Implementation of health information system


Malaysia Ministry of Health defines Health Informatics or medical informatics is the intersection of information science, computer science and health care. According to the Association for Computing Machinery there are three main academic fields in Health Computing which includes computer science, health science, and sociology. Recently, in 21's century, more researchers seem to have interest in computerization or information technology application that can apply in any industry. From Health Computing change to Health Medical, as the time goes by with the advances of technology, most of the researcher defined the terms Health Informatics for combination of healthcare and information technology. There is less research from Malaysia about implementation and issues regarding Health Information System (HIS).

HIS is the example of Health Informatics deliverable. In healthcare environment, information must be communicated with the right flow. Paper-based medical record is not the efficient method to implement. It is manual method of storing information in a folders or files. More information needs more storage and more folders that require bigger storage space. Practically, paper-based medical record is inefficient and ineffective. Electronic Medical Record is one of the implementation of HIS which can refer as paperless health record. This application applied in Healthcare Delivery System.

Healthcare Delivery System is referring to the medical or health institution such as hospital, clinic, rehabilitation center, and hospice. Healthcare Delivery System can be categorized in primary care, secondary care, and tertiary care. Primary care refers to early illness prevention or health promotion. Secondary care refers to diagnose and treatment and tertiary care refers to rehabilitation and restoration. Simply means Healthcare Delivery System is the organization that provides healthcare services to patient.

According to Bernama (2009, July 21), Health Minister Datuk Seri Liow Tiong Lai said a total of 121 of 135 government hospitals will be installed with digital filing system to speed up the retrieval of patient records.

Selayang Hospital in Malaysia is the pioneer of healthcare delivery system in Malaysia that implements HIS. This hospital is the first to introduce filmless technology in Malaysia (Siemens Health Services). Total Health Information System (THIS) is the structure being used by Hospital Selayang to implement Information Technology. Example of Health Information System implemented in THIS such as, Radiology Information System, Pharmacy Information System, Laboratory Information System, and Picture Archiving and Communication System.

Followed by Hospital Universiti Kebangsaaan Malaysia (HUKM) which reported by Daud (2007) from Bernama, HUKM-developed THIS called Caring Hospital Enterprise System (C-HEtS) which claimed to be cheaper than similar THIS system available in the market.

Problem Statement

Beyond expectation for the application and implementation of Information Technology which focusing on application of HIS implemented in healthcare practice. The strength and weakness of the implementation in Healthcare industries.

According to Bernama (2009, July 21) Health Minister Datuk Seri Liow Tiong Lai said that he notices there are still many hospitals which keep their records manually and spent about 15 minutes to look for them. He said it is time consuming to retrieve the record and can derive to a problem such as in decision making. He suggested using digital filing system which healthcare providers can retrieve the information accurately and instantly.

According to Chong (2006) reported in The Star local newspaper 28 July 2006 as required by Malaysia Ministry of Health, in health services delivery there is need for timely and accurate information for crisis management. A paradigm shift of HIS is required to cater for timely, accurate and user friendly evidence-based decision making. The problem that could arise in implementing HIS such as:

There is existing HIS that has been implemented in more than one hospital in Malaysia, but there is a little realistic insight of understanding the state-of-the-art of its application. There are not enough people to identify how such systems can be used. Medical practice makes implementation of HIS becomes difficult. Technology change rapidly, HIS must also combine some of the function of medical practice that are yet unproven.

The timely delivery or relevant needed information to the appropriate healthcare professionals is what HIS is all about. Hardware failures can decimate the system credibility.

Chong (2006) reported as guided by Ministry of Health that currently, there is limited ability to identify, monitor, access, analyze and utilize data for planning, management, and decision making.

Research Questions

The research questions throughout this research studies are:

  1. When the hospital ready to implement HIS?
  2. Did HIS can support functions and application for the whole operation of the hospitals?
  3. How far the utilization of HIS?
  4. What is the architecture of success HIS?
  5. How to implement HIS in general hospitals?

Research Objectives

The objectives are divided into main objective and specific objective for this research. These objectives are important for this research because it will give motivation and direction for whole process of this research.

Main objective:

  • To study the implementation of Health Information System in Malaysia's general hospitals.
  • To analyze the application of HIS.

Specific objectives:

  • To study the issues undergoes beyond application of HIS.
  • To analyze the national agenda that undergoes implementation of Health Information System towards Healthcare settings.
  • To analyze the factors of success and failure of HIS.

Scope of Study

The scope and limitation of this research are:

  1. The research area of this study is in the scope of Health Informatics.
  2. Research will be conducted for healthcare settings in Malaysia which focus on general hospitals.
  3. The research will analyze the application of HIS.
  4. The research also will differentiate success and failure of HIS application in comparison with other countries.

Expected Outcome and Conclusion

The challenge of implementing HIS is to enhance the ability of national health agenda to focusing practice health informatics in healthcare delivery system. Implementation of Health Information System effectively and the information must be available when needed and could overcome many issues especially on healthcare quality and services to the patient. These could contribute to the quality of management and services provided by healthcare providers in Malaysia Healthcare Delivery System. This research will conduct a study to identify the main challengers towards implementing HIS in general hospitals and the perspective of the implementation through the qualitative studies by applying Unified Theory of Acceptance and Use of Technology (UTAUT). The result will determine the factors that contribute to the success and failure or challenges of HIS towards the future. This research will propose a framework of effective implementation of HIS based on the analyzed data.


  • Bernama. (2009, July 21). [Digital filing system plan for govt hospitals]. The Star Online. Retrieved from
  • Chong, M., (2006). All Set To Tackle Crisis. Improving the Health Information System. Retrived on 6th April 2009 from
  • Daud, M. A., (2007). HUKM Develops Own Total Hospital Information System. Retrieved on 6th April 2009 from
  • Health informatics. (n.d). In Wikipedia. Retrieved on June 29, 2009, from
  • Hamid, S. A., (2009, April 4). [Kesihatan dipantau Menerusi IT]. Harian Metro. Retrieved from I
  • Ministry of Health. What is Health Informatics?. Retrieved on 29th June 2009 from
  • Siemens Health Services. SIENET at Selayang Hospital. Retrieved on 4th May 2009 from

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