Adoption Of Hospital Information Systems Research Articles

Strategy for scheduled downtime of hospital information system utilizing third-party applications

BackgroundThe widespread adoption of Hospital Information Systems (HIS) has brought significant benefits in healthcare quality and workflow efficiency. However, downtimes for system maintenance are inevitable and pose a considerable challenge to continuous patient care. Existing strategies, including manual prescription methods, are no longer effective due to increasing reliance on digital systems.MethodThis study implemented two main strategies to mitigate the impact of scheduled downtimes. First, we created an “Emergency query program” that switches to a read-only backup server during downtimes, allowing clinicians to view essential patient data. Second, an “Emergency prescription system” was developed based on the Microsoft Power Platform and integrated into Microsoft Teams. This allows clinicians to perform digital prescriptions even during downtimes.ResultsDuring a planned 90-minute downtime, 282 users accessed the Emergency Prescription System, resulting in 22 prescriptions from various departments. Average times for prescription confirmation and completion were 8 min and 3 s, and 18 min and 40 s, respectively. A post-downtime evaluation revealed high user satisfaction.ConclusionEssential maintenance-induced HIS downtimes are inherently disruptive to patient care process. Our deployment of an emergency query program and a Microsoft Teams-integrated emergency prescription system demonstrated robust care continuity during HIS downtime.

Enhancing EHR Implementation with Process Mining

Hospitals have increased the adoption of Hospital Information Systems to optimize processes for the efficient and effective delivery of services to customers (i.e., patients). However, there are still challenges in adopting information systems in healthcare, despite technological advancements and the enormous business benefits. These challenges have led to resistance of some healthcare providers to use these systems. Moreover, investigative and diagnostic measures are not exhaustively carried out to improve the processes of healthcare centers and the implemented information systems used in executing the processes. Fortunately, process mining techniques help optimize business processes, but they are primarily utilized post-implementation/post-go-live. This paper demonstrates the role process mining can play in adopting an EMR/EHR by improving the existing EHR Implementation Lifecycle by proposing an Enhanced Model. We suggest using process mining at suitable phases of the EHR Implementation lifecycle, not post-implementation/post-go-live only. Therefore, we propose an Enhanced EHR Implementation Lifecycle that supports process mining as part of a testing protocol adopted for EMRs/EHRs usability in conformance to the organization’s workflow in other implementation phases. An experiment is performed with event logs from an open-source EHR for the feasibility of the proposed Enhanced EHR/EMR implementation model.

DANP-based method for determining the adoption of hospital information system

The primary purpose of this study is to identify the essential factors that are significantly driving or hindering the decision to adopt a hospital information system (HIS). This study proposes the initial theoretical model that integrates Technology Organisation Environment (TOE) framework, Human Organisation Technology (HOT) fit model and institutional theory. The initial model consists of four main dimensions and 13 variables, which are the most frequently used in prior literature and essential for the investigation of HIS adoption. The data were collected from healthcare experts who have full knowledge of HIS. Accordingly, the recently developed DANP (Decision Making Trial and Evaluation Laboratory (DEMATEL) based Analytic Network Processes (ANP)) method is employed for assessing interdependency and give weights to dimensions and criteria. As per the expert's knowledge and experience, the results indicate that perceive technical competence, compatibility, top management support, and vendor support are found to be the most essential variables for the successful adoption of HIS.

DANP-based method for determining the adoption of hospital information system

The primary purpose of this study is to identify the essential factors that are significantly driving or hindering the decision to adopt a hospital information system (HIS). This study proposes the initial theoretical model that integrates Technology Organisation Environment (TOE) framework, Human Organisation Technology (HOT) fit model and institutional theory. The initial model consists of four main dimensions and 13 variables, which are the most frequently used in prior literature and essential for the investigation of HIS adoption. The data were collected from healthcare experts who have full knowledge of HIS. Accordingly, the recently developed DANP (Decision Making Trial and Evaluation Laboratory (DEMATEL) based Analytic Network Processes (ANP)) method is employed for assessing interdependency and give weights to dimensions and criteria. As per the expert's knowledge and experience, the results indicate that perceive technical competence, compatibility, top management support, and vendor support are found to be the most essential variables for the successful adoption of HIS.

Adoption of Hospital Information Systems in Public Hospitals in Turkey: An Analysis with the Unified Theory of Acceptance and Use of Technology Model

Information and communication technologies (ICTs) has become a tool which cannot be ignored in terms of public administrations, which provides advantage to the administrations as far as they can be adapted. The use of ICTs become widespread in the health sector as it is in all other sectors. In hospitals, hospital information systems (HIS) are used to keep records of patients and hospitals securely, to improve appointment, in-hospital management, decision support and workflow processes. Therefore, HISs are also used to increase efficiency and productivity, to reduce error rates, to increase service quality, to reduce service costs and to realize the specific purposes such as ensuring patient satisfaction. It is necessary that the end users should adopt HISs to obtain the expected benefits and to implement HIS successfully in public hospitals. The adoption of a technology product is also a sociological phenomenon at the same time. In this regard, the issue of adoption in the relevant literature is addressed in the context of a wide variety of models and many variables. This study is also a study of technology adoption. The subject of the study is the adoption of HISs in public hospitals in Turkey. In this context. The study aimed to determine the factors affecting the adoption of HISs by the personnel working in public hospitals in Turkey, in accordance with the Unified Theory of Acceptance and Use of Technology (UTAUT) model in the literature on technology adoption. In the study, the universe of the study consisted of the personnels (physicians, nurses, health officers, medical secretaries] which were working in public hospitals in the Bursa and Balıkesir Metropolitan Municipalities at the time of the study. According to the results of the study, performance expectancy, effort expectancy and social influence variables have positive and significant effects on the behavioral intention of hospital staff for using of HISs. In addition, facilitating conditions and behavioral intention variables have a positive and significant effect on usage behavior. On the other hand, it was found that gender has a moderator effect on the relationship between performance expectancy, effort expectancy and behavioral intention. Experience has a moderator effect on the relationship between the social influence and the behavioral intention while age has a moderator effect on the relationship between facilitating conditions and use behavior.

Adoption of Hospital Information System Among Nurses: a Technology Acceptance Model Approach.

Introduction:The successful implementation of Hospital Information Systems (HIS) depends on user acceptance. Nurses are the largest group of HIS users in hospitals. This study aims to evaluate some factors may affect the utilization of the Hospital Information System.Aim:To explore factors that contribute to using of Hospital Information System.Methods:In this cross-sectional study, 325 nurses from training Hospitals affiliated with Lorestan University of Medical Sciences (LUMS) were chosen. A valid and reliable structured questionnaire based on Technology Acceptance Model 1&2 and Unified Theory of Acceptance and Use of Technology was used as the data collection tool. Descriptive statistics, Correlations analysis, multiple regression analysis, path analysis technique, Structure Equation Model using AMOS software was used to examine factors that influenced the Adoption of Hospital Information System.Results:The findings indicate a significant direct relationship between Management Support and Perceived Usefulness of HIS. Perceived Usefulness has a significant effect on attitudes. While there was no significant effect of perceived ease of use on attitude. Attitude has a significant effect on behavioral intention.Conclusion:This research provides a tool to realize what factors undertake the behavioral intention of healthcare professionals to use hospital information system and how this may affect future use.

Essential factors for adopting hospital information system: a case study from Pakistan

Hospital information system (HIS) is an electronic system that aims to provide comprehensive hospital- and patient-related information to authorized people, on one click. The diffusion of HIS is in the early phase, and the rate of adoption is very slow in Pakistan. The aim of this study is to identify the factors influencing the adoption of HIS in public sector hospitals of Pakistan. Data were collected through a questionnaire from two major cities in Pakistan. In order to examine the data and test the hypothesis of this study, Confirmatory factor analysis (CFA) and Structure Equation Modeling (SEM) technique were applied. The empirical results clarify that top management support, financial revenue, relative Advantage, compatibility, coercive pressure, and mimetic pressure are positive while complexity is negatively influencing the adoption of HIS. Furthermore, these empirical results will be helpful in establishing the framework for the adoption of HIS in public sector hospitals of Pakistan.

Characteristics of Hospitals That Adopt Hospital Information Systems in Mongolia And Its Impact on Patient Safety and Quality of Care

Objectives: Our objective was to determine the relationship between the adoption of hospital information system (HIS) in Mongolian tertiary and secondary care hospitals and the hospital’s organizational & geographical characteristics, its impact on patient safety & quality of healthcare. Methods: This wasa cross sectional study involving the executive directors and 39 quality managersat 39 hospitals. Data werecollected using questionnaire to determine the adoption rate of HIS and their hospital’s organizational & geographical characteristics. Results: The adoption of HIS signifi cantly affected by hospital size, ownership type, health maintenance organization penetration, and hospital location (urban versus rural). The adoption of HIS was found to partially impactpatient safety and quality of healthcare outcomes. Conclusion: In terms of theoretical implications, this study confi rms that hospital organizational & geographical characteristics (structure) impact the adoption of HIS (process) which in turn affects healthcare outcomes (outcome). These fi nding validate Avedis Donabedian’s “Structure-Process-Outcome” model. The present fi ndings also confi rm that hospitals with these structural attributes adopted more technologies.

The moderating effect of hospital size on inter and intra-organizational factors of Hospital Information System adoption

Healthcare is a highly institutionalized industry, subject to multiple regulatory forces, high levels of professionalism, and growing network externalities which may affect the decisions to adopt. Hence, this research integrates the Resource Dependence Theory (RDT), institutional theory along with Human Organization Technology (HOT) fit model as the organization theories to explain the adoption of Hospital Information System (HIS). To examine the effects of inter and intra-organizational potential factors on HIS adoption, within the context of Malaysian public hospitals, a survey method using web-based questionnaire is employed. The role of hospital size in this study is investigated to determine its distinct moderating influence among the relationships of the HIS adoption and significant dimensional factors. The results indicated that system affiliation (p < 0.05), mimetic pressure-competitors (p < 0.1), normative pressure (p < 0.05), and employees' IS knowledge (p < 0.05) were the most significant drivers for adopting HIS in the public hospitals of Malaysia. The results also showed that hospital size as the only moderator of this study has no significant effect on the other relationships in our developed theoretical model. In other words, the effects of the significant factors on HIS adoption are the same in three small, medium, and large Malaysian public hospitals. This research presents a conceptual foundation for future researches and fills a gap in the literature regarding the inter-organizational factors influencing the adoption of HIS.

An evaluation model for the implementation of hospital information system in public hospitals using multi-criteria-decision-making (MCDM) approaches

Background: Hospital Information System (HIS) is implemented to provide high-quality patient care. The aim of this study is to identify significant dimensional factors that influence the hospital decision in adopting the HIS.Methods: This study designs the initial integrated model by taking the three main dimensions in adopting HIS technology. Accordingly, DEMATEL was utilized to test the strength of interdependencies among the dimensions and variables. Then ANP approach is adapted to determining how the factors are weighted and prioritized by professionals and main users working in the Iranian public hospitals, involved with the HIS system.Results: The results indicated that “Perceived Technical Competence” is a key factor in the Human dimension. The respondents also believed that “Relative Advantage," “Compatibility” and “Security Concern” of Technology dimension should be further assessed in relation to other factors. With respect to Organization dimension, “Top Management Support” and “Vendor Support” are considered more important than others.Conclusion: Applying the TOE and HOT-fit models as the pillar of our developed model with significant findings add to the growing literature on the factors associated with the adoption of HIS and also shed some light for managers of public hospitals in Iran to successfully adopt the HIS.

Evaluation of key capabilities for hospital information system: A milestone for meaningful use of information technology

Objective: In line with socio-technical approach, evaluation of successful adoption of hospital information systems (HISs) is associated with several factors including operational, organizational, technical, managerial, legal, and social factors. This study attempts to evaluate these systems in five areas of technical, functionality, usability, and vendors' capabilities, and care quality provided by HIS vendors. Materials and Methods: Through a cross-sectional study, the key HIS capabilities were evaluated in Iran. The key capabilities/requirements for HIS were specified by expert panel focus group meeting through the idea webbing and review of related literature. Modified Delphi technique was employed to collect and analyze data. The expert panels express their view on each of the HIS key capabilities on a 5-point scale from “strongly agree” to “strongly disagree.” Checklist was designed based on expert panels' viewpoints and employed for evaluating HIS capabilities. Results: Technical requirements with 68.3% and vendors' capability requirements scored the highest marks (68%) while improved quality of patient care requirements scored the lowest mark (24.8%). Functional requirement of the studied eight departments showed that financial department scored the highest (71.6%) while nutrition department scored the lowest marks (22.8%). Results on the evaluation of technical requirements showed that response time scored the highest (75%) while communication services scored the lowest marks (59.7%). Conclusion: The favorable status of Iran's HISs in technical area, their poor performance on the requirements of quality patient care place emphasis on financial and reimbursement objective, and neglect of Systemized Nomenclature of Medicine-Clinical Terms as a basis to support quality of patient care requirements endorse the fact that Iran's current HIS is still in its infancy. To narrow the variability and diversity in structure and requirements of HIS vendors, reducing the gap between required and adopted HIS functions, and moving toward “meaningful use of HIS,” well-organized actions at the level of Iran Ministry of Health appear essential.

Hospital Information System adoption: Expert perspectives on an adoption framework for Malaysian public hospitals

Hospital Information System (HIS) is important in the healthcare industry as it supports a wide range of highly specialized health-care tasks and services. In Malaysia, HIS diffusion is still in its early stage and there is slow rate of adoption among large, medium, and small public hospitals. To investigate the factors influencing the adoption of HIS in the hospitals' work processes, this study proposed the initial theoretical framework based on the combined Technology Organization Environment (TOE), institutional theory, and Human Organization Technology (HOT) fit model. A nationwide survey was conducted on small, medium, and large public hospitals involving both HIS adopters and non-adopters in Malaysia to verify the validity of the initial integrated framework. We find that relative advantage, compatibility, security concern, hospital size, mimetic pressure-competitors, vendor support, perceived technical competence of IS staff, and employees’ IS knowledge as the influential factors on HIS adoption. In addition to the only moderator of this study (occupational level), any significant moderating effects on the Technology-Organization-Environment-Human dimensional factors and the adoption of HIS by Malaysian public hospitals was not found. Hence, these results indicated that the developed integrated framework provides an effective prediction of the HIS adoption by Malaysian public hospitals.

Barriers to Adoption of Hospital Management Systems : A Study of Punjab Healthcare Industry

The convergence of information technology in healthcare has the potential to revolutionise this sector. Technology integration in the form of hospital management systems popularly known as hospital information systems (HIS) offers a big opportunity not only to enhance service quality, but also reduce healthcare costs and increase patient satisfaction and care. It facilitates integration of hospital processes and management of medical information to foster a culture of efficiency. Nevertheless, in the Indian healthcare sector, as compared to its peer nations, the state of technology integration is dismal, with sluggish adoption of HIS. The state of Punjab is no exception to this. Interestingly, hospitals in Punjab possess advanced medical technology and health care delivery infrastructure, but still, they are trapped in relentless competition, high healthcare costs, and poor patient satisfaction. Numerous barriers exist that refrain the hospitals from implementing HIS. Punjab health challenges, though unique and complex, offer a remarkable opportunity. Our research aimed at specifically identifying the factors that are responsible for the low rate of adoption of hospital management systems in the hospitals of Punjab. It further proposed a suggestive framework to industry practitioners and policy makers to tackle these barriers so as to enhance HIS integration and change the face of the Punjab healthcare industry.

Understanding Technology and People Issues in Hospital Information System (HIS) Adoption: Case study of a tertiary hospital in Malaysia.

Hospital Information Systems (HIS) can improve healthcare outcome quality, increase efficiency, and reduce errors. The government of Malaysia implemented HIS across the country to maximize the use of technology to improve healthcare delivery, however, little is known about the benefits and challenges of HIS adoption in each institution. This paper looks at the technology and people issues in adopting such systems. The study used a case study approach, using an in-depth interview with multidisciplinary medical team members who were using the system on a daily basis. A thematic analysis using Atlas.ti was employed to understand the complex relations among themes and sub-themes to discover the patterns in the data. . Users found the new system increased the efficiency of workflows and saved time. They reported less redundancy of work and improved communication among medical team members. Data retrieval and storage were also mentioned as positive results of the new HIS system. Healthcare workers showed positive attitudes during training and throughout the learning process. From a technological perspective, it was found that medical workers using HIS has better access and data management compared to the previously used manual system. The human issues analysis reveals positive attitudes toward using HIS among the users especially from the physicians' side.

Determining the importance of Hospital Information System adoption factors using Fuzzy Analytic Network Process (ANP)

The Hospital Information System (HIS) is a computer system aimed at providing a paperless environment that covers all aspects of the hospital's operation such as clinical, administrative, and financial systems. The aim of this study is to provide more insight within the context of Malaysia to understand the potential factors that importantly driving or inhibiting the decision of HIS adoption from non-adopters' perspective. This study mainly integrates the diffusion of innovation theory, technology-organization-environment framework, institutional theory along with human-organization-technology fit model that can be tailored in understanding of the HIS adoption by Malaysian public hospitals. In this regard, the initial model is designed by considering four main dimensions (Technology, Environment, Human, Organization) with seventeen variables based on reviewing of the existing extensive literature of information system in particular information technology adoption in line with prior HIS adoption studies. Accordingly, a Fuzzy Analytic Network Process (ANP), one of the Multi-Criteria Decision Making (MCDM) techniques, model is developed to determine the most important factors among the four categories for the HIS adoption in the context of Malaysian public hospitals. These factors are identified and compared by 20 hospital experts and decision makers, who are fully familiar of HIS technology with also professional management and decision-making experience in hospitals. Then fuzzy ANP is applied to compute the weights of incorporated factors in the HIS adoption. The results reveal that hospitals with compatibility, complexity, mimetic pressure and vendor support are more likely to adopt HIS. Hence, the decision to adopt HIS is mainly determined by technological and environmental context. The study and its findings have resulted in theoretical contributions and research implications where the integrated theoretical model serves as a tool for healthcare industry to gain insight into the process of HIS adoption.

Adoption and Assessment of Hospital Information Systems: A Study of Hospitals in Jalandhar

There is a progressive integration of technology by different sectors of our economy so as to enhance the productivity and efficiency of the business operations. However, in the Indian health care sector, it is discouraging to observe that not much is being spent on the hospital information systems (HIS). Technology integration has the potential to not only accelerate the speed but also enhance the quality and efficiency of hospital operations. The present research aims to determine the degree of adoption of HIS in hospitals of Jalandhar city and also explores the barriers in HIS implementation. An attempt has been made to study the impact of different hospital-related variables on the adoption of HIS. To attain the purpose, a questionnaire survey was conducted on 31 hospitals of Jalandhar city and the data collected were analysed using percentages, cross-tabulation and chi-square test. Results revealed that a scanty percentage of hospitals in Jalandhar adopt HIS and that too primarily for clinical and administrative functions. However, an increased adoption of HIS was observed, with an increase in the size of the hospital in terms of its investment, number of employees and sales revenue. Greater infrastructure and financial requirements, rigorous staff training needs and reluctance of top management and medical specialists to implement the system emerged as the prominent barriers to HIS implementation. Nevertheless, a vast majority of hospitals adopting HIS were satisfied from its performance. The current research has strong implications and great value for hospital authorities. It not only determines the degree to which HIS is adopted in hospitals but also reviews the satisfaction derived from it. Its real value lies in identifying the specific problems or barriers that lead to the lower rate of HIS adoption.

Organizational decision to adopt hospital information system: An empirical investigation in the case of Malaysian public hospitals

ObjectivesThis study mainly integrates the mature Technology-Organization-Environment (TOE) framework and recently developed Human-Organization-Technology (HOT) fit model to identify factors that affect the hospital decision in adopting Hospital Information System (HIS). MethodsAccordingly, a hybrid Multi-Criteria-Decision-Making (MCDM) model is used to address the dependence relationships of factors with the aid of Analytic Network Processes (ANP) and Decision Making Trial and Evaluation Laboratory (DEMATEL) approaches. The initial model of the study is designed by considering four main dimensions with 13 variables as organizational innovation adoption factors with respect to HIS. By using DEMATEL, the interdependencies strength among the dimensions and variables are tested. The ANP method is then adopted in order to determine the relative importance of the adoption factors, and is used to identify how these factors are weighted and prioritized by the public hospital professionals, who are wholly familiar with the HIS and have years of experience in decision making in hospitals’ Information System (IS) department. ResultsThe results of this study indicate that from the experts’ viewpoint “Perceived Technical Competence” is the most important factor in the Human dimension. In the Technology dimension, the experts agree that the “Relative Advantage” is more important in relation to the other factors. In the Organization dimension, “Hospital Size” is considered more important rather than others. And, in the Environment dimension, according to the experts judgment, “Government Policy” is the most important factor. The results of ANP survey from experts also reveal that the experts in the HIS field believed that these factors should not be overlooked by managers of hospitals and the adoption of HIS is more related to more consideration of these factors. In addition, from the results, it is found that the experts are more concerned about Environment and Technology for the adoption HIS. ConclusionsThe findings of this study make a novel contribution in the context of healthcare industry that is to improve the decision process of innovation in adoption stage and to help enhance more the diffusion of IS in the hospital setting, which by doing so, can provide plenty of profits to the patient community and the hospitals.

Adoption of Hospital Information System (HIS) in Malaysian Public Hospitals

Hospital Information System (HIS) is important to be adopted by the hospitals to improve their operations and services. Despite their importance, only 15.2% of Malaysian Public Hospitals implemented the system through THIS, IHIS and BHIS categories which shows low adoption level of HIS in Malaysia. This study aims to identify factors affecting the HIS adoption across different categories of HIS’s hospitals. The finding showed that there are significant differences between factors affecting HIS adoption in the THIS compared to IHIS’s hospitals, and THIS and BHIS’s hospitals. However there is no significant difference among factors between IHIS with BHIS’s hospitals. © 2015 The Authors. Published by Elsevier Ltd. Peer-review under responsibility of GLTR International Sdn. Berhad.

External Factors in Hospital Information System (HIS) Adoption Model: A Case on Malaysia

Studies related to healthcare ICT integration in Malaysia are relatively little, thus this paper provide a literature review of the integration of information and communication technologies (ICT) in the healthcare sector in Malaysia through the hospital information system (HIS). Our study emphasized on secondary data to investigate the factors related to ICT integration in healthcare through HIS. Therefore this paper aimed to gather an in depth understanding of issues related to HIS adoption, and contributing in fostering HIS adoption in Malaysia and other countries. This paper provides a direction for future research to study the correlation of factors affecting HIS adoption. Finally a research model is proposed using current adoption theories and external factors from human, technology, and organization perspectives.

Implementation of Consolidated HIS: Improving Quality and Efficiency of Healthcare

ObjectivesAdoption of hospital information systems offers distinctive advantages in healthcare delivery. First, implementation of consolidated hospital information system in Seoul National University Hospital led to significant improvements in quality of healthcare and efficiency of hospital management.MethodsThe hospital information system in Seoul National University Hospital consists of component applications: clinical information systems, clinical research support systems, administrative information systems, management information systems, education support systems, and referral systems that operate to generate utmost performance when delivering healthcare services.ResultsClinical information systems, which consist of such applications as electronic medical records, picture archiving and communication systems, primarily support clinical activities. Clinical research support system provides valuable resources supporting various aspects of clinical activities, ranging from management of clinical laboratory tests to establishing care-giving procedures.ConclusionsSeoul National University Hospital strives to move its hospital information system to a whole new level, which enables customized healthcare service and fulfills individual requirements. The current information strategy is being formulated as an initial step of development, promoting the establishment of next-generation hospital information system.