Abstract
Healthcare is provided to patients by caregivers who give in complex organizational arrangements but the overwhelming amount of their own daily work is part of a clinical microsystem. The concept of clinical microsystem places medical error and harm reduction into the broader context of safety and quality of care by providing a framework to assess and evaluate the structure, processes and outcomes of care. The purpose of this paper is to examine the elements of the clinical microsystem developed by the Institute of Medicine (Godfrey & colleagues, 2004) and how it could be used to improve electronic medical records (EMR) practices in the Malaysian Government Hospitals. Among the critical elements of the clinical microsystem analysed in this paper include leadership roles, teamwork, working environment, patient needs and market focus, the use of electronic tools for patient care improvement, process of changes in implementing EMR and the role of technology in facilitating the integration of healthcare work. The concept of microsystem could provide a new frontier in organizational health services management research. There is an urgent need for research to be carried out to asses how well the government of Malaysia is in a position to provide efficient healthcare services within the context of electronic medical records practices as the government is making a significant investment in healthcare for its citizens.