Abstract

BackgroundThe Ministry of Health of Malaysia has invested significant resources to implement an electronic health record (EHR) system to ensure the full automation of hospitals for coordinated care delivery. Thus, evaluating whether the system has been effectively utilized is necessary, particularly regarding how it predicts the post-implementation primary care providers’ performance impact.MethodsConvenience sampling was employed for data collection in three government hospitals for 7 months. A standardized effectiveness survey for EHR systems was administered to primary health care providers (specialists, medical officers, and nurses) as they participated in medical education programs. Empirical data were assessed by employing partial least squares-structural equation modeling for hypothesis testing.ResultsThe results demonstrated that knowledge quality had the highest score for predicting performance and had a large effect size, whereas system compatibility was the most substantial system quality component. The findings indicated that EHR systems supported the clinical tasks and workflows of care providers, which increased system quality, whereas the increased quality of knowledge improved user performance.ConclusionGiven these findings, knowledge quality and effective use should be incorporated into evaluating EHR system effectiveness in health institutions. Data mining features can be integrated into current systems for efficiently and systematically generating health populations and disease trend analysis, improving clinical knowledge of care providers, and increasing their productivity. The validated survey instrument can be further tested with empirical surveys in other public and private hospitals with different interoperable EHR systems.

Highlights

  • The Ministry of Health of Malaysia has invested significant resources to implement an electronic health record (EHR) system to ensure the full automation of hospitals for coordinated care delivery

  • Study design An EHR system–user evaluation survey was designed by selecting appropriate questions from past quantitative instruments designed based on the DeLone and McLean (D&M) models related to the study constructs and the local context of EHR system adoption

  • This study determined that system quality is the most crucial construct influencing the effective use of an EHR system

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Summary

Introduction

The Ministry of Health of Malaysia has invested significant resources to implement an electronic health record (EHR) system to ensure the full automation of hospitals for coordinated care delivery. Adoption of the EHR system in Malaysia Electronic health records (EHRs) are created from integrated health information systems via secured computer networks. With the Malaysia HIE (myHIX) project initiated in 2008, these IT hospitals have been progressing towards implementing health information exchange (HIE) in participated MoH hospitals and clinics to enable the secure and smooth sharing of demographics and patient information, such as discharge summaries, referral letters, lab results, and imaging reports, through virtual private networks and later via cloud platforms

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