Challenges in Using Electronic Medical Records to Improve Hospital Service Quality: A Systematic Literature Review
DOI:
https://doi.org/10.51143/jksi.v10i2.1022Keywords:
Electronic medical record, Hospital service quality, Healthcare digitalization, Literature reviewAbstract
Meskipun Rekam Medis Elektronik (RME) berpotensi meningkatkan efisiensi dan keselamatan pasien, hambatan implementasi sering kali menghalangi tercapainya kualitas layanan yang optimal. Studi ini bertujuan mengidentifikasi, mengkategorikan, dan mensintesis hambatan utama yang membatasi efektivitas RME dalam meningkatkan kualitas layanan rumah sakit. Tinjauan literatur sistematis dilakukan mengikuti pedoman PRISMA 2020 dengan menganalisis 28 studi empiris yang diterbitkan dalam bahasa Inggris antara tahun 2020 hingga 2024 dari basis data Scopus dan PubMed. Sintesis naratif mengidentifikasi delapan tantangan utama, yaitu masalah kegunaan dan beban kerja; kesenjangan pelatihan; risiko interoperabilitas dan keamanan; tata kelola yang lemah; kendala infrastruktur; resistensi adopsi; manajemen perubahan yang tidak memadai; serta implikasi terhadap keselamatan pasien. Oleh karena itu, efektivitas implementasi RME bergantung pada strategi multidimensi di luar aspek teknis. Penguatan tata kelola, jaminan interoperabilitas, pelatihan berkelanjutan, serta kepemimpinan yang kuat dan manajemen perubahan proaktif sangat penting untuk mengatasi resistensi budaya dan memaksimalkan kontribusi RME terhadap kualitas layanan rumah sakit.
Despite the potential of Electronic Medical Records (EMR) to enhance hospital efficiency and patient safety, implementation barriers often hinder optimal service quality. This study identifies, categorizes, and synthesizes the primary barriers limiting EMR effectiveness in improving hospital service quality. A systematic literature review was conducted following the PRISMA 2020 guidelines, analyzing twenty-eight peer-reviewed empirical studies published in English between 2020 and 2024 retrieved from Scopus and PubMed. The narrative synthesis revealed eight dominant themes posing major challenges: usability and workload issues; training gaps; interoperability and security risks; weak governance; infrastructure constraints; resistance to adoption; insufficient change management; and negative implications for patient safety. Consequently, the effectiveness of EMR implementation depends on multidimensional strategies beyond technical capabilities. Strengthening governance, ensuring secure interoperability, and providing continuous user training, alongside strong leadership and proactive change management, are essential to overcome cultural resistance and maximize EMR contributions to hospital service quality.
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References
Abdekhoda, M., Ahmadi, M., Dehnad, A., Noruzi, A., & Gohari, M. (2016). Applying Electronic Medical Records in health care. Applied Clinical Informatics, 07(02), 341–354. https://doi.org/10.4338/aci-2015-11-ra-0165
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Alibrandi, A., Gitto, L., Limosani, M., & Mustica, P. F. (2023). Patient satisfaction and quality of hospital care. Evaluation and Program Planning, 97(September 2022), 102251. https://doi.org/10.1016/j.evalprogplan.2023.102251
Antor, E., Owusu-Marfo, J., & Kissi, J. (2024). Usability evaluation of electronic health records at the trauma and emergency directorates at the Komfo Anokye teaching hospital in the Ashanti region of Ghana. BMC Medical Informatics and Decision Making, 24(1). https://doi.org/10.1186/s12911-024-02636-7
Bekele, T. A., Gezie, L. D., Willems, H., Metzger, J., Abere, B., Seyoum, B., Abraham, L., Wendrad, N., Meressa, S., Desta, B., & Bogale, T. N. (2024). Barriers and facilitators of the electronic medical record adoption among healthcare providers in Addis Ababa, Ethiopia. Digital Health, 10. https://doi.org/10.1177/20552076241301946
Bersani, K., Fuller, T. E., Garabedian, P., Espares, J., Mlaver, E., Businger, A., Chang, F., Boxer, R. B., Schnock, K. O., Rozenblum, R., Dykes, P. C., Dalal, A. K., Benneyan, J. C., Lehmann, L. S., Gershanik, E. F., Bates, D. W., & Schnipper, J. L. (2020). Use, Perceived Usability, and Barriers to Implementation of a Patient Safety Dashboard Integrated within a Vendor EHR. Applied Clinical Informatics, 11(1), 34–45. https://doi.org/10.1055/s-0039-3402756
Bhati, D., Deogade, M. S., & Kanyal, D. (2023). Improving Patient Outcomes Through Effective Hospital Administration: A Comprehensive Review. Cureus, 15(10). https://doi.org/10.7759/cureus.47731
Booth, A., Sutton, A., Clowes, M., & Martyn, M. (2021). Systematic Approaches To A Successful Literature Review. SAGE Publication Ltd.
Bramer, W. M., Giustini, D., De Jong, G. B., Holland, L., & Bekhuis, T. (2016). De-duplication of database search results for systematic reviews in endnote. Journal of the Medical Library Association, 104(3), 240–243. https://doi.org/10.3163/1536-5050.104.3.014
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