Exploring the Digitalization of Hospitals Upon the EMRAM Model: The Case of Türkiye

Yıl 2025, Cilt: 13 Sayı: 1, 20 - 27, 27.03.2025

Burak Tekerek , Oğuz Işık

https://doi.org/10.22139/jobs.1593092

Öz

Scarcity of resources, difficulties in service delivery, and demand for efficiency in healthcare services may be counted among the most prominent reasons for the digitalization of healthcare services, ultimately leading to the emergence of digital hospitals. In this sense, the present study attempted to reveal to what extent Ankara-based private hospitals comply with digital maturity criteria and the deficiencies of these hospitals for the Stage 7 digital excellence benchmark. While the target population consisted of Ankara-based private hospitals, we aimed to reach all hospitals within the population, and the officials of 17 hospitals agreed to participate in the study. The methodology of the research relies on the updated EMRAM criteria by HIMSS. We collected the data face-to-face from the authorized staff in the hospitals (e.g., information processing managers). The data were analyzed using the Microsoft Excel 2016 Office program. Based on the EMRAM criteria, we found out that six out of 17 participating hospitals could only be rated as Stage 0, one as Stage 1, three as Stage 2, and seven as Stage 3. However, no hospital could attain Stage 6 and Stage 7 achievements, the top levels for being accredited as a “digital hospital” by HIMSS. Overall, we can confidently assert that the information systems of the participating hospitals bear too many deficiencies to be accepted as digitalized. Such shortcomings may stem from the lack of investment, the hospitals’ concerns for data protection, and the lack of user-friendly information technologies in these hospitals.

Anahtar Kelimeler

Digital Hospital, HIMSS, EMRAM, Health Technology Assessment

EMRAM Modeli ile Hastanelerin Dijitalleşmesinin Araştırılması: Türkiye Örneği

Öz

Kaynakların kıtlığı, hizmet sunumundaki zorluklar ve sağlık hizmetlerinde verimlilik talebi, sağlık hizmetlerinin dijitalleşmesinin ve nihayetinde dijital hastanelerin ortaya çıkmasının en önemli nedenleri arasında sayılabilir. Bu bağlamda, bu çalışmada Ankara merkezli özel hastanelerin dijital olgunluk kriterlerine ne ölçüde uyum sağladığı ve bu hastanelerin 7. Aşama dijital mükemmellik ölçütüne yönelik eksiklikleri ortaya konulmaya çalışılmıştır. Hedef evren Ankara merkezli özel hastanelerden oluşmakla birlikte, evrendeki tüm hastanelere ulaşılması hedeflenmiş ve 17 hastanenin yetkilileri çalışmaya katılmayı kabul etmiştir. Araştırmanın metodolojisi HIMSS tarafından güncellenen EMRAM kriterlerine dayanmaktadır. Veriler hastanelerdeki yetkili personelden (örn. bilgi işlem müdürleri) yüz yüze toplanmıştır. Veriler Microsoft Excel 2016 Office programı kullanılarak analiz edilmiştir. EMRAM kriterlerine dayanarak, 17 katılımcı hastaneden altısının yalnızca Aşama 0, birinin Aşama 1, üçünün Aşama 2 ve yedisinin Aşama 3 olarak derecelendirilebileceğini tespit ettik. Ancak hiçbir hastane, HIMSS tarafından “dijital hastane” olarak akredite edilmek için en üst seviyeler olan Aşama 6 ve Aşama 7 başarılarına ulaşamadı. Genel olarak, katılımcı hastanelerin bilgi sistemlerinin dijitalleşmiş olarak kabul edilemeyecek kadar çok eksiklik taşıdığını rahatlıkla söyleyebiliriz. Bu eksiklikler yatırım eksikliğinden, hastanelerin veri koruma kaygılarından ve bu hastanelerde kullanıcı dostu bilgi teknolojilerinin bulunmamasından kaynaklanıyor olabilir.

Anahtar Kelimeler

Dijital Hastane, HIMSS, EMRAM, Sağlık Teknolojisi

Kaynakça

• Ak, B. (2013). Sağlıkta yeni hedef: Dijital hastaneler. Akademik Bilişim, 23-25
• Agarwal, R., Gao, G., DesRoches, C., & Jha, A. K. (2010). Research commentary—The digital transformation of healthcare: Current status and the road ahead. Information systems research, 21(4), 796-809.
• Ayat, M., & Sharifi, M. (2016). Maturity assessment of hospital information systems based on electronic medical record adoption model (EMRAM)—Private hospital cases in Iran. International Journal of Communications, Network and System Sciences, 9(11), 471-477.
• Sharma, V., Augustine, T., Ainsworth, J., & Van Der Veer, S. N. (2022). The evaluation of digital transformation in renal transplantation in the United Kingdom: A national interview study. International Journal of Medical Informatics, 164, 104800.
• Bonello, K., Riley, M., McBain, D., Lee, J., Prasad, N., Campbell, S., ... & Robinson, K. (2021). Implementation status of hospital EMRs: Findings from a survey of public hospitals in Victoria, Australia. In 38th National Conference 2021 (Vol. 25, p. 23).
• Chen, C.-M., Hsu, C.-Y., & Worley, J. A. (2013). Evaluation systems of the electronic medical records: A comparative study. 2013 IEEE 4th International Conference on Software Engineering and Service Science.
• El-Hassan, O., Sharif, A., Al Redha, M., & Blair, I. (2017). Tracking the implementation of electronic medical records in Dubai, United Arab Emirates, using an adoption benchmarking tool. In MEDINFO 2017: Precision Healthcare Through Informatics (pp. 64-68). IOS Press.
• Henry, J., Pylypchuk, Y., Searcy, T., & Patel, V. (2016). Adoption of electronic health record systems among US non-federal acute care hospitals: 2008–2015. ONC Data Brief, 35(35), 2008-2015.
• HIMSS. (2021, July 13). HIMSS hakkında. https://himsseurasia.com/himss-hakkinda/
• Jiang, H., & Zhang, F. (2004). Integration of the regional public health resources and establishment of the digital hospital. 2004 IDEAS Workshop on Medical Information Systems: The Digital Hospital (IDEAS-DH'04)
• Juhra, C. (2022). Clinic 4.0: The Digital Hospital. In Handbook Industry 4.0 (pp. 843-855). Springer, Berlin, Heidelberg.
• Kanakubo, T., & Kharrazi, H. (2019). Comparing the trends of electronic health record adoption among hospitals of the United States and Japan. Journal of Medical Systems, 43(7), 1-13.
• Karahanna, E., Chen, A., Liu, Q. B., & Serrano, C. (2019). Capitalizing on health information technology to enable digital advantage in US hospitals. MIS Quarterly, 43(1), 113-140
• Kharrazi, H., Gonzalez, C. P., Lowe, K. B., Huerta, T. R., & Ford, E. W. (2018). Forecasting the maturation of electronic health record functions among US hospitals: Retrospective analysis and predictive model. Journal of Medical Internet Research, 20(8), e10458.
• Kim, Y.-G., Jung, K., Park, Y.-T., Shin, D., Cho, S. Y., Yoon, D., & Park, R. W. (2017). Rate of electronic health record adoption in South Korea: A nation-wide survey. International Journal of Medical Informatics, 101, 100-107.
• King, L. A., Fisher, J. E., Jacquin, A. & Zeltwanger, P. E. (2003). The digital hospital: Opportunities and challenges. Journal of Healthcare Information Management: JHIM, 17(1), 37-45.
• Klauber, J., Geraedts, M., Friedrich, J., & Wasem, J. (2019). Krankenhaus-Report 2019: Das Digitale Krankenhaus. Springer Nature.
• Kose, I., Rayner, J., Birinci, S., Ulgu, M. M., Yilmaz, I., & Guner, S. (2020). Adoption rates of electronic health records in Turkish Hospitals and the relation with hospital sizes. BMC Health Services Research, 20(1), 1-16.
• Liang, J., Li, Y., Zhang, Z., Shen, D., Xu, J., Zheng, X., Wang, T., Tang, B., Lei, J., & Zhang, J. (2021). Adoption of Electronic Health Records (EHRs) in China during the past 10 years: Consecutive survey data analysis and comparison of sino-american challenges and experiences. Journal of Medical Internet Research, 23(2), e24813.
• Najjar, A., Amro, B., & Macedo, M. (2021). The adoption level of electronic medical records in hebron hospitals based on the electronic medical record adoption model (EMRAM). Health Policy and Technology, 10(4), 100578.
• Pettit, L. (2013). Understanding EMRAM and how it can be used by policy-makers, hospital CIOs and their IT teams. World Hospitals and Health Services: The Official Journal of the International Hospital Federation, 49(3), 7-9.
• Shu, T., Liu, H., Goss, F. R., Yang, W., Zhou, L., Bates, D. W., & Liang, M. (2014). EHR adoption across China’s tertiary hospitals: A cross-sectional observational study. International Journal of Medical Informatics, 83(2), 113-121.
• Weiss, G. (2002). Welcome to the (almost) digital hospital. IEEE Spectrum, 39(3), 44-49.