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Management in health

XVIII/3/2014; pp. 26-33 QUALITY

Dr. Rajesh Kumar SINHA1, Associate BACKGROUND: Hospital Information System (HIS) assist the hospital staff
in carrying out their clinical, nursing, administrative and other daily activities.
Professor Assessment of satisfaction of the end users in using the system is important to ensure
Susanna KURIAN2, Student the proper functioning of the system.
OBJECTIVE: To assess the satisfaction level of end user towards Hospital
Department of Health Information Management Information System.
School of Allied Health Sciences METHOD: A prospective cross sectional study was carried out among 127 end
Manipal University, India users of HIS, including nursing, front office, administrative, para medical, medical
records, maintenance and accounts staff of a women’s hospital of Southern India.
The data was collected using a structured and validated questionnaire based on 5
point Likert scale from Extremely satisfied to Not satisfied (Score 5-1).
1. INTRODUCTION DATA ANALYSIS: The collected data was analysed using SPSS 20.0 and
Hospitals are very complex institutions with large presented in terms of frequency, percentage, mean score and standard deviation.
RESULTS: The study result revealed that the respondents were moderately satisfied
departments and units intended to coordinate care with the general and module specific features (Mean score < 4). The issues identified
of the patients [1]. It consists of different groups were mainly related to Outpatient, Inpatient, Payroll, and Ward Management
performing highly specified functions that lead to System to which suggestions were raised and implemented accordingly. The post-
the generation of large amount of data. An endless implementation satisfaction result indicated that the respondents were satisfied with
flow of data begins with the outpatient and admit- the implemented changes. Their major concern was to have regular induction and
ting departments and emanates from every depart- refresher training and to include their requirements in the HIS to assist them in
performing their daily routine tasks effectively.
ment throughout the hospital. Some data is vital CONCLUSION: The acceptability and sustainability of HIS largely depends on
for the care and well-being of patients, while other the inclusion of end users during the design and implementation of the system and
data enhance the overall efficiency of hospital their satisfaction with the same. The study result indicated the need to conduct
itself. The way the hospital responds to the chal- regular and refresher training, and assess the end user need and their interaction
lenges of managing these data determines the with HIS on a regular basis to achieve maximum satisfaction.
quality of patient cares and hence its success [2]. Keywords: Hospital Information System, Health Care Organization, Hospital,
Since last few decades, Information and communi- Information, End user satisfaction
cation technology has played a vital role in man-
aging healthcare data that are getting generated from the mentation. Their requirements should be addressed as this
various sources in the hospital. A Hospital Information creates a feeling that they are a part of the system and
System (HIS) as one of the important application of infor- hence become more enthusiastic to use them. Proper and
mation and communication technology, support the health- systematic training should be provided to the end users
care provider in managing variety of information generated regarding the use of the system [5].
in a hospital on a day to day basis. It is a comprehensive Satisfaction in a given situation is a person’s feeling or
and integrated information system designed to collect, re- attitudes towards a variety of factors affecting that situa-
trieve, manipulate and use of information to support all the tion [6]. Similarly, end user satisfaction is significant to
administrative and clinical activities of a hospital [3]. successful implementation of hospital information system.
Initially hospital information systems were used only to It is generally understood that failure of these information
automate financial and accounting areas. But now with systems is mainly due to psychological and organizational
advancement in computer technology, it has pervaded al- issues. Therefore it is essential for the hospitals to assess
most every activity and revolutionized the entire flow of the end user satisfaction towards the usage of hospital in-
information within the hospital. Therefore, a good hospital formation system. This should be done on a regular basis
information system has the potential to improve the qual- to ensure satisfaction towards the system [7] [8] which
ity, safety and efficiency of healthcare apart from perform- ultimately lead to better acceptability and sustainability of
ing the routine administrative and financial tasks. Cur- the hospital information system in the health care organi-
rently, hospitals are becoming more dependent on these zation.
information systems in carrying out all the functions re-
lated to patient care, education and research for better and 2. METHODS
improved services and practices [4].
A prospective cross sectional study was carried out in a
The implementation of Hospital Information System women’s hospital of Southern India. It was carried out
should be well planned. Care should be taken while choos- among 127 end users of HIS; including nursing, front of-
ing the vendor and software. The chosen software should fice, administrative, para medical, medical records, main-
be able to meet the objectives of the organization. The end tenance and accounts staff. A structured and vali-
users should always be involved in the process of imple- dated questionnaire was used to assess the end user 26

Here. Ward Management System.5 Lab technician 4 3.0 and presented in 36-40 9 7. Among 127 respondents.4 Assessment about the general features of HIS 6-10 28 22. QUALITY Management in health XVIII/3/2014.5 Module wise feedback of HIS 11-15 17 13. 89(70%) were nurses. group of 21-25 years. 2 maintenance staff and 4 end users of hospital information system where the end accounts staff.8%) in the age group of 56-60 informed consent.1. 3.8 3. 7(5%) vey front office staff. 28(22. General features.8% 3.7%) female.2% 46-50 0 0% deviation. The study was conducted in three phases.3 Usage of Hospital Information System Distribution based on years of experience (interval in years) 1-5 73 57.1. In-charge 10 7.1 3.1% terms of frequency.1.9 The assessment of end user satisfaction was conducted Staff nurse 65 51. They were also asked to rate their level of satisfac.1 Results of the assessment of end user satisfaction Satisfied to Not satisfied (Score 5-1) was used to collect level the data.2%) after briefing them about the survey and taking their due of 41-45 years and 1 (0.1 Characteristics of the Respondents OT technician 2 1. with 11-15 years.1%) with 6-10 years and 17(13.5 puter Chief Operating Officer 2 1.6 3. Payroll and Accounts. 8 (6.1 Characteristics of the respondents Demographic Characteristics. the respondents were briefed about 21-25 40 31. percentage. 8(6.9%) in 31-35 years.3 respondents were asked whether the suggestions given by Female 119 93. a post implementation satisfaction survey quency age was conducted among 25 end users who had reported the Gender-wise Distribution issues and made suggestions during the initial survey.2 Implementation of recommendations 26-30 0 0 31-35 1 0.5%) were in the age Management System. pp.7 them are implanted and how satisfied they are with the Age-wise distribution (interval in years) implementation. The questionnaire consisted 9 sections namely.1%) in 36-40 years. Pharmacist 7 5.1) users were asked about their knowledge about HIS and its About 73(57. Out. The result obtained is presented and discussed here HIS.8 level Radiology technician 2 1. 1 MRD staff. Equipment (93. 49 (38. mean score and standard 41-45 4 3. experience. In F r e .1.1. the issues and years.3%) had 16-20 years 27 .1 Biochemist 1 . 40 (31.5% the purpose of the interview and prior expressed consent 26-30 49 38.5%) respondents had 1-5 years of working usage.6 3. Among them. Percent- the third phase. RESULTS AND DISCUSSION Designation-wise distribution Associate executive 5 3. The questionnaire based on 5 point Likert scale from Extremely 3.2 Knowledge about basic functionality of com.6 in each phase is presented in the form of table and dis. 4 (3. (Table. Out of 127 respondents. During second phase. 6(4%) administrative staff.3 Results of the post-implementation satisfaction sur.4 16-20 8 6.3%) were male and 119 patient. The first under following headings: phase included a structured interview to assess the end user satisfaction towards the general features of the HIS. (Table.8 3.4%) of 26-30 years. 24 The questionnaire was administered to the respondents (18.1 Results of the assessment of end user satisfaction Embryologist 1 . 51-55 0 0% 56-60 1 .1) suggestions raised by the respondents during the end user satisfaction survey were studied and recommendations to Table 1 .4%) tion with regard to general and module specific fea.Characteristics of the Respondents (n=127) address these issues were provided and implemented.4% was obtained. Pharmacy.3 21-25 0 0 3.1 3. 9 (7. Inpatient.9% phase was analysed using SPSS 20. The data collected during first and third 31-35 24 18.2 among 127 end users in three phases. 26-33 satisfaction level of respondents regarding the usage of tures. The result obtained Associate staff nurse 16 12.5 3.6 Assistant Manager 4 3.9 cussed under the following headings: Guest relations executive 7 5. 18(14%) Phase 1 included the assessment of satisfaction level of the paramedical staff.1. The Male 8 6.

1.8 127 100 whereas 42 (32.4. The acceptance or rejection depends on the previous experience study results evident that 71(55.1.1 Data display The study results revealed that 72(56. which showed the related overall satisfaction of the HIS ture and functionality with the present system of HIS. who have whereas 44 (34.692 respectively.Distribution of respondents based on their (7. The rea- 28 .693.2 95 74.3%) were slightly satisfied with it .34 and standard deviation 0.2 Knowledge about basic functionality of computer erately satisfied with the accessibility feature of HIS The success of any HIS implementation depends on the whereas 41(32. fied. (Table 2) The HIS should provide comfortable access to data at point of care in the healthcare facility [10].7%) respondents The display of information in hospital information system were moderately satisfied with the format of the HIS should be clear and appropriate to the end users for its where about 36(28. The study result evident that only 10 (3.9%) claimed to be extremely satisfied. 26-33 QUALITY Table 2 .9%) respondents claimed that they are Parameter Yes No Total Have you used f f f moderately satisfied with response time of the system % % % HIS before?  32 Response time HIS is said to provide timely access to information as re- Table 3 .4. (Table.4 Data input 3.4. 39 asked to rate the general and module specific features. all the respondents were found to have that indicates the related satisfaction level as moderate. f=Frequency.3%) total of 127 end users were interviewed and they were respondents reported to be moderately satisfied. A location and geographical area. Among 127 respondents.657 that their experience was good and they expect similar fea.3) 3. The overall satisfaction related to the data retrieval ceived form all the respondents about the general features was found to be moderate with the mean score 3. 57 (44. The knowledge of basic functionality of computer among end mean score and standard deviation being 3. The study re- sult reported about 70(55.5 Data Retrieval 3.4) Note: n=total number of respondents 3. tem to assist the end user in accessing data irrespective of faction level towards the Hospital Information System.7%) very satisfied and only 3 (2.2%) moderately Parameter Yes No Total satisfied with the data display feature of the HIS. %=Percentage 3.The mean score of 3.1.693 shows the satisfaction with the response time as moderate.1.39 and 0.1.4%) were very satisfied and 65 (51. The response re. 3.1%) respondents who were mod- 3. (Table. (Table.4).34 and 0.6%) were very satisfied.1. they (30.4 Assessment about the general features of HIS The HIS should have the fast and secure data retrieval sys- The objective of the study was to assess the end user satis. pp. In view to this.4.1.721 indicated the satisfaction level of respondents about basic 127 100 0 0 127 100 towards the data display as moderate. The mean score the previous experience of using HIS where they claimed and standard deviation was found to be 3.4) hereunder: 3.4) functionality of computer Note: n=total number of respondents. Management in health XVIII/3/2014.3 Usage of HIS A good data input feature assists the end users in entering The hospital information systems always have a chance of the correct data into the hospital information system.3%) were found to be very satisfied. users.23 and of HIS are presented in the form of table and discussed standard deviation 0.6 Format 3.4%) extremely satis- use in the Hospital Information System. In this study.46 and the standard deviation Knowledge f % F % f % of 0.4.3%) were very satisfied and only 5 comfortable usage.9%) respondents were extremely satisfied whereas 45 knowledge about basic functionality of computer (n=127) (35. (Table.3 Accessibility whereas 1 respondent had 31-35 years of experience in their area of expertise.4.2%) respondents. 69 (54.9%) respondents were of the end users about hospital information system.4) (Table. the knowledge on the basic functionality of computer (Table. among end users as moderate (Table.Distribution of respondents based on the usage sponse time is an important factor contributing to the effi- of Hospital Information System before (n=127) ciency of hospital information systems [9]. The moderately satisfied with the data input feature of HIS study result evident only 32(25.2). The mean score of the response 3.

2%) were slightly sat- isfied that drop down the overall satisfaction as slightly to 3.827 cal support provided with respect to HIS.4) A good hospital information system should reduce the duplication of information entries and reduce the end users time in documenting patient and administrative data [4].7%) (34.42 0. not assisting much in performing their jobs. The mean lysed and implemented to enhance their overall satisfaction score 3. The end users of the HIS are HIS whereas 38(29.4%) (56. %=Percentage Job satisfaction is important from the per- the moderate satisfaction was the presentation of entry spective of maintaining and retaining the forms which was not well organised. f f f f f port should be provided to the end users (%) (%) (%) (%) (%) during their use of the system.1 0Job satisfaction SD=Standard deviation. 3.88 0.6%) (55.8%) very satisfied and about 17(13.4.3%) (44.80 0. M=Mean Score. 65 (51.93 and standard deviation 0.46 0.1.28 0.4%) key factor in the successful use of hospital 10 Training 5 22 61 37 2 2. MS= Moderately satisfied.6%) on the success of the implementation has 12 Reduction of 2 21 65 38 1 2.1. (Table.6%) (0%) (Table. 3.0%) (0%) 8 Customization 0 23 69 32 3 2.701 (3.562 score 2.3%) (55.88 and Standard Devia- tion: 0.23 0.8%) (0%) (29.4%) (30.86 and 5 Data storage 7 47 66 6 1 3. VS=Very satisfied. QUALITY Management in health XVIII/3/2014. Reduction of duplicate work moderate with the Mean score 2.651 ing as moderate.7%) (2.11. The mean score 3. The mean score 3.2%) (2.6%) (18.4.1%) (47.0%) (4.1%) (39.720.4) 7 Format 5 36 72 14 0 3.5%) (54. (2.7%) (37.7%) (54.3%) (0%) (0%) indicate the overall satisfaction about train- 16 Overall satisfac. SS=Slightly satisfied.8%) isfaction level with respect to technical 6 Data retrieval 3 39 69 16 0 3.4%) were software to suit the working environment of the end users slightly satisfied and they also mentioned that the HIS is and hospital.8 %) respondents were moderately satis- Hospital based customisations are required for the HIS fied. f=Frequency. (Table.3%) (56.93 0. Therefore strong technical sup- No. about 60(47. pp. ana.613 (4.0%) (52.1.741 been discussed in many research works [3] duplicate work (1.3%) satisfaction as moderate with respect to the HIS support.2%) (30.21 and standard deviation 0.9%) (0. ES=Extremely satisfied.7%) (11.4) cause it contribute directly to maximum job satisfaction and considered to be very important for the successful working of the organization itself.573 the training provided to them whereas 37 (3.7%) (1.5%) (51.7%) (32. In this 1 Data display 10 45 65 7 0 3. respondents were moderately satisfied with the customiza.4.2%) (5.2%) respondents were (7. 61(48%) re- 13 Confidentiality 6 47 72 2 0 3.5%) (0%) found moderately satisfied with the techni- 2 Response time 2 22 57 42 5 2.1%) (42. The and standard deviation 0.828 information systems [6]. (Table. 2 23 60 39 3 2. NS=Not satisfied. In this study.9%) (32.9%) (35.1%) (7.Response related to General features of the module (n=127) usually unaware of the technical aspects of Sl.1%) (1.803 information systems and its direct impact (5. (1.1.4%) 9 Technical sup. Features ES VS MS SS NS M SD the system.1%) were slightly satisfied.9%) (0%) Note: n= total number of respondents.1.8%) [12][13][14].1%) (54.25 0.693 (4.8%) (7.8%) (13.794 Training has been identified as one of the port (1.7 Customisation cates that 67 (52. The importance of (3.6%) (0%) spondents were moderately satisfied with 14 Privacy 4 50 72 1 0 3. The study result indi- 3. 4 37 76 10 0 3.9%) On the other hand 39(30.86 0.9%) (0%) slightly satisfied because of inadequate 4 Data input 6 44 71 6 0 3.9%) (28. 26-33 Table 4 .5%) (26.49 0. The mean 15 Security of data 4 54 69 0 0 3.1%) (59.794 indicated the sat- (5.4) tion (3.88 0.4%) (1.25 appropriate employees within the organization [15].4) tions of the system and about 32(25.8%) (52.39 0.0%) (56.706 standard deviation 0.9%) (17.6%) (16.657 technical support from the information sys- (4. (Table.9%) (4.7%) (0.7%) said they are 3 Accessibility 6 41 70 10 0 3.1%) (29. The end user needs should be assessed.721 study.2%) respondents were found to be Information technology is the backbone of hospital moderately satisfied with duplication of work in using 29 information systems.3%) (48%) (29.7%) (0%) tem department.5%) (37.3%) (3.45 0. 34(26.4. The study result shows that 69 (54.3%) (25.9 Training (0%) (18.803 shows overall towards HIS [11].7%) (0.34 0.6%) (17.45 0.4%) (51.692 support as moderate to very satisfy.4.3%) (12.720 3.8 Technical support In this study.21 0.828 (3.9%) were slightly satisfied because .701 shows the overall satisfaction end user should feel good in working with the HIS be- related to the presentation of format as moderate.2%) (29.6%) training end users in the use of hospital 11 Job satisfaction 7 34 67 17 2 3.

file management. The validated questionnaire based on 5 tiality of patient and other data. the use of HIS and it support in managing 1 Out-patient (n=36) 2. (Table.28 and Standard deviation 0. scan ap- hospital information system has a strong impact on quality pointments.4. reduction in duplication of work and ders. day activities. It is impor. (Table.3%) respondents. vaccination appointments and reports.7%) rated that they are moderately sat.13. about 72(56. scan appointments.05 (3. doctor’s appointment. tracking of patient infor- The secure management of patient and other data using mation.8%) respondents claimed that they ported in the study of Nour El Din. interoperabil- ity. Point Likert scale from Extremely Satisfied to Not Satis- dard deviation being 3. 76(59. The mean score and standard devia- A total of 36 respondents were found to use outpatient tion was found to be 3. timesaving. This study also pointed out the issues with respect to Sl.1.45 and 0.4. customization.651 also work and require more time and effort and decreases their indicate the overall satisfaction of HIS as moderate. The mean score and standard deviation was found spondents were asked to rate their overall satisfaction with 2. time. are moderately satisfied with the overall working of HIS.4. billing. This module that individual’s right to privacy is being protected. doctors the respondents were asked whether the HIS support them appointment. productivity [16].12. (Table. racks patient movement and ob- tive data.1 Out-patient Module Protecting the privacy of health and other administrative The Outpatient module is being used in Front office. When they were asked satisfaction level as moderate.4.1%) respondents. Module Average MS No. faction about the module they use for performing their day isfied with the support of HIS in maintaining the confiden. (Table.4) The similar finding was re.4) cussed hereunder: 3.15. patient rights and health care professionals average mean score and standard deviation was 30 . tant to maintain the confidentiality of these data in the good interest of both the patient and the healthcare pro- vider.20 overall satisfaction with the above issues as 8 Payroll (n=2) 2 moderate. The of patient care.45 and 0.562 revealed the 7 Admin (n=7) 3.7%) respondents rated their satisfac. ments. tion level as moderate. When takes care of the outpatient registration.4) 9 Accounts (n=4) 3. MS= Mean Score 3. as moderate. 72(56. Management in health XVIII/3/2014. (Table.1.85 the secure patient data.56 (54.4) to rate their response regarding their satisfaction level about the out-patient module in terms of storage of demo- 3.14. administrative data etc. 26-33 QUALITY Table 5 . result obtained is present in the form of table and dis- ing the confidentiality of data. vaccination appoint- in protecting the privacy of patient and other administra. tain various reports.75 Note: n= Total number of actual respondents. to data activities.741 respectively which showed the satisfaction respect to the support of HIS in performing their day to level as moderate. very satisfied among 4 Ward Management System (n=76) 3.573 which denoted the module to document patient data. Confidentiality jection of the system. plained that the hospital information systems adds more The mean score 3.5 and standard deviation 0.49 54(42.Response related to the module specific features of HIS (N= 127) and their work practices [17].34 level were found to be moderate among 69 3 Diagnostic (n=100) 3.49 6 Pharmacy (n=93) 3. pp.1. Overall satisfaction HIS used to increase their time in documenting the patient Usefulness of a system is often measured by examining and other data on paper as well as in all administrative the user satisfaction with the system [18]. OPD and Emergency departments.5.613 which signified the fied (Score 5 – 1) was use to collect their response. The result of the study also revealed Information generated in the hospital information system the significance (p<0.5%) and extremely satisfied among 4 5 Equipment Management System (n=127 ) 3. The satisfaction 2 In-patient (n= 84) 3.4) As stated earlier. When the re- work. The satisfaction level with respect the HIS support in maintain. outpatient billing. clinical or. previous experience of hospital informa- tion system has a direct impact on the acceptance and re- 3. The mean score 3. laboratory results. The mean score and stan. identification data. reduced patient handling time. job satisfaction.1.e.5 Module wise feedback on HIS terms of HIS support in maintaining the confidentiality of The respondents were also asked to rate their level of satis- patient data.88 and 0.05) of use of HIS with the response can be of many types i. data in hospital information system is important to ensure MRD. Privacy 3 1. where the users com. When the question asked to rate their satisfaction in 3 1. Security of data graphic data. file management.

response received from 4 end users of Account module break down/ complaint reporting and rectification of com. very satisfied. billing.687 which de. bed transfer. (Table.691.5 Equipment Management System budget calculation. have asked to rate their satisfaction about the features of leave allotment and various reports. room and bed allocation.34 and 0. service management. The This module deals with all kind of maintenance report. About 7 end users of This is the radiology and laboratory information system. The average mean score 3. and standard deviation was found to be 3. moderate with the average mean score and standard devia- patient module to be moderate.5) tion of 3. Among ing drugs.5) average mean score and standard deviation to be 3. storage of inpa.3 Diagnostic Module tem for the Operations department. of medication lists. format of reports. (Table.75 and 0. instruments The end users satisfaction survey result evident the satis- management and sterile supplies. showed the average mean score and standard deviation as plaints.5. The results indi. Admin module were identified and they were asked to rate This module helps the end user in maintaining all the labo. which are.5) 3 1. The average mean score respect to Diagnostic module in terms of i.5.e. vouchers.688.7 Admin Module The administration module maintains the information sys- 3 1. drug issu- fer.85 and 0. It helps in managing the drug indents.20 and 0.711 which indicated their satisfaction level as tem module were asked to rate their satisfaction level re. A the features of payroll module namely. The mean ing.2 In-patient Module 3 1. accuracy the patient. diet indents have asked to rate their satisfaction level with respect to etc. reduc. 3 1. tracking of patient in.6 Pharmacy Module This module deals with the patient admission. (Table. consultation. Its features include bed 2 end users of Payroll module were identified and they transfer. It helps in managing the manpower (employees) of the hospital. tracking of patient information.49 and the standard deviation 0. It also provides the 127.743. 3. stock management. request handling. complete stock report.5) 3 1. who were the actual users and hence. procedure and surgery listing and reports.8 Payroll Module It is the Human Resource Management module. issuing and dispens- treatment.5. It 3 1. score and standard deviation being 2 and 0. (Table. the expired medicine list.675 which reported the above feature was found to be 3.e. (Table. Around 93 end users were asked patient module namely.56 and 0. complaint re. biomed waste management. (Table.05 and 0. 26-33 found to be 2. The mean score and stan- score and standard deviation of the response related to the dard deviation being 3.5.5) 3 1. satisfaction level as moderate to very satisfy. inpatient billing. sales details of a particular item and rated their response with respect to the features of in. pay slip issuing.5. About 100 users rated their satisfaction with of data.5) noted the satisfaction level as moderate with the features of in-patient module.9 Accounts Module ment system. drug indents.5) garding its features i. their response regarding their satisfaction level with fea- ratory and radiology investigations during the treatment of tures such as report generation. test requisi. 3 1. (Table. storage of em- total of 76 end users found to be using WMS where they ployee information. com- plaint registering. results handling.4 Ward Management System (WMS) provides facilities for employee’s salary management and This module manages the nursing services provide by the calculation of provident fund and professional taxes. drug indents. Only nursing staff in the inpatient wards. 84 respondents. service management.5) The end users of Accounts module were asked to reveal their satisfaction level regarding its features. and stock management. tures of pharmacy module namely. discharge and OT management. tions. billing. report generation This signified the overall satisfaction regarding the admin and information on investigations.5 and 0. masters and statistics.715 of the response showed the satisfaction level as moderate with the ward manage. The result indicated the overall cated the overall satisfaction with the above features as satisfaction of the respondents with the features of out. pp.5) surgery listing and reports.5. display tion of duplicate work. bed trans. faction level as moderate with most of the feature of 31 . stock management. The average mean ward management system namely. The 127 end users of equipment management sys. order handling. (Table. drug indents.565 revealed formation. It helps to track the information about the inpatients. audit management. The result showed the module as moderate. QUALITY Management in health XVIII/3/2014.750 and indicated the overall satisfaction as moderate to very satisfy. rectification of complaints. procedure and of payroll module. financial reports. and purchase management. that the end users were slightly satisfied with the feature porting.5. (Table. TDS and other reports. to rate their response about their satisfaction with the fea- tient information.5. salary management.

exe ver- ing patient discharge. over time. They were also asked to and use to take more time to respond and delay the rate their satisfaction on a five point Liker scale from Ex- processes of patient admission. The issues were studied and Provident Fund Calculation (n=2) discussed and recommendations to solve the 7 Payroll Module: 2 2 issues were communicated to the Chief Op- Pay slip issuing proper (n=2) erating Officer.2 Implementation of recommendations 3 Ward Management System 5 1 2 2 1 During the survey. • Outpatient Module: In File Management page of out. sugges- NICU-3rd consultation visit added (n=2) tions to the related issues. ES= Extremely satisfied. functionality of hospital information system. Changes suggested Implemented ES VS MS SS NS after they resigned and left the hospital. issues were department and module specific and needed • A diet masters is created in the Dietetics module and improvement to enhance the level of acceptance. tremely Satisfied to Not Satisfied on a score of 5 to 1. 8 Payroll Module: 2 2 The recommendations related to the above Loss of pay and extra earnings calcula. when the files are avoid unnecessary waiting time and queue in the out- returned in the MRD. module. These turns in the final bill of the patient. VS=Very satisfied.In some systems run time errors used issues and given recommendation to improve the overall to happen while staff performed their work. • To avoid run time errors. Another issue was the Token system • Multiple options for entering the consultation visits is for patient queue which was not present in outpatient added in the NICU module.Response related to Post Implementation Satisfaction Survey The pay slip was send to employees even S l . NS=Not satisfied. adding multiple visits of the consultant. During the survey. • A token system is started in the outpatient module to patient module. SS=Slightly satisfied. During post implementation survey. cal record module was corrected to avoid MS= Moderately satisfied. Due to this. f=Frequency any confusion. not shown in the billing sheet which uses to create • The error related to the calculation of provident fund confusion among patients. total of 25 end users were identified who have raised the • Run time errors. the nurses used to manage the diet indent given suggestions during the initial satisfaction survey. pp. The NICU In-charge felt and extra allowance is rectified in the payroll module. from Windows 8 to XP. extra wages were not calculated 1 Outpatient Module: 1 1 by the system. end users also provided Diet intend started ( n= 5) suggestions to improve the overall perform- 4 Outpatient Module: 3 1 2 ance of HIS.3 Results of Post Implementation Satisfaction Survey lated to the specific diet plan were not present in the The objective of the study was to assess the end user satis- diet indent of WMS. • Payroll: The provident fund calculation was not accu. all the respondents rate which caused the staff to calculate it manually. 26-33 QUALITY Table 6 . dents were asked to state whether the issues are resolved The emergency room system were found to be slow and changes are implemented. the pharmacy return amount is sion software better. IT Manager and the vendor. A manually. issues given and implemented were: tion (n=2) 9 Run time errors (n=14) 14 5 7 • The issues related to the date for updat- 10 System slow (n=9) 9 6 3 ing of status of medical record in the medi- Note: n= total number of actual respondents. 3. the respondents pointed out the final bill sheet is included to show the pharmacy re- issues related to the overall functionality of HIS. nurses were finding faction towards implemented recommendations. were found to be satisfied with the changes 32 . if any and imple- 6 Payroll Module: 2 1 1 ment the same. that the inpatient module should have the provision for Even the pay slip issuing issues is also resolved. Management in health XVIII/3/2014. This re. the date of all the entries use to patient department. As the objective of the study Token system started (n=3) 5 Inpatient Module: 2 2 was to provide recommendations. The respon- quires the staff to do the entire work all over again. The vari- also trained the staff to use diet indents in ward man- ous issues identified are listed below as per the module: agement system. while marking “IN”. • A head called Pharmacy Return in IP HIS. No Yes No f f f f f Additional allowances such as loss of pay. ple included only those who had pointed out issues and Hence. • Ward Management System (WMS): The features re. as XP supports the . File management date corrected (n=1) 2 Inpatient Module: 5 5 Pharmacy Return head added (n=5) 3. the system is downgraded • IP Module: While preparing the final billing sheet dur. change including those which were returned in the previous days. The sam- difficult to indent the specific diet from cafeteria.

nih. Milstein.ncbi. 2012. Technical and Human Challenges of Implementing Hospital Information Systems in Saudi Arabia. Todd PA . 2010. TBS. 8. Adler.pdf. et. 2010 Vol. Physicians use of and attitudes toward electronic medical record system implemented at a teaching hospital in Saudi G. 18. [Cited on 2014 May 12] Available from: www. R.yuntech. ZohrehMohammadi. Abdullah AA. 17. 2003 10. T C Edwin understanding-of-end-user-information-systems-satisfaction-formation-an-equitable-needs-fulfillment-model-approach. The result showed that almost all the a separate medical record department module has been users were satisfied with overall functionality of the sys- identified.ncbi. Confidentiality. Indah Mohd Amin. Hospitals – Facilities Planning and Management. During the survey. Available from: http://virtualmentor. Extending the understanding of end user information systems satisfaction forma- tion: An equitable fulfilment model approach. [Cited on 2014 March 5]Available from: http://www. Jusop M. No. 2014. [Cited on 2014 May 22]. Available from: www. [Cited on 2014 March 22]. Availablefrom:www. Nour El Din. Hospital Information System. 82(5-6). The Journal of the Egyptian Public Health Association. Overcoming barriers to adopting and implementing computerized physician order entry systems in US hos- pitals. et. W T Eric Ngai. The end users also lacked a proper platform to with the changes. Available Some dissatisfaction existing among the end users is ment staff to perform all their functions using a single because of not addressing the user requirements and not module. 2012. ACKNOWLEDGEMENT The study investigated the satisfaction of end users to- We are thankful to the hospital authority for allowing us wards the hospital information system and establishes a to conduct the study. Wixom BH. International journal of medical informatics. Perceptions. 184-190. 125-127. 2st Ed. 23(4).pdf no1/45-H00097. A theoretical integration of user satisfaction and technology acceptance.Available from: www. [Cited on 2014 May 18]. J. W. 7. SimaAjami. 347-364. healthcare. CONCLUSION conduct similar studies in the future to achieve maximum Hospital Information System plays a vital role in modern sustainability of Hospital Information System. the requirement of among end users. and Security. tem.2.aspc?alld=4464 16. Electronic Health Record: Privacy. [Cited on 2014 April 3] Available from: www.nih.healthcareglobal. G. Mohamed Khalifa.html. success and improvisation. 16.100011. (Table. 2007. Laurinda B. Bates. pp. QUALITY Management in health XVIII/3/ /articles/ PMC1480209.html 9.lib. 2014. 2. Information System. On the other hand. The Facts About Job Satisfaction. Extend of Use. 13. 2004 3. [Cited on 2014 May 18].org/journals/ 11. Ammenwerth Evaluation of clinical Information systems.nlm. Assessing User Satisfaction of using Hospital Information System (SIS) in Malaysia. and Knowledge of a Hospital Information System by Staff Physicians. Hospital Information System (SIS) Implementation In A Public Hospital: A Case Study From Malaysia. The same is communicated to the IT manager and involving them during the design and implementation of implemented where all the end users found to be satisfied the system. [Cited on 2014 February 14] Available from: GAtewayLink.wikipedia. and D. Norman Au.nlm. Hayajneh.pdf news_archive/industry-focus/management-best-practices/benefits-hospital-information-system.fareastjournals. 26-33 made to the system.ama-assn. et.ncbi.nlm. 75 (2). . 2011. [Cited on 2014 May 24].org/wiki/ Hospital_information_system. 14. 2nd Ed. Training and its Impact on Hospital Information System (SIS) Success.2004. 85-102. What can be evaluated and what cannot? [Cited on 2014 May 22]. McGraw Hill. Available from: hayajneh. Kunder. et.system-SIS-success-2165- 12.php/ jhidc/article/view/111.nih. 2006. Carrie Bloomfield. Hospital Management and Information System. 15. Health Affairs. 5. Harman. Available from: http://www.startlogic. Yaseen A. end user satisfaction is criti- cal for the existence of information system itself. Medical Informatics. firm system to continuously improve the satisfaction References 1.nih. Proceedings of the International Conference on Social Science and Humanity. Mohan Bansal. D. The need identified was to 4. Mohd-Fadhil NF. 2005. [Cited on 2014 February 14]. [Cited on 2014 April 28]. Jour- nal of Health Informatics in Developing Countries [JHIDC]. [Cited on 2014 May 12] Available from:www. [Cited on 2014 April 10] Available from: http://misq.6) express their issues regarding the hospital information system and therefore most of their issues remained unad- dressed by the administration. Health information systems: Failure. Paperless healthcare: Progress and challenges of an IT-enabled healthcare 33 . Available from: www.pdf. 2010. as it was raised by the medical records depart. [Cited on 2014 May 5] Available from:http://www. Benefits of hospital information system. Busi- ness Horizons.