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

Digitalisation Medical Records: Improving Efficiency and Reducing Burnout in Healthcare

(1) Background: electronic medical record (EMR) systems remain a significant priority for the improvement of healthcare services. However, their implementation may have resulted in a burden on healthcare workers (HCWs). This study aimed to determine the prevalence of burnout symptoms among HCWs who use EMRs at their workplace, as well as burnout-associated factors. (2) Methods: an analytical cross-sectional study was conducted at six public health clinics equipped with an electronic medical record system. The respondents were from a heterogeneity of job descriptions. Consent was obtained before enrolment into the study. A questionnaire was distributed through an online platform. Ethical approval was secured. (3) Results: a total of 161 respondents were included in the final analysis, accounting for a 90.0% response rate. The prevalence of burnout symptoms was 10.7% (n = 17). Three significant predictors were obtained in the final model: experiencing ineffective screen layouts and navigation systems, experiencing physical or verbal abuse by patients, and having a poor relationship with colleagues. (4) Conclusions: the prevalence of burnout symptoms among healthcare workers working with electronic medical record systems was low. Despite several limitations and barriers to implementation, a paradigm shift is needed to equip all health sectors with electronic medical record systems to improve healthcare service delivery. Continuous technical support and financial resources are important to ensure a smooth transition and integration.

Predictive Analysis of Hospital HIS System Usage Satisfaction Based on Machine Learning

Hospital information system (HIS) can provide a full range of information support for various hospital business activities and information collection, processing, and transmission, helping medical service providers. And HIS can reduce medical service costs and improve work efficiency, greatly reducing errors in diagnosis and treatment. Although the advantages of using the HIS are obvious, there are still some challenges in its use, the most prominent being how to make the medical staff use HIS effectively. Based on this background, this paper uses machine learning (ML) technology to predict and analyze the satisfaction of HIS use in hospitals and completes the following work: firstly, introduce the situation and development trend of HIS construction at home and abroad and provide theoretical basis for model design. The related development technologies are discussed and studied in detail. Second, the ML algorithm is used to provide a prediction strategy. The support vector machine (SVM) can handle small data sets well, and this study applies the AdaBoost technique to improve the model's generalization ability and accuracy. Lastly, a diversity metric is included to guarantee that the basic learner has good variety in order to increase the algorithm's performance. Accuracy rates may reach more than 95% in the case of tiny data sets, according to the self-built data set used for testing. This proves the superiority of the model proposed in this paper.

Health Information Systems for Older Persons in Select Government Tertiary Hospitals and Health Centers in the Philippines: Cross-sectional Study

Background

The rapid aging of the world’s population requires systems that support health facilities’ provision of integrated care at multiple levels of the health care system. The use of health information systems (HISs) at the point of care has shown positive effects on clinical processes and patient health in several settings of care.

Objective

We sought to describe HISs for older persons (OPs) in select government tertiary hospitals and health centers in the Philippines. Specifically, we aimed to review the existing policies and guidelines related to HISs for OPs in the country, determine the proportion of select government hospitals and health centers with existing health information specific for OPs, and describe the challenges related to HISs in select health facilities.

Methods

We utilized the data derived from the findings of the Focused Interventions for Frail Older Adults Research and Development Project (FITforFrail), a cross-sectional and ethics committee–approved study. A facility-based listing of services and human resources specific to geriatric patients was conducted in purposively sampled 27 tertiary government hospitals identified as geriatric centers and 16 health centers across all regions in the Philippines. We also reviewed the existing policies and guidelines related to HISs for OPs in the country.

Results

Based on the existing guidelines, multiple agencies were involved in the provision of services for OPs, with several records containing health information of OPs. However, there is no existing HIS specific for OPs in the country. Only 14 (52%) of the 27 hospitals and 4 (25%) of the 16 health centers conduct comprehensive geriatric assessment (CGA). All tertiary hospitals and health centers are able to maintain medical records of their patients, and almost all (26/27, 96%) hospitals and all (16/16, 100%) health centers have data on top causes of morbidity and mortality. Meanwhile, the presence of specific disease registries varied per hospitals and health centers. Challenges to HISs include the inability to update databases due to inadequately trained personnel, use of an offline facility–based HIS, an unstable internet connection, and technical issues and nonuniform reporting of categories for age group classification.

Conclusions

Current HISs for OPs are characterized by fragmentation, multiple sources, and inaccessibility. Barriers to achieving appropriate HISs for OPs include the inability to update HISs in hospitals and health centers and a lack of standardization by age group and disease classification. Thus, we recommend a 1-person, 1-record electronic medical record system for OPs and the disaggregation and analysis across demographic and socioeconomic parameters to inform policies and programs that address the complex needs of OPs. CGA as a required routine procedure for all OPs and its integration with the existing HISs in the country are also recommended.

The Use of Blockchain Technology in the Health Care Sector: Systematic Review

Background

Blockchain technology is a part of Industry 4.0’s new Internet of Things applications: decentralized systems, distributed ledgers, and immutable and cryptographically secure technology. This technology entails a series of transaction lists with identical copies shared and retained by different groups or parties. One field where blockchain technology has tremendous potential is health care, due to the more patient-centric approach to the health care system as well as blockchain’s ability to connect disparate systems and increase the accuracy of electronic health records.

Objective

The aim of this study was to systematically review studies on the use of blockchain technology in health care and to analyze the characteristics of the studies that have implemented blockchain technology.

Methods

This study used a systematic review methodology to find literature related to the implementation aspect of blockchain technology in health care. Relevant papers were searched for using PubMed, SpringerLink, IEEE Xplore, Embase, Scopus, and EBSCOhost. A quality assessment of literature was performed on the 22 selected papers by assessing their trustworthiness and relevance.

Results

After full screening, 22 papers were included. A table of evidence was constructed, and the results of the selected papers were interpreted. The results of scoring for measuring the quality of the publications were obtained and interpreted. Out of 22 papers, a total of 3 (14%) high-quality papers, 9 (41%) moderate-quality papers, and 10 (45%) low-quality papers were identified.

Conclusions

Blockchain technology was found to be useful in real health care environments, including for the management of electronic medical records, biomedical research and education, remote patient monitoring, pharmaceutical supply chains, health insurance claims, health data analytics, and other potential areas. The main reasons for the implementation of blockchain technology in the health care sector were identified as data integrity, access control, data logging, data versioning, and nonrepudiation. The findings could help the scientific community to understand the implementation aspect of blockchain technology. The results from this study help in recognizing the accessibility and use of blockchain technology in the health care sector.

Managing E-Patient Case Notes in Tertiary Hospitals

Telemedicine is the use of information and communication technologies to extend healthcare work to the vulnerable in the rural areas. It is unfortunate that telemedicine is yet to be deployed in sub Sahara Africa where there is acute shortage of medical professionals with many rural dwellers without medical facilities. This paper proposes an electronic Patient’s Case-Note to replace existing manual method so as to mitigate the challenges associated with manual record keeping. The tree theory was used to motivate the information follows which the basis for the theoretical framework for the study also presented is the Cyclic structure that depicts information flow in the system. The conceptual model and the algorithms to implement the model are presented. The Model was implemented and few screenshot presented.

Investigating the Barriers of Health Information System implementation in Malaysian Public Hospitals

The advent of information and communication technology (ICT) has shaped the world today. Due to the potential increase in technology, the introduction into the healthcare industry has been progressively investigated. In 1997, Malaysia introduced a health initiative called telehealth. However, progress in IT implementation is progressively slow. Although the global healthcare sector is increasing, the implementation of the Health Information System (HIS) in Malaysia has been slow-informed due to various barriers. These barriers are due to a series of problems related to end users and challenges for IT departments and vendors. This article therefore focuses on the current situation of HIS in selected Malaysian public hospital. In addition, an interview conducted with the end users, IT department and the system providers. The data from the interview was then converted into a summary of the table. In this context, the obstacles that delay the implementation of HIS in Malaysia have been identified primarily in terms of suppliers, financial, organizational and human aspects.

Prevalence and characteristics of medication errors at an emergency department of a teaching hospital in Malaysia

BACKGROUND

Medication use process in the emergency department (ED) can be challenging and the risk for medication error (ME) to occur is high. In Malaysia, several studies on ME have been conducted in various hospital settings. However, little is known about the prevalence of ME in emergency department (ED) in these hospitals. The objective of this study was to determine the prevalence and characteristics of ME at an ED of a teaching hospital in Malaysia.

METHODS

A cross-sectional study was conducted over the period of 9 weeks in patients who visited the ED of Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia. Data on patient medication orders and demographic information was collected from the doctor's clerking sheet. Observations were made on nursing activities and these were documented in the data collection form. Other information related to the administration of medications were obtained from the nursing care records.

RESULTS

Observations and data collections were made for 547 patients who fulfilled the study criteria. From these, 311 patient data were randomly selected for analysis. Ninety-five patients had at least one ME. The prevalence of ME was calculated to be 30.5%. The most common types of ME were wrong time error (46.9%), unauthorized drug error (25.4%), omission error (18.5%) and dose error (9.2%). The most frequently drug associated with ME was analgesics. No adverse event was observed.

CONCLUSIONS

The prevalence of ME in our ED setting was moderately high. However, the majority of them did not result in any adverse event. Intervention measures are needed to prevent further occurrence.

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.

Success or failure of hospital information systems of public hospitals affiliated with Zahedan University of Medical Sciences: A cross sectional study in the Southeast of Iran

INTRODUCTION

After implementation, evaluation of hospital information systems (HISs) is critical to ensure the fulfillment of the system goals. This study aimed to assess the success or failure of HISs in public hospitals affiliated with Zahedan University of Medical Sciences.

MATERIALS AND METHODS

A cross-sectional descriptive and analytic study was performed in 2016. The study population comprised IT and HIS authorities and hospital information system users. The sample consisted of 468 participants. The data were collected using two questionnaires and analyzed with the SPSS software using descriptive and analytical statistics.

RESULTS

The mean score of functional, behavioral, ethical, organizational, cultural and educational factors from the users' perspective was 3.14±0.66, 2.97± 0.60, 3.39±0.70, 2.96±0.642, 3.09±0.63, and 2.95±0.74, respectively. The mean score of organizational, behavioral, cultural, technological, educational and legal factors from IT and HIS authorities' perspective was 3.51±0.54, 3.35±0.45, 2.75±0.61, 3.58±0.32, and 3.96±0.59, respectively.

CONCLUSIONS

The evaluated hospital information systems were considered relatively successful in terms of functional, ethical, and cultural factors but were considered as a relative failure in terms of behavioral, organizational, and educational factors form the users' perspective. Only the legal factor showed success, while organizational, behavioral, technical and educational factors showed relative success and the cultural factor showed relative failure from HIS and IT authorities' perspective. Therefore, assessing the users' needs before implementing the system, involving them in various stages of implementation, training them, and improving their computer skills seem to be necessary to achieve a better level of system success.

User acceptance factors of hospital information systems and related technologies: Systematic review

This study reviews the literature on the most important acceptance factors associated with Hospital Information Systems (HIS) and related technologies based on user groups' perspectives (medical staff, hospital management, administrative personnel, patient, medical student, and IT staff), which can assist researchers and hospital management to develop suitable acceptance models to improve the quality of HIS. We conducted searches in online databases with large repositories of academic studies, written in English and fully accessible by the authors. The articles being reviewed are related to health information technology (HIT), clinical information systems (CIS), HIS, electronic medical records (EMR), telemedicine or telehealth, picture archiving and communication systems (PACS), radio frequency identification (RFID), and computerized physician order entry (CPOE), where the use of most of those applications and technologies is highly integrated. A predefined string was used to extract 1,005 articles, and the results were reviewed and checked. The results of this study found 15 user acceptance factors related to HIS and related technologies that were frequently identified by a minimum of five previous studies. These factors were related to individual, technological, and organizational factors. In addition, HIS and related technologies' user acceptance factors in each user group describe different results.

Acceptance model of a Hospital Information System

PURPOSE

The 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.

METHOD

This 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.

RESULTS

The 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.

CONCLUSIONS

Based 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.