Human Resources, Work Culture, Leadership, and Infrastructure in Electronic Medical Record Optimization and Employee Performance

Purpose: This study examines whether human resources, organizational work culture, leadership, and infrastructure predict electronic medical record (EMR) optimization and employee performance at Bhayangkara Level III Hospital, Pusdik Brimob, Pasuruan, Indonesia.
Research Methodology: A quantitative cross-sectional design involved 67 employees engaged in outpatient EMR operations. Data were collected using a five-point Likert questionnaire based on the Doctor’s Office Quality-Information Technology (DOQ-IT) readiness framework. Data analysis included descriptive statistics, validity and reliability testing, multiple regression, and path decomposition.
Results: Human resources, organizational work culture, leadership, and infrastructure significantly predicted EMR optimization, explaining 35.0% of its variance, with leadership showing the strongest contribution. The employee performance model explained 32.0% of the variance, with EMR optimization and leadership remaining significant predictors. Indirect-path estimates indicated that EMR optimization partially transmitted the effects of organizational readiness factors on employee performance, although formal mediation significance was not established.
Conclusions: EMR optimization and employee performance depend on the integration of technical infrastructure, leadership, workforce capability, and organizational culture.
Limitations: The study is limited by its single-hospital setting, cross-sectional design, small census sample, self-reported data, and lack of formal bootstrapped mediation testing.
Contributions: This study integrates organizational readiness factors with EMR optimization and employee performance, highlighting the importance of managing human, cultural, leadership, and technological dimensions in digital health implementation.