1. Title of Thesis:
The Management of EMR (Electronic Medical Records) in Government Hospitals of Malaysia
i) To explore the implementation of EMR in THIS Hospitals. ii) To identify the factors that contribute to successful implementation of EMR at THIS Hospitals.
iii) To investigate the EMR adoption factors at Government Hospital at Malaysia. iv) To develop and test EMR adoption model for Government Hospitals in Malaysia.
3.0 Literature Review
EMR is important in nowadays hospitals to ensure the patients experience a good care. More than that, it brought to positive impacts in an overall hospital’s business including the first time registration of one patient until the patient pay the bill and leaving the hospital. Based on Chor (1999), EMR is captures and stores all relevant clinical data for each patient in electronic form. Based on Garets and Davis (2006), EMR is an application environment composed of the clinical data repository, clinical decision support, controlled medical vocabulary, order entry, computerized provider order entry, pharmacy, and clinical documentation applications. EMR was first introduced in the United States of America, and followed by some others developed countries all over the world. Nowadays, the EMR are introduced in many developing countries to develop their medical care, as well as to support the technology usage in this technological era. More than that, Malaysia also support the technology to enhance the medical care and treatments at hospitals. The Malaysian Government had support the implementation and the development of EMR, especially in the Government Hospitals. Nowadays, some hospitals are fully implemented the system, some are in an intermediate status, some are in a basic status and some are still on hold. Furthermore, in Malaysia, the implementation of EMR is been prepared in some stages. Based on Sharifah Mastura, Haslina and Zaharin (2005), 2 hospitals which are fully implemented the EMR are Hospital Selayang and Hospital Putrajaya.
3.1 Background of EMR in the United States of America. In the 1960s, Lawrence L. Weed who is a physician first expressed the concept of computerized or electronic medical records when he introduced the concept of the Problem Oriented Medical Record (PROMIS) into medical practice at the University of Vermont. The project was involved a collaborative effort to both of the physicians and the information technology experts. At 1967, they started to develop an automated system. In 1970, the POMR was used in a medical ward of the Medical Center Hospital of Vermont for the first time, including a touchscreen technology. In 1972, the Regenstreif Institute developed the first medical records system. During the 1970s and 1980s, several electronic medical record systems were developed and further refined by various academic and research institutions. Examples of EMR are The Technicon system was hospital-based, Harvard's COSTAR system for ambulatory care, HELP system and Duke's 'The Medical Record' are examples of early in-patient care systems. More than that, an Indiana's Regenstrief record was one of the earliest combined in-patient and outpatient systems. Although the concept was widely spreading in medical practice, the physicians did not gather to the technology. Based on Starfield et al. (1976), there is a high concordance between important information on co-ordination of care for a patient being reflected in the recording of problems in the medical record by the practitioner. More than that, SOAP could be inappropriately complex for simple patient care problems and in some instances POMR did little to organise the narrative and confusing note-keeping of the healthcare professional (Switz, 1976). However, since the 1970‘s, mostly in government hospitals and a few visionary health institutions, EMR use has not taken off. It is predictable that 20% hospitals in the United States...
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