Readiness and Acceptance of Electronic Medical Records Among Health Professionals in Indonesia
Abstract
With the launch of Indonesia Health Services (IHS) as a platform for the digitization and data integration of the country's various healthcare systems, the implementation of electronic medical records (EMR) has become inevitable. Ministry of Health also urged health service facilities to run an electronic patient medical history recording system until December 31, 2023. EMR can assist practitioners in performing routine duties and assignments records-keeping more efficiently and effectively. However, implementation of EMRs is typically accompanied by concerns of additional burden due to data entry, disruptions in productivity, apprehension of shifting from paper records to computerized records, and modifications in organizational culture necessary to use EMRs efficiently. Technology's perceived ease of use and usefulness are considered by people when deciding whether or not to adopt new technology. This study aimed to assess health professional readiness and intention toward EMR implementation in Indonesia based on Technology Acceptance Model (TAM) and Technology Readiness Index (TRI). This cross-sectional study used an online questionnaire to gather data. We used convenient sampling since the population is infinite and unknown. At the end of the study, we managed to get 124 responses from all over Indonesia. Most of the participants were specialists and experienced for more than fifteen years. Data were analyzed using SEM-PLS. Our analysis found that optimism, innovativeness, discomfort, and insecurity simultaneously explained 69.9% of perceived usefulness (PU), while perceived ease of use (PEU) was explained by 63.4% of the variance. Further, the model explained 67.2% of behavioral intention. Optimism and innovativeness significantly influenced PU. Optimism also significantly influenced PEU. Insecurity influenced PEU in a negative role. Therefore, all influential factors in EMR adoption must be considered for improving and developing EMR in Indonesia.
Keywords: electronic medical record (EMR), health professionals, Technology acceptance model (TAM), Technology readiness index (TRI)
Full Text:
81-92References
Ayaad, O., Alloubani, A., ALhajaa, E. A., Farhan, M., Abuseif, S., Al Hroub, A., & Akhu-Zaheya, L. (2019). The role of electronic medical records in improving the quality of health care services: Comparative study. International Journal of Medical Informatics, 127(January), 63–67. https://doi.org/10.1016/j.ijmedinf.2019.04.014
Cabinet Secretariat of the Republic of Indonesia. (2022). Health Ministry Launches' SatuSehat' Platform. https://setkab.go.id/en/health-ministry-launches-satusehat-platform/
Davis, F. D. (1989). Perceived Usefulness, Perceived Ease of Use, and User Acceptance of Information Technology. MIS Quarterly, 13(3), 319. https://doi.org/10.2307/249008
Dönmez, E., Kitapçı, N. Ş., Kitapçı, O. C., Yay, M., Aksu, P. K., Köksal, L., & Mumcu, G. (2020). Readiness for health information technology is associated to information security in healthcare institutions. Acta Informatica Medica, 28(4), 265–271. https://doi.org/10.5455/AIM.2020.28.265-271
Durrani, H., Khoja, S., Naseem, A., Scott, R. E., Gul, A., & Jan, R. (2012). Health needs and eHealth readiness assessment of health care organizations in Kabul and Bamyan, Afghanistan. Eastern Mediterranean Health Journal, 18(6), 663–670. https://doi.org/10.26719/2012.18.6.663
Gefen, D., Rigdon, E. E., & Straub, D. (2011). An Update and Extension to SEM Guidelines for Administrative and Social Science Research. MIS Quarter, 35(2), 1–7.
Ghazisaeidi, M., Ahmadi, M., Sadoughi, F., & Safdari, R. (2014). A Roadmap to pre-implementation of electronic health record: The key step to success. Acta Informatica Medica, 22(2), 133–138. https://doi.org/10.5455/aim.2014.22.133-138
Gopidasan, B., Amanullah, S., & Adebowale, A. (2022). Electronic medical records – A review of cost-effectiveness, efficiency, quality of care, and usability. Journal of Psychiatry Spectrum, 1(2), 76. https://doi.org/10.4103/jopsys.jopsys_17_22
Hair, Joe F., Ringle, C. M., & Sarstedt, M. (2011). PLS-SEM: Indeed a silver bullet. Journal of Marketing Theory and Practice, 19(2), 139–152. https://doi.org/10.2753/MTP1069-6679190202
Hair, Joseph F., Hult, G. T., Ringle, C., & Sarstedt, M. (2017). A Primer on Partial Least Squares Structural Equation Modeling (PLS-SEM). In Sage.
Hair, Joseph F., Page, M., & Brunsveld, N. (2020). Essentials of Business Research Methods. In Routledge Taylor & Francis Group (4th ed.). Routledge.
Hair, Joseph F, Risher, J. J., Sarstedt, M., & Ringle, C. M. (2019). When to use and how to report the results of PLS-SEM. European Business Review, 31(1), 2–24. https://doi.org/10.1108/EBR-11-2018-0203
Henseler, J. (2017). Partial Least Squares Path Modeling. In P. S. H. Leeflang, J. E. Wieringa, & T. H. . Bijmolt (Eds.), Advanced Methods for Modeling Markets (pp. 361–381). Springer International Publishing. https://doi.org/10.1007/978-3-319-53469-5_12
IOM. (2000). To Err Is Human: Building a Safer Health System Linda. In L. T. Kohn, J. M. Corrigan, & M. S. Donaldson (Eds.), Institute of Medicine: Committee on Quality of Health Care in America. National Academy Press.
Jimma, B. L., & Enyew, D. B. (2022). Barriers to the acceptance of electronic medical records from the perspective of physicians and nurses: A scoping review. Informatics in Medicine Unlocked, 31. https://doi.org/10.1016/j.imu.2022.100991
Khoja, S., Scott, R. E., Casebeer, A. L., Mohsin, M., Ishaq, A. F. M., & Gilani, S. (2007). e-Health readiness assessment tools for healthcare institutions in developing countries. Telemedicine and E-Health, 13(4), 425–431. https://doi.org/10.1089/tmj.2006.0064
Lin, H.-L., Wu, D.-C., Cheng, S.-M., Chen, C.-J., Wang, M.-C., & Cheng, C.-A. (2020). Association between Electronic Medical Records and Healthcare Quality. Medicine, 99(31), e21182. https://doi.org/10.1097/MD.0000000000021182
Mauco, K. L., Scott, R. E., & Mars, M. (2021). Development of a conceptual framework for e-health readiness assessment in the context of developing countries. Telehealth Innovations in Remote Healthcare Services Delivery: Global Telehealth 2020, 68–77. https://doi.org/10.3233/SHTI210029
Mick, D. G., & Fournier, S. (1998). Paradoxes of technology: Consumer cognizance, emotions, and coping strategies. Journal of Consumer Research, 25(2), 123–143. https://doi.org/10.1086/209531
Peraturan Menteri Kesehatan Nomor 46 Tahun 2017 Tentang Strategi E-Kesehatan Nasional, (2017).
Ministry of Health. (2022a). Fasyankes Wajib Terapkan Rekam Medis Elektronik. Bureau of Communications and Community Services. https://sehatnegeriku.kemkes.go.id/baca/umum/20220909/0841042/fasyankes-wajib-terapkan-rekam-medis-elektronik/#:~:text=Rekam medis pasien mulai beralih,riwayat medis pasien secara elektronik
Ministry of Health. (2022b). Kemenkes Luncurkan Platform SATUSEHAT Untuk Integrasikan Data Kesehatan Nasional. Bureau of Communications and Community Services. https://sehatnegeriku.kemkes.go.id/baca/umum/20220726/5140733/kemenkes-ri-resmi-luncurkan-platform-integrasi-data-layanan-kesehatan-bernama-satusehat/
Najaftorkaman, M., Ghapanchi, A. H., Talaei-Khoei, A., & Ray, P. (2013). Recent Research Areas and Grand Challenges in Electronic Medical Record: A Literature Survey Approach. The International Technology Management Review, 3(1), 12. https://doi.org/10.2991/itmr.2013.3.1.2
Neves, A. L., Freise, L., Laranjo, L., Carter, A. W., Darzi, A., & Mayer, E. (2020). Impact of providing patients access to electronic health records on quality and safety of care: A systematic review and meta-analysis. BMJ Quality and Safety, 29(12), 1019–1032. https://doi.org/10.1136/bmjqs-2019-010581
Parasuraman, A. (2000a). Technology Readiness Index (TRI): A Multipleitem Scale To Measure Readiness To Embrace New Technologies. Journal Of Service Research, 2:307(May).
Parasuraman, A. (2000b). Technology Readiness Index (TRI): a multiple-item scale to measure readiness to embrace new technologies. Journal of Service Research, 2(4), 307–320. https://doi.org/10.1177/109467050024001
Parasuraman, A., & Colby, C. L. (2001). Techno-ready marketing : how and why your customers adopt the technology. The Free Press.
Parasuraman, A., & Colby, C. L. (2014). An Updated and Streamlined Technology Readiness Index. Journal of Service Research, 18(1), 59–74. https://doi.org/10.1177/1094670514539730
Permenkes 24 Tahun 2022 Tentang Rekam Medis, (2022).
Pujani, V., Hardisman, & Nazir, R. (2019). Electronic health readiness (EHR) in Indonesia: Managerial perspectives. ACM International Conference Proceeding Series, 316–320. https://doi.org/10.1145/3364335.3364401
Rhoades, C. A., Whitacre, B. E., & Davis, A. F. (2022). Higher Electronic Health Record Functionality Is Associated with Lower Operating Costs in Urban—but Not Rural—Hospitals. Applied Clinical Informatics, 13(03), 665–676. https://doi.org/10.1055/s-0042-1750415
Rojas-Méndez, J. I., Parasuraman, A., & Papadopoulos, N. (2017). Demographics, attitudes, and technology readiness: A cross-cultural analysis and model validation. Marketing Intelligence and Planning, 35(1), 18–39. https://doi.org/10.1108/MIP-08-2015-0163
Saragih, C., Nafa Sari, C., Nurtjahyo Moch, B., & Muslim, E. (2020). Adoption of Electronic Medical Record in Hospitals in Indonesia based on Technology Readiness and Acceptance Model. ACM International Conference Proceeding Series, 79–85. https://doi.org/10.1145/3429551.3429565
Schopf, T. R., Nedrebø, B., Hufthammer, K. O., Daphu, I. K., & Lærum, H. (2019). How well is the electronic health record supporting the clinical tasks of hospital physicians? A survey of physicians at three Norwegian hospitals. BMC Health Services Research, 19(1), 934. https://doi.org/10.1186/s12913-019-4763-0
Vaishnavi, V., & Suresh, M. (2022). Assessment of healthcare organizational readiness for change: A fuzzy logic approach. Journal of King Saud University - Engineering Sciences, 34(3), 189–197. https://doi.org/10.1016/j.jksues.2020.09.008
Venkatesh, Morris, Davis, & Davis. (2003). User Acceptance of Information Technology: Toward a Unified View. MIS Quarterly, 27(3), 425. https://doi.org/10.2307/30036540
Walczuch, R., Lemmink, J., & Streukens, S. (2007). The effect of service employees' technology readiness on technology acceptance. Information and Management, 44(2), 206–215. https://doi.org/10.1016/j.im.2006.12.005
World Health Organization. (2012). National eHealth Strategy Toolkit. World Health Organization and International Telecommunication Union.
DOI: https://doi.org/10.26905/icgss.v7i1.9274
Refbacks
- There are currently no refbacks.