Handayani P W, Hidayanto A N, Ayuningtyas Dumilah, Budi Indra
Faculty of Computer Science, Universitas Indonesia, Indonesia.
Faculty of Public Health, Universitas Indonesia, Indonesia.
Int J Med Inform. 2016 Nov;95:17-34. doi: 10.1016/j.ijmedinf.2016.08.005. Epub 2016 Aug 31.
The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals' management is more motivated to implement HIS to comply with the regulations, while private hospitals' management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors-self-efficacy, social influence, and management support-have a significant influence on the individual acceptance of HIS.
医院信息系统（HIS）可以帮助作为公共实体的医院提供最佳的医疗服务。实施HIS的主要挑战之一是机构变革。本研究以制度理论为分析视角，旨在解释印度尼西亚将HIS作为电子健康计划实例的制度化过程。此外，本文旨在帮助医院管理层和研究人员更好地理解在组织背景下影响医院工作人员接受HIS的社会力量。我们通过四个公立政府医院和四个私立（综合和专科医院）医院的案例研究，运用制度理论的三个概念：制度同构、制度逻辑和制度创业，来解释HIS的制度化过程。本研究表明，公立政府医院和私立医院在制度化过程中存在差异：公立政府医院的管理层更倾向于实施HIS以遵守规定，而私立医院的管理层则将HIS视为必须实现的紧迫要求。研究结果还表明，在这个过程中出现了各种制度同构机制和制度逻辑形式。最后，自我效能感、社会影响和管理支持这三个因素对个人接受HIS有显著影响。
