Evaluasi Implementasi Rekam Medis Elektronik di RS. M. Djamil Padang

DEVI OLIVIA, Ir. Adhistya Erna Permanasari, ST,MT,Ph.D; Dr. dr. Guardian Yoki Sanjaya, M.HlthInfo

2026 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Latar belakang: Transformasi sistem kesehatan melalui UU No. 17 Tahun 2023 dan PMK No. 24 Tahun 2022 mendorong seluruh fasilitas pelayanan kesehatan menyelenggarakan rekam medis elektronik (RME). RME sebagai bagian dari Sistem Informasi Manajemen Rumah Sakit (SIMRS) diharapkan mampu mendukung integrasi pelayanan, kualitas informasi, efisiensi kerja, dan pengambilan keputusan. Keberhasilan implementasi RME perlu dinilai melalui kesesuaian aspek human, organization, dan technology terhadap kebermanfaatan sistem. Penelitian ini juga menelaah hambatan implementasi dan saran perbaikan agar hasil evaluasi tidak hanya menggambarkan hubungan statistik tetapi juga kebutuhan pengguna di lapangan.

Metode: Penelitian ini merupakan penelitian kuantitatif dengan desain survei analitik observasional dan pendekatan cross-sectional. Penelitian dilakukan di RS M. Djamil pada Januari - Maret 2026. Sampel berjumlah 289 tenaga kesehatan pengisi RME dari berbagai profesi yang dipilih menggunakan stratified random sampling. Variabel independen meliputi human, organization, dan technology sedangkan variabel dependen adalah kebermanfaatan RME. Data dikumpulkan menggunakan kuesioner skala Likert 1 - 4 yang disusun peneliti dan telah reliabel dengan nilai Cronbach’s Alpha 0,743. Kuesioner juga dilengkapi pertanyaan terbuka untuk menggali hambatan dan saran responden. Jawaban terbuka dianalisis melalui pengkodean, pemaknaan, sintesis tema berdasarkan HOT-Fit serta klarifikasi kepada SIMRS. Analisis kuantitatif dilakukan secara univariat, bivariat dengan uji Spearman, dan multivariat menggunakan regresi linear berganda.

Hasil: Responden didominasi perempuan mayoritas berprofesi sebagai perawat dan memiliki masa kerja cukup lama sehingga telah terbiasa menggunakan RME. Persepsi responden terhadap human, organization, technology, dan kebermanfaatan RME berada pada kategori sedang. Hasil uji simultan menunjukkan human, organization, dan technology berpengaruh signifikan terhadap kebermanfaatan RME (F=298,199; p=0,0001). Secara parsial human (p=0,0001) dan technology (p=0,003) berpengaruh signifikan sedangkan organization tidak berpengaruh signifikan (p=0,690). Nilai koefisien determinasi sebesar 0,756 menunjukkan ketiga variabel menjelaskan 75,6% variasi kebermanfaatan RME. Meskipun hasil pertanyaan tertutup menunjukkan persepsi cukup baik, pertanyaan terbuka yang diklarifikasi kepada SIMRS mengungkap hambatan terutama pada aspek technology yaitu jaringan, kelengkapan fitur, integrasi data, perangkat, pemahaman pengguna, sosialisasi, dan koordinasi antarprofesi.

Kesimpulan: Prioritas perbaikan implementasi RME sebaiknya difokuskan pada penguatan aspek teknologi, khususnya stabilitas jaringan, ketersediaan komputer, dan keandalan sistem. secara statistik faktor organisasi tidak terbukti berpengaruh langsung atau kuat terhadap manfaat RME dalam model penelitian namun, perbaikan teknologi tersebut memerlukan dukungan kebijakan organisasi dalam bentuk perencanaan anggaran, penyediaan sarana, pemeliharaan infrastruktur, dan monitoring berkala.

Background: Health system transformation through Law No. 17 of 2023 and Minister of Health Regulation No. 24 of 2022 encourages all health care facilities to implement electronic medical records (EMR). EMR as part of the Hospital Management Information System (HMIS) are expected to support service integration, information quality, work efficiency, and decision-making. The success of EMR implementation needs to be assessed through the fit between human, organization, and technology aspects and the perceived benefits of the system. This study also examined implementation barriers and improvement recommendations to ensure that the evaluation findings reflect not only statistical relationships but also user needs in practice.

Methods: This was a quantitative study using an observational analytic survey design with a cross-sectional approach. The study was conducted at RS M. Djamil from January to March 2026. A total of 289 health care professionals who completed EMR documentation from various professions were selected using stratified random sampling. The independent variables were human, organization, and technology, while the dependent variable was the perceived benefit of EMR. Data were collected using a researcher-developed Likert-scale questionnaire ranging from 1 to 4, which was reliable with a Cronbach’s Alpha value of 0.743. The questionnaire also included an open-ended question to explore respondents’ barriers and suggestions. Open-ended responses were analyzed through coding, meaning interpretation, thematic synthesis based on the HOT-Fit framework, and clarification with the HMIS unit. Quantitative data were analyzed using univariate analysis, Spearman correlation, and multiple linear regression.

Results: Most respondents were female, the majority were nurses, and many had long work experience, indicating familiarity with EMR use. Respondents’ perceptions of human, organization, technology, and EMR benefits were in the moderate category. The simultaneous test showed that human, organization, and technology had a significant effect on EMR benefits (F=298.199; p=0.0001). Partially, human (p=0.0001) and technology (p=0.003) had significant effects, while organization was not significant (p=0.690). The coefficient of determination was 0.756, indicating that the three variables explained 75.6% of the variation in EMR benefits. Although the closed-ended responses indicated relatively good perceptions, the open-ended responses clarified with the HMIS unit revealed barriers, particularly in the technology aspect, including network access, feature completeness, data integration, device availability, user understanding, socialization, and interprofessional coordination.

Conclusion: The priority for improving EMR implementation should be focused on strengthening the technological aspect, particularly network stability, computer availability, and system reliability. Statistically, the organizational factor was not proven to have a direct or strong influence on EMR benefits in the research model. However, technological improvements still require organizational policy support through budget planning, facility provision, infrastructure maintenance, and regular monitoring.

Kata Kunci : Rekam Medis Elektronik, Human, Organization, Technology, Net Benefit