Ananda Dhea
Ananda Dhea
Ananda Dhea
ABSTRACT
The implementation of hospital information systems and electronic medical records can
improve health care services in hospitals, but there are still many things that inhibits its
user acceptance. The purpose of this study is to find out things that can support the
acceptance of hospital information systems and medical records by electronic users and
their obstacles. Methods:This is a literature review research and uses the Preferred
Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) methods.Relevant
articles were obtained from PubMed in 1982 to June 2021. Articles were selected if they
met the criteria in the form of discussing the acceptance of hospital information systems
in the form of electronic medical records in hospitals. Results: A total of 1535 articles
were obtained from PubMed. The same article was deleted with Zotero's delete duplicate
feature and manually with the results of 215 relevant articles, 89 articles were selected
through abstract reading and 22 articles were obtained for full text reading.A total of 21
journals were analyzed in this review. Factors that affect the acceptance of hospital
information systems and electronic medical records are perceived usefulness, perceived
ease of use, human-related factors, demographics and the human environment,
technological factors, organizational and organizational environmental factors, effort
expectancy and performance expectancy. Conclusion: Implementation of information
systems and electronic medical records can be maximized by increasing user acceptance
of the system so that health services can be provided optimally.
INTRODUCTION
One of the hospital’s strategy in carrying out its duties as a service provider
for the community is using an information system, so that patient’s data can be
properly recorded and documented. Some of the information systems that have
been widely used in various hospitals are electronic office systems (e-office),
electronic medical records (ERM) and others. There are several important roles of
information systems namely: supporting the health care service in hospitals,
supporting hospital management in decision making and supporting various
strategies for competitive advantage (Kisdianata et al., 2016). The role of the
Hospital Management Information System (SIMRS) in managing hospital data is
actually quite large and complex, both for patient medical data and administrative
data owned by hospitals. So that if it is managed conventionally, it has the
potential to cause duplication of data, resulting in the increasing of data storage
capacity. Data that is not integrated can cause ‘out of sync’ in each part and cause
the presentation of information that is late and less reliable. This finally will lead
to human error. Out of sync data entry for the same patient or item will complicate
data processing and often result in significant material losses for hospitals.
(Handiwidjojo, 2009).
RESEARCH METHODOLOGY
This study uses a literature review method and the Preferred Reporting
Items for Systematic Reviews and Meta-analyses (PRISMA) method, this method
is carried out systematically by following the correct stages or research
protocols.The literature obtained in this study was sourced from an electronic
database, namely PubMed (https://www.ncbi.nlm.nih.gov/pubmed/). The article
search method uses advanced search so that the search is more focused with
search keywords in the form of: "hospital information system" and "behavior".
After deleting the same journal, the title and abstract were identified. Research
journals deemed eligible for full-text screening were taken for full review. The
inclusion criteria of this study were: English-language articles, published in 1982
to June 2021 and articles. published internationally, articles that discuss the
hospital information system in the form of electronic medical records and
conducted at the hospital. An ethical review was not required for this study. The
following is a list of searches on PUBMED along with the PRISMA diagram:
At the start of the search we found 1553 articles from PubMed. Checking
the same article was carried out using Zotero's delete duplicate feature and
manually with the result did not find the same article. There are 215 articles left
after reading the relevant titles, 89 articles were selected through abstract reading
and 22 articles were obtained for full text reading of the article. A total of 21
research articles were taken for analysis regarding user acceptance of the
implementation of technology, especially electronic medical records in hospitals.
All research journals described in table 1. User acceptance of electronic medical
records and hospital information systems was measured using different
questionnaires so that the factors that influenced acceptance were also found to be
different. In this study, the factors that affect acceptance are grouped into several
groups, namely: perceived usefulness, perceived ease of use, human-related
factors, demographics and the human environment, technological factors,
organizational and organizational environmental factors, effort expectancy and
performance expectancy.
Perceived usefulness is the user's belief that technology can improve his
work performance in health facilities, while the perception of user’s convenience
is defined as the system used by the user can be used easily. Research conducted
at the Zahedan University Hospital of Medical Sciences on hospital information
system users using a new validated questionnaire obtained the results of perceived
usefulness and perceived ease of use affecting the acceptance of hospital
information systems (Alipour et al., 2019). The same thing was also found where
the acceptance of the Electronic Prescribing Decision Support Systems (EPDSS)
which is an application or digital drug prescribing system was carried out on
paediatricians at Karolinska University Hospital using semi structured interview
questions based on the Extended Technology Acceptance Model 2, namely
perceptions of usefulness and perception of user’s convenience ( Omar et al.,
2017). The results above are in line with a review of articles discussing the
acceptance of electronic medical records. We found that factors in the form of
perception of user’s convenience, perceived usefulness, behavioural intentions to
use and actual use are interconnected and affect the acceptance of medical records
(Putri &Sevtiyani, 2020).
men thought that it could be useful (p < 0.001), regarding usability, 18.5% of the
group over 40 years of age stated that they would use the device (p < 0.05) and
30.9% of participants in the 31-35 year age group considered that the potential use
for psychiatrists was high (p = 0.022) (Bourla et al., 2020). Gender was also found
to be a factor influencing both perceived usefulness and perception of user’s
convenience, which is an indirect factor that influences doctors in using electronic
medical records (Hwang et al., 2019).
Several obstacles in the acceptance of the system were also found in the
review of this article in the form of anxiety about computers, transition costs, the
fear of not feeling useful, increasing the workload and lacking facilities and
training. Anxiety about computers (computer anxiety) has a negative effect on
perceptions of usefulness and perceived ease of use so that it can reduce users'
motivation to accept existing technology (Barzekar et al., 2019). A literature
review states that computer anxiety can be corrected depending on the cause.
When anxiety is caused by psychological factors, it is necessary to change
individual technological attitudes and beliefs. In the case where the cause is lack
of knowledge about computers, training can be given about computers and if the
cause of anxiety is due to operational factors then extra time can be given to add
experience and to get used to the system (Chien, 2008). The negative perception
that arose at the beginning of the use of Computerized Provider Order Entry
(CPOE) in pediatric tertiary hospitals in Australia was due to ignorance of the
system. In this study, it was found that over time users became more proficient
and efficient in using the CPOE system so that the additional perceived security
benefits became clear (Baysari et al., 2018). Transition costs are also known to
have a significant relationship with refusal to use electronic medical records, in
this study the transition costs can be reduced by minimizing the number of
updates and changes to electronic medical records and testing updates properly to
solve problems before updating electronic medical records is implemented.
(Darby et al., 2019).
CONCLUSION
REFERENCES