Assessment of Readiness for Electronic Medical Record Implementation in the Inpatient Unit of Port Hospital, Jakarta, Indonesia

This study aims to assess Port Hospital Jakarta’s readiness to implement Electronic Medical Records (EMR) in inpatient units using the Doctor’s Office Quality Information Technology (DOQ-IT) method. EMR systems are essential in modern healthcare, enhancing efficiency, accuracy, and data security while ensuring compliance with government regulations, such as the Ministry of Health Regulation No. 24 of 2022. Port Hospital Jakarta has implemented EMR only in outpatient services, while inpatient services rely on conventional medical records. This study employed a descriptive quantitative approach, collecting primary data from 127 respondents using a non-probability purposive sampling technique. Data were analyzed using Microsoft Excel to assess organizational readiness in two key aspects: organizational alignment and capacity. The findings indicate that the hospital’s inpatient units fall within Range II regarding organizational alignment, with a score of 17.19, categorized as "Moderately Ready”. Similarly, the organizational capacity aspect also falls within Range II, scoring 33.72, which is also categorized as "Moderately Ready." Overall, the hospital’s readiness level for EMR implementation in inpatient services, considering both organizational alignment and capacity, is in Range II with a total score of 50.91, indicating a "Moderately Ready" status. These findings suggest that while Port Hospital Jakarta has made progress toward EMR adoption in inpatient units, further organizational alignment and capacity improvements are needed to ensure a seamless and effective implementation.

INTRODUCTION

According to Minister of Health Regulation No. 3 of 2020, hospitals are healthcare institutions that provide comprehensive individual health services, including outpatient, inpatient, and emergency care¹¹. Hospitals must ensure patient satisfaction through efficient and effective service delivery as healthcare providers. A critical element in this is the rapid and efficient processing and storage of data, particularly medical records²². Medical records contain essential patient information such as identification, treatment history, examination results, procedures, and other services provided³³.

The advent of Industry 4.0 has significantly advanced technology, especially in healthcare. Artificial Intelligence (AI) technologies, like the Internet of Things (IoT), have transformed data processing and storage capabilities through cloud-based solutions. In hospitals, these technologies support the development of Electronic Medical Records (EMRs). An Electronic Medical Record (EMR) is a system that includes a patient’s medical and disease history, diagnostic test results, information on medical expenses, and other medical data⁴⁴. The implementation of EMRs has become a global priority, both in developed and developing countries, with several healthcare facilities in Indonesia beginning to adopt them⁵⁵.

Government regulations, such as Minister of Health Regulation No. 24 of 2022, mandate that all healthcare facilities in Indonesia implement EMRs by December 31, 2023. However, as of 2024, only 53% of hospitals have integrated EMRs, indicating challenges such as institutional readiness⁶⁶. Assessing readiness is crucial for effective implementation, and frameworks like the Electronic Health Record Assessment and Readiness Starter Assessment by Doctor’s Office Quality Information Technology (DOQ-IT) provide valuable insights for designing training and implementation strategies⁷⁷.

Port Hospital Jakarta is one such facility that has not fully adopted integrated EMRs. While outpatient services have transitioned to electronic records, inpatient units still rely on paper-based records. Observations reveal resource shortages in the filing and assembling departments, leading to excessive paperwork and risks of damage or loss. Implementing EMRs addresses these challenges and ensures compliance with regulatory standards. Therefore, readiness assessments are essential for hospitals like PortHospitas Jakarta to minimize errors and failures in system implementation.

This study analyzes Port Hospital Jakarta’s readiness to implement electronic medical records (EMR), focusing on two aspects: Organizational Alignment (Culture, Leadership, Strategy) and Organizational Capacity (Information Management, Staff, Training, Workflow, Accountability, Finance, Patient Engagement, IT Support, Technology Infrastructure). These aspects are adapted from the DOQ-IT method for assessing EMR readiness.

MATERIALS AND METHODS

This research was conducted from January to March 2024 at the Port Hospital Jakarta. The study utilized a cross-sectional approach with the Doctor’s Office Quality Information Technology method, employing a descriptive quantitative approach. This research has received an ethical certificate from the Health Research Ethics Committee, Research Ethics Committee Esa Unggul University, with approval number 0925-05.075/DPKE-KEP/FINAL-EA/UEU/V/2025 dated May 22, 2025. The population consisted of 172 individuals, with a sample of 127 respondents calculated using Slovin’s formula, with a significance level of 0.05.

Sampling was carried out using proportional random sampling. Respondents filled out a modified 28-item questionnaire based on the Doctor’s Office Quality Information Technology tool, previously validated and tested for reliability⁸⁸. Participants included nurses from inpatient units, medical record and health information personnel, IT staff, financial department members, doctors, and pharmacy personnel from the inpatient unit.

Data analysis employed descriptive analysis with a quantitative approach. Quantitative results were obtained by summing scores from respondents’ answers. Each question had six options: (a) scored as 0, (b) scored as 1, (c) scored as 2, (d) scored as 3, (e) scored as 4, and (f) scored as 5. The readiness assessment of the DOQ-IT method is comprised of two aspects: organizational alignment and organizational capacity. Each element had three readiness categories with different score ranges. Organizational alignment ranged from 0-15 (not ready), 16-30 (moderately ready), and 31-45 (ready). Organizational capacity ranged from 0-33 (not ready), 34-66 (moderately ready), and 67-100 (ready). Overall readiness assessment ranged from 0-43 (not ready), 44-96 (moderately ready), and 97-140 (ready).

Data analysis was performed using Microsoft Excel to calculate the average score for each aspect and determine readiness scores per aspect. The overall readiness score was calculated by summing the average scores of both aspects to ascertain the overall readiness level.

RESULTS

The Readiness For Implementing EMRs In Inpatient Care At Port Hospital Jakarta In Terms Of Organizational Alignment Aspect.

Table 1.Organization Alignment Readiness

Questions	Average Score
Organizational Culture Readiness
Q1	2.91
Q2	2.11
Q3	2.66
Q4	0.93
Sub-total	8.61
Average	2.08
Leadership Readiness
Q1	3.16
Q2	1.65
Sub-Total	4.81
Average	2.40
Strategy
Q1	2.45
Q2	1.61
Sub-Total	4.06
Average	2.03
1 Organizational Alignment Readiness	17.19 (Moderately Prepared)

Figure 1.Diagram of Organizational Alignment Readiness

Figure 2.Diagram of Organizational Capacity Readiness

Table 2.Organizational

Question	Average Score
Information Management Readiness
Q9	0.69
Q10	0.10
Sub-Total	0.79
Average	0.81
Clinical and Administrative Staff Readiness
Q11	3.67
Q12	2.14
Q13	2.81
Sub-Total	8.62
Average	2.87
Training Readiness
Q14	2.27
Q15	1.94
Sub-Total	4.21
Average	2.10
Workflow Process Readiness
Q16	1.20
Q17	1.06
Sub-Total	2.26
Average	0.92
Accountability Readiness
Q18	2.05
Sub-Total	2.05
Average	2.05
Financial and Budget Readiness
Q19	1.19
Q20	1.11
Sub-Total	2.30
Average	1.15
Patient Engagement Readiness
Q21	0.56
Q22	0.55
Q23	0.78
Sub-Total	1.89
Average	0.63
IT Management Support Readiness
Q24	3.44
Q25	1.81
Q26	2.37
Sub-Total	7.62
Average	2.47
IT Infrastructure Readiness
Q27	1.84
Q28	1.14
Sub-Total	2.98
Average	1.49
2 Organizational Capacity	33.72
Hospital Readiness (1+2)	50.91