2016 Infokes Sesi 7 GYS Standard dan Interoperabilitas Informatika Kesehatan

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_{Kenapa standar dan interoperabilitas}

_{Standar dalam informatika kesehatan dan permasalahannya} _{Model maturitas interoperabilitas, inisiatif dan contoh}

pelaksanaanya

_{Konsep pertukaran data kesehatan (HIE)}

_{Strategi untuk mendorong interoperabilitas}

_{Tatakelola untuk mencapai interoperabilitas sistem informasi}

kesehatan

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_{Berapa banyak sistem informasi kesehatan di tempat kita?}

_{Berapa banyak vendor dan organisasi kesehatan bekerja pada}

sistem informasi kesehatan?

_{Apakah fasilitas kesehatan telah mengadopsi rekam}

kesehatan elektronik?

_{Berapa banyak biaya yang terbuang akibat duplikasi}

pengumpulan data?

_{Dapatkah interoperabilitas meningkatkan kualitas pelayanan}

dan keselamatan pasien?

(5)

MoH

SIHA _SITT

KARTINI

SI STBM Faskes

Faskes_FaskesHealthca

re Facility

Lainny

a REGISTRY

SURVEILANCE

VITAL STATISTIC REPORT Lainny

a HEALTH

FACILITY REGISTRY

MEMBERSHIP

SEP

P-CARE

Social Health Insuranc

e

Individual

Data

Aggregate

Data

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Sistem Informasi digunakan di semua level organisasi

kesehatan

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Sistem Informasi di Fasilitas

Kesehatan

_{An EMR is a computerized medical record used to capture,}

store and share information between health-care providers in an organization, supporting the delivery of health services to patients.

_{An EHR is a computerized health record used to capture,}

store, access and share summary information for a patient between health-care organizations and providers.

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 _{patient’s problem list,}  _{medication record,}  _{history and physical,}  _{progress notes,}

 _{consultation reports,}  _{physicians’ orders,}

 _{nurses’ notes and interventions,}

 _{rehab and other clinical documentation,}  _{imaging and x-ray results,}

 _{lab results,}

 _{immunization record,}  _{operative report,}

 _{pathology report, and}  _{discharge summary}

Data Klinis

_{demographic information about the}

patient,

_{consents for treatment and surgery,}

_{authorizations,}

_{pre-authorization,}

_scheduling,

_{insurance eligibility,}

_{billing, and}

_{diagnosis and procedure codes}

(klaim)

Data Administratif

Tipe data yang dikumpulkan

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_{Data standards} _Resistensi

_{Regulasi dan tatakelola}

_{Privasi dan kerahasiaan data} _{Mekanisme insentif}

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_{An essential building block of interoperability is the adoption}

and use of:

Terminology, and

Messaging standards

_{Terminology standards will provide an unambiguous,}

machine-readable meaning of specific terms and messaging standards permitting the electronic exchange of information in a consistent manner

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_{ICD 10}

_{ICD 9CM}

_ICD-O

_UMDNS

_LOINC

_{NANDA, NOC, NIC}

_…….

Standar Internasional

_{Sosio-demografi}

_Obat

_Billing

_{Unit layanan}

_{Panamaan tempat tidur}

_…….

Standar Lokal/Nasional

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_{Struktur informasi/ messege}

untuk setiap aktivitas

Pasien baru Admisi pasien

Pemeriksaan fisik Hasil pemeriksaan

penunjang

Diagnosis

Tindakan medis Obat

<confidentialityCode code="N"

codeSystem="2.16.840.1.113883.5.25"/>

</referenceRange>

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_{Classification, vocabulary, and terminology standards;} _{Data interchange standards; and}

_{Health record content standards}

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1. Ad hoc – when a group of interested people or organizations agree on a certain specification;

2. Defacto – when a vendor or other commercial enterprise

controls such a large segment of the market that its product becomes the recognized norm;

3. Government mandate – when the government mandates a standard;

4. Consensus – when representatives from interested parties work together and reach a consensus.

Pengembangan standard

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_{IHTSDO  SNOMED-CT}

_{Regenstrief Institute  LOINC}

_{WHO  WHO International Family of Classification}

_HL7

_DICOM

_{NLM  RxNorm}

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_{Need for multi-purpose standards and terminologies} _{Lack of content in terminology standards}

_{Gaps in data standards} _{Overlapping standards}

_{Different requirements from different agencies when}

exchanging data

_{Changes in standards}

Isu yang berkaitan dengan

standar

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Interoperabilitas

_{Kemampuan antar sistem yang berbeda untuk komunikasi}

dan pertukaran informasi secara akurat, efektif dan konsisten serta menggunakan informasi tersebut.

Antar sistem di dalam organisasi kesehatan (EMR) Antar sistem lintas organisasi kesehatan (EHR)

_{Kebutuhan interoperabilitas}

Arsitektur interoparabilitas (OpenHIE)

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Maturitas model interoperabilitas

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Collector

Phase 1 Document_er Phase 2

Create

data/informatio n,

Unidirectional Goal: intention

Point-of-care data capture, Simple Alert system, Result management Goal: Efficiency

Longitudinal record

DSS in acute care and ambulatory Goal: efficiency, patient safety

Helper

Phase 3

Evidence-based practice

Combine with PHR

Goal: Consumer empowerment

Health Information exchange Goal: Integrated health service

Partne r

Phase 4 Mentor

Phase 5

GartnerGroup generation of EHR (Amatayakul, 2009)

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Keuangan

Pendaftaran

Laboratorium

Radiologi

In

te

rf

a

ce

1

Interfa ce 2

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Interface Engine

Pendaftaran

Laboratorium

Radiologi

Sha re da_ta

Share data

Sha re d_ata

Share data

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Technical Interoperability

Semantic Interoperability

P

ro

ce

ss

In

te

ro

pe

ra

bil

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PUSKESMAS:

Programs use DHIS2, both data use and

reporting DISTRICT:

Integrated data warehouse & dashboard

Puskesmas – Health facility

PROVINCE:

Integrated data warehouse & dashboard used by all

DHIS2

Data access & use

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Output

Data Bank E-Logsitik

Pharmacy Warehouse MoH

Internet

Internet Internet

Primary Care Information

Systems

Pharmacy Warehouse PHO

Web Services/ txt File

Web Services

MoH

202.70.136.60:8181/e-logistics Pharmacy

Warehouse DHO

Monthly report Medical Product Distribution

Promoting Drug Standard

Distribution

Reporting

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INA-CBGs (DRG)

HOSPITAL SYSTEMS

SEP SYSTEM

WEB SERVICE

CLIENT REGISTR

Y

P-CARE

WEB SERVICE

PRIVATE CARD ID

REFERRAL ID

SEP ID

CARD ID REFERRAL ID

C

Admission registry

SUPPLY DATA

PHC SYSTEMS

SIKDA

e-Puskesmas OTHERS

SIMPUS

HOSPITAL SYSTEMSHOSPITAL _SYSTEMS

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Arsitektur Pertukaran Data Kesehatan

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Health Information Exchange

Healthcare Providers Payors Supply Chain Personal Health _Portal Others

Community health workers

Systems Hospital

Systems Lab.

Systems

Pharmacy Systems Primary Care

Systems

Private Insurance Providers Public Insurance Providers

Pharmaceutical company Distribution

channel Medical Suppliers

Personal Health

Records HealthPublic Research

Government Community/NGOs

Client Registry

Health Provider

Registry

Health Facility Registry

Terminology Standard

Shared Health Records

Emergency Medical Services

Health Managament

Information Systems

Telemedicine Finance/Bank

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Goal of EHR: Health Information exchange

_{Model Consolidated: Central Repository System}

Central Database

Praktek Pribadi

Puskesmas

Rumah Sakit

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Local repository

Local

repository Localrepository

Local repository

Goal of EHR: Health Information exchange

_{Federated: independence repository system}

Praktek Pribadi _Puskesmas Dinas Kesehatan Klinik/RS Swasta Rumah Sakit

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Patient's repository Standard

Interoperabilitas

Goal of EHR: Health Information exchange

_{Patient Manage model}

Praktek Pribadi Puskesmas

Rumah Sakit

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Bagaimana mencapai interoperabilitas?

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_{Standar terminologi kesehatan mulai dikembangkan}

(idn-hdd.depkes.go.id)

_{Tersedia standar internasional}

_{Adanya dukungan kebijakan (Peraturan pemerintah)} _{Keragaman sistem informasi}

_{Inisiasi integrasi sistem dan interoperabilitas}

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_{Standar mendukung komunikasi data antar organisasi}

kesehatan, pelayanan kesehatan yang efisien (interoperabilitas)

_{Beberapa inisiatif yang mengarah pada isu interoperabilitas} _{Banyak model interoperabilitas yang sudah terjadi}

_{Perlu tatakelola yang jelas terhadap pencapaian}

interoperabilitas

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