be said personal quality represents the functional quality of health services as it relates to how to provide services to patients and the relationships that arise between service providers and patients receiving the health service. As for the patient's comfort, it represents the mental image of the patient's quality level, which corresponds to the perceived quality.

Technical quality in health services includes medical knowledge; Physical examination; Arrange tests when needed; Making the correct diagnosis; He described the appropriate treatment. Patients, especially the elderly, may not distinguish between the technical quality of health services and other aspects related to the technical quality of a doctor's performance. The technical quality of health services is closely related to communication skills; Interpersonal skills; Trustworthiness (Rao et al., 2006). While (AlHassan et al., 2015) indicated that the results of the technical quality assessment without taking into account the experiences and opinions of patients might not enhance the quality from the customer/patient perspective, which is required. The Safe Care Initiative, in collaboration with the Pharm Access Foundation, the Southern Africa Health Services Accreditation Council (Southern Africa -COHSASA), and the Joint Commission International (JCI), has proposed evaluation criteria categorized as: (Leadership and Accountability; Competent Workforce Capacity; Safe Environment for Employees and Patient Auditors; Clinical Care For patients; improving quality and safety).

Technical quality represents the degree to which the service can meet the requirements correctly. "It is measured according to technical standards; it represents the equivalent of service to quality specifications. The absence of complications when treating patients is an example of the technical quality of health services. The importance of technical quality of services is highlighted. Health focuses on medical and health tools and means and medical diagnosis (Fiala et al., 2012). Chakraborty and Frick (2002) were referring that the technical quality of health services determines the level of application of WHO standards. In addition to that, the technical quality works to diagnose the nature and quality of the problems related to the technical aspects of health services. It can be said that the technical quality highlights its importance in improving the mental image of patients about health services.

Quality of health service is affected by factors including analyzing patient expectations; Design quality of service; The performance of health and administrative staff; And other factors represented in the financial capabilities of the health institution (Al-Asadi, 2019). Similarly, the technical quality of health services is also affected by several factors that can be summarized according to the following (Chakraborty and Frick., 2002):

? Performance: The technical quality of health services is affected by the performance of medical personnel, which requires them to possess the knowledge and skill necessary to provide the minimum performance by accepted health standards that lead to customer satisfaction. For these health organizations work to develop the performance of their cadres through specialized training programs. ? Medical devices and equipment: The lack of available devices, equipment, and tools for medical diagnosis affects the technical quality of the health service. ? Excessive prescribing of the drug without regard to the social and economic condition of patients.

The technical quality in the health service is the extent to which the health services conform to the preestablished standards. To measure the technical quality in health services, the dimensions indicated by (Keramidou and Triantafyllopoulos, 2018) have been adopted with the addition of a safety dimension because of its importance in measuring the technical quality of health services in our current field of study. Below are dimensions the technical quality of health services:

? Reliability: represents the health institution's ability to provide a service that matches the pre-determined criteria. It is the degree of dependence on providing the required service with the accuracy and the right time (Al Jazari et al., 2011). ? The efficiency of performance: means having the skills and knowledge required to perform the service. The efficiency of performance includes both the knowledge and skills of service providers at their various levels and specialties and the research capacity of the organization (Parasuraman et al., 1985). It is the skills, technical capabilities and consistent, correct, and actual performance of the health institution providing the services (Al-Zubaidi and Al-Shujairy, 2018). ? Safety: means that health services are free from errors, risks, and skepticism (Al Jazari et al., 2011).

For the purpose of upgrading the health service provided, health organizations strive to improve their services for the survival and growth that are linked to patient satisfaction, and since patient satisfaction is affected by the technical quality of health services obtained from health organizations. The importance of this study was highlighted by knowing the effect of information and communication technology on the technical quality of the health service provided at Al-Shatrah General Hospital. What kind of relationships do they have. The hypotheses stated as follows:

H1: There is a significant correlation between the ICT variable and the technical quality variable. H2: There is a significant correlation between the Hardware and Equipment dimension and technical quality.

H3: There is a significant correlation between Software and Technical Quality. H4: There is a significant correlation between communication networks and technical quality. H5: There is a significant correlation between human resources and technical quality. H6: There is a significant effect of the ICT variable on the technical quality variable.

H7: There is a significant effect of Hardware and Equipment dimension on the technical quality variable. H8: There is a significant effect of Software dimension on technical quality. H9: There is a significant effect of the dimension of Communication Networks on technical quality. H10: There is a significant effect of the Human Resources dimension on technical quality. Below is a hypothesized model for the study

The sampling method used in the present study is an intentional sampling. To represent this community for study realistically, all the doctors working in Al-Shatrah General Hospital were chosen. The questionnaire was distributed electronically to 108 doctors from different specialties, and 93 usable answers, or 86.1%, were received.

Respondents included 67 (72.05%) male from doctor and 26 (27.95%) female doctor. Most of the educational qualifications of the respondents were MA 40 and Ph.D. 35 with a percentage of (43% and 37.6%), respectively while the number of respondents with a bachelor's degree was 18 doctors with a percentage (19.4%). The majority of respondents had work experience from 20 -less than 25 years (39.6 %) followed by 15 -less than 20 years (25.2%) and 10 -less than 15 years (15.3%) and less than 5 years (10.8%) and five -less than ten years (8.1%) 25 years and over (0.9%).

V.

To measure the variable of information and communication technology, the questionnaire used by (Abdul Hadi and Hadi, 2018) was approved after making adjustments and developments in proportion to the field of study. The ICT questionnaire has four dimensions: hardware and equipment; and software; Communication networks; and human resources. The questionnaire was organized from 15 indicators to measure the four dimensions of information and communication technology. The technical quality of health services was measured using a questionnaire. Because the questionnaire consisted of 3 dimensions, the reliability and efficiency measurements were relied on from the study (Keramidou and Triantafyllopoulos2018). Still after safety, it was designed to fit the field of study. The indicators for measuring the technical quality of health services, according to the questionnaire reached 14 indicators.

The questionnaire was designed according to the Likert pentatonic scale 1 "I strongly disagree" and 5 "Strongly agree." Then the validity of the questionnaire was tested by distributing it to a pilot sample of 30 doctors. The Cronbach's Alpha value was obtained, which was 0.94, which is greater than 0.6, and thus, the designed resolution is suitable for exploring the research. A data distribution test was also conducted to determine the type of data distribution, whether it was normal or abnormal. The Kolmogorov-Smirnov was

The collected data were processed using the SPSS V.23. In Table 2, the results refer that the mean for the ICT variable was 3, 2426, with a standard deviation of 0.77625. The dimension of human resources got the highest relative importance, as it reached 66.546%, while the dimension of communication networks got the least relative importance, which reached 61.712%.

In Table 3, the results refer that the mean value of the technical quality variable for health services was 3.4180, with a standard deviation of 0.75296. While the dimension of efficiency obtained the highest relative importance, which amounted to 71.352%. While dimension reliability got the least relative importance, which was 68.36%.

In Table 4, the results indicate the correlation relationships between the ICT dimension and its variable and the technical quality dimension and its dimensions. As the positive correlations.

The aim of the research is to investigate the impact of information and communication technology on the technical quality of health services. Where descriptive statistics reveal, as shown in Table 2, that the mean to Hardware and Equipment has reached (3.2680), which indicates that the health institution suffers from weaknesses in the maintenance programs for devices and equipment for information and communication technology. While the mean to a dimension of Software (3.3108) indicates that the health organization is not interested in developing the software used in the performance of its health work continuously. As for the value of the mean to the Communication Networks dimension, it reached (3.0856), and this indicates that the health organization is using the internal and external communications network poorly, in addition to weakness in health information security techniques. As for the Human Resources dimension, the mean reached (3.3273), which indicates the lack of interest of the health organization in allocating a financial budget for human resources training.

Descriptive statistics related to technical quality, as shown in Table 3, reveal that the mean to a dimension of Reliability has reached (3.4180), which indicates that the health institution abides somewhat poorly by its promises to patients in providing health services and providing the appropriate environment as expected by patients. The mean to a dimension of Efficiency (3.5676)

The results showed a positive relationship between information and communication technology and technical quality. Information and communication technology also affects the technical quality, which means that Al-Shatrah General Hospital must pay attention to information and communications technology and work to improve and develop it. This leads to improving the technical quality of the health service.

The results indicated that Al-Shatrah General Hospital includes qualified and skilled doctors who care for patients during the treatment period. Still, they suffer from the limited time required for the medical diagnosis process. This means that the Al-Shatrah General Hospital suffers from a shortage of doctors. The administration of Al-Shatrah General Hospital must develop a plan to attract doctors to hide the workload from existing doctors.

The results also showed that the internal and external communications system in Al-Shatrah General Hospital is poor. Also, there is no strong security system, which the hospital administration must take care of with such systems because this helps them to improve the performance of their health work.

This study was conducted only in Al-Shatrah General Hospital -Dhi Qar -Iraq. The study relied on taking the intentional sample. The future researcher can expand the scope of the study by taking several government hospitals or conducting a comparative study between government and private sector hospitals.

Table 5 reveals the results of the relationship of ICT impact and all its dimensions on the technical quality. Where the results reveal that Information and Communication Technology; Hardware and Equipment; Software; Communication Networks Human Resources have a statistically significant effect on technical quality since the sig values were below the significance level at (0.05). Thus we accept hypotheses of impact. This indicates that attention to information technology and communications, improvement and development will positively affect the level of technical quality of health services. Therefore attention must be paid to information and communications technology to improve the quality of health services. dimensions were positive relations and statistically significant because the sig values were less than the value of the significance level at (0.05). Thus we accept the correlation Hypotheses. entirely on international standards for safety in health services, and this is what made the patients' lack of confidence in the health services provided in Al-Shatra General Hospital.

Table 4 reveals the correlation relationships between the independent variable ICT and the dependent technical quality variable. Whereas, the correlation relationships for the variable of information and communication technology and all its dimensions with the variable of technical quality and all its guaranteeing the rights of patients in the event of a medical error. The health organization does not rely