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GROUP TASK

STRATEGY FOR SUCCESSFUL ACCELERATION OF USAGE

ELECTRONIC HEALTH RECORDS OF HOSPITALS IN INDONESIA

IN NURSING THEORY IMPLICATIONS

Compiled to fulfill the assignment of the Nursing Science course

Supporting Dosage:
Ns, Satriya Pranata , M.Kep, Ph.D
Dr. Siti Aisah, S.Kep., M.Kep., Sp.Kom

GROUP 4
MANAGEMENT SPECIALIZATION

SRI HANDAYANI G4A022004

IDA FARIDA KOMALA G4A022002
NAU'UL MASDARYAH G4A022025
EDY RAHARJA G4A022024
EDY PURWANTO G4A022029

MASTER OF NURSING STUDY PROGRAM

FACULTYNURSING AND HEALTH SCIENCES

MUHAMMADIYAH UNIVERSITY SEMARANG

 2022
STRATEGY FOR SUCCESSFUL ACCELERATION OF USAGE

ELECTRONIC HEALTH RECORDS OF HOSPITALS IN

INDONESIA

Ida Farida Komala1, Sri Handayani2, Nau'ul Masdaryah3, Edy Raharja4, Edy Purwanto5,
Satriya Pranata6, Siti Aisah7

Master of Nursing, University of Muhammadiyah Semarang

1-5

Lecturer and Health Sciences, Muhammadiyah University Semarang, Indonesia

6-7

1. Abstract

Information technology has a major and fundamental role in the management of

the distribution and storage of information in nursing services. To improve the quality of
service and keep abreast of developments in science and technology, it is necessary to
change the recording of manual documentation on paper to transition to EHR (Electronic
Health Records).Transition Theory is very appropriate to be applied in implementing
strategies to accelerate usage acceleration EHR (Electronic Health Records).The purpose
of this paper is to find out the strategy for accelerating the implementation of the EHR
(Electronic Health Record). The key to successful EHR (Electronic Health Record)
implementation in hospitals is inseparable from the government's participation in
preparing policies related to EHR (Electronic Health Record)
implementation.Implementation of usage acceleration EHR (Electronic Health Records)by
conducting training and education, financial support, system selection EHR (Electronic
Health Records), and implementation of phased implementation.

Keywords: Acceleration of Electronic Health Record, Transition theory

2. Background

Information technology has a large and fundamental role in the management,

distribution and storage of information in nursing services. Health information is
expected to improve the quality and continuity of patient care and treatment [1]. At first
health records were done manually using paper records. This causes a lot of kerrors in
recording, errors in taking medical action, delays in obtaining the required medical data
and can also result in delays in medical treatment of patients.

3. Aim
The purpose of writing this article is so that we can analyze strategies for the
success of EHR (Electronic Health Record) in Indonesia. In addition, we will know what
obstacles or problems will arise if we apply EHR in the hospital. Moreover, there is a
change in habits in writing manually in medical records to electronic medical records,
there must be many obstacles,

Based on this, it is necessary to make changes to deal with these problems in

accordance with developments in technology and information in the world of health.EHR
use (Electronic Health Records) is a product of the development of science and
technology which has been growing in recent years. This relates to the healthcare
industry's efforts to do everything necessary to provide better quality medical services as
well as increase the profitability of the hospital business.During in the last decade in
western countries, handwritten nursing documentation has been replaced by electronic
nursing documentation and integrated into nursing documentation EHR (Electronic
Health Records).

EHR (Electronic Health Records)is a comprehensive electronic record of patient

health information which is an integration of several health information databases. The
information provided includes patient demographics, progress notes, problems,
medications, vital signs, past medical history, immunizations, laboratory data, and
radiology reports.[2]. Documentation EHR (Electronic Health Records) can be filled in by
health service providers ranging from doctors, nurses, dentists, and others with the aim of
increasing efficiency, accuracy and reducing recording time which often takes a long
time. This system is carried out in a computerized way so that it requires HR where the
HR records the results of the documentation into the computer which can then be
accessed by other medical members. Making it easier for nurses when searching for
patient data or continuing patient documentation when changing shifts.

Several studies conducted in different health care settings show that EHR
(Electronic Health Records) assisting health workers in reducing medical errors,
coordinating effective care, increasing safety and quality and reducing treatment
costs.EHR (Electronic Health Records) has been proven to play an important role in the
improvement of health service information systems. The main driver for the increasing
interest inEHR (Electronic Health Records)including the need to increase efficiency in
the delivery of health services, improve patient safety, improve access to health care
services, reduce medical expenses.

The implementation of EHR (Electronic Health Record) is a demand and need for
every health service facility that is triggered by efforts to improve the quality of health
services. This requires a shared understanding of the EHR implementation strategy. The
key to successful implementation of the EHR (Electronic Health Record) in Indonesian
health services is inseparable from the government's participation in preparing policies
related to the implementation of the EHR (Electronic Health Record). For that we need a
strategy to accelerate the use of EHR (Electronic Health Record) in Indonesia.

4. Transition Theory
Transition Theory is included in Nursing Theories which are very appropriate to
implement in the implementation of strategies to accelerate usage EHR (Electronic
Health Records). This theory aims inprovides a framework for identifying the experiences
of people who have had to face life and cope with situations that require the development of
new skills and behaviors[3]. A transitional condition is a condition that affects the way a
person moves from a transition, and is facilitated towards the process of achieving a
health transition. Transition conditions include individual, community or social factors
that will accelerate or prevent the process and achievement of health transitions.There are
four main types of transitions:
a. Developmental transitions include changes related to birth, adolescence, aging, or
motherhood
b. Situational transitions are based on personal experiences such as death or
rehabilitation of a family member.
c. The health transition combines the diagnosis of an unknown disease and the need
for intervention.
d. Organizational transitions can be caused by unexpected environmental changes.

In accelerated applicationsEHR (Electronic Health Records)The type of transition

used is an organizational transition where the hospital organization chooses to make
changes in accordance with the development of science and technology that is developing
in the world of health. With the hope that there will be changes from manual health
documentationpaper/paper transition usingEHR (Electronic Health Records).
General concept of Meleis theory[4]:

a. Types and patterns of transitions that can be in the form of developmental

transitions (growth), health and illness (health-illness), situational and
organizational. Situational and organizational transitions are organizational
changes that lead to changes in recording paper-based documentation to based
documentationEHR (Electronic Health Records).
b. The nature of the transition experience includes awareness, engagement,
changes and differences, time span, and critical points and events. The main
point is the awareness of every member of the Hospital to make progress
changes to keep up with the times and advances in science and technology.
c. Transition conditions (facilitators and inhibitors), namely motivation and
innovation from hospital management in influencing hospital members
through the transition process, facilitating, in order to achieve a healthy
transition. Transitional conditions consist of personal conditions, community,
or social factors.
 d. Response patterns include feeling connected, interacting, location and being
positioned, and developing confidence and coping. Feeling connected to the
need for interpersonal relationships in hospitals in interacting to support each
other in dealing with transitional changes to develop forward together to
improve service quality in accordance with scientific developments so that it
will foster a sense of togetherness and confidence in hospital development
e. Nursing therapeutics, as a communication measurement tool that is widely
applied to therapeutic interventions during transition.
A healthy transition is marked by both process and outcome indicators. The
transition takes place over time, identifying process indicators that move the client
toward health or toward vulnerability and risk that the nurse facilitates to facilitate
healthy outcomes[2]

5. Intervention Transition Theory in the strategy of successful acceleration of use

EHR (Electronic Health Records)
a. Training and Education
Provide outreach, training and guidance on activities EHR (Electronic Health
Records) to hospital management and all hospital staff.
b. Financial support
Influence management decision makers in hospitals in the allocation of budgetary
needs EHR (Electronic Health Records)
c. System selection EHR (Electronic Health Records) right
Manager executive management EHR (Electronic Health Records) determine
system usage EHR (Electronic Health Records) appropriate for all activities in the
hospital according to the needs and type of hospital
d. Phased implementation
After carrying out a series of interventions above, the manager implements them
EHR (Electronic Health Records) gradually, so that Implementation activities EHR
(Electronic Health Records) in the field is acceptable and runs according to the
expectations of the hospital.
Transition Theory is a the transition process carried out to improve quality and
services in hospitals in improving the system so that it is hoped that it will achieve positive
outcomes or healthy transitions in carrying out the accelerated processEHR (Electronic
Health Records). There is a situational transition where the organization and management
of the hospital make system changes that are better in accordance with the development of
science and technology.
This transitional condition is due to the condition of changing from manual
recording to electronic recording so that it requires cooperation and commitment from all
parties within the scope of the hospital to make changes. There is a pattern of response,
interaction, mutually agreed in carrying out transitional changes in implementationEHR
(Electronic Health Records) dan establishment of communication, having the same vision
and mission towards progress in improving hospital services in line with current
developments in science and technology.

The implementation of EHR (Electronic Health Record) is a demand and need for
every health service facility that is triggered by efforts to improve the quality of health
services. For this reason, a shared understanding is needed in the strategy to accelerate the
implementation of the EHR (Electronic Health Record). The key to successful EHR
(Electronic Health Record) implementation in hospitals is inseparable from the role of the
government in preparing policies related to the implementation of EHR (Electronic Health
Record) such as standardization of the appropriate EHR (Electronic Health Record) model
in Indonesian health care facilities and the availability of government regulations. related
to the implementation of EHR (Electronic Health Record).

This information can be a rationale for hospital service institutions in using the
EHR (Electronic Health Record) according to the internal context Transition Theory
whereuseEHR (Electronic Health Records )in the hospital based on situational
developments in the hospital environment, looking at the implementation process EHR
(Electronic Health Records), evaluate implementationEHR (Electronic Health
Records)and implement accelerationEHR (Electronic Health Records) in the hospital

6. Conclusion

The strategy for accelerating the use of the EHR (Electronic Health Record) is a
process from the Transition Theory Meleis regarding the transition from the use of manual
documentation to the EHR (Electronic Health Record). This change will affect the quality
of hospital services and will improve the quality of the nursing profession in accordance
with what will be accepted to be applied in the nursing profession.
 Authority in decision making for the use of acceleration EHR (Electronic Health
Records) in hospital management by taking into account the implementation of use
interventions EHR (Electronic Health Records). Implementation of use EHR (Electronic
Health Records)by conducting training and education, financial support, system selection
EHR (Electronic Health Records)and implementation implementation EHR (Electronic
Health Records) gradually.
 BIBLIOGRAPHY

1. Hellesø R, Ruland CM. Developing a module for nursing documentation integrated in

the electronic patient record. J Clin Nurs 2001;10(6):799–805.

2. ibrahim Meléis A. Transitions theory : middle-range and situation-specific theories in

nursing research and practice. 2010.

3. Nursing_ Transitions Theory by Afaf Ibrahim Meleis _ Free Essay Example.

4. Paech M. Nursing Theorists and Their Work (6th edn). 2007.