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An Overview of Hospital Information System (HIS) Implementation in
Malaysia
Conference Paper · January 2012
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3rd INTERNATIONAL CONFERENCE ON BUSINESS AND ECONOMIC
1176 RESEARCH ( 3rd ICBER 2012 ) PROCEEDING
12 - 13 MARCH 2012. GOLDEN FLOWER HOTEL, BANDUNG, INDONESIA
ISBN: 978-967-5705-05-2. WEBSITE: www.internationalconference.com.my
AN OVERVIEW OF HOSPITAL INFORMATION SYSTEM (HIS) IMPLEMENTATION IN
MALAYSIA
Nurul Izzatty Ismail
Department of Technology Management
Faculty of Technology Management, Business and Entrepreneurship
Universiti Tun Hussein Onn Malaysia (UTHM)
[email protected] Nor Hazana Abdullah
Department of Technology Management
Faculty of Technology Management, Business and Entrepreneurship
Universiti Tun Hussein Onn Malaysia (UTHM)
[email protected] ABSTRACT
Information system plays an important role in various sectors, including healthcare sector such as hospitals. Hence,
the implementation of Hospital Information System (HIS) in Malaysian Public Hospitals is aimed to improve the
quality of public healthcare services especially in terms of enhancing patients’ satisfactions and patient record
management. However, not all public hospitals in Malaysia have embraced the use of the system. Thus, this paper
discusses an overview of HIS implementation at Malaysian hospitals based on previous studies done in this area. Prior
to the discussion, several components and types of HIS are explained in general. Furthermore, benefits on HIS
implementation are also being described to emphasise the importance of HIS implementation in Malaysian Public
Hospitals which is recognising the reasons to implement the system in Malaysian Hospitals.
Field of Research: Hospital information system, information system, hospitals.
-----------------------------------------------------------------------------------------------------------------------------------------------------------
1. Introduction
Information System (IS) refers to a computer system which is designed to manage all the hospital’s medical and
administrative information in hospitals (Biomedical Informatics Ltd., 2006). Shasha and Vossen (2011) defines the IS
as software and hardware systems that support data-intensive applications. It is also known as an integrated set of
components for collecting, storing, processing, and communicating information and the main components of it is
3rd INTERNATIONAL CONFERENCE ON BUSINESS AND ECONOMIC
1177 RESEARCH ( 3rd ICBER 2012 ) PROCEEDING
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ISBN: 978-967-5705-05-2. WEBSITE: www.internationalconference.com.my
computer hardware and software, databases, telecommunications systems, human resources, and procedures
(Brittanica, 2010).
According to the past reviews in IS terms, the understanding of IS refers to a computer system which includes
software, hardware and database to collect, store and display data and information in electronic format. It has
various advantages to improve the filing system in an organisation, including the healthcare sector such as hospitals.
According to Yamauchi et al. (1994), IS may lower the health cost by coordinating services, reduce errors and speed
of care, as well as increasing speed of care and accuracy to improve quality of care. Moreover, the IS enables the
health sector, especially the hospitals in managing their tasks more systematically. Today, the IS is being used in all
over Malaysia as part of the government’s initiative to upgrade the public hospitals in Malaysia.
2. Hospital Information System (HIS)
Hospital Information System (HIS) is defined as a system focusing on the integration of clinical application collectively
with financial and administrative applications to enhance service efficiency (Hyung et al., 2004). Biomedical
Informatics Ltd. (2006) reported that HIS consists of two or more of these components, such as Clinical Information
System (CIS), Financial Information System (FIS), Laboratory Information System (LIS), Nursing Information Systems
(NIS), Pharmacy Information System (PIS), Picture Archiving Communication System (PACS) and Radiology
Information System (RIS) as shown in Figure 1.
Figure 1: Components in Hospital Information System (HIS) (adapted by Biomedical Informatics Ltd., 2006)
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These components of HIS are differentiated by their core functions, departments that used them and type of users.
Thus, Table 1 examines the differences of those components by their departments and users. A Clinical Information
System (CIS) is a computer-based system that is designed for collecting, storing, manipulating and making available
clinical information important to the healthcare delivery process. Usually, it has been used in clinical department,
especially by doctors and nurses. Moreover, a Financial Information Systems (FIS) is referred as computer systems
that manages the business aspects of a hospital and used in financial department by accountants. Furthermore, a
Laboratory Information System (LIS) is a computer information system that manages laboratory information for all
the laboratory disciplines such as clinical chemistry, haematology and microbiology which are used in laboratory by
laboratory officers. Besides that, Nursing Information Systems (NIS) is a computer system that manages clinical data
from a variety of healthcare environments, and made available in a timely and orderly fashion to aid nurses in
improving patient care which is used in wards by doctors and nurses. A Pharmacy Information System (PIS) is a
complex computer system that has been designed to meet the needs of a pharmacy department which is used in
pharmacy department by pharmacists. Otherwise, a Picture Archiving Communication System (PACS) is a loose term
to describe a set of systems that facilitate the archiving, processing and viewing of digital radiological images and
their related information and used in x-ray and imaging department by Imaging Officers. Lastly, a radiology
information system (RIS) is a computer system that assists radiology services in the storing, manipulation and
retrieving of information. In addition, it is also used to manage and store radiology information also used in x-ray and
imaging department by imaging officers.
HIS components Differences
Departments Type of Users
CIS Clinical Doctors, Nurses,
FIS Financial Accountant
LIS Laboratory Lab officers
NIS Ward Nurses, Doctors
PIS Pharmacy Pharmacists
PACS Imaging Imaging Officer
RIS Imaging Imaging Officer
Table 1: Differences between HIS Components
However, not all of these components in HIS are the Information Systems used by hospitals. On the other hand,
different hospitals might use different combinations of the components. For example in Malaysia, most public
hospitals used the CIS.
3. Implementation Of Hospital Information System (HIS) In Malaysia
In Malaysia, the implementation of HIS is broadening in both of private and public hospitals. There are 49 private
hospitals known as good quality hospitals which accredited by Joint Commission International (JCI), the Malaysian
Society for Quality of Health (MSQH) and International Organisational of Standardisation (ISO) as the government
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introduced “health tourism” in this country (Bernama, 2011). Thus, it has been proved to benefit the hospitals in
terms of service quality. Hence, the country acquired up to RM380 millions from the previous year and the total is
expected to increase to RM431 millions this year because of the low medical costs for the foreigners, as well as
excellent and modern infrastructures (Bernama, 2011). This includes the IS usage as their electronic filing system to
increase the efficiency and productivity of the hospitals. However, the public hospitals in Malaysia are accredited
only by the ISO. According to Md. Zan (2007), the public hospitals provided slow services and are inefficient. It might
be that the public hospitals have limited facilities especially limited medical facilities and limited electronic filing
systems where patients need to wait a long time for treatment. Moreover, the public hospitals which used the IS
tools are less than 10%. It is divided into three categories which are Total Hospital Information System (THIS),
Intermediate Hospital Information System (IHIS) and Basic Hospital Information System (BHIS) (Aniza et al., 2010).
Thus, according to Nor Bizura (2010), eight (8) hospitals known as THIS, two (2) hospitals known as IHIS and six (6)
hospitals known as BHIS as appeared on Table 2.
THIS IHIS BHIS
Hospital Putrajaya, Hospital Keningau, Hospital Kuala
Hospital Selayang, Hospital Lahad Batas, Hospital
Hospital Serdang, Datu Setiu, Hospital
Hospital Pandan, Pekan, Hospital
Hospital Ampang, Pitas, Hospital
Hospital Sg. Buloh, Kuala Penyu,
Hospital Alor Setar, Hospital Kunak.
and Hospital Sungai
Petani
Table 2: Categories of Hospital Information System (HIS) (adapted by Nor Bizura, 2010).
Accordingly, the level of implementation of HIS is still low in Malaysia. Hence, various issues may need to identify to
discover the problem, for example the benefits of the HIS may need to be clearly analysed. It enabled the hospitals
to implement the HIS. This is because the information about the system’s benefits will influence them to adopt HIS.
Moreover, Haslina and Sharifah Mastura (2005) claimed that THIS, IHIS and BHIS are classified according to budgets,
specialties and number of beds in the hospitals. However, the number of beds is highlighted in this classification.
Hence, the hospitals with more than 400 beds are classified with THIS, more than 200 beds but less than 400 beds
are classified as IHIS and less than 200 beds are classified as BHIS (Nor Bizura, 2010; Aniza et al., 2010). This is
because, the implementation of HIS may overcome usual problems such as inefficiency and slow services provided in
bigger public hospitals.
In Malaysia, the implementation of HIS is developed by the different components of HIS either the THIS, IHIS or BHIS.
In addition Abu Bakar (2008) explained the IS components that involved in THIS, IHIS and BHIS as shown in Table 3.
According to the table, THIS has maintained complete HIS, while IHIS and BHIS have maintained a midway and
essential components of HIS.
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Basic Hospital Intermediate Total Hospital
Information Hospital Information
System (BHIS) Information System (THIS)
System (IHIS)
Patient Integration of BHIS IHIS + Radiology +
Management + Laboratory + PACS +
System + Clinical Pharmacy administration +
Information Information Financial +
System System Inventory +
Personnel
Information
System
Table 3: The IS components in THIS, HIS and BHIS (adapted by Abu Bakar, 2008).
4. Discussion
The Information System (IS) is important in healthcare sector, especially in hospitals. In Malaysia, the
implementation of IS in healthcare sector is significant to our country’s improvement of healthcare quality services in
most Malaysian public hospitals. Therefore, Hospital Information System (HIS) is implemented by the government to
provide the public hospitals with a good automated filing system. It has several components such as CIS, FIS, LIS, NIS,
PIS, PACS and RIS. The major differences between those components are based on the departments and the
personnel in those departments that use the system. In addition, different hospitals may have different Information
Systems which is used by different personnel. In Malaysia, the implementation of HIS are divided into 3 categories
which are THIS, HIS and BHIS. Moreover, the HIS have allowed the information from different sources and nature
such as documents, images and signals that can be integrated within the hospital (Tachinardi, 2007). However, the
level of HIS application is still low which is less than 10% hospitals that are classified as HIS out of 137 public hospitals
in Malaysia. Thus, the benefits of the overall HIS implementation is necessary to be known in details.
According to the past studies, the researchers found that there are various benefits by using HIS in the hospitals.
There are some positive issues relating to HIS implementation by them. The examples of HIS benefits are sharing
data and information, as well as automation of transaction or work processes (Abdollah Salleh, 2006), easy access to
patients’ data and structured information (Indian Centre for Development of Advanced Computing, 2005; Biomedical
Informatics Ltd), reduces transcription errors and reduces duplication of information entries (Harrison, 2007) and
improved monitoring of drug usage, and study of effectiveness (Indian Centre for Development of Advanced
Computing, 2005; Biomedical Informatics Ltd). Thus, a good understanding of the HIS is needed. Moreover, the
information of benefits in HIS may influence the hospitals to apply it.
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1181 RESEARCH ( 3rd ICBER 2012 ) PROCEEDING
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5. Conclusion And Future Research
In a nutshell, the implementation of the HIS is necessary as it gives many positive impacts by many reviewers. In
addition, the implementation of such IS tools in healthcare sector especially in hospitals has encourage Malaysia to
achieve the 2020 Vision as a developed country. Although today’s medical tourism in Malaysia has been growing in
many private hospitals, the importance of public hospitals in this country are also of needed to be concern especially
to serve unaffordable nations. However, the critical issue found in the study is low adoption of the electronic system
in Malaysian Public Hospitals where only less than 10% public hospitals have adopted the HIS. Thus, a more detailed
investigation is necessary to reveal the real issues or problems occurring in implementing the system, especially in
Malaysian Public Hospitals and good understanding on overall HIS implementation according to the past reviews is
necessary to develop a framework prior to test and revise the issues in HIS implementation as a future research.
Therefore, in this technological era, the HIS is needed to be applied in many other hospitals as it is beneficial in
improving and enhancing the filing system in hospitals. Consequently, the HIS may increase the quality and services.
Thus, the HIS implementation is necessary to be improved in all Malaysian Public Hospitals in the future.
Acknowledgement
This paper is under scholarship of the University Tun Hussein Onn Malaysia and the authors would like to thank the
relevant parties that have directly or indirectly contributed to the success of this study. Furthermore, the authors
wish to express their gratitude to the anonymous referees for their helpful comments and numerous suggestions to
improve the paper.
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3rd INTERNATIONAL CONFERENCE ON BUSINESS AND ECONOMIC
1182 RESEARCH ( 3rd ICBER 2012 ) PROCEEDING
12 - 13 MARCH 2012. GOLDEN FLOWER HOTEL, BANDUNG, INDONESIA
ISBN: 978-967-5705-05-2. WEBSITE: www.internationalconference.com.my
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