Vol. 5, No. 12, December 2024

E-ISSN:2723 – 6692

P-ISSN:2723– 6595

http://jiss.publikasiindonesia.id/

Journal of Indonesian Social Sciences, Vol. 5, No. 12, December 2024 3191

Analysis of Technology Acceptance Model (TAM) on The Use of

Electronic Medical Records in Hospitals

Farah Shania, Vip Paramarta

Universitas Sangga Buana, Bandung, Indonesia

Email: farahshaniaa99@gmail.com, vip@usbypkp.ac.id

Correspondence: [email protected]om

KEYWORDS

ABSTRACT

Electronic Medical Record;

Technology Acceptance Model;

ease of use; usefulness; patient

satisfaction

Hospitals have begun adopting Electronic Medical Record (EMR)

systems to enhance healthcare services and meet service standards.

The Technology Acceptance Model (TAM) has been widely utilized

in research related to technology implementation in the healthcare

sector, including electronic medical record systems. This research

aims to analyze the acceptance of EMR systems in public hospitals

(RSUD) using TAM, focusing on the main variables of perceived ease

of use and perceived usefulness. A qualitative approach was

employed, with data collected through literature review and in-

depth interviews with medical staff at RSUD. The results indicate

that perceived ease of use significantly influences the initial

adoption of EMR, as medical personnel are more likely to embrace

technology that they find easy to use. Additionally, perceived

usefulness plays a crucial role in determining the sustained use of

EMR, particularly when medical staff experience increased work

efficiency and accuracy in managing patient data. This research also

reveals that the implementation of EMR positively impacts patient

satisfaction, enhancing service quality and the speed of information

access. In conclusion, the factors of ease of use and usefulness are

essential in ensuring the successful acceptance and sustainable use

of EMR in public hospitals, as well as contributing to patient

satisfaction.

Attribution-ShareAlike 4.0 International (CC BY-SA 4.0)

Introduction

The development of information technology in the health sector has provided many

opportunities to improve service quality, operational efficiency, and patient data accuracy. One of the

significant implementations of information technology in this field is the electronic medical record

system (RME). RME is a system that replaces paper-based patient data storage methods with digital

technology that allows faster access, secure storage, and ease of information sharing between medical

personnel. According to Rahimi et al. (2018), the application of RME has the potential to improve

clinical efficiency and accuracy in diagnosis and treatment, so that it can have a positive impact on the

overall quality of hospital services.

In Indonesia, many regional public hospitals (RSUD) have begun to adopt the RME system to

support the improvement of health services and meet the service standards expected by the Ministry

of Health. However, the implementation of RME in the hospital cannot be separated from various

challenges. One of the main challenges is the adaptation of medical staff to this new system. The

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transition from manual to digital systems often requires training and adjustment of work habits,

which can cause resistance or difficulty for some medical personnel to adapt. According to Warren

and Diala (2017), one of the keys to the successful implementation of RME is the involvement of all

stakeholders in the change process, including doctors, nurses, and hospital management.

In overcoming these challenges, understanding the acceptance of technology by users is very

important. The Technology Acceptance Model (TAM), developed by Davis in 1989, offers a framework

that can be used to analyze the factors that affect the acceptance of new technologies, including RME.

This model emphasizes two main variables that affect the acceptance of technology, namely perceived

ease of use and perceived usefulness. Rahimi et al. (2018) stated that TAM has been widely used in

research related to the application of technology in the healthcare sector, including electronic medical

record systems, due to its ability to provide an overview of how user perception can affect technology

adoption.

RSUD as a health service institution has the need to ensure that the implementation of RME can

run effectively and efficiently. Factors such as ease of use and perceived benefits by medical staff can

be key in determining whether the RME system will be accepted and used continuously by users.

Garavand et al. (2016) stated that the perception of ease of use greatly affects the readiness of medical

personnel in adopting RME technology, where the easier a system is to use, the more likely it is that

the system will be accepted by its users.

Perceived usefulness is another factor that is no less important in TAM. Utility refers to the

extent to which a user believes that using a particular technology will improve his or her job

performance. In the context of RME, this can mean accelerating access to patient information,

reducing medical errors, and making it easier to carry out clinical documentation. Abdekhoda et al.

(2016a) showed that the perception of usefulness has a significant influence on the intention to use

RME technology among medical personnel, especially in improving work efficiency and accuracy in

clinical services.

However, the biggest challenge of implementing RME comes not only from the technical aspect,

but also from the aspect of user behavior. According to Tavares and Oliveira (2017), the adoption of

technology such as RME is influenced by various social and individual factors related to trust in the

system, readiness to accept change, and support from hospital management. Therefore, an in-depth

understanding of how these factors affect users' decisions to stick with RME in the long term is

essential.

Based on the above background, three problem formulations were obtained. The first problem

formulation is how the influence of the perception of convenience (X1) on the behavior to continue

using RME (Y), the second problem formulation is how the influence of the perception of utility (X2)

on the behavior to continue using RME (Y), the third problem formulation is how the relationship

between the use of RME and the level of patient satisfaction in the hospital.

The novelty of this study lies in its dual focus: analyzing both the behavioral determinants of

EMR adoption (ease of use and usefulness) and their broader implications for patient satisfaction. By

doing so, this research contributes new insights into how hospitals can optimize EMR systems not

only to improve operational efficiency but also to enhance patient outcomes.

This study was made to achieve 2 objectives, namely to analyze the influence of perception of

convenience and usefulness on user behavior in using RME in hospitals and to examine the

relationship between the use of RME and the level of patient satisfaction in hospitals. So, after this

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study was made, several benefits were obtained for individuals and groups. The first benefit can be

used as a basis for an individual to develop research from existing technologies, so that it can add to

the literature on the acceptance of technology in the health sector, especially related to the TAM

model and the factors that affect the adoption of technology in hospitals. The benefits to the agency

are, it can provide input to the management of the hospital regarding the development and

optimization strategy of the use of RME and can help other hospitals in developing a more effective

approach in implementing RME to improve service quality and patient satisfaction

Materials and Methods

Research Approach

This study uses a qualitative approach that aims to understand the phenomenon of acceptance

and use of Electronic Medical Records (RME) in hospitals by referring to the Technology Acceptance

Model (TAM). According to Creswell (2021), qualitative research focuses on exploring the meaning

given by individuals or groups to a phenomenon. In this context, a qualitative approach is used to

explore how medical personnel in hospitals interpret the ease of use and benefits of RME and how

these perceptions affect their behavior in using the RME system sustainably. This research also relies

on library research. The qualitative approach was chosen because it allows researchers to explore

and explore the meaning of individuals and community groups related to the social issues that are the

focus of the research. The qualitative method in this study leads to a deep understanding of human

or social phenomena, by creating a comprehensive picture through words and reporting detailed

views from informants.

The results of the literature review are then discussed in detail in a section called Related

Literature or Literature Review, which will be the basis for comparison with the findings obtained

from this study. Thus, the qualitative approach and literature review are the main methodological

foundations in this study, allowing researchers to understand and describe the social phenomena that

are their focus comprehensively and deeply

The qualitative approach was chosen because it is more suitable for understanding the

experiences, perceptions, and interpretations of RME users, especially in complex contexts such as

hospitals. As explained by Miles and Huberman (1994), qualitative research allows researchers to

understand the context in depth through rich, hands-on experience-based descriptive data.

Research Subject

The research subjects in this study are medical personnel in hospitals who use RME in their

daily work, including doctors, nurses, and medical administrative personnel. Sampling was carried

out by the purposive sampling method, which is to select informants who are considered the most

relevant and have direct experience with RME. According to Sugiyono (2019), purposive sampling is

used in qualitative research to ensure that the samples taken can provide rich and in-depth

information regarding the topic being researched. The number of research subjects is not determined

exactly, but will be adjusted to the saturation point principle, which is when no more new information

is obtained from the informants who have been interviewed.

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Data Collection Techniques

The data collection technique in this study is carried out through three main methods. First, in-

depth interviews with medical personnel at the hospital to explore their perception of the ease and

benefits of using RME. This interview guide is compiled based on the main variables of the Technology

Acceptance Model (TAM), namely ease of use, usefulness, and behavior to continue using (Davis,

1989) (Safi et al., 2018). Second, participatory observation, where researchers make direct

observations of user interactions with RME in daily work situations to see firsthand how medical

personnel use the system (Spradley, 1980). Third, documentation in the form of reports and policies

related to the implementation of RME in RSUD is collected to complement and support the data

obtained from interviews and observations. These three methods are designed to provide a

comprehensive understanding of the reception and use of RME in hospitals.

Data collection in this study was also carried out through literature studies or literature

reviews. This technique involves the process of gathering information from various literature sources

relevant to the research topic. The literature review was carried out with the aim of obtaining a

deeper understanding of the research topic, as well as a source of data and references that support

the formulation of hypotheses.

Data Analysis Techniques

Data from interviews and observations were analyzed using thematic analysis methods to

identify and report emerging themes (Braun & Clarke, 2006). The steps include: collecting recorded

and transcribed data, encoding to break down the data into units of meaning, drafting themes from

similar codes, and interpretation to understand the relationship between ease, usefulness, and intent

to use RME. The validity of the results was tested by triangulation of data, comparing interviews,

observations, and documentation to ensure consistency of findings (Miles & Huberman, 1994).

Results and Discussions

Consumer Perception of RME's Ease of Use

Based on the results of interviews with medical personnel at the hospital, most respondents

stated that they felt that the Electronic Medical Record (RME) system was quite easy to use. They

appreciate the ease of access to patient data and features that make it easy to find information, such

as an intuitive interface and fast data management. This is in line with research that shows that

perceived ease of use is one of the key factors in the adoption of technology in the work environment.

According to Abdekhoda et al., (2016) the ease of use of technology such as RME affects user readiness

to switch from manual to digital systems, as well as increasing the adoption rate among early

adopters.

However, some respondents also mentioned challenges in early adoption, especially related to

training and adaptation needs. This indicates that while RME has easy-to-use features, user readiness

in terms of technological capabilities is also an important factor to consider to ensure successful

adoption.

Effect of Ease of Use on User Behavior

Further discussion of interviews and literature reveals that the perception of ease of use greatly

influences user behavior in adopting and continuing to use RME. Users who feel that RME does not

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require a large effort to operate are more likely to maintain the use of this technology in the long term.

This is supported by research by Mudavadi et al. (2016), which shows that systems with user-friendly

and simple interfaces are accelerating the adoption of technology in hospitals. The discussion from

the interview also confirmed that ease of use increases productivity and reduces time spent on

administration, which is highly valued by medical personnel.

Benefits and Relevance to Users' Desire to Continue Using RME

In addition to ease of use, perceived usefulness was also found to be the main factor influencing

users' desire to continue using RME. Medical professionals who feel that RME helps them improve the

efficiency and accuracy of their work, especially in the management of patient data and the medical

decision-making process, are more likely to continue using this system. Research by Rago and Zucchi

(2020) shows that the perception of utility, especially related to access speed and error reduction,

plays an important role in improving the sustainability of RME use.

The results of the interviews support these findings, where most medical professionals say that

RME makes it easier for them to access patient data quickly and accurately, which is essential for

effective medical decision-making. Thus, the positive perception of the benefits of RME contributes

to the user's intention to continue using this technology.

The Relationship between RME Use and Improved Patient Satisfaction

The use of RME was also found to have a significant impact on patient satisfaction. Based on

interviews, many medical personnel reported that RME improved the quality of service, especially in

et al. (2020), which states that RME allows patients to feel more involved in their treatment process,

ultimately increasing their satisfaction levels.

Research by Wali et al. (2020) also supports these findings, by showing that patients in clinics

that use RME are more satisfied with the speed and quality of service compared to clinics that still use

paper-based medical records. Therefore, the use of RME not only improves the internal efficiency of

hospitals, but also improves the overall patient experience, which is an important factor in

maintaining the quality of healthcare services.

Integrated TAM Analysis

By synthesizing the findings through the TAM framework, this study provides a comprehensive

understanding of the factors driving EMR adoption and sustained use. The analysis demonstrates that

both perceived ease of use and perceived usefulness are interdependent and mutually reinforcing.

While ease of use facilitates initial adoption by reducing resistance, usefulness ensures sustained

engagement by delivering tangible benefits to users.

Furthermore, the findings highlight the necessity of addressing external factors, such as

training programs and organizational support, to maximize the potential of EMR systems. As

suggested by Warren and Diala (2017), successful technology implementation requires a holistic

approach that integrates user feedback, adequate resources, and management commitment.

Implications for Practice and Policy

The results of this study have several practical implications for hospital management and

policymakers. First, the development of user-centric EMR systems with intuitive interfaces should be

prioritized to encourage widespread adoption. Second, investment in training and capacity-building

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programs is essential to address user resistance and skill gaps. Lastly, fostering interoperability

between EMR and other hospital systems can amplify the perceived usefulness of these technologies,

enhancing their overall impact on healthcare delivery.

Conclusion

This study explored the factors influencing the adoption and sustained use of Electronic Medical

Records (EMR) systems in Indonesian public hospitals (RSUD) through the lens of the Technology

Acceptance Model (TAM). The findings underscore the critical role of perceived ease of use and

perceived usefulness in determining both initial adoption and long-term engagement with EMR

technology. 1) The Effect of Convenience and Benefit on the Use of RME; The results of the study show

that the perception of ease of use and usefulness are the two main factors that affect the adoption and

sustainability of the use of RME in hospitals. Medical personnel who find the RME system easy to use

and useful are more likely to continue using it. This is supported by interviews and literature studies

that show that ease of navigation and benefits in work efficiency increase user satisfaction and desire

to maintain the use of RME. 2) The Importance of Convenience and Usefulness Factors in Increasing

Technology Acceptance; The perception of convenience and usefulness plays a significant role in

influencing the acceptance of technology in the hospital environment. Users who feel that RME makes

their job easier and improves overall performance are more likely to adopt this technology quickly

and maintain it in the long run. Therefore, hospitals need to ensure that the implementation of RME

is supported by adequate training to increase the positive perception of this system. The Role of RME

in Improving Patient Satisfaction; The use of RME has been proven to not only improve internal

efficiency in hospitals, but also have a positive impact on patient satisfaction. Patients served in

hospitals who use RME are more satisfied with the speed of service, their involvement in the

treatment process, and the reduction of medical errors. Therefore, the implementation of RME is an

important step in improving the quality of health services and patient satisfaction at the hospital.

Research Implications: The research highlights the need for hospitals to prioritize user-centric

EMR designs, provide comprehensive training programs, and ensure seamless integration with

existing systems. Policymakers and hospital management should adopt a holistic approach to

technology implementation, addressing both user needs and organizational goals to maximize the

potential of EMR systems. By addressing these aspects, hospitals can foster a more efficient and

patient-focused healthcare environment, ensuring that the adoption of EMR systems contributes

meaningfully to both operational improvements and enhanced patient satisfaction.

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