The impact of implementing electronic health record system in Malaysia

Abstract

The applications of the Internet technology have contributed in the advancements in many fields including education, business, health and entertainment. In the field of medicine, new concepts like telemedicine, e-medicine and health informatics have been introduced to optimize healthcare services. Driven by the needs to facilitate the administrative process and reduce medical errors, healthcare institutions may decide to use the electronic health records (EHR) and as a result will most likely undergo changes in its clinical work processes. In spite of all the benefits, the use and implementation of EHR in hospitals usually face difficulties and obstacles. Besides challenges in the implementation complexity in its content, integration of various workflows and communication of databases, the resistance from the people involved remains the biggest factor. Healthcare practitioners may look at the system as hindrance to their effective clinical work during patient consultation due to the inconvenience of having to key in data and carrying their laptops to inappropriate places. While numerous researches can be found in the area of technology acceptance in healthcare systems, much work needs to be done in investigating the implementation process of the system and its impact within the healthcare institutions, especially in the Malaysian context. As such, this study seeks to investigate the implementation process of EHR in the selected Malaysia healthcare institutions and its influence on the healthcare practitioners using a case study approach. This multi-method research will incorporate the findings of the qualitative study in the beginning and the results of a survey among healthcare practitioners. As a result, the study has identified the different models of implementation being used in the selected institutions and proceeded to study whether the implementation process impacts system service quality in terms of healthcare practitioners’ utilization and their satisfaction using the EHR system. The study also examines if healthcare practitioners’ use and satisfaction with the EHR system influence their individual performance in terms of job performance, professional autonomy and personal wellbeing. Relevant model and theory on individual performance of EHR implementation among healthcare practitioners which can subsequently assist in the development of strategies for a successful EHR systems and appropriate implementation strategy and policy has been established. The finding has also shown the importance of the Security and Privacy factor to the individual performance, especially to enhance their autonomy.