Implementation Of Electronic Medical Record Research Articles

Attitudes toward implementation of electronic medical record and its associated factors among health professional workers in selected public hospitals in Addis Ababa, Ethiopia, 2023: A multi-center cross-sectional study.

Electronic medical record (EMR) systems in healthcare delivery have the potential to transform healthcare in terms of saving costs, reducing medical errors, and improving data quality. This study aimed to assess the Attitudes toward implementing electronic medical records and associated factors among health professional workers in selected public hospitals in Addis Ababa. An institution-based cross-sectional study was conducted on 422 health professionals in selected hospitals in Addis Ababa, Ethiopia, in 2023. The study participants were selected using a simple random sampling technique. A binary and multivariable logistic regression model was used to identify associated factors for electronic medical record implementation. A p-value < .05 was considered statistically significant. The overall electronic medical record implementation perceived as useful by health workers is 298 (73.6%), with an allocation of enough budget [AOR = 3.196 (1.49-6.735)] has no networking or problem with internet access [AOR = 1.794(1.089-2.954)]. Electronic medical record increases workload [AOR = 2.350 (1.302-4.243)], which was significantly associated with electronic medical record implementation. According to this study, the overall perception of health professionals toward electronic medical record implementation was high. However, it would be better to build and establish strong internet connectivity and stable power supply or internet access without networking problems, allocate enough budget, and work in collaboration with hospitals and health bureaus to strengthen and support the electronic medical record in their facilities.

THE INCREASE OF BPJS CLAIMS AT HOSPITAL AFTER CHANGING TO E-MEDICAL RECORDS: CASE ANALYSIS AND MITIGATION STRATEGY

With the advancement of digital transformation, EMR has become an important step towards operational efficiency and better care. Through Permenkes No.24 of 2022, all health facilities in Indonesia are expected to have implemented the EMR system by the end of 2023. This is a mixed-methods study that combines primary data from interviews with 5 respondents and secondary data regarding BPJS claims during the period before and after EMR implementation, from January to August 2023. Secondary data analysis will be conducted using tables, graphs, and descriptive statistics such as mean, median, and standard deviation to detail and explain changes in BPJS claims patterns before and after EMR implementation. Qualitative data will be analysed. The results showed that EMR implementation increased the number of cases (11.27%) and the nominal amount of BPJS claims (15.04%). In addition, this study identified several factors that became challenges after the change to EMR. These factors include data errors, lack of staff training, technical constraints, and changes in operational processes that have not been fully integrated with the EMR system. Mitigation strategies include staff training, periodic monitoring and evaluation, internal claim audits, improvement of claim business processes, and monitoring and evaluation from management. Based on the results of the study, it can be concluded that the change to electronic medical records (EMR) at Sultan Agung Islamic Hospital has increased starting from the number of patients, the number of cases and the nominal amount of BPJS claims. Despite the increase in the nominal amount of BPJS claims, there are still challenges and problems that need to be overcome after the implementation of EMR.

The use of Electronic Medical Record (EMR) in hospitals during the COVID-19 pandemic in Indonesia: a systematic literature review

Purpose: Electronic medical records (EMR) are information technology-based systems that store and manage patient medical data. EMR are beneficial for improving healthcare services' efficiency, effectiveness, and security. The COVID-19 pandemic has driven the adoption of EMR, but there are still challenges, such as the surge in patient numbers and problems with EMR filling. This study aimed to investigate the use of EMR in hospitals during the COVID-19 pandemic in Indonesia. &#x0D; Method: This study was a systematic literature review using the PRISMA diagram. Article search was conducted based on the PICO model eligibility criteria. The articles used were retrieved from 3 databases: Google Scholar, ResearchGate, and Cerdika. The researcher limited the publication year of the journals to 2020-2021, when the COVID-19 pandemic was ongoing, and added the keyword "COVID-19" to the journals published in 2022-2023. &#x0D; Results: The results of the study showed that the COVID-19 pandemic has had a significant impact and the need for the implementation of EMR due to its various benefits, such as improving the efficiency and effectiveness of healthcare services, facilitating access to patient health information, increasing collaboration among healthcare workers, accelerating the process of clinical decision-making, and improving the security and accuracy of health data. However, implementing EMR during the COVID-19 pandemic has only sometimes been smooth. Some challenges include suboptimal infrastructure, untrained human resources, and inadequate policies. &#x0D; Conclusion: To overcome these challenges, efforts from various parties, including the government, hospitals, and healthcare workers, are needed.

Review: application of the Safety Attitudes Questionnaire (SAQ) in primary care - a systematic synthesis on validity, descriptive and comparative results, and variance across organisational units

Patient safety research has focused mostly on the hospital and acute care setting whereas assessments of patient safety climate in primary health care settings are warranted. Valid questionnaires as e.g., the Safety Attitudes Questionnaire (SAQ) may capture staff perceptions of patient safety climate but until now, an overview of the use of SAQ in primary care has not been systematically presented. Thus, the aim of this systematic review is to present an overview of SAQ used in primary care.Methods The electronic databases: PubMed, Embase, Cinahl, PsycInfo and Web of Science were used to find studies that used any version of SAQ in primary care. Studies were excluded if only abstract or poster was available, as the information in abstract and posters was deemed insufficient. Commentaries and nonempirical studies (e.g., study protocols) were excluded. Only English manuscripts were included.Results A total of 43 studies were included and 40 of them fell into four categories: 1) validation analysis, 2) descriptive analysis, 3) variance assessment and 4) intervention evaluation and were included in further analyses. Some studies fell into more than one of the four categories. Seventeen studies aimed to validate different versions of SAQ in a variety of settings and providers. Twenty-five studies from fourteen different countries reported descriptive findings of different versions of SAQ in a variety of settings. Most studies were conducted in primary health care centres, out-of-hours clinics, nursing homes and general practice focusing on greatly varying populations. One study was conducted in home care. Three studies investigated variance of SAQ scores. Only five studies used SAQ to assess the effects of interventions/events. These studies evaluated the effect of electronic medical record implementation, a comprehensive Unit-based Safety Program or COVID-19.Conclusion The synthesis demonstrated that SAQ is valid for use in primary care, but it is important to adapt and validate the questionnaire to the specific setting and participants under investigation. Moreover, differences in SAQ factor scores were related to a variety of descriptive factors, that should be considered in future studies More studies, especially variance and intervention studies, are warranted in primary care.Trial registration This systematic review was not registered in any register.

Optimizing Nutrition Care Management at Nutrition Care Center (NCC)

In nutrition care services, the creation and storage of medical records at the Nutrition Care Center (NCC) are still relatively simple and paper-based or manual. Additionally, management challenges, in the form of system constraints, are one of the obstacles to healthcare management at NCC. Therefore, there is a need for optimizing healthcare management at NCC. The aim of this study is to optimize nutrition care management at the NCC clinic through the use of EMR (Electronic Medical Records) facilitated by QR Codes and the implementation of a Whatsapp Bot. The results indicate that optimizing Nutrition Care Management through the Implementation of EMR with QR Codes and Whatsapp Bot simplifies nutritionists' access to previous client allergy and therapy history in one view and facilitates clients in accessing their medical record number without a physical card. This research has also designed a system that can be used both through web and mobile platforms

Benefits, facilitators, and barriers of electronic medical records implementation in outpatient settings: A scoping review.

This scoping review examined the breadth and depth of evidence on Electronic Medical Record (EMR) implementation benefits in outpatient settings. Following PRISMA guidelines for scoping reviews, five databases were searched, and 24 studies were retained and reviewed. Benefits, facilitators, and barriers to EMR implementation were extracted. Direct benefits included improved communication/reporting, work efficiency, care process, healthcare outcomes, safety, and patient-centredness of care. Indirect benefits were improved financial performance and increased data accessibility, staff satisfaction, and decision-support usage. Barriers included time and financial constraints; design/technical issues; limited information technology resources, skills, and infrastructure capacity; increased workload and reduced efficiency during implementation; incompatibility of existing systems and local regulations; and resistance from healthcare professionals. Facilitators included training, change management, user-friendliness and alignment with workflow, user experience with EMRs, top management support, and sufficient resources. More rigorous, systematic research is needed, using relevant frameworks to inform healthcare policies and guide EMR projects in outpatient areas.

Supporting and Inhibiting Factors in Implementing Electronic Medical Records (EMR) Policy in Indonesia

Health service facilities are obliged to provide quality services to patients. The increasingly rapid pace of information technology has influenced digital health services, one of which is through Electronic Medical Record (EMR) services. EMR, can improve the quality of health services for patients. The government issued a policy regarding medical records through the Indonesian Ministry of Health’s Regulation Number 24 of 2022 on Medical Records mandating that all health facilities implement EMR by December 2023. However, health facilities have not fully complied this policy. Based on the monitoring of the SATU SEHAT implementation, only 61.42% of health service facilities in Indonesia have adopted EMR due to several obstacles related to human resources, infrastructure, and management elements. This research aims to analyze the supporting and inhibiting factors in the implementation of the EMR policy in health service facilities in Indonesia. The research used a narrative review method by searching for articles using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, resulting in16 journals that were the required criteria. The analysis of these 16 articles show that, in general, health service facilities in Indonesia are ready to implement EMR. However, the implementation of the EMR policy faces inhibiting factors, such as unprepared IT infrastructure, lack of EMR implementation guidelines, and insufficient human resource training. Supporting factors include policies regulated by the Ministry of Health and government facilitation in implementing EMR. To achieve success in implementing the EMR policy, efforts are needed to improve IT infrastructure, improve the quality of EMR, develop strategies for EMR implementation, and provide continuous government assistance from the to health service facilities.

Analisis Kesiapan Penerapan Rekam Medis Elektronik Di Klinik AMC ‘Aisyiyah

Electronic Medical Records (EMR) is one of the health IT applications that is becoming a trend around the world. EMRs are considered to improve the overall quality of care and have an impact on patient safety. EMRs can also help reduce costs, improve accessibility, and improve the quality of hospital services. Therefore, the preparedness analysis of the implementation of EMR with the DOQ-IT approach (Doctor's Office Quality-Information Technology) is the goal of this research. This research uses a type of quantitative descriptive research with a cross sectional approach. The samples were taken from all the officers who were in direct contact with the medical records at AMC Aisyiyah Clinic. Sampling technique using a total sampling of eight officers. Primary data collection is done with a questionnaire. The method of analysis used is descriptive analysis of frequencies, percentages, graphs and tables. From the results of analysis using the DOQ-IT method obtained a total score of 104.75 belongs to category III which shows that human resources, organizational work culture, governance and leadership, IT infrastructure AMC Aisyiyah Clinic is ready to take advantage of EMR as well as overcome the potential challenges for successful adoption of the EMR.

A Cross-Sectional Study of Investigating the Errors in Prescription and Drug Prescribing Pattern among General Community

The main purpose of this study is to access the awareness and knowledge of finding out errors in prescription among general public which include determination of the quality of prescription in hospital pharmacy and to address the errors identified in prescriptions. Implementation of teaching electronic medical record within didactic using drug info assignment. This survey emphasised the need for monitoring and evaluating the prescription handling conducted through google form. Therefore, the present study will help to understand the prescribing patterns and errors to the general community which will, in turn, improve the quality of the use of medicine and healthcare facilities. This following report has comprehensive studies that public have developed knowledge about prescription parts, drug information, self-evaluation, health care factors when compared to previous studies

S66 High Rates of Patient-Reported Outcome Measurements in Patients With Inflammatory Bowel Disease With Electronic Medical Record Implementation

S66 High Rates of Patient-Reported Outcome Measurements in Patients With Inflammatory Bowel Disease With Electronic Medical Record Implementation

Patient privacy protection: Generating available medical treatment plans based on federated learning and CBR

Although the favorable impact of sharing electronic medical records (EMRs) with other hospitals on improving clinical decision-making efficiency is widely acknowledged, the actual implementation of EMR sharing has been limited to some extent because of patient privacy protections. This study proposes a three-stage framework to retrieve medical treatment plans from multiple hospitals based on federated learning and case-based reasoning (CBR). We demonstrate that the proposed framework compensates for the privacy protection weaknesses of CBR and solves the problem of data islands among hospitals.

Integration of Electronic Medical Record and SATUSEHAT’s Platform : Patient’s Legal Protection Perspective

Integration of Electronic Medical Record and SATUSEHAT’s Platform : Patient’s Legal Protection Perspective

Development of the Unified Theory of Acceptance and Use of Technology (Utaut) Model in the Acceptance of Electronic Medical Records Systems at Colonel Abundjani Bangko Hospital

The implementation of Electronic Medical Records at the Colonel Abundjani Bangko Hospital has not run optimally because human resource behavior is still low. This research aims to analyze the development of the Unified Theory of Acceptance and Use of Technology (UTAUT) Model in the acceptance of the Electronic Medical Record system at the Colonel Abundjani Bangko Hospital. This type of research is quantitative with an analytical observational approach with a cross sectional design. This research was conducted at the Colonel Abundjani Bangko Hospital from September to October 2023. The population in this study were all health workers associated with the implementation of medical records consisting of doctors, nurses, medical records officers and pharmacists at the Colonel Abundjani Bangko Hospital. 152 people (Total population). Data analysis was carried out univariate, bivariate (Chi Square), and multivariate (logistic regression). The results of the research show that there is an influence of the perception aspect of usability on the acceptance of the Electronic Medical Record system (p&lt; 0,05). There is an influence of job suitability aspects on the acceptance of the Electronic Medical Record system (p&lt; 0,05). There is an influence of the relative profit aspect on the acceptance of the Electronic Medical Record system (p&lt; 0,05). There is an influence of social influence aspects on the acceptance of the Electronic Medical Record system (p&lt; 0,05). There is an influence of the facility aspect on the acceptance of the Electronic Medical Record system (p&lt; 0,05). The dominant variable influencing the acceptance of the Electronic Medical Record system at Colonel Abundjani Bangko Hospital is the social aspect variable. The conclusion in this research is that there is an influence of the development of the Unified Theory of Acceptance and Use of Technology (UTAUT) Model in the acceptance of the Electronic Medical Record system at the Colonel Abundjani Bangko Hospital, so it is recommended that the results of this research become input material for conducting a review of the implementation of the system electronic medical record.

Analysis of Readiness For Implementation of Electronic Medical Records Using DOQ-IT Method

This study addresses the challenge of managing medical records in Indonesia’s health sector, particularly focusing on the transition to electronic medical records (RME) as mandated by PMK No. 24 of 2022. The primary objective is to assess the readiness for implementing Electronic Medical Records (EMR) at the Milla Husada Clinic using the DOQ-IT (Doctor’s Office Quality-Information Technology) Approach. The research adopts a descriptive design with a quantitative approach, utilizing questionnaires to gather data from 40 clinic officers. Total sampling technique was employed for participant selection. Univariate analysis was used for data interpretation. The findings reveal a high level of readiness for RME implementation at the clinic, with a total readiness score of 117.74, placing it in range III, indicative of a very ready status. The readiness levels, in descending order of scores, were: organizational work culture (4.34), governance and leadership (4.26), IT infrastructure (4.23), and human resource readiness (3.80). Despite the overall readiness, the study identifies human resources as an area requiring further enhancement, specifically the need for specialized training in RME implementation. This research highlights the critical areas for improvement to ensure successful adoption of electronic medical records in the healthcare setting.

An Assessment of Success Factors and Challenges in Implementation of Electronic Medical Record System in Referral Hospital in Northern Tanzania.

The Electronic Medical Record (EMR) has significant benefits in improving the quality of hospital services in low resources settings. Despite efforts to implement various EMRs in different health facilities, there is scarce information on the challenges and success factors regarding EMR Implementation in Regional hospitals. The aim of this study is to assess the success and challenging factors in the implementation of an electronic medical record system at the regional referral Hospital. This was a cross-sectional design study involving qualitative and quantitative approaches that was conducted at Haydom Lutheran Hospital a Regional Referral Hospital in northern Tanzania. The semi-structured questionnaires and the Key Informant Interview Guide questions were used for quantitative and qualitative data collection respectively. The quantitative data were analyzed using Stata Version 13.0. The quantitative data was summarized using descriptive statistics. Thematic method was used to analyze the qualitative data. Among 303 participants more than half were male 167(55.1%) and 119(39.3%) aged between 31 and 40 years. The nurses and medical attendants were the predominant group 188(62%). Most of the staff were on full-time employment 273(90.1%) and more than thirty percent 118(38.09%) have worked for over 10 years. The age group of between 31-60 years had a higher influence on the EMR net benefit compared to respondents aged 20 to 30 years and 60 years. The easy use, learning, usefulness, and relevance to work as well as leadership, staff involvement in processes, and use of champions were among of success factors for EMR implementation. Challenges include inadequate training, lack of funding, and inadequate IT equipment. The net benefit includes increases in efficiency in service delivery and better resource management. Staff involvement, use of champions and the fact that the system is easy to use contributed to the success of EMR system. In order to scale up and sustain the EMR system in hospitals, adequate funding, training as well as continuous support to all staff in the hospital is required.

Legal Protection of Patient's Electronic Medical Record: Indonesian Legal Perspective

Health is the most fundamental factor of every citizen, particularly in Indonesia. Considering that many people need health services, patients’ data are pivotal as they contain patients’ health and medical records, identity, examination, medication, and other services patients receive in health services. Medical record in Indonesia is regulated by the Minister of Health Regulation No. 269 of 2008 on Medical Record and the Minister of Health Regulation No .22 of 2022 on Electronic Medical Record. The transition to electronic medical records is expected to finish on 31 December 2023. Electronic Medical Records (EMRs), which are now being implemented across the healthcare system in Indonesia, have the potential to fulfill the rights of citizens in the healthcare sector. On the other hand, data security for patients requires protection, as electronic systems may be vulnerable to data breaches and misuse by unauthorized individuals. The objective of this research is to examine the legal protection for patients when their electronic medical record data is misused and to elucidate patients' rights in the realm of healthcare, particularly concerning medical records. The research employs a normative juridical approach with a legislative regulation focus. Article 29 of Minister of Health Regulation No. 22 of 2022 already addresses data protection for patients' personal information, although continuous monitoring of the implementation of patient's Electronic Medical Records is still necessary. The findings of this study emphasize the necessity of ensuring data protection guarantees for patients stored within electronic systems.

Health Information System Strengthening During Antenatal Care in Haiti: Continuous Quality Improvement Study.

Journey to 9 Plus (J9) is an integrated reproductive, maternal, neonatal, and child health approach to care that has at its core the goal of decreasing the rate of maternal and neonatal morbidity and mortality in rural Haiti. For the maximum effectiveness of this program, it is necessary that the data system be of the highest quality. OpenMRS, an electronic medical record (EMR) system, has been in place since 2013 throughout a tertiary referral hospital, the Hôpital Universitaire de Mirebalais, in Haiti and has been expanded for J9 data collection and reporting. The J9 program monthly reports showed that staff had limited time and capacity to perform double charting, which contributed to incomplete and inconsistent reports. Initial evaluation of the quality of EMR data entry showed that only 18% (58/325) of the J9 antenatal visits were being documented electronically at the start of this quality improvement project. This study aimed to improve the electronic documentation of outpatient antenatal care from 18% (58/325) to 85% in the EMR by J9 staff from November 2020 to September 2021. The experiences that this quality improvement project team encountered could help others improve electronic data collection as well as the transition from paper to electronic documentation within a burgeoning health care system. A continuous quality improvement strategy was undertaken as the best approach to improve the EMR data collection at Hôpital Universitaire de Mirebalais. The team used several continuous quality improvement tools to conduct this project: (1) a root cause analysis using Ishikawa and Pareto diagrams, (2) baseline evaluation measurements, and (3) Plan-Do-Study-Act improvement cycles to document incremental changes and the results of each change. At the beginning of the quality improvement project in November 2020, the baseline data entry for antenatal visits was 18% (58/325). Ten months of improvement strategies resulted in an average of 89% (272/304) of antenatal visits documented in the EMR at point of care every month. The experiences that this quality improvement project team encountered can contribute to the transition from paper to electronic documentation within burgeoning health care systems. Essential to success was having a strong and dedicated nursing leadership to transition from paper to electronic data and motivated nursing staff to perform data collection to improve the quality of data and thus, the reports on patient outcomes. Engaging the nursing team closely in the design and implementation of EMR and quality improvement processes ensures long-term success while centering nurses as key change agents in patient care systems.

Implementation of Electronic Medical Records at Primary Care in Semarang City Region: An Analysis of Individual and Organisational Determinants

Implementing electronic medical records (EMR) in Puskesmas faces various challenges and barriers that hinder system users. This study aims to identify the effects of individual and organizational factors on the implementation of EMR in Puskesmas located in Semarang City. The study was designed as a cross-sectional study and was conducted between August and September 2023. Participants were selected from five health centres representing five regions of Semarang city, and included 46 health professionals, including physicians, nurses, midwives, medical record keepers and IT staff. The survey was taken from a standardized questionnaire based on the Technology Acceptance Theory and Institutional Theory. The results showed that 34% of the respondents were between 20 and 30 years old, where 76.1% were female and 52.2% had a bachelor's degree, and were dominated by nurses, where the majority had 1-5 years of experience. The constant (a) of 1.770 indicates the value of the independent variables in increasing EMR usage. The regression coefficient of the individual factor variable of 0.207 has a positive effect on EMR implementation. Organisational factors negatively affect the implementation of EMR use. The test results found that individual factors partially and significantly (0.005 &lt;0.05) affect the implementation of EMR utilised.

Addressing complexity when developing an education program for the implementation of a stroke Electronic Medical Record (EMR) enhancement

BackgroundDigital interventions in health services often fail due to an underappreciation of the complexity of the implementation. This study develops an approach to address complexity through an evidenced-based, theory-driven education and implementation program for an Electronic Medical Record (EMR) digital enhancement for acute stroke care.MethodsAn action research approach was used to design, develop, and execute the education and implementation program over several phases, with iterative changes over time. The study involved collaboration with multiple statewide and local key stakeholders and was conducted across two tertiary teaching hospitals and a regional hospital in Australia.ResultsInsights were gained over five phases. Phase 1 involved a review of evidence that supported blended learning strategies for the education and training of staff end-users. In Phase 2, contextual assessment was conducted via observation of study sites, providing awareness of local context variability and insight into key implementation considerations. The Non-adoption, Abandonment, Scale-Up, Spread and Sustainability (NASSS) framework assisted in Phase 3 to identify and manage the key domains of complexity. Phase 4 involved the design of the program which included group-based training and an e-learning package, endorsed and evaluated by key leaders. Throughout implementation in Phase 5, further barriers were identified, and iterative changes were tailored to each context.ConclusionsThe NASSS framework, combined with a multi-phased approach employing blended learning techniques, context evaluations, and iterative modifications, can serve as a model for generating theory-driven and evidence-based education strategies that adresss the complexity of the implementation process and context.

The Influence of the Information System Success Model and the Technology Acceptance Model on the Behavioral Intention of Specialist Doctors to use Electronic Medical Records For Inpatient Care Unit

The acceleration of technological developments affects the management of information systems within the hospital, especially in using of Electronic Medical Records (EMR). Behavioral intention to use EMR is the essential factor, the role of user is one of the keys to successful EMR implementation. This study aims to analyze the factors that influence behavioral intention of specialist doctors to use inpatient EMR. Data were obtained through questionnaires using the Likert measuring scale and data analysis was processed using SEM (Structural Equation Modelling). Quantitative analytical research method with cross-sectional design using a total sampling of 144 specialists. Of the total 144 respondents, the majority of respondents were male (59%), aged 40-50 years (30.6%) and had a working period of more than 20 years (25.7%). Hypothesis analysis found that there was an effect of system and information quality on perceived ease of use and usefulness. System quality, perceived ease of use and usefulness influence behavioral intention, while information quality has no effect, but indirectly influences behavioral intention through perceived ease of use and usefulness. Service quality has no effect on perceived ease of use, perceived usefulness, and behavioral intention. Perceived usefulness has the greatest influence on behavioral intentions to use inpatient EMR. As an implication of this study, it was found that it is necessary to optimize the inpatient EMR system in the aspects of reliability and connectivity.