Evaluation of Electronic Medical Record Implementation Based on the Hot-Fit Model at Universitas Sebelas Maret Hospital, Indonesia
DOI:
https://doi.org/10.26911/Abstract
Background: Electronic Medical Record (EMR) has become an essential component of digital transformation in healthcare services. However, the successful implementation of EMR depends on the interaction between human, organizational, and technological factors. This study aimed to evaluate the effect of human, organization, and technology factors on the net benefit of EMR implementation based on the Human Organization Technology-Fit (HOT-Fit) model at Universitas Sebelas Maret Hospital.
Subjects and Method: This was an analytic observational study with a cross-sectional design conducted at Universitas Sebelas Maret Hospital, Surakarta, Indonesia, from December 2025 to July 2026. A total of 184 healthcare professionals were selected using proportionate stratified accidental sampling from a population of 515 EMR users. The dependent variable was the net benefit of EMR implementation. The independent variables were human, organization, and technology. Data were collected using a validated and reliable self-administered questionnaire adapted from previous studies. Data were analyzed using descriptive statistics, Pearson correlation, and multiple linear regression.
Results: Human had a positive and significant effect on the net benefit of EMR implementation (b=0.16; 95% CI= 0.06–0.26; p = 0.002). Organization also had a positive effect (b=0.16; 95% CI=0.05–0.28; p = 0.006), while technology showed the strongest effect (b=0.295; 95% CI=0.19–0.40; p < 0.001). Simultaneously, human, organization, and technology significantly influenced the net benefit of EMR implementation (F=71.63; p<0.001) and explained 54% of the variance (Adjusted R²=0.54).
Conclusion: Human, organization, and technology factors significantly influence the net benefit of EMR implementation, with technology as the most influential factor. Strengthening system quality, user competency, and organizational support is essential to optimize the benefits of EMR implementation in hospitals.
Keywords:
electronic medical record, healthcare services, healthcare qualityHow to Cite
References
Adriani PNE, Putri PCS, Adiningsih LY, Putra GW, Cempaka PPAR (2025). Evaluation of electronic medical record implementation using the HOT-Fit method in the inpatient unit of Bhayangkara Hospital Denpasar. MAINTEKKES. 3(2): 42–58. https://doi.org/10.36049/maintekkes.v3i2.423.
Ahmadi H, Nilashi M, Shahmoradi L, Ibrahim O (2017). Hospital information system adoption: Expert perspectives on an adoption framework for Malaysian public hospitals. Comput Human Behav. 67: 161–189. https://doi.org/10.1016/j.chb.2016.10.023.
Ahmadi H, Sadoughi F, Gholamhosseini L, Azadi T, Sheikhtaheri A, Nilashi M, Dehnad A (2019). Organizational factors affecting the adoption of a technological innovation: A study of the hospital information system (HIS). ICWR. 240–245. https://doi.org/10.1109/ICWR.2019.8765270.
Arismanda R, Rizqi A (2025). Effectiveness of electronic medical record (EMR) use at UPTD Manggari Community Health Center, Lebakwangi District, Kuningan Regency in 2024. Innov J Soc Sci Res. 5: 6077–6084. https://doi.org/10.31004/innovative.v5i4.20452.
Davis FD (1989). Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q. 13(3): 319–340. https://doi.org/10.2307/249008.
Deharja A, Santi MW, Damayanti NA, Hargono A, Nandini N (2020). Evaluating the usability of hospital information system (HIS) through human organization technology-fit (HOT-Fit) model. Int Proc 2nd ISMoHIM. https://publikasi.aptirmik.or.id/index.php/ismohim2020/article/view/160.
Fennelly O, Cunningham C, Grogan L, Cronin H, O’Shea C, Roche M, Lawlor F, O’Hare N (2020). Successfully implementing a national electronic health record: A rapid umbrella review. Int J Med Inform. 144: 104281. https://doi.org/10.1016/j.ijmedinf.2020.104281.
Fitriana LP, Widiyanto WW (2025). An assessment of electronic medical record adoption in the emergency unit using HOT-FIT model: Evidence from RSUD A.M. Parikesit. Int J Health Med. 2(3): 61–68. https://doi.org/10.62951/ijhm.v2i3.454.
Ilmada H (2023). Evaluation of hospital management information systems using the HOT-Fit method: A literature review. World J Adv Res Rev. 19(3): 685–693. https://doi.org/10.30574/wjarr.2023.19.3.1844.
Indah RN, Supriyantoro, Munawar (2026). Evaluating electronic medical records implementation using the HOT-Fit model: A SEM study at Sumber Waras General Hospital, Cirebon. Indones J Nurs Health Sci. 11(1): 1–12. https://doi.org/10.47007/ijnhs.v11i1.10178.
Lindsay MR, Lytle K (2022). Implementing best practices to redesign workflow and optimize nursing documentation in the electronic health record. Appl Clin Inform. 13(3): 711–719. https://doi.org/10.1055/a-1868-6431.
Munjirin, Intisari AD, Aji B (2024). Evaluation of the implementation of the hospital management information system (SIMRS) using the HOT-Fit method: Systematic review. Sci Midwifery. 12(3). https://doi.org/10.35335/midwifery.v12i3.1585.
Mutamakin A (2025). Hospital transformation and the future of EMR in Indonesia. GovInsider. https://govinsider.asia/intl-en/article/hospital-transformation-and-the-future-of-emr-in-indonesia.
Ministry of Health of the Republic of Indonesia (2022). Regulation of the Minister of Health of the Republic of Indonesia Number 24 of 2022 concerning medical records. Jakarta: Ministry of Health of the Republic of Indonesia. https://www.peraturan.go.id.
Prameswari D, Wardani R, Ellina AD (2025). Evaluation of the implementation of electronic medical records (EMR) using the HOT-Fit method. Indones J Glob Health Res. 7(3): 259–266. https://doi.org/10.37287/ijghr.v7i3.5983.
Rokim A, Putra DH, Rumana NA, Indawati L (2024). Evaluation of the community health center management information system (SIMPUS) using the HOT-FIT method at Cakung District Community Health Center. J Manaj Inf Kes Indones. 12(1). https://doi.org/10.33560/jmiki.v12i1.495.
Siswati S, Syafrawati, Khairunnisa M (2025). Assessment of electronic medical record implementation using the HOT-Fit method at community health centers in Padang City. J Kes Komun. 11(1): 64–73. https://doi.org/10.25311/keskom.vol11.iss1.2140.
Tawar, Santoso AF, Salma YS (2022). HOT-Fit model in information system management. Bincang Sains Teknol. 1(2): 76–82. https://doi.org/10.56741/bst.v1i02.144.
Urbanantika R, Fauziati S, Sanjaya GY (2024). Evaluation of electronic medical records using HOT-Fit to improve service quality at DKT dr. Soetarto Hospital. J Inf Syst Public Health. 9(3): 127–135. https://doi.org/10.22146/jisph.97306.
Wardhana ES, Yaniawati P, Santoso B (2025). A comprehensive evaluation of hospital information systems based on the HOT-Fit framework. Indones J Dent. 5(2): 89–99. https://doi.org/10.26714/ijd.v5i1.18256.
Waris CD, Hilmy MR (2024). Analysis of electronic medical record utilization based on the HOT-Fit method in the outpatient installation of Tanjungpinang City Regional Hospital. J Nurs Public Health. 12(2): 293–305. https://doi.org/10.37676/jnph.v12i2.7304.
Yusof MM, Papazafeiropoulou A, Paul RJ, Stergioulas LK (2008). Investigating evaluation frameworks for health information systems. Int J Med Inform. 77(6): 377–385. https://doi.org/10.1016/j.ijmedinf.2007.08.004.
Zhai Y, Yu Z, Zhang Q, Qin W, Yang C, Zhang Y (2022). Transition to a new nursing information system embedded with clinical decision support: A mixed-method study using the HOT-Fit framework. BMC Med Inform Decis Mak. 22(1). https://doi.org/10.1186/s12911-022-02041-y.
