Jurnal Administrasi Kesehatan Indonesia Volume 9 No 1 June 2021

Published by Universitas Airlangga

doi: 10.20473/jaki.v9i1.2021.23-32

ORIGINAL RESEARCH

ANALYSIS OF HOSPITAL INFORMATION MANAGEMENT

SYSTEM USING HUMAN ORGANIZATION FIT MODEL

Analisis Sistem Informasi Manajemen Rumah Sakit dengan

Human Organization Fit Model
Husnaina Febrita1, Martunis2, *Dedy Syahrizal1, Munifah Abdat3, Bakhtiar4
1Faculty of Medicine, Syiah Kuala University, Banda Aceh, Indonesia
2
Aceh Health Training Center, Aceh Health Department, Banda Aceh, Indonesia
3
Faculty of Dentistry, Syiah Kuala University, Banda Aceh, Indonesia
4Department of Pediatrics, Faculty of Medicine, Syiah Kuala University, Banda Aceh, Indonesia

*Correspondence: dedysyahrizal@unsyiah.ac.id

ABSTRACT

Background: Hospital is a health care institution that provides public services for patients. It needs computerized
information technology, for example, a hospital information management system.
Aims: This study was aimed at analyzing the implementation of hospital management information system using
the human organization fit model at the Outpatient Department of Sabang General Hospital.
Methods: This study was conducted from March-June 2020 using a cross sectional design. The study’s
population was the hospital managers, administration staff and health workers at the hospital. The study’s sample
size was 106 respondents selected using a purposive sampling. This study used a quantitative design in which
the data analysis was done using a spearman correlation test with P-value of =<0.05. The independent variables
were the quality of system, quality of information, and quality of care. While the dependent variables included
system user, user satisfaction and organization. The data were collected through questionnaire distributed to the
respondents.
Results: The quality of system did not have a relationship with the system user (P=0.585), user satisfaction
(P=0.541), and organization (P=0.256). The quality of information had a relationship with the system
user(P=0.004) and user satisfaction (P=0.000), but it did not have a relationship with organization (P=0.132). The
quality of care had a relationship with the system user(P=0.000), user satisfaction (P=0.000) and organization
(P=0.000).
Conclusion: The Sabang General Hospital, Aceh, needs to improve the hospital management information
system with the HOT-fit model, especially the quality of system. They can conduct training for users and provide
applicable and attractive manuals.

Keywords: hospital, information management system, quality of care, quality of information, quality of system.

ABSTRAK

Latar Belakang: Rumah sakit merupakan institusi pelayanan kesehatan kepada pasien. Hal ini menuntut rumah
sakit untuk menerapkan teknologi informasi berbasis computer seperti Sistem Manajemen Informasi Rumah
Sakit.
Tujuan: Penelitian ini bertujuan untuk menganalisa penerapan dari Sistem Manajemen Informasi Rumah Sakit
yang menggunakan human organization fit model di Instalasi Rawat Jalan Rumah Sakit Umum Daerah Sabang.
Metode: Penelitian ini dilakukan pada bulan Maret-Juni 2020 dengan desain cross sectional. Populasi penelitian
ini adalah manajer rumah sakit, staf administrasi dan petugas kesehatan. Sampel dalam penelitian berjumlah 106
responden yang didapatkan melalui purposive sampling. Desain penelitian ini adalah kuantitatif dimana data
dianalisis menggunakan korelasi spearman dengan skala ukur didasarkan pada nilai p =<0.05. Variabel
independen dalam penelitian ini adalah kualitas sistem, kualitas informasi, kualitas pelayanan. Variabel dependen
dari penelitian ini adalah sistem pengguna, kepuasan pengguna dan organisasi. Data dikumpulkan menggunakan
kuesioner yang didistribusikan kepada responden.
Hasil: Kualitas sistem tidak berhubungan dengan sistem pengguna (p = 0.585), kepuasan pengguna (p = 0.541),
dan organisasi (p = 0.256). Kualitas informasi berhubungan dengan sistem pengguna (p = 0.004) dan kepuasan
pengguna (p = 0.000), dan tidak berhubungan dengan organisasi (p = 0.132). Kualitas perawatan berhubungan
dengan sistem pengguna (p = 0.000), kepuasan pengguna (p = 0.000) dan organisasi (p = 0.000).
Kesimpulan: Penerapan dari Sistem Manajemen Informasi Rumah Sakit dengan Model HOT-fit di rumah sakit
umum daerah Sabang, Aceh perlu ditingkatkan khususnya terkait kualitas system yang tersedia. Perbaikan
kualitas sistem dapat diperbaiki melalui pelatihan kepada pengguna dan menyediakan sistem yang aplikatif dan
menarik bagi para pengguna sistem.

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 Jurnal Administrasi Kesehatan Indonesia Volume 9 No 1 June 2021
Published by Universitas Airlangga
doi: 10.20473/jaki.v9i1.2021.23-32

Kata kunci: Rumah Sakit, Sistem Informasi Manajemen, Kualitas Sistem, Kualitas Informasi, Kualitas Pelayanan

Received: 24 August 2020 Accepted: 15 February 2021 Published: 24 March 2021

INTRODUCTION implemented system to determine aspects

that improve the use of the system.
Health and information technology is Hospitals can develop this system by
growing rapidly. Currently, the field of considering user needs and factors
health relies greatly on the development of affecting the user and its benefits that the
information technology for fast and precise user obtains (Agustina and Susilani,
services provided to the community 2018). The evaluation of the information
(Saputra, 2016). The information of technology must comprehensively involve
technology can improve types of to the hospital (Erimalata, 2016). The
businesses, increase the efficiency and evaluation of quality of the ongoing
effectiveness of business processes, and information system is necessary to
make management decisions and work determine to which exent it provides
groups for health service providers that services and gain user’s perspective of
can be competitive in an ever-changing their convenience and satisfaction with the
market later (Rusdiana, 2014). A study system (Nofikasari and Sunyoto, 2017).
has shown that information management The health information system could
system can reduce the error rates, improve the patient care and reduce
increase the quality system (Agustina and medication errors, as well as support
Susilani, 2018) and reduce diagnostic clinical decisions effectively (Farzandipou
errors (El-Kareh, Hasan and Schiff, 2013). et al., 2017).
Alotaibi and Federico (2017) assert that an The Human Organization Fit Model
electronic medical record reduces medical proposed by Yusof et al. (2006) is one of
errors and improves patient safety. the theoretical frameworks to evaluate
Hospitals are agencies providing information systems in the field of health
public services that require a good services. It places the most important
information management system. This components in the information system:
system has become a necessity and humans, organizations, technology and
demand for hospitals to implement a the compliance of those components
computerized information and (Diantono and Winarno, 2018). The
communication technology, known as information system considers some
hospital information management system. factors, such as the user, the frequency of
This system is also a perequisite from the use, training for the user, user’s
government to to improve the hospital experience, knowledge, expectations, and
performance, efficiency, effectiveness, attitudes towards the system. The user
professionality, and services. The system satisfaction is the overall evaluation of
implementation is common for all hospitals user’s experience and social impact in
in Indonesia (Peraturan Menteri using information systems (Ayuardini and
Kesehatan, 2013). Ridwan, 2019). The organizational
With the hospital information component views the system from the
management system, hospitals could organizational structure and environment.
manage complicated problems, such as Besides, planning, management, system
medical records and other administrative control, management support, financing
data (Sudiarti, Soepangat and Wiyono, and technology components are evaluated
2019). It is necessary to evaluate the from the system quality, information

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doi: doi: 10.20473/jaki.v9i1.2021.23-32

quality and service quality (Poluan, There were three stages of data analysis:
Lumenta and Sinsuw, 2015). descriptive/univariate analysis and
Larinse (2015) and Saputra (2016) bivariate analysis. The univariate stage
have discovered the quality of the system described variables, and the bivariate
was not related to user satisfaction. Good analysis using a spearman correlation test
user satisfaction and quality system do not identified the relationship between
indicate any problems in terms of human variables (Dahlan, 2017). The dependent
resource variable. Especially, human variables included the quality of system,
resources with high education levels and quality of information, and quality of care.
work experience may perform a high level The quality of system was the user’s
of motivation and productivity (Diantono subjective assessment on the system
and Winarno, 2018). The hospital functions and implementation at the
information management system is hospital. The indicators of this variable
prominent for the hospital development. were its navigation, time to respond, the
Without integrated, comprehensive, up-to- functions and availability of features,
date and sustainable data, it is impossible system reliability, completeness of the
to improve, prepare and consider a large features, system flexibility, and system
amount of funds to improve the efficiency security. This variable was evaluated from
and effectiveness of hospital services some indicators: information
(Saputra, 2016). An evaluation is completeness, accuracy, easy to read,
necessary to identify the implementation punctuality, relevance, and consistency or
of the hospital information management clarity. The quality of care was the user’
system as a reference for policy making assessment on the services requested
from the user’s perspective. Based on the and received from the hospital information
background, this study aimed to analyze a management. Its indicators included
hospital information management system provider’s responsiveness, guarantee,
using the human organization fit (HOT-fit) empathy, and technical support.
model at Sabang General Hospital, Aceh. In addition, the study’s dependent
variables were the system user, user
METHOD satisfaction, and organization. The system
This study was conducted in March- user was the frequency of using the
June 2020 with a quantitative design and information management system app. This
cross-sectional approach. The population variable’s indicators involved navigation,
of this study was the hospital manager, user’s needs and desires. The user
administration staff and health workers in satisfaction was a subjective response to
the General Hospital of Sabang, Aceh. the user’s experience in using the
The initial number of the respondents information management system app. The
were 114 people, but 8 people could not variable’s indicators varied from system
be interviewed did not return the completeness, accuracy, format, easy
questionnaire distributed by the navigation and system accuracy. Another
researchers. The final study’s sample size dependent variable was organization
was 106 respondents selected using a which was assessed from the hospital
purposive sampling technique which took management aspect. App maintenance,
some criteria for the selected repsondents employer commitment, and teamwork
to be more representative. procedures were the indicators of
The analysis indicator was that P- organization variable.
value should be equal or less than 0.05.

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doi: doi: 10.20473/jaki.v9i1.2021.23-32

This study obtained data through making of an organization. It is also an

questionnaire distributed to the output resulted from the input of
respondents. Before conducting the information from various processes to
meet certain objectives in the
research, the ethical approval was given
management activities. The hospital’s
by the Ethics Committee of Health information system can influence the
Research, Faculty of Medicine, Syiah quality of care if properly repaired.
Kuala University, District General Hospital Whether the system works well or not
of Zainoel Abidin Banda Aceh. depends on the quality of information and
types of services offered. An information
RESULTS AND DISCUSSION management system app can support
patient care and administration process in
Respondents’ Characteristics
a relevant and accessible use, as well as
There are four respondents’ flexible format that people in different
characteristics investigated in this study: locations can access. Service transaction
gender, age, education level and type of data are collected, stored, processed, and
work in the hospital structure. documented to generate information about
the quality of patient care and the
Table 1. Respondents’ Characteristics hospital’s service performance and costs.
Characteristics n=106 % The HOT-Fit model is the
development of SI DeLone and McLean's
Gender
success model by adding organizational
- Male 23 21.7
factors and dimensions: structure and
- Female 83 78.3
environment; technological, human and
Age
organizational factors, two ways of
- 20-30 26 24.5
relationship between information quality
- 31-40 49 46.2
and system use, information quality and
- 41-50 28 26.4
user satisfaction, structure and
- 50-60 3 2.8
environment, structure and net benefit,
Education Level
and environment and net benefit
- Specialist doctor 11 10.3
(Pamugar, Winarno and Najib, 2014). This
- Master degree 1 0.9
study found that there are some
- Bachelor degree 34 32.1
meaningful use of the information
- Associate degree 60 56.6
management system. According to
Type of work Ingebrigtsen et al., (2014), the application
- Management staff 15 14.2 of information management system can be
- Health staff 87 82 a capture key patient health information,
- Insurance staff 4 3.8 clinical decision support, facilitate
Source: Primary data
reporting the quality of measures to inform
The number of female respondents quality improvement efforts and to
(78.3%) was more dominant than males facilitate cost of care. The system user
(21.7%). Most of the respondents were at can be assessed from the effects of work,
the age of 31-40 years(46.2%) and had efficiency and effectiveness of the system,
Associate degree (56.6%). The communication, and low error rates by
respondents participating in this study controlling expenses and costs. “Fit” is
were mostly health staff (82%). measured and analyzed using three
factors, such as human, organization, and
Analysis of Hospital Management technology.
Information System Using HOT-Fit
Model Univariate Analysis
A information management system Univariate analysis tests a single
is an integrated system providing variable to identify the characteristics of
information to support the operational the variable.
activities, management and decision

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doi: doi: 10.20473/jaki.v9i1.2021.23-32

The study shows that a half of the Bivariate Analysis

respondents thought the quality of the This study used a correlation
system was lacking (52.8%), and more hypothesis using the Spearmen test to
than a half mentioned the quality of look at the relationship between the
information given was good. The quality of independent variables and dependent
the service was good according to most of variables.
the respondents (61.3%) in this study. Table 3 shows the significance
Around 50 respondents (67.9%) value was greater than 0.05 (0.585>0.05).
considered the hospital has a good It means that the quality of system was not
system user while 50 respondents (67.9%) related to system user. The information
felt dissatisfied with the system. management system is a vital supportting
Additionally, a half of the respondents tool for the hospital’s operational
(51.9%) thought the organization of the management. Quick responses to services
system was good. cause computer networks to be
indispensable. A good computer network
Table 2. Univariate Analysis will have fast and integrated data flow
Variable n=106 % which is also easily monitored. Besides,
Quality of system the test shows the quality of system had
- Poor 56 52.8 no relation with the system user due to
- Good 50 47.2 server damage. The quality of system was
poor because of limited system use
Quality of
(Munzir and Khaira, 2020). The system
information
user by most users affects the quality of
- Poor 46 43.3
the system which naturally affects the
- Good 60 56.6 users (Saputra, 2016). The perception of
Quality of care good quality will increase the user’s
- Poor 41 38.7 enthusiasm to use the system. On the
- Good 65 61.3 other hand, poor quality system will
System user decrease the frequency of use. McGill et
- Poor 50 47.2 al. (2013) supports this assumption by
- Good 56 52.8 saing that that improved perceptions of
User Satisfaction the quality systemmay affect users to use
- Poor 50 47.2 the system.
The bivariate analysis also shows
- Good 56 52.8
that the quality of the system had no
Organization relation with the user satisfaction with the
- Poor 51 48.1 significance value greater than 0.05
- Good 55 51.9 (0.541>0.05). Soraya et al. (2019) asserts
Source: Primary data
the users might gain the benefits of using
better quality system. The improvement of
Table 3. Bivariate Analysis of Quality of information system and the stability of
System. service providers will increase the
Variables Results frequency of system use which leads to
System user improved user satisfaction (Poluan,
- Quality of system r = -0.054 Lumenta and Sinsuw, 2015). User
- Spearman Correlation p = 0.585 (>0.05) satisfaction reflects how far users believe
User Satisfaction in an information system to meet their
- Quality of system r = 0.060 information needs. It was proven that the
- Spearman Correlation p = 0.541 (>0.05) quality of system haaffected on user
Organization satisfaction (Saputra, 2016). If the system
- Quality of system r = -0.111 has technical difficulties, inadequate
infrastructure and errors, it can reduce the
- Spearman Correlation p = 0.256 (>0.05)
Source: Primary data level of user satisfaction (DeLone and
McLean, 2003).

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doi: doi: 10.20473/jaki.v9i1.2021.23-32

Table 3 explains the quality of 0.004. The result shows that the quality of
system was not related to the organization information had a positive effect on the
with the significance level of 0.05 system use. In other words, the better the
(0.256>0.05). This findings might be quality of information, the higher the
triggered by no regular network frequency of the system use (Soraya,
maintenance for either software or Adawiyah and Sutrisna, 2019). Simialrly,
hardware (Mudiono and Hernawati, Sri. (Nurlani and Permana, 2017) discover that
Bukhori, 2018). Contrastly, the quality of the quality of information affected the use
system had a positive effect on the of the information system significantly.
organization (Agustina and Susilani, Moreover, the level of accuracy
2018). Saputra (2016) finds that the and relevance of information data become
organization needs to prepare the human the aspects that determine the quality of
resources to adapt to problems that may information (Yusof et al., 2008). The
occur in the information system app accuracy of information is free from errors
(Saputra, 2016). According to Agustina and unbiased. Meanwhile, the relevance
and Susilani (2018), the organization had of the information measures the benefits
a positive effect on benefits to improve the for the system users (Saputra, 2016). The
system of hospital to be significant and relevance of information for each person
directly. varies. In other words, the quality of
In its use, the users often information is relatively based on the
complained about the information users’ needs. When it meets the needs, it
management system app at Sabang may be able to attract users to use the
Hospital. It indicates that the user system. The respondents agreed that the
satisfaction with the app was still low. The quality of information was good, and thus
hospital management should respond to the use of the system was relatively
the complaints and find alternatives to optimal.
solve it. Larinse (2015) and Saputra The results show the quality of
(2016) find the quality of the system is not information contributed more to the use of
related to the user satisfaction. Good user the application compared to the quality of
satisfaction and system use do not the application and the quality of the
indicate any problems in terms of human service. Besides, it is necessary to
resource variables. Especially, human improve the quality of the system to
resources with a high level of education produce good quality information for the
and work experience may perform a high users (Soraya, Adawiyah and Sutrisna,
level of motivation and productivity 2019). The quality of information by far
(Diantono and Winarno, 2018). had a relationship with the user
satisfaction (P-value=0.000). This finding
Table 4. Bivariate Analysis of Quality of is in line with the research (Soraya,
Information. Adawiyah and Sutrisna, 2019) who find
Variables Results the quality of information could affect the
System user user satisfaction.
- Quality of information r = 0.278 Meanwhile, the quality of
- Spearman Correlation p = 0.004 (<0.05) information had no relationship with the
User Satisfaction organization (P-value=0.132). In another
- Quality of information r = 0.545 study, the quality of information was also
- Spearman Correlation p = 0.000 (<0.05) determined the organizational control
Organization consecutively(Erimalata, 2016). Good and
responsible organizations can support the
- Quality of information r = 0.147
quality of information in the system.
- Spearman Correlation p = 0.132 (>0.05)
Source: Primary data
Bayu and Izzati (2013) assert user
satisfaction can improve if the system is
The bivariate analysis in Table 4 good and precise with the its quality of
explains that the quality of information was technology. (Krisbiantoro, Suyanto and
related to the system user with P-value of Taufiqluthfi, 2015) state user satisfaction

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doi: doi: 10.20473/jaki.v9i1.2021.23-32

had a positive and significant effect on the staff are the aspects of measuring a
use of the system. system (Soraya, Adawiyah and Sutrisna,
The information management 2019). According to (Habiburrahman,
system app provided by Sabang Hospital 2016), leadership of the top management
processes and integrates the entire flow of support and staff also supports the
healthcare management processes success of system implementation.
through coordinated networks, reports and Besides, established policies or rules by
administrative procedures to obtain the hospital management may push the
precise and accurate information quickly. quality of service and care much better.
Higher level of satisfaction suggests that a The implementation of information
hospital has better quality performance system requires to measure the quality of
and employees (Saputra, 2016). the information system which can give
hints on the quality of service and user
Table 5. Bivariate Analysis of Quality of satisfaction (Saputra, 2016). In achieving
Care this target, the hospital management
Variables Results needs to handle complaints quickly to
System user improve the user satisfaction (Nofikasari
- Quality of care r = 0.452 and Sunyoto, 2017). This study further
- Spearman Correlation p = 0.004 (<0.05) uncovers that the quality of information
User Satisfaction system services was poor and had the
- Quality of care r = 0.375 most influence on user satisfaction.
- Spearman Correlation p = 0.000 (<0.05) Therefore, the hospital should prioritize
Organization the quality of service to improve user
satisfaction (Saputra, 2016).
- Quality of care r = 0.360
The successful implementation of
- Spearman Correlation p = 0.000 (>0.05)
Source: Primary data
information management system app is
measured from three components:
The result also shows there was a technology, human and organization. The
relationship between the quality of care information management system app
and system user with P-value of 0.000. measures its technological component
Another study also finds similar result that from the quality of its system, information,
the service quality had a positive effect on and frequency of use It also has
the system user. When the system user something to do with the human
has good qualities, the service quality will component which is assessed from the
be better (Soraya, Adawiyah and Sutrisna, use of the system and user satisfaction.
2019). Each aspect of the technology component
This study also reveals that the affects the use of system and organization
quality of care had a relationship with the (Soraya, Adawiyah and Sutrisna, 2019).
user satisfaction. Another previous study The organizational component will
supports this finding as it finds that the determine the use of the system which
quality of care had a significant positive affects user satisfaction later on. In
effect on user satisfaction (Erlirianto et al., summary, the use of the system, user
2015). Some factors that affect the quality satisfaction, and organizational control will
of care are response speed, assurance, affect the implementation of information
empathy and continued service, and the management system app
user satisfaction is a measure of (Habiburrahman, 2016).
perceived benefits and user attitudes
towards an information system (Ayuardini CONCLUSION
and Ridwan, 2019). The information management
In the same way, the quality of system integrates information to support
care was related to organization with the the organizational operation, management
P-value of 0.00. Another study argues that and decision-making functions. It is an
the quality of care affected an organization output of information system to meet
where the support of top management and certain objectives in managerial activities.

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doi: doi: 10.20473/jaki.v9i1.2021.23-32

The quality of information management 8(4), pp. 75–80.

system is measure from the quality of Alotaibi, Y. K. and Federico, F. (2017)
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Analysis of Hospital 32 Febrita, Martunis, Syahrizal, Abdat, Bakhtiar