The Acceptance and Use of Electronic Medical Records in Developing Countries within the Unified Theory of Acceptance and Use of Technology Framework

Authors

  • Eka Wilda Faida Faculty of Public Health, Airlangga University, Surabaya, Indonesia
  • Stefanus Supriyanto Faculty of Public Health, Airlangga University, Surabaya, Indonesia
  • Setya Haksama Faculty of Public Health, Airlangga University, Surabaya, Indonesia
  • Hosizah Markam Faculty of Health Information Management, Esa Unggul University, Jakarta, Indonesia
  • Amir Ali Lecturer of Medical Record Health Information, College of Health Sciences, Soetomo Hospital Foundation, Surabaya, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2022.8409

Keywords:

Acceptance, Usage, Electronic medical record, Unified theory of acceptance and use of technology

Abstract

BACKGROUND: The Indonesian Ministry of Health requires hospitals to record and report all activities in the Hospital Management Information System (SIMRS). However, the disruptive use of software, hardware, and Brainware has reduced its effective management and usability, which has become a separate workload. Electronic Medical Record (EMR) is one of the important implementations of SIMRS because it relates to the ability to identify information, results, history taking, examinations, and records of all patients. Furthermore, it has become a current global trend for most hospitals and has also been used as a substitute for paper medical records.

AIM: This study aims to collect and identify the user characteristic, technology used, and other variables influencing the acceptance and use of information and technology systems based on the unified theory of acceptance and use of technology (UTAUT) model.

METHOD: Secondary data were obtained from scientifically published journals online in the form of original articles that are accessed in full text with the help of search engines such as Springer link, Proquest, PubMed, and Prospero.

RESULT: It was found that the most dominant technology system in hospitals outside the use of HIS, Electronic Health Record (EHR), physician assistants, E-Prescribing, Telemedicine, extended producer responsibility, and Technology solution for tuberculosis was EMR. It had the largest influence variable in several studies based on the UTAUT model. The most dominant characteristics of users were women between the ages of 20 and 30 years with 0 and 5 years working experience, and also 60% were nurses. The result also showed that 17 other variables had influenced the use of information and technology systems in the UTAUT model.

Conclusion: Literature study provides evidence that acceptance and use of health information technology systems, especially RME in hospitals influenced by the main variable UTAUT. Variables related to technical aspects, behavior, and user characteristics as new endogenous and new exogenous mechanisms. Management of health service providers in increasing acceptance and use of EMR needs to pay attention to the availability of infrastructure, user factors are also an important concern in helping to deal with problems in developing countries.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Buse K, Hawkes S. Health in the sustainable development goals: Ready for a paradigm shift? Global Health. 2015;11(1):13. https://doi.org/10.1186/s12992-015-0098-8 PMid:25890267 DOI: https://doi.org/10.1186/s12992-015-0098-8

Kemenkes RI. Peraturan Menteri Kesehatan RI No. 21 Tahun 2020 Tentang Rencana Strategis Kementerian Kesehatan Tahun 2020-2024. Indonesia: Kemenkes RI; 2020.

Kemenkes RI. Peraturan Menteri Kesehatan Nomor 46 Tahun 2017 Tentang Strategi e-Kesehatan Nasional. Indonesia: Kemenkes RI; 2017.

Deborah K. When the Writ Hits the Fan: The Importance of Managing Electronic Health Records (EHR). Chicago: American Health Information Management; 2004.

Margret KA. Electronic Health Records: A Practical Guide for Professionals and Organizations. Chicago: American Health Information Management Assosiation; 2004.

Enaizan O, Zaidan AA, Alwi NH, Zaidan BB, Alsalem MA, Albahri OS, et al. Electronic medical record systems: decision support examination framework for individual, security and privacy concerns using multi-perspective analysis. Health Technol (Berl). 2020;10(3):795-822. https://doi.org/10.1007/s12553-018-0278-7 DOI: https://doi.org/10.1007/s12553-018-0278-7

Boonstra TW, Nicholas J, Wong QJ, Shaw F, Townsend S, Christensen H. Using mobile phone sensor technology for mental health research: integrated analysis to identify hidden challenges and potential solutions. J Med Internet Res. 2018;20(7):e10131. https://doi.org/10.2196/10131 PMid:30061092 DOI: https://doi.org/10.2196/10131

Ajami S, Bagheri-Tadi T. Barriers for adopting electronic health records (EHRs) by physicians. Acta Inform Med. 2013;21(2):129-34. https://doi.org/10.5455/aim.2013.21.129-134 PMid:24058254 DOI: https://doi.org/10.5455/aim.2013.21.129-134

Gastaldi L, Lettieri E, Corso M, Masella C. Performance improvement in hospitals: Leveraging on knowledge asset dynamics through the introduction of an electronic medical record. Meas Bus Excell. 2012;16(4):14-30. https://doi.org/10.1108/13683041211276410 DOI: https://doi.org/10.1108/13683041211276410

Reina R, Cristofaro C, Lacroce A, Ventura M. Managing the knowledge interdependence with electronic medical record. Meas Bus Excell. 2012;16(4):31-41. https://doi.org/10.1108/13683041211276429 DOI: https://doi.org/10.1108/13683041211276429

Richards RJ, Prybutok VR, Ryan SD. Electronic medical records: Tools for competitive advantage. Int J Qual Serv Sci. 2012;4(2):120-36. https://doi.org/10.1108/17566691211232873 DOI: https://doi.org/10.1108/17566691211232873

Menteri Kesehatan RI. Kebijakan Digitalisasi di Rumah Sakit. Indonesia: Menteri Kesehatan RI; 2020.

Fraser HSF, Biondich P, Moodley D, Choi S, Mamlin BW, Szolovits P. Implementing electronic medical record systems in developing countries. Inform Prim Care. 2005;13(2):83-95. https://doi.org/10.14236/jhi.v13i2.585 PMid:15992493 DOI: https://doi.org/10.14236/jhi.v13i2.585

Bawack RE, Kamdjoug JR. Adequacy of UTAUT in clinician adoption of health information systems in developing countries: The case of Cameroon. Int J Med Inform. 2018;109(1):15-22. https://doi.org/10.1016/j.ijmedinf.2017.10.016 PMid:29195701 DOI: https://doi.org/10.1016/j.ijmedinf.2017.10.016

EBSCO. What is the PICO Process? (2019). Available from: https://www.ebsco.com/sites/g/files/nabnos191/files/acquiadam-assets/What-is-the- PICO-Process-Handout.pdf [Last accessed on 2019 November 15].

Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https://doi.org/10.1136/bmj.n71 PMid:33782057 DOI: https://doi.org/10.1136/bmj.n71

Ma CC, Kuo KM, Alexander JW. A survey-based study of factors that motivate nurses to protect the privacy of electronic medical records. BMC Med Inform Decis Mak. 2016;16(1):13. https://doi.org/10.1186/s12911-016-0254-y PMid:26837539 DOI: https://doi.org/10.1186/s12911-016-0254-y

Tavares J, Oliveira T. Electronic health record patient portal adoption by health care consumers: An acceptance model and survey. J Med Internet Res. 2016;18(3):e49. https://doi.org/10.2196/jmir.5069 PMid:26935646 DOI: https://doi.org/10.2196/jmir.5069

Venugopal P, Priya SA, Manupati VK, Varela ML, Machado J, Putnik GD. An analysis of the impact of UTAUT predictors on the intention and usage of electronic health records and telemedicine from the perspective of clinical staffs. Int J Mechatronics Appl Mech. 2018;2018(4):263-9. https://doi.org/10.17683/ijomam/issue4.37 DOI: https://doi.org/10.1007/978-3-319-91334-6_24

Chiu TM, Ku BP. Moderating effects of voluntariness on the actual use of electronic health records for allied health professionals. JMIR Med Inform. 2015;3(1):e7. https://doi.org/10.2196/medinform.2548 PMid:25720417 DOI: https://doi.org/10.2196/medinform.2548

Archer N, Cocosila M. A comparison of physician pre-adoption and adoption views on electronic health records in canadian medical practices. J Med Internet Res. 2011;13(3):1-12. https://doi.org/10.2196/jmir.1726 PMid:21840835 DOI: https://doi.org/10.2196/jmir.1726

Abdekhoda M, Salih KM. Determinant factors in applying picture archiving and communication systems (PACS) in healthcare. Perspect Heal Inf Manag. 2017;14(1):1c. PMid:28855856

Wrzosek N, Zimmermann A, Balwicki Ł. Doctors’ perceptions of e-prescribing upon its mandatory adoption in Poland, using the unified theory of acceptance and use of technology method. Healthcare (Basel). 2020;8(4):563. https://doi.org/10.3390/healthcare8040563 PMid:33333824 DOI: https://doi.org/10.3390/healthcare8040563

Luyten J, Marneffe W. Examining the acceptance of an integrated Electronic Health Records system: Insights from a repeated cross-sectional design. Int J Med Inform. 2021;150:104450. https://doi.org/10.1016/j.ijmedinf.2021.104450 PMid:33848941 DOI: https://doi.org/10.1016/j.ijmedinf.2021.104450

Sharifian R, Askarian F, Nematolahi M, Farhadi P. Factors influencing nurses’ acceptance of hospital information systems in iran: Application of the unified theory of acceptance and use of technology. Health Inf Manag J. 2014;43(3):23-8. https://doi.org/10.1177/183335831404300303 PMid:27009793 DOI: https://doi.org/10.1177/183335831404300303

Shiferaw KB, Mengiste SA, Gullslett MK, Zeleke AA, Tilahun B, Tebeje T, et al. Healthcare providers’ acceptance of telemedicine and preference of modalities during COVID-19 pandemics in a low-resource setting: An extended UTAUT model. PLoS One. 2021;16(1):e0250220. https://doi.org/10.1371/journal.pone.0250220 PMid:33886625 DOI: https://doi.org/10.1371/journal.pone.0250220

Maillet É, Mathieu L, Sicotte C. Modeling factors explaining the acceptance, actual use and satisfaction of nurses using an Electronic Patient Record in acute care settings: An extension of the UTAUT. Int J Med Inform. 2015;84(1):36-47. https://doi.org/10.1016/j.ijmedinf.2014.09.004 PMid:25288192 DOI: https://doi.org/10.1016/j.ijmedinf.2014.09.004

Lulin Z, Owusu-Marfo J, Antwi HA, Xu X. The contributing factors to nurses’ behavioral intention to use hospital information technologies in Ghana. SAGE Open Nurs. 2020;6:2377960820922024. https://doi.org/10.1177/2377960820922024 PMid:33415277 DOI: https://doi.org/10.1177/2377960820922024

Shiferaw KB, Mehari EA. Modeling predictors of acceptance and use of electronic medical record system in a resource limited setting: Using modified UTAUT model. Inform Med Unlocked. 2019;17(1):100182. https://doi.org/10.1016/j.imu.2019.100182 DOI: https://doi.org/10.1016/j.imu.2019.100182

Zhou LL, Owusu-Marfo J, Antwi HA, Antwi MO, Kachie AD, Ampon-Wireko S. Assessment of the social influence and facilitating conditions that support nurses adoption of hospital electronic information management systems (HEIMS) in Ghana using the unified theory of acceptance and use of technology (UTAUT) model. BMC Med Inform Decis Mak. 2019;19(1):230. https://doi.org/10.1186/s12911-019-0956-z PMid:31752840 DOI: https://doi.org/10.1186/s12911-019-0956-z

Kim S, Lee KH, Hwang H, Yoo S. Analysis of the factors influencing healthcare professionals’ adoption of mobile electronic medical record (EMR) using the unified theory of acceptance and use of technology (UTAUT) in a tertiary hospital. BMC Med Inform Decis Mak. 2016;16(1):12. https://doi.org/10.1186/s12911-016-0249-8 PMid:26831123 DOI: https://doi.org/10.1186/s12911-016-0249-8

Ahmed MH, Bogale AD, Tilahun B, Kalayou MH, Klein J, Mengiste SA, et al. Intention to use electronic medical record and its predictors among health care providers at referral hospitals, north-West Ethiopia, 2019: Using unified theory of acceptance and use technology 2(UTAUT2) model. BMC Med Inform Decis Mak. 2020;20(1):207. https://doi.org/10.1186/s12911-020-01222-x PMid:32883267 DOI: https://doi.org/10.1186/s12911-020-01222-x

Seethamraju R, Diatha KS, Garg S. Intention to use a mobilebased information technology solution for tuberculosis treatment monitoring applying a UTAUT model. Inf Syst Front. 2018;20(1):163-81. https://doi.org/10.1007/s10796-017-9801-z DOI: https://doi.org/10.1007/s10796-017-9801-z

Venkatesh V, Morris MG, Davis GB, Davis FD. User acceptance of information technology: Toward a unified view. MIS Q Manag Inf Syst. Published online 2003. https://doi.org/10.2307/30036540 DOI: https://doi.org/10.2307/30036540

Zhou T. Examining location-based services usage from the perspectives of unified theory of acceptance and use of technolog and privacy risk. J Electron Commer Res. 2012;13(2):135-44.

Fillion G, Braham H, Ekionea JP. Testing UTAUT on the use of ERP systems by middle managers and end-users of medium- to large-sized Canadian enterprises. Acad Inf Manag Sci J. 2012;15(2):1-28.

Yu CS. Factors affecting individuals to adopt mobile banking: Empirical evidence from the utaut model. J Electron Commer Res. 2012;13(2):105-21.

Venkatesh V, Thong JY, Xu X. Unified theory of acceptance and use of technology: A synthesis and the road ahead. J Assoc Inf Syst. 2016;17(5):328-76. https://doi.org/10.17705/1jais.00428 DOI: https://doi.org/10.17705/1jais.00428

Ajzen I. From intentions to actions: A theory of planned behavior. In: Action Control. SSSP Springer Series in Social Psychology: Verlag Berlin Heidelberg; 1985. p. 11-39. https://doi.org/10.1007/978-3-642-69746-3_2 DOI: https://doi.org/10.1007/978-3-642-69746-3_2

Depkes RI. Manual Rekam Medis Konsil Kedokteran Indonesia. Buku Man Rekam Medis. 2006. Available from: http://www.kki.go.id/assets/data/menu/Manual_Rekam_Medis.pdf [Last accessed on 2021 Aug 28].

Kemenkes RI. PMK Nomor 269/MENKES/PER/III/2008 Tentang Rekam Medis. Peratur Menteri Kesehat tentang Rekam Medis; 2008. Available from: http://dinkes.surabaya.go.id [Last accessed on 2021 Aug 28].

Astini NK, Saleh B, Syarifuddin S. Literasi teknologi informasi dan komunikasi masyarakat di Kawasan Mamminasata. J Perkommas. 2015;18(3):151-60.

Pemerintah Republik Indonesia. Undang-Undang Republik Indonesia Nomor 44 Tahun 2009 Tentang Rumah Sakit; 2009. https://doi.org/10.1017/CBO9781107415324.004 DOI: https://doi.org/10.1017/CBO9781107415324.004

Setyawan DA. Rekam Medis Elektronik (RME). Surakarta, Indonesia. 2017. p. 2-28. Available from: https://adityasetyawan.files.wordpress.com/2017/03/handout-rme-2017.pdf

Downloads

Published

2022-03-09

How to Cite

1.
Faida EW, Supriyanto S, Haksama S, Markam H, Ali A. The Acceptance and Use of Electronic Medical Records in Developing Countries within the Unified Theory of Acceptance and Use of Technology Framework. Open Access Maced J Med Sci [Internet]. 2022 Mar. 9 [cited 2024 Nov. 21];10(E):326-3. Available from: https://oamjms.eu/index.php/mjms/article/view/8409

Issue

Section

Public Health Disease Control

Categories