Electronic Recording Culture among Maternal and Child Health Workers: A Case Study of E-RM Implementation at Adina Wonosobo Maternity Hospital
DOI:
https://doi.org/10.56359/igj.v4i1.728Keywords:
Electronic Medical Records, Recording Culture, Maternal and Child Health Workers, Qualitative Study, Digital Transformation, RSIAAbstract
Background & Objective: Digitalization in healthcare systems has driven the implementation of electronic medical records (EMR) as the primary means of improving the efficiency and quality of medical documentation. However, the successful implementation of EMR in specialized hospitals such as RSIA is greatly influenced by the work culture and recording practices of healthcare workers. This study aims to explore the electronic documentation culture among maternal and child healthcare workers at RSIA Adina Wonosobo, focusing on user perceptions, socio-cultural barriers, and adaptation strategies toward the EMR system.
Method: This study employs a qualitative approach with an intrinsic case study design. Data were collected through semi-structured in-depth interviews, non-participatory observation, and document review. Analysis was conducted using a thematic approach through inductive coding stages.
Result: The study findings indicate that healthcare workers' perceptions of EMR are ambivalent; the system is seen as facilitating data access but also increasing administrative burdens. Cultural barriers such as the dominance of manual record-keeping, resistance to change, and low participation in system design pose significant challenges. However, adaptive strategies were identified among younger healthcare workers, including peer training, utilization of underutilized system features, and hybrid record-keeping practices.
Conclusion: The implementation of EMR in RSIA requires a socio-technical approach that is responsive to the values, perceptions, and work practices of healthcare workers. This study emphasizes the importance of user involvement in the digital transformation process and offers policy recommendations to strengthen a sustainable electronic recording culture in maternal and child health facilities.
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Adrian, V., Sari, I. R., & Hikmahrachim, H. G. (2021). Application of executive information system for COVID‑19 reporting system and management: An example from DKI Jakarta, Indonesia. arXiv.
Agustiany, A., Andriani, D., & Suwardhani, Y. (2024). Kualitas rekam medis elektronik dalam meningkatkan produktivitas dan keselamatan pasien: Studi di RSIA Mutiara Putri, Bandar Lampung. Intisari Sains Medis, 13(2), 54–62. https://doi.org/10.21609/jsi.v13i2.544
Al‑Shorbaji, N., et al. (2019). Adoption of eHealth strategies in maternal and child care: A WHO perspective. BMJ Global Health.
Amin, et al. (2021). Implementasi rekam medis elektronik: Sebuah studi kualitatif. Jurnal Teknik Informatika dan Sistem Informasi, 8(1), 430–440.
Björvell, C., Thorell‑Ekstrand, I., & Wredling, R. (2000). Development of an audit instrument for nursing care plans in the client record. Quality in Health Care, 9(6), 6–9.
Choi, Y., et al. (2019). Impact of digital literacy on acceptance of EHR among nursing staff in rural hospitals. BMC Medical Informatics and Decision Making.
Gupta, S., et al. (2022). User readiness and acceptance of EMR: A cross‑sectional study among midwives in Indonesia. International Journal of Medical Informatics.
Hapsari, E., & Mubarokah, I. (2023). Analysis of readiness for electronic medical record (RME) implementation. arXiv.
Hoque, R., & Sorwar, G. (2017). Understanding factors influencing the adoption of mHealth by the elderly: An extension of TAM. Health Informatics Journal.
Hossain, M. K., Sutanto, J., Handayani, P. W., Haryanto, A. A., Bhowmik, J., & Frings‑Hessami, V. (2025). An exploratory study of electronic medical record implementation and recordkeeping culture: The case of hospitals in Indonesia. BMC Health Services Research, 25, 249. https://doi.org/10.1186/s12913-025-12399-0
Janett, & Yeracaris. (2020). Analisis keberhasilan implementasi rekam medis elektronik dalam meningkatkan efisiensi dan mutu pelayanan. Jurnal Kesehatan dan Kedokteran.
JMIR. (2024). The ICT maturity assessment at primary health care services across nine provinces in Indonesia: Evaluation study. JMIR Medical Informatics.
Juliansyah, R., Aqid, B. M., & Salsabila, A. P. (2024). Analysis of readiness of EMR at Cahaya Sangatta MCH Hospital. IJRSS, 4(5), 20–28. https://doi.org/10.47505/IJRSS.2023.V4.5.2
Juliansyah, R., et al. (2024). Implementation of EMR system in Indonesian health facilities: Benefits and constraints. arXiv.
Kumar, R., & Sharma, V. (2022). Cultural factors influencing electronic recordkeeping in maternity hospitals. Journal of Nursing Management.
Lee, E., & Kim, H. (2020). Electronic health record adoption among nurses: A structural equation model approach. Computers in Biology and Medicine.
Liu, F., et al. (2023). Training and digital competence of midwives in ASEAN countries for EMR usage. Asian Journal of Nursing Research.
Mayasafira, S. D., & Almansoob, M. (2024). Electronic medical records as digital transformation in Indonesian health services 4.0. International Journal of Nursing and Midwifery Science, 8(2), 229–239.
Moore, L., et al. (2025). Nurses’ perceptions on the usability of electronic health records: A scoping review. Science of Nursing and Health Practices. https://doi.org/10.62212/snahp.130
Mutiara, A. B., Muslim, A., Oswari, T., & Miharja, R. A. (2012). A model of OpenEHR based electronic medical record in Indonesia. arXiv.
Nanda, et al. (2019). Utilisation of electronic health records for public health in Asia. Journal of Clinical Medicine.
National Client Safety Agency. (2007). Recognising and responding appropriately to early signs of deterioration in hospital clients. NPSA, London.
Novianti, N., & Bakhtiar, H. S. (2023). Implementation of electronic medical record system in Indonesia viewed from perspective of legal certainty. International Journal of Engineering Business and Social Science, 2(4), 1114–1122.
Open Nursing Journal. (2018). Description and validation of nursing diagnosis using electronic documentation: Case studies in mother and child hospital Indonesia. Open Nursing Journal.
Palanisamy, S., et al. (2021). Barriers to EMR adoption in South Asia: A systematic review. Journal of Global Health.
Pérez, M., et al. (2020). Electronic documentation quality and challenges: Comparative study in perinatal units. International Journal of Nursing Studies.
Ritonga, & Ayuningtyas. (2019). The benefits of electronic medical records reviewed from economic, clinical, and informational perspectives. Jurnal Teknik Informatika.
Santoso, Y., et al. (2019). Challenges and proposed model in implementing integrated medical record systems in Indonesia. IJAST, 13(1), 1–15. https://doi.org/10.33832/ijast.2019.130.01
Sawitri, F., & Rahman, A. (2024). Effectiveness and user satisfaction of EMR in Indonesian private hospitals. SEEZJPH.
Scheibner, et al. (2021). Benefits, challenges and contributors to success for national eHealth systems implementation: A scoping review. arXiv.
Setyadi, & Nadjib. (2023). Implementasi rekam medis elektronik: Studi kualitatif. Jurnal Teknik Informatika dan Sistem Informasi, 8(1), 430–440.
Susanti, A. I., et al. (2022). Midwifery continuity of care in Indonesia: Initiation of mobile health development integrating midwives’ competency and service needs. International Journal of Environmental Research and Public Health, 19(21), 13893. https://doi.org/10.3390/ijerph192113893
Tan, X., et al. (2021). Healthcare provider’s readiness for digital record adoption in low‑resource settings. Global Health Action.
Vimalachandran, P., Wang, H., Zhang, Y., Heyward, B., & Whittaker, F. (2018). Ensuring data integrity in electronic health records: A quality health care implication. arXiv.
Wang, N., Hailey, D., & Yu, P. (2011). Quality of nursing documentation and approaches to its evaluation: A mixed‑method systematic review. Journal of Advanced Nursing, 67, 1858–1875.
Wiley, et al. (2012). mHealth for midwives: A call to action. Journal of Midwifery & Women’s Health.
Windari, A., et al. (2023). Exploring stakeholder experiences with electronic medical records…. ResearchSquare.
World Health Organization. (2018). Digital health interventions for maternal and child health: WHO guideline. WHO
Yumul, A., et al. (2023). Exploring digital culture and recordkeeping behaviour among healthcare staff in Southeast Asia. Health Informatics Journal.
Zhang, Y., Yu, P., & Hailey, D. (2012). Comparison of quality of electronic versus paper‑based nursing admission forms in Australian aged care facilities. International Journal of Medical Informatics.
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