<![CDATA[This study evaluates the implementation success and multidimensional alignment of the Hospital Management Information System (SIMRS) at RSUD Tombulilato using the Human, Organization, Technology–Fit (HOT-Fit) framework and examines the effects of technological and organizational dimensions on system use, user satisfaction, and organizational net benefits. A descriptive quantitative evaluative approach was employed using total sampling of 122 active SIMRS users, including medical personnel, administrative staff, and IT specialists. Data were collected through a structured four-point Likert-scale questionnaire and analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) with SmartPLS 4, including out-of-sample prediction through PLSpredict. Descriptively, all HOT-Fit dimensions were rated “Very Good” (84.8%–88.8%). However, the technology dimension did not significantly affect user satisfaction, including system quality (β=0.075, p=0.340), information quality (β=0.026, p=0.734), and service quality (β=−0.082, p=0.185). In contrast, organizational structure strongly influenced system use (β=0.717, p<0.001, f²=1.058), while organizational environment significantly affected user satisfaction (β=0.531, p<0.001, f²=0.468). System use did not significantly affect net benefits (β=0.105, p=0.385). User satisfaction was the significant pathway to organizational net benefits (β=0.728, p<0.001, f²=0.526), with R² values of 0.816 for satisfaction and 0.667 for net benefits. The findings indicate that in mandatory-use settings, organizational governance and user satisfaction are more important for realizing net benefits than usage frequency alone.]]>
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