<![CDATA[Electronic Medical Records (EMR) play a crucial role in transforming hospital services toward greater operational efficiency and improved service quality. However, during the early stages of implementation, challenges such as inadequate infrastructure, limited digital readiness, and organizational resistance often hinder optimal efficiency outcomes. This study aimed to compare hospital service efficiency before and after EMR implementation and to identify challenges and adaptation strategies during the digital transition at Mitra Siaga Hospital, Tegal Regency. A mixed-methods approach was employed, integrating quantitative and qualitative analyses. Quantitatively, Data Envelopment Analysis (DEA) using Constant Return to Scale (CRS) and Variable Return to Scale (VRS) models measured technical efficiency across four key service units: the Emergency Room (ER), Delivery room (VK), Intensive Care Unit (ICU), and Inpatient Ward. Qualitatively, in-depth interviews with healthcare professionals explored barriers and supporting factors in EMR implementation. Results indicated that post-EMR implementation, the ER, VK, and Inpatient wards achieved full efficiency (CRS = 1.000; VRS = 1.000), while the ICU reached pure technical efficiency (VRS = 1.000) but remained scale-inefficient (CRS = 0.4395). The Wilcoxon test (p = 0.655) showed no significant difference between pre- and post-digitalization periods. Identified barriers included limited hardware, network disruptions, and user resistance, while managerial support and continuous training enhanced adaptation. In conclusion, EMR implementation has a positive impact on hospital operational efficiency, particularly when supported by adequate infrastructure, skilled human resources, and adaptive change management.]]>
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