Implementation Of Hospital Information System Research Articles

Acceptance model of a Hospital Information System

PurposeThe purpose of this study is to develop a model of Hospital Information System (HIS) user acceptance focusing on human, technological, and organizational characteristics for supporting government eHealth programs. This model was then tested to see which hospital type in Indonesia would benefit from the model to resolve problems related to HIS user acceptance. MethodThis study used qualitative and quantitative approaches with case studies at four privately owned hospitals and three government-owned hospitals, which are general hospitals in Indonesia. The respondents involved in this study are low-level and mid-level hospital management officers, doctors, nurses, and administrative staff who work at medical record, inpatient, outpatient, emergency, pharmacy, and information technology units. Data was processed using Structural Equation Modeling (SEM) and AMOS 21.0. ResultsThe study concludes that non-technological factors, such as human characteristics (i.e. compatibility, information security expectancy, and self-efficacy), and organizational characteristics (i.e. management support, facilitating conditions, and user involvement) which have level of significance of p<0.05, significantly influenced users’ opinions of both the ease of use and the benefits of the HIS. This study found that different factors may affect the acceptance of each user in each type of hospital regarding the use of HIS. Finally, this model is best suited for government-owned hospitals. ConclusionsBased on the results of this study, hospital management and IT developers should have more understanding on the non-technological factors to better plan for HIS implementation. Support from management is critical to the sustainability of HIS implementation to ensure HIS is easy to use and provides benefits to the users as well as hospitals. Finally, this study could assist hospital management and IT developers, as well as researchers, to understand the obstacles faced by hospitals in implementing HIS.

Hospital Information Systems Implementation: An Evaluation of Critical Success Factors in Northeast of Iran

&lt;p&gt;&lt;strong&gt;INTRODUCTION:&lt;/strong&gt; Implementation of hospital information systems (HIS) is considered as a difficult and sensitive task in terms of its scope and its mission to collect identity-related, demographic, clinical and managerial data of patients in an integrative manner as well as due to the changes it makes in users’ working practices. The purpose of the present study was to investigate users’ views and attitudes towards the key elements of successful implementation of HIS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;METHODOLOGY:&lt;/strong&gt; This applied study was conducted in a descriptive cross-sectional form. To this end, 248 users of HIS at teaching hospitals in the city of Mashhad (Northeast of Iran) were selected through stratified random sampling, and then a questionnaire was distributed to collect the required data. After collecting the questionnaires, data was entered into the SPSS software and the findings were examined by using descriptive statistics (frequency) and then illustrated in tables and diagrams.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;RESULTS:&lt;/strong&gt; Functional factors, meeting users’ needs and ease of use had the highest prominence in successful implementation of a HIS. This mean that HIS considering demands of users is the first critical success factors in HIS implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;CONCLUSION: &lt;/strong&gt;The analysis of the research findings demonstrated that three groups including system users, technical operators (professionals) and managers have important role in implementation of HIS. Furthermore, successful implementation of HIS was required to be performed through a formulated program with specified time, costs, and manpower in which the employment and participation of various users of the system had been precisely defined. In this respect, financial supports and presence of hospital management team in meetings and decisions was also of utmost importance.&lt;/p&gt;

Hospital information system institutionalization processes in indonesian public, government-owned and privately owned hospitals

The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals’ management is more motivated to implement HIS to comply with the regulations, while private hospitals’ management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors—self-efficacy, social influence, and management support—have a significant influence on the individual acceptance of HIS.

A Newly Proposed HIS Implementation Success Model for Nursing, using an Electronic Approach for Design

Despite the advantages of utilizing hospital information systems (HISs) in nursing care, and their contribution to nursing structures and care processes, the troubling issue of HIS underutilization continues. Low utilization of installed systems has been identified as a major problem in implementing information technology (IT). Unfortunately, nurses have been unwilling to apply technology to healthcare delivery, although they generally have a positive attitude toward computers. In this study, based on the Critical Success Factos (CSFs) and DeLone and McLean's Information Systems success model, an implementation framework, made up of essential elements to guide successful HIS implementation for nursing staff is proposed. This study is among the few that have tested empirically an implementation framework in the developing countries settings, and provides helpful guidelines for hospital managers in planning HIs implementation in such countries.

Influence of mechanism of patient-accessible hospital information system implementation on doctor–patient relationships: A service fairness perspective

The relationship between a doctor and a patient plays an important role in patient satisfaction with health-care services. It has become an important and contentious issue in China’s health-care reform. This study uses service fairness as a theoretical lens to investigate the influence an implementation of a patient-accessible hospital information system (HIS) has on doctor–patient relationships and patient satisfaction. We developed a research model that relates patient-accessible HIS implementation with perception of service fairness, doctor–patient relationships, and patient satisfaction. Data were collected from patients in one of the biggest hospitals in East China that has implemented patient-accessible HIS. Results of the study show that patient-accessible HIS promotes patients’ perception of service fairness, improves doctor–patient relationships, and increases patient satisfaction.

Factors Affecting Successful Implementation of Hospital Information Systems.

Background:Today, the use of information systems in health environments, like any other fields, is necessary and organizational managers are convinced to use these systems. However, managers’ satisfaction is not the only factor in successfully implementing these systems and failed information technology projects (IT) are reported despite the consent of the directors. Therefore, this study aims to determine the factors affecting the successful implementation of a hospital information system.Methods:The study was carried out as a descriptive method in 20 clinical hospitals that the hospital information system (HIS) was conducted in them. The clinical and paraclinical users of mentioned hospitals are the study group. 400 people were chosen as samples in scientific method and the data was collected using a questionnaire consisted of three main human, managerial and organizational, and technological factors, by questionnaire and interview. Then the data was scored in Likert scale (score of 1 to 5) and were analyzed using the SPSS software.Results:About 75 percent of the population were female, with average work experience of 10 years and the mean age was 30 years. The human factors affecting the success of hospital information system implementation achieved the mean score of 3.5, both organizational and managerial factors 2.9 and technological factors the mean of 3.Conclusion:Human factors including computer skills, perceiving usefulness and perceiving the ease of a hospital information system use are more effective on the acceptance and successful implementation of hospital information systems; then the technological factors play a greater role. It is recommended that for the successful implementation of hospital information systems, most of these factors to be considered

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.

The effect of hospital information systems on healthcare facilities efficiency indicators

Aim. Comparative assessment of an automation facilities influence on labor input and business processes’ productivity indicators related to primary functions of healthcare facilities of different types.Methods. We performed medical personnel’s work timing in emergency rooms, as well as medical records timing in clinical departments. The automated electronic health records processing while operating hospital information systems created by authors among different types of healthcare facilities was also performed. Output data included personal health record operation periods values and system events timestamps.Results. The data concerning hospital information systems’ influence on electronic health records operating time changes and hospitalization delays was obtained. A correlation between the initial hospitalization delay and hospital capacity was discovered (r=0.917). The emergency room automation significantly reduces hospitalization delays. Under clinical information system operating conditions, the primary examination time recording increases twice, while the time spent for all other electronic health records decreases in higher order. Considerable difference between primary examination recording time and the time, necessary for other personal health record registrations, has satisfactory interpretation within the heterogeneous medical data sources integration model, but not within usability model. In general, the gained data does not confirm results of previously published researches pointing the increased time doctors spent for data management in automation conditions.Conclusion. Hospital information systems implementation improved the specialist’s labor productivity and main working processes work capacity. The obtained data indicate a greater influence of automation in large healthcare facilities and reject usability hypothesis of hospital information systems efficiency.

Hospital Information Systems (HIS) Acceptance and Satisfaction: A Case Study of a Tertiary Care Hospital

Abstract OBJECTIVES The main objective of this study is to evaluate hospital information systems (HIS) acceptance and satisfaction, through exploring the influential factors that might increase or decrease acceptance and satisfaction levels among different healthcare professionals, in order to provide solutions for successful HIS implementation. METHODS: The study used objective quantitative survey methods to collect data directly from different types of HIS users. The questionnaire included five sections; a demographic user information section, a general HIS assessment section, a section about accessibility and availability of computers, a section about HIS and patient care and a section about satisfaction with HIS. RESULTS: The availability of computers in the hospital was one of the most influential factors, with a special emphasis on the availability of laptop computers and computers on wheels to facilitate direct and immediate data entry and information retrieval processes when healthcare professionals are at the point of care. Users believed that HIS might frequently slow down the process of care delivery and increase the time spent by patients inside the hospital especially during slow performance and responsiveness phases. RECOMMENDATIONS: Three main areasshowed improvement potential; system performance, organizational support and users’feedback. Improving the performance of the HIS is very crucial for its success, in addition to increasing the availability of computersat the point of care. User friendliness and new innovative methods for data entry, such as automated voice recognition,can improve the workload and enhance information quality. Organizational support is very crucial, through providing training, dedicated and protected time during working hours for users to learn and practice on HIS. Better and more reliable channels of communication and feedback are needed to consider users’ complaints, suggestions and contribution.

Prioritizing barriers to successful implementation of hospital information systems.

Hospital information systems (HIS) are often implemented to enhance the quality of care, as well as to improve the efficiency and safety of health care services. However, there are various barriers for their successful implementation. The aim of this paper is to prioritize these barriers. This research is a cross sectional analytic-descriptive study. The study populations were hospital managers, IT department administrators, and clinical supervisors at the academic and non-academic hospitals of two cities in Iran. The data was collected by a questionnaire that its content validity was confirmed by three specialists. Its reliability was confirmed using Cronbach's alpha (α = 0.78). Questionnaire contained five dimensions and 39 implementation barriers. The collected data was analyzed by descriptive and analytical statistics using the Kendall Rank Correlation Coefficient and Chi2 tests. The findings of the study revealed that lack of powerful information networks, error in data entry, technical problems related to system design, lack of organizational training, lack of users' knowledge about system and working with it, and negative attitudes of providers and patients toward systems are the most important barriers of HIS implementation. Prioritizing of these barriers helps policy makers to decide what to do when planning for HIS utilization.

Factors influencing nurses' acceptance of hospital information systems in Iran: application of the Unified Theory of Acceptance and Use of Technology.

User acceptance is a precondition for successful implementation of hospital information systems (HISs). Increasing investment in information technology by healthcare organisations internationally has made user acceptance an important issue in technology implementation and management. Despite the increased focus on hospital information systems, there continues to be user resistance. The present study aimed to investigate the factors affecting hospital information systems nurse-user acceptance of HISs, based on the Unified Theory of Acceptance and Use of Technology (UTAUT), in the Shiraz University of Medical Sciences teaching hospitals. A descriptive-analytical research design was employed to study nurses' adoption and use of HISs. Data collection was undertaken using a cross-sectional survey of nurses (n=303). The research model was examined using the LISREL path confirmatory modeling. The results demonstrated that the nurses' behavioural intention (BI) to use hospital information systems was predicted by Performance Expectancy (PE) (β= 2.34, p<0.01), Effort Expectancy (EE) (β= 2.21, p<0.01), Social Influence (SI) (β= 2.63, p<0.01) and Facilitating Conditions (FC) (β= 2.84, p<0.01). The effects of these antecedents of BI explained 72.8% of the variance in nurses' intention to use hospital information systems (R2 = 0.728). Application of the research model suggested that nurses' acceptance of HISs was influenced by performance expectancy, effort expectancy, social influence and facilitating conditions, with performance expectancy having the strongest effect on user intention.

A Low Cost Hospital Information System: A Case Study of the Mehr Hospital in Mashhad City

Nowadays healthcare organizations globally recognize the importance of applying information technologies to improve the quality of their services and reduce costs. The Hospital Information Systems (HISs) are the information systems applied in hospitals in order to provide necessary services for the hospitals. In addition to include all the facilities of the HIS, the implementation cost of the system should be reasonable and cost worthy. In this study we explain different parts of the HIS which has been implemented at the Mehr hospital in the Mashhad city of Iran. The HIS implementation cost is low and economical with the hospital income. Furthermore we investigate the effect of the HIS in different aspects of the hospital. The results indicate that applying HIS in Mehr hospital reduces the hospital cost by reducing the amount of paper consumption, omitting several stages of the hospital procedure doing by staff which concludes thrift. It also improves the quality of services in the hospital by increasing the speed of services.

The status of hospital information systems in Iranian hospitals.

Background:The area of e-Health is broad and has an excellent growth potential. An increasing number of experts believe that e-Health will fuel the next breakthroughs in health system improvements throughout the world, but there is frequent evidence of unsustainable use of e-Health systems in medical centres, particularly hospitals, for different reasons in different countries. Iran is also a developing country which is presently adopting this promising technology for its traditional healthcare delivery but there is not much information about the use of e-Health systems in its hospitals, and the weakness and opportunities of utilization of such Hospital Information Systems (HIS).Methods:For this research, a number of Hospitals from Isfahan, Iran, are selected using convenient sampling. E-health research professionals went there to observe their HIS and collect required data as a qualitative survey. The design of interview questions was based on the researchers’ experiences and knowledge in this area along with elementary interviews with experts on HIS utilization in hospitals.Results:Efficient administration of e-health implementation improves the quality of healthcare, reduces costs and medical errors, makes healthcare resources available to rural areas, etc. However, there are numerous issues affecting the successful utilization of e-health in Hospitals, such as a lack of a perfect HIS implementation plan and well-defined strategy, inadequate IT-security for the protection of e-health-related data, improper training and educational issues, legal challenges, privacy concerns, improper documentation of lessons learned, resistance to the application of new technologies, and finally a lack of recovery plan and disaster management. These results along with some informative stories are extracted from interview sessions to uncover associated challenges of HIS utilization in Iranian hospitals.Conclusion:The utilization of e-health in Iranian hospitals, particularly those in Isfahan, is subject to several challenges and there is no proper long-term strategy plans for HIS initiation, development, and improvement in Iranian hospitals. In order to address these problems, six recommendations are provided. Hence, human resource and e-health professionals from third party consultancy companies along with medical university scholars have to assist such hospitals to undertake the proposed solutions in order to provide proper plans to overcome future challenges and have a mature HIS in accordance with expected HIS utilization from hospitals and medical universities.

Synthesising hospital information system critical success factors in Indonesia

The health issue today is becoming one of the biggest challenges in Indonesia since the Indonesian Government started the Universal Health Coverage programme in the early 2014. In order to support the programme, hospitals should be equipped with a hospital information system (HIS). This research is aimed at synthesising the critical success factors (CSFs) in implementing HIS in hospitals in Indonesia. This quantitative study is using survey and accordingly distributing questionnaires to the Directorate of the Referral Health Effort of the Ministry of Health, three high rank officials of the Hospital Accreditation Commission, 27 high level management officers of two public central hospitals, two public district general hospitals, nine private hospitals and two academicians of public health and computer science. The study shows the top three CFSs of HIS implementation are, in sequence, top management commitment, thorough communication process, and good project management. Also, eight additional CSFs are proposed for future work.

A Conceptual Study on Hospital Information System in Public Hospital of Bangladesh: Electronic Medical Record and Clinical Information System Perspective

The empirical data is used in organizations all over the world which require the integration of some informational systems like Electronic Medical Record (EMR) and Clinical Information System (CIS); these concepts will discover with new form of Bangladeshi public hospital’s improvement in Information Technology (IT) sector. The objective of this conceptual paper is to review critically and identify the gaps in current literature aligning with Hospital Information System (HIS) and Electronic Medical Record (EMR), building relationship between EMR and CIS in terms of Bangladeshi public hospital; towards hospital’s effectiveness of service operator when public hospital plays an important role to keep the patients data. The proposed conceptual framework assists HIS providers to understand how EMR and CIS can contribute to improve the hospitals patient database. More over the paper presents an analysis in various aspects of EMR and CIS complying with a conceptual framework which can attract the researchers in Hospital information System field and public hospital management field for the better presences of information technology for the patients. Hospital Information System (HIS) is essential in hospitals especially which deals with high-quality healthcare treatments. HIS helps to improve patients care services. Thus, the Bangladesh Government has not introduced any kind of HIS for public hospitals of Bangladesh. Moreover, there is no study on HIS implementation in Bangladeshi public hospital.

Evaluating the impact of ICT-tools on health care delivery in sub-Saharan hospitals.

This research explores to what extent Information and Communication Technology (ICT)-based information management methods can help to improve efficiency and effectiveness of health services in sub-Saharan hospitals and how clinical information can be made available for secondary use enabling non-redundant reporting of health- and care performance indicators. In the course of a 6 years research effort between 2006 and 2012, it was demonstrated that patient identification, financial management and structured reporting improved dramatically after implementation of well adapted ICT-tools in a set of 19 African health facilities. Real-time financial management metrics helped hospitals to quickly identify fraudulent practices and defective invoicing procedures. Out-patient case load significantly increased compared to the national average, average length of stay has been shortened in 15 of 19 health facilities and global hospital mortality decreased. Hospital workforce-evaluated impact of hospital information system implementation on local working conditions and quality of care was very positive. It was demonstrated that local sub-Saharan health professionals strongly believe in the importance of health information systems.

Implementation of hospital information system based on VMware virtualization

Contemporary hospital information systems normally contain multiple applications,which are traditionally deployed as one application per server.More servers in the system will incur high system costs,low server efficiency and poor management and maintenance.The information system reform project of Wuxi Maternal and Child Health Hospital called into play the virtualization based on VMware.The project brought forth a number of merits,namely sizably raising efficiency of servers integration,simplifying server group management,reducing cost and promoting hospital informationization. Key words: VMware; Virtualization; Information system

Information technology systems in public sector health facilities in developing countries: the case of South Africa

BackgroundThe public healthcare sector in developing countries faces many challenges including weak healthcare systems and under-resourced facilities that deliver poor outcomes relative to total healthcare expenditure. Global references demonstrate that information technology has the ability to assist in this regard through the automation of processes, thus reducing the inefficiencies of manually driven processes and lowering transaction costs. This study examines the impact of hospital information systems implementation on service delivery, user adoption and organisational culture within two hospital settings in South Africa.MethodsNinety-four interviews with doctors, nurses and hospital administrators were conducted in two public sector tertiary healthcare facilities (in two provinces) to record end-user perceptions. Structured questionnaires were used to conduct the interviews with both qualitative and quantitative information.ResultsNoteworthy differences were observed among the three sample groups of doctors, nurses and administrators as well as between our two hospital groups. The impact of automation in terms of cost and strategic value in public sector hospitals is shown to have yielded positive outcomes with regard to patient experience, hospital staff workflow enhancements, and overall morale in the workplace.ConclusionThe research provides insight into the reasons for investing in system automation, the associated outcomes, and organisational factors that impact the successful adoption of IT systems. In addition, it finds that sustainable success in these initiatives is as much a function of the technology as it is of the change management function that must accompany the system implementation.

Implementation Differences of Hospital Information System (HIS) in Malaysian Public Hospitals

Hospital Information System (HIS) is important to healthcare sector especially in public hospitals as they need to serve the public with high-quality healthcare treatments. HIS helps to improve patients care services. Thus, the Malaysian Government has introduced three (3) categories of HIS namely Total Hospital Information System (THIS), Intermediate Hospital Information System (IHIS), and Basic Hospital Information System (BHIS) among Malaysian public hospitals. However, only 15.2% of the Malaysian public hospitals are implementing the system. Moreover, there is limited number of empirical studies on HIS implementation in Malaysia. Thus, this paper aims to investigate issues and challenges in HIS implementation for each category of HIS by using in-depth interviews. Nine participants were involved in the interviews. The interview data were transcribed verbatim and analysed based on Content and Thematic Analysis using NVivo software. The results showed that different category of HIS faced different issues and challenges.

Improving Service Accessibility in Service-Oriented HIS

Nowadays, new trend in design and implementation of Hospital Information System (HIS) is towards using Web-based Service-Oriented Architecture (SOA). However, the standard SOA includes an insensitive service store through which the accessibility of some hospital services becomes difficult when their specification or network address are changed or missed. This paper discusses problems of insensitive service store and then presents a model where a sensitive service store is used to mitigate the problems. To show the efficiency of the proposed model, HIS of the Shahid Beheshti Hospital of Kashan including information systems of Admission, Outpatient, Ward, Pharmacy, Medical Document, Discharge and Insurance was designed and implemented with sensitive service store and its performance was considered.