Socio-Technical Determinants of Electronic Medical Record Implementation Among Nurses: A Mixed-Methods Study in a Regional Indonesian Hospital

Authors

  • Hani Purwo Ariyanto Universitas Muhammadiyah Surakarta
  • Yusuf Alam Romadhon Universitas Muhammadiyah Surakarta
  • Dr. Aflit Nuryulia Praswati, S.Sos., SE., MM, CMA Universitas Muhammadiyah Surakarta

DOI:

https://doi.org/10.51143/jksi.v11i1.1098

Keywords:

Electronic Medical Record, Hospital Service Quality, Infrastructure, Training, Interoperability and Privacy

Abstract

Electronic Medical Records (EMR) aim to improve healthcare quality, but successful implementation relies on infrastructure, training, interoperability, and data privacy. This sequential explanatory mixed-methods study examines these factors' impact on hospital service quality at a regional Indonesian hospital. Quantitative data from 227 nurses, analyzed via multiple linear regression, were contextualized through qualitative stakeholder interviews. The results show all four factors significantly improve EMR service quality (R = 0.793), with infrastructure being the most dominant. However, qualitative findings highlight ongoing challenges: uneven infrastructure, limited continuous training, and inconsistent integration and security practices. Ultimately, maximizing EMR benefits requires a sustainable socio-technical approach integrating technological readiness, human capacity, and robust data governance.

References

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2026-07-04

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Ariyanto, H. P., Romadhon, Y. A., & Praswati, A. N. (2026). Socio-Technical Determinants of Electronic Medical Record Implementation Among Nurses: A Mixed-Methods Study in a Regional Indonesian Hospital. JURNAL KEPERAWATAN SUAKA INSAN (JKSI), 11(1), 77–92. https://doi.org/10.51143/jksi.v11i1.1098

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Vol. 11 No. 1 (2026): Jurnal Keperawatan Suaka Insan (JKSI)

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Copyright (c) 2026 Hani Purwo Ariyanto, Yusuf Alam Romadhon, Dr. Aflit Nuryulia Praswati, S.Sos., SE., MM, CMA

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References

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Almanasreh, E., Moles, R., & Chen, T. F. (2019). Evaluation of methods used for estimating content validity. Research in Social and Administrative Pharmacy, 15(2), 214–221. https://doi.org/10.1016/j.sapharm.2018.03.066

Amin, M., Setyonugroho, W., & Hidayah, N. (2021). Implementasi Rekam Medik Elektronik: Sebuah Studi Kualitatif. JATISI (Jurnal Teknik Informatika Dan Sistem Informasi), 8(1), 430–442.

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Ariyanto, H. P., Romadhon, Y. A., & Praswati, A. N. (2025). Challenges in Using Electronic Medical Records to Improve Hospital Service Quality?: A Systematic Literature Review. JURNAL KEPERAWATAN SUAKA INSAN (JKSI), 10(2), 319–331.

Ati, N. L. P. A. P., Basabih, M., Najah, M., & S, M. A. (2024). Digital Transformation: Challenges And Implementation Electronic Medical Record System In Indonesia. Jurnal Publikasi Kesehatan Masyarakat Indonesia, 11(1). https://doi.org/10.20527/jpkmi.v11i1.18709

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

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

Bisrat, A., Minda, D., Assamnew, B., Abebe, B., & Abegaz, T. (2021). Implementation challenges and perception of care providers on Electronic Medical Records at St. Paul’s and Ayder Hospitals, Ethiopia. BMC Medical Informatics and Decision Making, 21(1), 1–12. https://doi.org/10.1186/s12911-021-01670-z

Budiyanti, R. T., Herlambang, P. M., Fuad, A., & Kusumastuti, W. (2023). Integration of Electronic Medical Record and SATUSEHAT’s Platform?: Patient’s Legal Protection Perspective. International Journal of Health Literacy and Science, 1(2), 1–8. https://doi.org/10.60074/ihelis.v1i2.18

Christodoulou, M. (2025). Grounded theory as a framework for explanatory sequential mixed-method design, an example from educational research. Quality and Quantity, 0123456789. https://doi.org/10.1007/s11135-025-02214-7

Creswell, J. W. (2017). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.

Enaizan, O., Zaidan, A. A., Alwi, N. H. M., Zaidan, B. B., Alsalem, M. A., Albahri, O. S., & Albahri, A. S. (2020). Electronic medical record systems: decision support examination framework for individual, security and privacy concerns using multi-perspective analysis. Health and Technology, 10(3), 795–822. https://doi.org/10.1007/s12553-018-0278-7

Faida, E. W., Wiliyanarti, P. F., & ... (2023). Readiness Analysis of Electronic Medical Record System (RME): A Case Study of Secondary Hospitals in Surabaya. Health and Technology …, 01(05), 461–473. https://journalkhd.com/ojs/index.php/htechj/article/view/92%0Ahttps://journalkhd.com/ojs/index.php/htechj/article/view/92/75

Fatima, I., Humayun, A., Iqbal, U., & Shafiq, M. (2019). Dimensions of service quality in healthcare: a systematic review of literature. International Journal for Quality in Health Care, 31(1), 11–29. https://doi.org/10.1093/intqhc/mzy125

Feryansyah, A., Suprapto, S. I., & Wardani, R. (2025). Analysis of the Implementation of Electronic Medical Records in Community Health Centers. Indonesian Journal of Global Health Research, 7(2), 919–930. https://doi.org/10.37287/ijghr.v7i2.5695

Fiaz, M., Ikram, A., & Ilyas, A. (2018). Enterprise resource planning systems: Digitization of healthcare service quality. Administrative Sciences, 8(3). https://doi.org/10.3390/admsci8030038

Firdaus, M. (2019). Improving Patient Safety and Hospital Service Quality Through Electronic Medical Record: A Systematic Review. Jurnal ARSI?: Administrasi Rumah Sakit Indonesia, 6(1). https://doi.org/10.7454/arsi.v6i1.2880

Gatiti, P., Ndirangu, E., Mwangi, J., Mwanzu, A., & Ramadhani, T. (2021). Enhancing Healthcare Quality in Hospitals through Electronic Health Records: A Systematic Review. Journal of Health Informatics in Developing Countries, 15(2), 1–25. https://www.jhidc.org/index.php/jhidc/article/view/330

Gunawan, C. (2018). Mahir menguasai SPSS (mudah mengolah data dengan IBM SPSS Statistic 25). Deepublish.

Halimuzzaman, M., Sharma, J., Hossain, M. I., Akand, F., Islam, M. N., Ikram, M. M., & Khan, N. N. (2024). Healthcare Service Quality Digitization with Enterprise Resource Planning. Journal of Angiotherapy, 8(5). https://doi.org/10.25163/angiotherapy.859716

Harahap, N. C., Handayani, P. W., & Hidayanto, A. N. (2022). Barriers and facilitators of personal health record adoption in Indonesia: Health facilities’ perspectives. International Journal of Medical Informatics, 162(March), 104750. https://doi.org/10.1016/j.ijmedinf.2022.104750

Hidayat, A. A. (2021). Menyusun instrumen penelitian & uji validitas-reliabilitas. Health Books Publishing.

Hossain, M. K., Sutanto, J., Handayani, P. W., Haryanto, A. A., Bhowmik, J., & Frings-Hessami, V. (2025). An exploratory study of electronic medical record implementation and recordkeeping culture: the case of hospitals in Indonesia. BMC Health Services Research, 25(1). https://doi.org/10.1186/s12913-025-12399-0

Hossan, D., Dato’ Mansor, Z., & Jaharuddin, N. S. (2023). Research Population and Sampling in Quantitative Study. International Journal of Business and Technopreneurship (IJBT), 13(3), 209–222. https://doi.org/10.58915/ijbt.v13i3.263

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