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Background. HIS can play an important role to improve patient safety. Whilst implementation of an HIS still a dark area for many hospital management. The aim of the research is to identify the obstacles in the implementation of HIS, also the cost that bears to the hospital management in the implementation of HIS Method. A systematic search of the literature, which is published between 1982 and 2017 was conducted. We conduct the search in four databases, “PubMed”, “Science Direct”, and “Web of Science”. This study focuses on the obstacles and the implementation of HIS, especially the cost involved in the implementation. In this study, we include all types of information systems available and use within the hospital environment, not strictly to the Electronic Medical Record (EMR) only. Result. The obstacles to implementation are varied. From the lack of training, the lack of IT support, and even the most basic requirement, the lack of electricity. On the other side, the user also complains that is not comfortable in using the system, eg: computer that in a fixed position, worried about the security, and they do not believe that the system will solve the problems. Even one study report that they cancel the implementation. On the other side, the cost of implementation also varied, ranging from 3000 to 26 million US dollars. The differences in the cost are due to the difference in the complexity and the place of the implementation itself (ie. single department vs the whole hospital). Conclusion. With the cost of implementation that is considered expensive for a complex system, the anticipation of the probable problem is mandatory. The HIS implementation should be planned thoroughly and carefully, covering the aspect of hardware - software, data, users (people), and also policy.