This study analyzed the effect of PACS technology automation and integration maturity on hospital quality scores in U.S. hospitals (n = 2,256). We found cardiology PACS level of integration (CPLI) had a significant effect on hospital efficiency (p=0.000); while level of radiology PACS integration (RPLI) had a significant effect on patient experience and outcome scores (p<0.005). Post hoc tests found that each of three different maturity levels were significantly different from one another. Results suggest that high levels of PACS automation and integration with other hospital information systems has an effect on hospital quality. Findings are expected to help formulate strategic plans for the implementation, continued investment, and evolution of costly health IT systems.