The implementation of Electronic Medical Records (EMR) is a crucial part of the digital transformation of healthcare services, but its success is greatly influenced by the alignment between human, organizational, and technological aspects. This study aims to analyze the success factors and barriers to EMR implementation based on the Human–Organization–Technology Fit (HOT-Fit) model at RSU 'Aisyiyah Ponorogo. This study used a qualitative method with a case study approach. A total of 12 informants, consisting of healthcare workers, IT staff, and management, were selected purposively. Data were collected through in-depth interviews and document reviews, then analyzed using thematic content analysis with a deductive approach based on the HOT-Fit components. The results indicate that the successful implementation of EMR is supported by the integration of three main aspects: (1) adequate technology in the form of an integrated, flexible, and secure system; (2) good user acceptance, demonstrated by ease of use and increased work efficiency; and (3) organizational support through clear policies, structures, and funding. Key success factors include a mandatory EMR policy, the development of adaptive internal systems, a supportive organizational culture, and strong leadership. However, misalignments were still found in the HOT-Fit components, particularly regarding system stability, variations in user adaptation, and suboptimal training and evaluation. In conclusion, the implementation of EMR at RSU 'Aisyiyah Ponorogo has been successful and shows positive results. However, optimal success depends on continuously improving the alignment between human, organizational, and technological aspects.
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