The Impact of Upgrade towards Comprehensive Electronic Medical Record System on Hospital Performance: A Single Tertiary Care Center Experience in Saudi Arabia

Mohammad Mahal Alrehaili^1, and Omar Zayyan Alsharqi²

¹Department of Medical Oncology, Oncology Center, King Abdullah Medical City, Makkah, Saudi Arabia

²Department of Health Services and Hospital Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia

Cite this paper

Mohammad Mahal Alrehaili and Omar Zayyan Alsharqi. The Impact of Upgrade towards Comprehensive Electronic Medical Record System on Hospital Performance: A Single Tertiary Care Center Experience in Saudi Arabia. Journal of Business and Management Sciences. 2021; 9(1):17-30. doi: 10.12691/JBMS-9-1-3

Abstract

In line with the global trend, hospitals in the Kingdom of Saudi Arabia, including tertiary medical care centers, have increasingly adopted comprehensive electronic medical record (EMR) systems in the past twenty years. However, knowledge of these systems and the extent of their impact on performance is still limited in the Kingdom due to the lack of studies researching in this field. Accordingly, this study aims to investigate the impact of implementing a comprehensive EMR system in King Abdullah Medical City (KAMC) on hospital performance and to test the assumed hypotheses which propose that implementing a comprehensive EMR significantly improves the clinical effectiveness, patient-centeredness, patients’ safety and production efficiency in an advanced tertiary care setting in Saudi Arabia. To achieve this, a quantitative cross-sectional survey was conducted, using a valid questionnaire, on a random representative sample of 150 participants from healthcare professionals working in KAMC who experienced the upgrade towards the comprehensive EMR. The data collected was analyzed and the results showed the existence of statistically significant relationships between the implementation of comprehensive EMR as an independent variable and the four investigated dependent variables which are clinical effectiveness, patient-centeredness, patients’ safety and production efficiency in an advanced tertiary care setting in Saudi Arabia at significance level p=0.000 < 0.05. The study concluded the necessity of implementing comprehensive EMR to the point where tertiary care hospitals should pay attention to the application of such advanced electronic system because of their role in improving health care performance. Eventually, the study recommends the need to build an integrated EMR system at the level of the Kingdom that ensures the safe exchange of information between hospitals and health national centers which would enhance the provision of more distinguished health service for each patient, increase administrative efficiency and reduce the use of traditional means of recording like paper.

Keywords

electronic medical record, tertiary care center, clinical effectiveness, patient-centeredness, patients’ safety, production efficiency

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Kwan J, Lo L, Ferguson J, Goldberg H, Diaz-Martinez J, Tomlinson G et al. Computerised clinical decision support systems and absolute improvements in care: meta-analysis of controlled clinical trials. BMJ. 2020; 370 :m3216.
[2]	Mahmoudi E, Kamdar N, Kim N, Gonzales G, Singh K, Waljee A et al. Use of electronic medical records in development and validation of risk prediction models of hospital readmission: systematic review. BMJ. 2020; 369: m958.
[3]	The National Alliance for Health Information Technology (NAHIT).
[4]	Lee J, Kuo YF, & Goodwin J. The effect of electronic medical record adoption on outcomes in US hospitals. BMC Health Services Research. 2013; 13:39.
[5]	Gardner J, Boyer K, & Gray J. Operational and strategic information processing: Complementing healthcare IT infrastructure. Journal of Operations Management. 2015; 33-34: 123-129.
[6]	Waithera L, Muhia, J, & Songole R. Impact of Electronic Medical Records on Healthcare Delivery in Kisii Teaching and Referral Hospital. Medical & Clinical Reviews. 2017; 03(04): 1-7.
[7]	Jha A, DesRoches C, Campbell E, Donelan K, Rao S, Ferris T, et al. Use of electronic health records in US hospitals. New England Journal of Medicine. 2009; 360(16): 1628-1638.
[8]	Campanella P, Lovato E, Marone C, & Fallacara L. The Impact of Electronic Health Records on Healthcare Quality: A Systematic Review and Meta-analysis. The European Journal of Public Health. 2016; 26(1): 60-64.
[9]	Colicchio T, Fiol G, Stoddard G & Narus S. Evaluation of a systematic methodology to detect in near real-time performance changes during electronic health record system implementations: a longitudinal study. AMIA Annu Symp Proc. 2018; 2017: 595-604.
[10]	Appari A, Johnson M & Anthony D (2013). Meaningful Use of Electronic Health Record Systems and Process Quality of Care: Evidence From a Panel Data Analysis of U.S. Acute-Care Hospitals. Health Services Research. 2013; 48(2 Pt 1): 354-375.
[11]	Adler-Milstein J, Scott K, Jha A. Leveraging EHRs to improve hospital performance: the role of management. Am J Manag Care. 2014; 20(11 Spec No. 17):SP511-SP519.
[12]	DesRoches C, Campbell E, Vogeli C, Zheng J, Rao S, Shields A, et al. Electronic Health Records’ Limited Successes Suggest More Targeted Uses. Health Affairs. 2010; 29(4): 639-646.
[13]	Noraziani K, Ain A, Azhim M, Eslami S, Drak B, WP S, et al. An Overview of Electronic Medical Record Implementation in Healthcare System: Lesson to Learn. World Applied Sciences Journal. 2013; 25(2): 323-332.
[14]	Bain C. The Implementation of the Electronic Medical Records System in Health Care Facilities. Procedia Mnufacturing. 2015; 3: 4629-4634.
[15]	NHS Executive (1996) Promoting Clinical Effectiveness: A Framework for Action in and Through the Nhs.
[16]	Kalra S, Baruah M & Unnikrishnan A. Responsible Patient-centered Care. Indian J Endocrinol Metab. 2017; 21(3): 365-366.
[17]	World health organization. (2018). Patient safety Global action on patient safety Report by the Director-General of world health organization.
[18]	Chappelow J (2019). Production Efficiency. Investopedia.
[19]	Bryman A & Bell E (2007). Business research methods. Oxford university press.
[20]	Rawbone R. Doing a Successful Research Project—Using Qualitative or Quantitative Methods. Occupational Medicine. 2015; 65(2): 169-170.
[21]	Leedy P & Ormrod J (2005). Practical Research: Planning and Design. Prentice Hall, Upper Saddle River, NJ.
[22]	Gupta S & Shabbir J. On improvement in estimating the population mean in simple random sampling. Journal of Applied Statistics. 2008; 35(5): 559-566.
[23]	Martínez-Mesa J, González-Chica D, Duquia R , Bonamigo R & Bastos J. Sampling: how to select participants in my research study?. Anais brasileiros de dermatologia. 2016; 91(3): 326-330.
[24]	Krejcie R & Morgan D. Determining sample size for research activities. Educational and psychological measurement. 1970; 30(3):607-610.
[25]	Karen Lowing (2011) Educational Research and Inquiry: Qualitative and Quantitative Approaches. Edited by D. Hartas, British Journal of Educational Studies. 2011; 59(3): 350-351.
[26]	Al-Mujaini A, Al-Farsi Y, Al-Maniri A & Ganesh A. Satisfaction and perceived quality of an electronic medical record system in a tertiary hospital in Oman. Oman medical journal. 2011; 26(5): 324-328.
[27]	Aldosari B, Al-Mansour S, Aldosari H & Alanazi A. Assessment of factors influencing nurses acceptance of electronic medical record in a Saudi Arabia hospital. Informatics in Medicine Unlocked. 2018; 10: 82-88.
[28]	Otieno O, Toyama H, Asonuma M, Kanai‐Pak M & Naitoh K. Nurses’ views on the use, quality and user satisfaction with electronic medical records: questionnaire development. Journal of Advanced Nursing. 2007; 60(2): 209-219.
[29]	Graham J. Congeneric and (essentially) tau-equivalent estimates of score reliability: What they are and how to use them. Educational and psychological measurement. 2006; 66(6): 930-944.
[30]	Dobronte A (2013). The importance of socio-demographics in online surveys. Check Market.
[31]	Yanamadala S, Morrison D, Curtin C, McDonald K & Hernandez-Boussard T. Electronic Health Records and Quality of Care. Medicine. 2016; 95(19): e3332.
[32]	Kaneko K, Onozuka D, Shibuta H & Hagihara A. Impact of electronic medical records (EMRs) on hospital productivity in Japan. International Journal of Medical Informatics. 2018; 118: 36-43.
[33]	Hasanain R, Vallmuur K, and Clark M. “Electronic Medical Record Systems in Saudi Arabia: Knowledge and Preferences of Healthcare Professionals”, Health Informatics Journal. 2015; 9(1): 23-31.
[34]	Adler-Milstein J, Everson J, Lee SY. EHR Adoption and Hospital Performance: Time-Related Effects. Health Serv Res. 2015; 50(6): 1751-1771.
[35]	Aldebasi B, Alhassan A, Al-Nasser S & Abolfotouh M. Level of awareness of Saudi medical students of the internet-based health-related information seeking and developing to support health services. BMC Medical Informatics and Decision Making. 2020; 20(1): 1-8.
[36]	Ariffin N, Ismail A, Kadir I & Kamal J (2018). Implementation of Electronic Medical Records in Developing Countries: Challenges & Barriers. International Journal of Academic Research in Progressive Education and Development. 2018; 7(3): 187-199.
[37]	Lin HL, Wu DC, Cheng SM, Chen CJ, Wang MC, Cheng CA. Association between Electronic Medical Records and Healthcare Quality. Medicine (Baltimore). 2020; 99(31):e21182.
[38]	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. Measuring Business Excellence. 2012; 16 (4): 14-30.