The implementation of Hospital Management Information Systems (SIMRS) has become a strategic necessity to improve healthcare service quality and operational efficiency. This study focuses on evaluating the performance of SIMRS in the outpatient registration unit of Nur Hidayah Hospital Bantul, where system disruptions, inconsistent SOP application, and limited user training were identified as core issues. The research aims to assess how well the SIMRS aligns with the Human, Organization, and Technology components through the HOT-Fit model framework. A descriptive qualitative method was employed using purposive sampling to select five informants directly involved in SIMRS operations, including registration officers, IT staff, and the head of the medical records unit. Data were collected through in-depth interviews, direct observation, and documentation, and analyzed thematically based on the HOT-Fit model. The findings show that SIMRS contributes positively to workflow efficiency and data management; however, human factors such as inconsistent training and input errors remain prevalent. Organizational support is visible but lacks structured evaluation routines, and although the technological infrastructure is generally stable, peripheral device and network issues persist. The study synthesizes that effective SIMRS performance requires not only technological readiness but also consistent organizational commitment and continuous human resource development. It concludes that strengthening user competence, formalizing SOP usage, and improving infrastructure are essential to optimize the system's functionality and alignment with the HOT-Fit model.