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  1. Salahuddin L, Ismail Z
    Int J Med Inform, 2015 Nov;84(11):877-91.
    PMID: 26238706 DOI: 10.1016/j.ijmedinf.2015.07.004
    This paper provides a systematic review of safety use of health information technology (IT). The first objective is to identify the antecedents towards safety use of health IT by conducting systematic literature review (SLR). The second objective is to classify the identified antecedents based on the work system in Systems Engineering Initiative for Patient Safety (SEIPS) model and an extension of DeLone and McLean (D&M) information system (IS) success model.
  2. Salahuddin L, Ismail Z, Abdul Rahim F, Anawar S, Hashim UR
    Appl Clin Inform, 2023 Aug;14(4):693-704.
    PMID: 37648223 DOI: 10.1055/s-0043-1771394
    BACKGROUND: Implementing health information technology (HIT) may cause unintended consequences and safety risks when incorrectly designed and used. Yet, the tools to assess self-reported safe use of HIT are not well established.

    OBJECTIVE: This study aims to develop and validate SafeHIT, an instrument to assess self-reported safe use of HIT among health care practitioners.

    METHODS: Systematic literature review and a semistructured interview with 31 experts were adopted to generate SafeHIT instrument items. In total, 450 physicians from various departments at three Malaysian public hospitals participated in the questionnaire survey to validate SafeHIT. Exploratory factor analysis and confirmatory factor analysis (CFA) were undertaken to explore the items that best represent a specific construct and to confirm the reliability and validity of the SafeHIT, respectively.

    RESULTS: The final SafeHIT consisted of 14 constructs and 58 items in total. The result of the CFA confirmed that all constructs demonstrated adequate convergent and discriminant validity.

    CONCLUSION: A reliable and valid theoretically underpinned measure of determinants of safe HIT use behavior has been developed. Understanding external factors that influence safe HIT use is useful for developing targeted interventions that favor the quality and safety of health care.

  3. Salahuddin L, Ismail Z, Hashim UR, Ismail NH, Raja Ikram RR, Abdul Rahim F, et al.
    Health Informatics J, 2020 Mar;26(1):420-434.
    PMID: 30843460 DOI: 10.1177/1460458219833090
    This study aims to investigate healthcare practitioner behaviour in adopting Health Information Systems which could affect patients' safety and quality of health. A qualitative study was conducted based on a semi-structured interview protocol on 31 medical doctors in three Malaysian government hospitals implementing the Total Hospital Information Systems. The period of study was between March and May 2015. A thematic qualitative analysis was performed on the resultant data to categorize them into relevant themes. Four themes emerged as healthcare practitioners' behaviours that influence the unsafe use of Hospital Information Systems. The themes include (1) carelessness, (2) workarounds, (3) noncompliance to procedure, and (4) copy and paste habit. By addressing these behaviours, the hospital management could further improve patient safety and the quality of patient care.
  4. Salahuddin L, Ismail Z, Abd Ghani MK, Mohd Aboobaider B, Hasan Basari AS
    J Eval Clin Pract, 2020 Oct;26(5):1416-1424.
    PMID: 31863517 DOI: 10.1111/jep.13326
    OBJECTIVES: The objective of this study was to identify the factors influencing workarounds to the Hospital Information System (HIS) in Malaysian government hospitals.

    METHODS: Semi-structured interviews were conducted among 31 medical doctors in three Malaysian government hospitals on the implementation of the Total Hospital Information System (THIS) between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes.

    RESULTS: Five themes emerged as the factors influencing workarounds to the HIS: (a) typing skills, (b) system usability, (c) computer resources, (d) workload, and (e) time.

    CONCLUSIONS: This study provided the key factors as to why doctors were involved in workarounds during the implementation of the HIS. It is important to understand these factors in order to help mitigate work practices that can pose a threat to patient safety.

  5. Salahuddin L, Ismail Z, Hashim UR, Raja Ikram RR, Ismail NH, Naim Mohayat MH
    Health Informatics J, 2019 12;25(4):1358-1372.
    PMID: 29521162 DOI: 10.1177/1460458218759698
    The objective of this study is to identify factors influencing unsafe use of hospital information systems in Malaysian government hospitals. Semi-structured interviews with 31 medical doctors in three Malaysian government hospitals implementing total hospital information systems were conducted between March and May 2015. A thematic qualitative analysis was performed on the resultant data to deduce the relevant themes. A total of five themes emerged as the factors influencing unsafe use of a hospital information system: (1) knowledge, (2) system quality, (3) task stressor, (4) organization resources, and (5) teamwork. These qualitative findings highlight that factors influencing unsafe use of a hospital information system originate from multidimensional sociotechnical aspects. Unsafe use of a hospital information system could possibly lead to the incidence of errors and thus raises safety risks to the patients. Hence, multiple interventions (e.g. technology systems and teamwork) are required in shaping high-quality hospital information system use.
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