The pharmaceutical management information system (SIMF) has the potential to improve the efficiency of prescription services, but the relationship with perceived service quality is influenced by infrastructure readiness, integration, and users. Evidence from Puskesmas that links the level of SIMF implementation with efficiency and quality is still limited. To analyze the relationship between SIMF implementation and the efficiency and quality of prescription services perceived at the Palembang City Health Center and explain the obstacles to implementation. Sequential mixed-methods explanatory research was conducted in six health centers in 2026. Cross-sectional surveys of 18 pharmacists (total sampling) and 96 patients were followed by semi-structured interviews with 6 pharmacists to explain the survey findings. The analysis included descriptive statistics, Shapiro–Wilk tests, Spearman correlation (with simple linear regression as sensitivity analysis), and exploratory MANOVA; interviews were analyzed thematically. High implementation was found in availability and use (94.4%), usefulness (94.4%), and convenience (88.9%), while resources and infrastructure were mainly in the moderate category (77.8%). Wait times ≤20 minutes were experienced by 90.6% of patients and 87.5% were very satisfied. Implementation was positively associated with efficiency (rs=0.512; p=0.030), but not significantly associated with perceived quality (rs=0.404; p=0.097); inconclusive due to limited testing power). Interviews showed that data flow and prescribing readability improved, but unstable connections, limited computers, double record-keeping, absence of clinical decision support, and uneven training still occurred. Higher implementation of SIMF was associated with better operational efficiency, but was not significantly associated with perceived quality (inconclusive due to limited testing power); interviews indicated that quality may be limited by sociotechnical gaps and integration. Strengthening infrastructure, interoperability, clinical decision support, and ongoing training are needed.
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