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  1. Organizational decision to adopt hospital information system: an empirical investigation in the case of Malaysian public hospitals
    Ahmadi H, Nilashi M, Ibrahim O
    Int J Med Inform, 2015 Mar;84(3):166-88.
    PMID: 25612792 DOI: 10.1016/j.ijmedinf.2014.12.004
    This study mainly integrates the mature Technology-Organization-Environment (TOE) framework and recently developed Human-Organization-Technology (HOT) fit model to identify factors that affect the hospital decision in adopting Hospital Information System (HIS).
    Matched MeSH terms: Hospital Information Systems*
  2. Investigating evaluation frameworks for health information systems
    Yusof MM, Papazafeiropoulou A, Paul RJ, Stergioulas LK
    Int J Med Inform, 2008 Jun;77(6):377-85.
    PMID: 17904898 DOI: 10.1016/j.ijmedinf.2007.08.004
    BACKGROUND AND PURPOSE: Evaluation of health information systems (HIS) enables the assessment of the extent to which HIS are fulfilling their objectives in supporting the services of healthcare delivery. This paper presents an overview of evaluation in health informatics and information systems.
    METHODS: Literature review on discourses, dimensions and methods of HIS and IS evaluation. A critical appraisal of selected HIS and IS evaluation frameworks is undertaken in order to identify HIS evaluation dimensions and measures. The frameworks are compared based on their inclusion of human, organizational and technological factors.
    RESULTS: We found that an increasing number of evaluation studies deal with two distinct trends of HIS: one considers human and organizational issues and the other is concerned with the employment of a subjectivist approach. Our review indicates that current evaluation methods complement each other in that they evaluate different aspects of HIS and they can be improved upon.
    CONCLUSIONS: Evaluation is complex; it is easy to measure many things but not necessarily the right ones. Nevertheless, it is possible to consider, a HIS evaluation framework with more comprehensive and specific measures that would incorporate technological, human and organizational issues to facilitate HIS evaluation.
    Matched MeSH terms: Hospital Information Systems/organization & administration*
  3. Fulltext Understanding Technology and People Issues in Hospital Information System (HIS) Adoption: Case study of a tertiary hospital in Malaysia
    Zakaria N, Mohd Yusof SA
    J Infect Public Health, 2016 Nov-Dec;9(6):774-780.
    PMID: 27686258 DOI: 10.1016/j.jiph.2016.08.017
    BACKGROUND: Hospital Information Systems (HIS) can improve healthcare outcome quality, increase efficiency, and reduce errors. The government of Malaysia implemented HIS across the country to maximize the use of technology to improve healthcare delivery, however, little is known about the benefits and challenges of HIS adoption in each institution. This paper looks at the technology and people issues in adopting such systems.

    METHODS: The study used a case study approach, using an in-depth interview with multidisciplinary medical team members who were using the system on a daily basis. A thematic analysis using Atlas.ti was employed to understand the complex relations among themes and sub-themes to discover the patterns in the data. .

    RESULTS: Users found the new system increased the efficiency of workflows and saved time. They reported less redundancy of work and improved communication among medical team members. Data retrieval and storage were also mentioned as positive results of the new HIS system. Healthcare workers showed positive attitudes during training and throughout the learning process.

    CONCLUSIONS: From a technological perspective, it was found that medical workers using HIS has better access and data management compared to the previously used manual system. The human issues analysis reveals positive attitudes toward using HIS among the users especially from the physicians' side.
    Matched MeSH terms: Hospital Information Systems*
  4. Using multi-attribute decision-making approaches in the selection of a hospital management system
    Arasteh MA, Shamshirband S, Yee PL
    Technol Health Care, 2018;26(2):279-295.
    PMID: 29309042 DOI: 10.3233/THC-170947
    The most appropriate organizational software is always a real challenge for managers, especially, the IT directors. The illustration of the term "enterprise software selection", is to purchase, create, or order a software that; first, is best adapted to require of the organization; and second, has suitable price and technical support. Specifying selection criteria and ranking them, is the primary prerequisite for this action. This article provides a method to evaluate, rank, and compare the available enterprise software for choosing the apt one. The prior mentioned method is constituted of three-stage processes. First, the method identifies the organizational requires and assesses them. Second, it selects the best method throughout three possibilities; indoor-production, buying software, and ordering special software for the native use. Third, the method evaluates, compares and ranks the alternative software. The third process uses different methods of multi attribute decision making (MADM), and compares the consequent results. Based on different characteristics of the problem; several methods had been tested, namely, Analytic Hierarchy Process (AHP), Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS), Elimination and Choice Expressing Reality (ELECTURE), and easy weight method. After all, we propose the most practical method for same problems.
    Matched MeSH terms: Hospital Information Systems/organization & administration*
  5. Sociotechnical factors influencing unsafe use of hospital information systems: A qualitative study in Malaysian government hospitals
    Salahuddin L, Ismail Z, Hashim UR, Raja Ikram RR, Ismail NH, Naim Mohayat MH
    Health Informatics J, 2019 12;25(4):1358-1372.
    PMID: 29521162 DOI: 10.1177/1460458218759698
    The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.
    Matched MeSH terms: Hospital Information Systems*
  6. Fulltext Evaluation of the clinical process in a critical care information system using the Lean method: a case study
    Yusof MM, Khodambashi S, Mokhtar AM
    BMC Med Inform Decis Mak, 2012;12:150.
    PMID: 23259846 DOI: 10.1186/1472-6947-12-150
    There are numerous applications for Health Information Systems (HIS) that support specific tasks in the clinical workflow. The Lean method has been used increasingly to optimize clinical workflows, by removing waste and shortening the delivery cycle time. There are a limited number of studies on Lean applications related to HIS. Therefore, we applied the Lean method to evaluate the clinical processes related to HIS, in order to evaluate its efficiency in removing waste and optimizing the process flow. This paper presents the evaluation findings of these clinical processes, with regards to a critical care information system (CCIS), known as IntelliVue Clinical Information Portfolio (ICIP), and recommends solutions to the problems that were identified during the study.
    Matched MeSH terms: Hospital Information Systems/organization & administration; Hospital Information Systems/standards*
  7. The development and design of an electronic patient record using open source web-based technology
    Syed-Mohamad SM, Ali SH, Mat-Husin MN
    Health Inf Manag, 2010;39(1):30-5.
    PMID: 20335647
    This paper describes the method used to develop the One Stop Crisis Centre (OSCC) Portal, an open source web-based electronic patient record system (EPR) for the One Stop Crisis Center, Hospital Universiti Sains Malaysia (HUSM) in Kelantan, Malaysia. Features and functionalities of the system are presented to demonstrate the workflow. Use of the OSCC Portal improved data integration and data communication and contributed to improvements in care management. With implementation of the OSCC portal, improved coordination between disciplines and standardisation of data in HUSM were noticed. It is expected that this will in turn result in improved data confidentiality and data integrity. The collected data will also be useful for quality assessment and research. Other low-resource centers with limited computer hardware and access to open-source software could benefit from this endeavour.
    Matched MeSH terms: Hospital Information Systems
  8. Exploring the contributing factors to workarounds to the hospital information system in Malaysian hospitals
    Salahuddin L, Ismail Z, Abd Ghani MK, Mohd Aboobaider B, Hasan Basari AS
    J Eval Clin Pract, 2020 Oct;26(5):1416-1424.
    PMID: 31863517 DOI: 10.1111/jep.13326
    OBJECTIVES: The objective of this study was to identify the factors influencing workarounds to the Hospital Information System (HIS) in Malaysian government hospitals.

    METHODS: Semi-structured interviews were conducted among 31 medical doctors in three Malaysian government hospitals on the implementation of the Total Hospital Information System (THIS) between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes.

    RESULTS: Five themes emerged as the factors influencing workarounds to the HIS: (a) typing skills, (b) system usability, (c) computer resources, (d) workload, and (e) time.

    CONCLUSIONS: This study provided the key factors as to why doctors were involved in workarounds during the implementation of the HIS. It is important to understand these factors in order to help mitigate work practices that can pose a threat to patient safety.

    Matched MeSH terms: Hospital Information Systems
  9. Fulltext The implementation of hospital information system (HIS) in tertiary hospitals in Malaysia: a qualitative study
    Aniza Ismail, Ahmad Taufik Jamil, Ahmad Fareed A Rahman, Jannatul Madihah Abu Bakar, Natrah Mohd Saad, Hussain Saadi
    Malaysian Journal of Public Health Medicine, 2010;10(2):16-24.
    MyJurnal
    Hospital Information System (HIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. This study is to describe those aspects of the implementation of hospital information system in three tertiary hospitals in Klang Valley; Serdang Hospital, Selayang Hospital and University Kebangsaan Malaysia Medical Centre (UKMMC). A qualitative study was conducted to obtain views on information system development and implementation in the hospitals mentioned above. In-depth interviews with personnel representing both the system providers and the end-users were done guided by a questionnaire. The results of the interviews were categorized into few themes namely the system development, human resource, scope of implementation, support system, user-friendly, training, hardware and security. There were differences in hospital information system development and implementation in the three hospitals. Each system has its own strengths and weaknesses that make it unique. In developing HIS, its important to ensure the system can work effectively and efficiently. Quality human resource, good support system, user-friendly and adequate training of the end-user will determine the success of implementation of HIS. Upgrading of hardware and software as needed is the basis to keep up with the pace of technology advancement and increasing number of patients. It is hoped that HIS will be implemented in all other hospitals with effective integration and networking.
    Matched MeSH terms: Hospital Information Systems
  10. External factors in hospital information system (HIS) adoption model: a case on Malaysia
    Lee HW, Ramayah T, Zakaria N
    J Med Syst, 2012 Aug;36(4):2129-40.
    PMID: 21384267 DOI: 10.1007/s10916-011-9675-4
    Studies related to healthcare ICT integration in Malaysia are relatively little, thus this paper provide a literature review of the integration of information and communication technologies (ICT) in the healthcare sector in Malaysia through the hospital information system (HIS). Our study emphasized on secondary data to investigate the factors related to ICT integration in healthcare through HIS. Therefore this paper aimed to gather an in depth understanding of issues related to HIS adoption, and contributing in fostering HIS adoption in Malaysia and other countries. This paper provides a direction for future research to study the correlation of factors affecting HIS adoption. Finally a research model is proposed using current adoption theories and external factors from human, technology, and organization perspectives.
    Matched MeSH terms: Hospital Information Systems/organization & administration*
  11. IT in health: two reports on the conference Streamlining IT Strategies in Healthcare, Kuala Lumpur, Malaysia, 9-10 March 2004
    Ah Yick N, Tindal RE
    Health Inf Manag, 2004;33(4):140-2.
    PMID: 18239234 DOI: 10.1177/183335830403300408
    Matched MeSH terms: Hospital Information Systems/standards*
  12. An evaluation framework for Health Information Systems: human, organization and technology-fit factors (HOT-fit)
    Yusof MM, Kuljis J, Papazafeiropoulou A, Stergioulas LK
    Int J Med Inform, 2008 Jun;77(6):386-98.
    PMID: 17964851
    The realization of Health Information Systems (HIS) requires rigorous evaluation that addresses technology, human and organization issues. Our review indicates that current evaluation methods evaluate different aspects of HIS and they can be improved upon. A new evaluation framework, human, organization and technology-fit (HOT-fit) was developed after having conducted a critical appraisal of the findings of existing HIS evaluation studies. HOT-fit builds on previous models of IS evaluation--in particular, the IS Success Model and the IT-Organization Fit Model. This paper introduces the new framework for HIS evaluation that incorporates comprehensive dimensions and measures of HIS and provides a technological, human and organizational fit.
    Matched MeSH terms: Hospital Information Systems/organization & administration*
  13. Fulltext The influence of system quality characteristics on health care providers' performance: Empirical evidence from Malaysia
    Mohd Salleh MI, Zakaria N, Abdullah R
    J Infect Public Health, 2016 Nov-Dec;9(6):698-707.
    PMID: 27659115 DOI: 10.1016/j.jiph.2016.09.002
    BACKGROUND: The Ministry of Health Malaysia initiated the total hospital information system (THIS) as the first national electronic health record system for use in selected public hospitals across the country. Since its implementation 15 years ago, there has been the critical requirement for a systematic evaluation to assess its effectiveness in coping with the current system, task complexity, and rapid technological changes. The study aims to assess system quality factors to predict the performance of electronic health in a single public hospital in Malaysia.

    METHODS: Non-probability sampling was employed for data collection among selected providers in a single hospital for two months. Data cleaning and bias checking were performed before final analysis in partial least squares-structural equation modeling.

    RESULTS AND CONCLUSIONS: Convergent and discriminant validity assessments were satisfied the required criterions in the reflective measurement model. The structural model output revealed that the proposed adequate infrastructure, system interoperability, security control, and system compatibility were the significant predictors, where system compatibility became the most critical characteristic to influence an individual health care provider's performance. The previous DeLone and McLean information system success models should be extended to incorporate these technological factors in the medical system research domain to examine the effectiveness of modern electronic health record systems. In this study, care providers' performance was expected when the system usage fits with patients' needs that eventually increased their productivity.
    Matched MeSH terms: Hospital Information Systems*
  14. Indirect effect of management support on users' compliance behaviour towards information security policies
    Humaidi N, Balakrishnan V
    Health Inf Manag, 2018 Jan;47(1):17-27.
    PMID: 28537207 DOI: 10.1177/1833358317700255
    BACKGROUND: Health information systems are innovative products designed to improve the delivery of effective healthcare, but they are also vulnerable to breaches of information security, including unauthorised access, use, disclosure, disruption, modification or destruction, and duplication of passwords. Greater openness and multi-connectedness between heterogeneous stakeholders within health networks increase the security risk.

    OBJECTIVE: The focus of this research was on the indirect effects of management support (MS) on user compliance behaviour (UCB) towards information security policies (ISPs) among health professionals in selected Malaysian public hospitals. The aim was to identify significant factors and provide a clearer understanding of the nature of compliance behaviour in the health sector environment.

    METHOD: Using a survey design and stratified random sampling method, self-administered questionnaires were distributed to 454 healthcare professionals in three hospitals. Drawing on theories of planned behaviour, perceived behavioural control (self-efficacy (SE) and MS components) and the trust factor, an information system security policies compliance model was developed to test three related constructs (MS, SE and perceived trust (PT)) and their relationship to UCB towards ISPs.

    RESULTS: Results showed a 52.8% variation in UCB through significant factors. Partial least squares structural equation modelling demonstrated that all factors were significant and that MS had an indirect effect on UCB through both PT and SE among respondents to this study.

    CONCLUSION: The research model based on the theory of planned behaviour in combination with other human and organisational factors has made a useful contribution towards explaining compliance behaviour in relation to organisational ISPs, with trust being the most significant factor. In adopting a multidimensional approach to management-user interactions via multidisciplinary concepts and theories to evaluate the association between the integrated management-user values and the nature of compliance towards ISPs among selected health professionals, this study has made a unique contribution to the literature.

    Matched MeSH terms: Hospital Information Systems*
  15. Fulltext Improving pediatric liquid medication labeling of the hospital information system in Malaysia: qualitative analysis of pharmacists' perceptions
    Chan HK, Hassali MA, Lim CJ, Saleem F, Ghani NA
    Pharm Pract (Granada), 2016 Apr-Jun;14(2):699.
    PMID: 27382422 DOI: 10.18549/PharmPract.2016.02.699
    BACKGROUND: Inadequacies of drug labeling have been frequently reported among Malaysian healthcare institutes, in which the Hospital Information System (HIS) is used.
    OBJECTIVE: To identify potential areas to improve the existing labels used for pediatric liquid medications.
    METHODS: This study was qualitative in nature, whereby focus group discussions (FGDs), face-to-face interviews (FTFIs), and onsite observation were used for data collection. Pharmacists stationed at three units (outpatient, inpatient and clinical pharmacy) of a tertiary hospital were targeted. Both FGDs and FTFIs were facilitated using a semi-structured interview guide, video-recorded and transcribed verbatim. All transcripts were thematically analyzed using content analysis approach.
    RESULTS: Thirteen pharmacists participated in FGDs, while five were approached for FTFIs. Data analysis resulted in four major themes: format of labels, presentation of medication instructions, insufficiency of information, and the need for external aids and education. Participants unanimously agreed on the need for enlarging font sizes of key information. Suggestions were made to use more specific instructions for administration times and pictograms to illustrate important directions. The absence of information about storage, stability and handling of liquid medications was also highlighted. While discussion mainly focused on improving drug labeling, participants consistently stressed the need for an instruction sheet and pharmacist-based, one-to-one education regarding medication instructions.
    CONCLUSION: This study provides important insights into critical shortcomings in current labeling practice, underlying the need for developing a new label that incorporates a new format, additional information and pictograms for pediatric liquid medications.
    KEYWORDS: Child; Drug labeling; Hospital; Hospital Information Systems; Malaysia; Medication Errors; Pharmacy Service
    Matched MeSH terms: Hospital Information Systems
  16. Fulltext Level of satisfaction in using the hospital information system among staff of a teaching hospital in Malaysia
    Sangaran, G., Ahmad Taufik, J., Aniza, I.
    Malaysian Journal of Public Health Medicine, 2014;14(1):29-38.
    MyJurnal
    Hospital information systems have evolved with the recent widespread, involving technology and target functions, and this involves the critical computer systems from multiple perspectives. Healthcare organizations increasingly use information technology as a basis for improving productivity and user satisfaction. A research had been done about the level of satisfaction in using the Hospital Information System. Data was obtained by using a set of questionnaires that have been tested for reliability and validity. The staff are comprised of two (2) categories: Nurses (community nurses / Head nurse / staff nurse, nurse managers and others) while the second category consists of administrative officers (administrative officers, administrative assistants and clerks) in selected departments. Variables consist of sociodemographic factors, occupational factors and perception factors. A total of 152 respondents identified using stratified sampling method. The factors studied were age, gender, marital status, level of qualifications, length of service, knowledge of the system, attitude towards the use of the system, behavioral intention to use the system and compatibility with work. Majority of respondents were females (88.2%). The level of satisfaction among the staff in using the hospital information system is high (88.8%) compared to the dissatisfied staff in UKMMC (11.2%). In overall, the staffs in UKMMC are satisfied using the hospital information system available now but there are always a room for improvement so that the system can be used more intensively.
    Matched MeSH terms: Hospital Information Systems
  17. An analysis of the healthcare informatics and systems in Southeast Asia: a current perspective from seven countries
    Nguyen QT, Naguib RN, Abd Ghani MK, Bali RK, Lee IM
    Int J Electron Healthc, 2008;4(2):184-207.
    PMID: 18676343
    This paper presents an overview of the healthcare systems in Southeast Asia, with a focus on the healthcare informatics development and deployment in seven countries, namely, Singapore, Cambodia, Malaysia, Thailand, Laos, the Philippines and Vietnam. Brief geographic and demographic information is provided for each country, followed by a historical review of the national strategies for healthcare informatics development. An analysis of the state-of-the-art healthcare infrastructure is also given, along with a critical appraisal of national healthcare provisions.
    Matched MeSH terms: Hospital Information Systems/organization & administration
  18. A case study evaluation of a Critical Care Information System adoption using the socio-technical and fit approach
    Yusof MM
    Int J Med Inform, 2015 Jul;84(7):486-99.
    PMID: 25881560 DOI: 10.1016/j.ijmedinf.2015.03.001
    Clinical information systems have long been used in intensive care units but reports on their adoption and benefits are limited. This study evaluated a Critical Care Information System implementation.
    Matched MeSH terms: Hospital Information Systems/utilization*
  19. Fulltext Descriptive analysis of type 2 diabetes mellitus patients using data from hospital information system
    Nurul Salwana Abu Bakar, Jabrullah Abdul Hamid, Sharifah Zawani Syed Ahmad Yunus, Nurul Syarbani Eliana Musa, Roslinda Abu Sapian, Nur Hidayati Abdul Halim, et al.
    Malaysian Journal of Medicine and Health Sciences, 2020;16(1):94-98.
    MyJurnal
    Introduction: Electronic medical records from hospital information system (HIS) offer a major potential for secondary data analysis which can improve the efficiency of healthcare delivery. This study describes an initiative to use HIS data to explore the level of diabetic care in patients with T2DM in a hospital-based outpatient clinic, the advantages and challenges in utilising HIS data. Methods: Patients age of 18 and above who received any diabetes medication in 2013 were retrospectively identified from HIS of Serdang Hospital. Demographic characteristics, anti-diabetic agent (ADA) dispensed, and glycaemic measures were quantified. Data was extracted using structured query lan- guage (SQL) and descriptive statistical analyses were conducted using Stata Version 12. Results: Prevalence of T2DM patients in the hospital was 7.5%. Male had slightly higher prevalence and patient at age of 61-70 years old. About 62% of patients were prescribed with metformin and 5% of newer combination of oral hypoglycemic agent. In pre- scribing pattern, stratification by age group, showed that patient age 41 to 70 years received mostly monotherapy, whilst 61.1% continue their regime for the year. Only 18% obtained good glycaemic control. Conclusion: Hospital Information system is a critical instrument in providing data as a platform in diabetic care in an outpatient care. Moving forward, steps to improve HIS should be taken to seize its potential as a tool to increase the efficiency of healthcare delivery.
    Matched MeSH terms: Hospital Information Systems
  20. Fulltext Comparison of patient controlled epidural analgesia (PCEA) with basal infusion and programmed intermittent epidural bolus (PIEB) with PCEA in labour analgesia – A year retrospective study
    Zawiah Kassim, Norliza Mohd Nor, Ariffah Mokhtar, Suhaina Mohamad, Sarina Osman, Isqandar Adnan
    Journal of Clinical and Health Sciences, 2021;6(1):25-31.
    MyJurnal
    Introduction: Over three decades, patient-controlled epidural analgesia with a basal infusion
    regimen (PCEA+BI) has successfully improved labour analgesia quality due to its advantage
    in allowing self-titration by the parturients. Recently, a newer programmed intermittent epidural
    bolus with PCEA regimen (PIEB+PCEA) was suggested to improve the epidural spread of
    local anaesthetic hence resulted in better analgesia quality and higher maternal satisfaction.
    Methods: We conducted a one-year retrospective analysis of data from obstetric analgesia
    service record sheet and hospital information system comparing maternal satisfaction towards
    their labour analgesia quality, mode of delivery and neonatal Apgar scores between these two
    methods of epidural delivery techniques. A total of 343 parturients were recruited in this study
    (PCEA+BI n=171, PIEB+PCEA n=172). Results: There were no significant difference in
    maternal satisfaction between the two groups (P=0.398) with a higher percentage of excellent
    satisfaction were found in the PIEB+PCEA group (PIEB+PCEA 146/172 (84.9%) vs PCEA+BI
    138/171 (80.7%)). No significant difference in the mode of delivery (P=0.296). However, the
    PIEB+PCEA group shown a higher spontaneous vaginal delivery rate (PIEB+PCEA 87/172
    (50.6%) vs PCEA+BI 70/171 (40.9%) and lower Caesarean delivery rate (PIEB+PCEA 71/172
    (41.3%) vs PCEA+BI 87/171 (50.9%)). Despite statistically significant differences found in
    Apgar scores at 1 minute (P=0.036), there was no significant difference in the scores at 5
    minutes (P=0.107). Mean Apgar scores (SD) at 1 minute and 5 minutes for PIEB+ PCEA were
    7.77(0.85) and 8.91(0.55) respectively and for PCEA + basal infusion, the scores for 1 minute
    and 5 minutes were 7.92(0.39) and 8.98(0.19) respectively. Conclusion: PIEB with PCEA is
    a newer epidural delivery technique for labour analgesia which produces a comparable
    outcome to PCEA with basal infusion.
    Matched MeSH terms: Hospital Information Systems
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