Student Dissertation

Agency : Hospital Information System; Electronic Medical Records; Medical Records; HMIS

Objective : To identify and categorize the barriers that different healthcare providers face in adoption of hospital information system and electronic medical record and to suggest remedial actions to address those barriers.

Background : HIS is a comprehensive computer-based system that establishes an orderly and systematic method of managing hospital operations, financial, administrative and clinical patient records more effectively and efficiently for both out patients and inpatients. EMR is a part of hospital information system that contains all the patient medical history. It is basically electronic version of paper records and more beneficial than paper records. Despite these benefits the hospital staff may face some barriers in adoption of the hospital information system. In this study the dimensions and barriers of HIS and EMR adoption will be analyzed, prioritized and suggestions will be provided to address those barriers.

Methodology : It was a descriptive cross-sectional study and a survey was designed and conducted to identify major barriers in adoption of HIS and EMR by healthcare professionals. A sample size of 150 respondents was taken. The study was conducted amongst various users of HIS and EMR working in different departments in various hospitals in Bangalore.

Findings : The barriers identified in this study as per clinical staff were difficulty in information exchange from one department to another department, technical support for hardware and network, hospital staff including doctors, nurses etc. are not trained enough to use HIS, workflow of various department not meeting with the software, software not providing any value addition in terms of CDSS, MIS reports, BCMA etc. And as per the administrative staff major barriers were financial space including lack of capital resources in HIS implementation as HIS and EMR have high initial cost, high operational and maintenance cost, uncertainty about the return on investment, lack of proper training, IT support system, software not providing any value to their tasks such as CDSS, MIS reports, BCMA, data safety issues with HIS implementation. Other barriers were support and loyalty from vendor and no enhancement in productivity, graphical user interface of HIS software, no reduction in turnaround time, and customization of software according to the requirements.

Recommendations : The results of study basically emphasized the prioritized barriers in using HIS. It was aimed to shed light on barriers in the adoption of HIS and EMR to make effective efforts in the relevant area of HIS challenges. This will help hospital information system developers and implementers to address important challenges first, which would support successful implementation of such systems in hospitals which lead to efficiency and safety of hospitals in providing high quality services to the patients.