The Role of 5S methodology in supporting electronic medical record digitalization: empirical insights from Indonesian hospitals

The global imperative for healthcare digitalization, particularly the mandated implementation of Electronic Medical Records (EMR) in Indonesia, presents significant operational and cultural challenges for hospitals. Successful EMR adoption critically hinges on a prepared physical and organizational environment. This qualitative study investigates the initial implementation of the 5S methodology (Sort, Set in order, Shine, Standardize, Sustain) as a foundational strategy to support and facilitate effective medical record digitalization. The research was conducted using a multiple-case study approach across three distinct hospital types (B, C, and D) in Central Java, between 2023 and 2024. Data were collected through semi-structured interviews with management, IT staff, and clinical personnel, direct observation of work areas, and review of internal project documentation. Thematic analysis was utilized to synthesize findings regarding 5S practices, their perceived impact on digitalization readiness, and associated barriers, especially concerning national interoperability requirements. The study reveals that 5S significantly contributes to physical space optimization, streamlining the paper-to-digital data transition, and enhancing data quality. Among the three hospitals investigated, the Sort phase at the Type D hospital particularly stood out for effectively addressing an longstanding overloaded medical record storage problem. This initiative not only generated IDR 11 million in revenue from shredding irrelevant archives but also critically emphasized the immediate urgency to digitize primary patient data. This phase also leveraged the existing Hospital Information System to identify and verify duplicate patient data, leading to data cleansing. Furthermore, the Standardize phase proved crucial for ensuring internal data consistency and alignment with national platform requirements like SatuSehat. This study provides empirical insights into the practical application of 5S as a strategic enabler for EMR adoption in Indonesian hospitals, offering a unique perspective on bridging physical readiness with digital transformation, including the critical aspect of national data interoperability.