Informatika pada Fasilitas
Pelayanan Kesehatan
Outline
•
Konteks sistem pelayanan kesehatan
•
Perspektif sistem informasi untuk pelayanan perorangan
•
Perspektif sistem informasi untuk manajemen organisasi
•
Perspektif sistem informasi untuk sistem kesehatan
•
Contoh informatika pada fasilitas kesehatan: Electronic
Medical/Health Records
Organizational model of health services
Essential Public Health management function
Sistem Jaminan Kesehatan Nasional dan Daerah
1. Regulasi sistem pelayanan kesehatan (rujukan
bertingkat)
2. Regulasi standar pelayanan kesehatan, kompetensi pelayanan masing-masing level, standar obat dan alkes 3. Monitoring sistem
Client/Patient Management Perspective
Essential Public Health management function
Client/Patient Management Perspective of
informatics
•
Effectiveness and efficiency of patient care
•
Patient safety and quality of care
–
Patient identification
–
Accessibility of patient informations=
–
Electronic prescription
–
Clinical decision support systems
•
Reduce cognitive load
•
Evidence-based practice
Health Unit Management perspective
Essential Public Health management function
Health Unit Management perspective of
Informatics
•
Accuracy and transparency of information (relating to patient care,
human resources, billing, financials, etc.)
•
To support management decisions for the purpose of service
improving organization and customer/client management
•
Assist health facilities in routine reports, both internal report
(Management, Owners) and externally (DHO, Ministry of Health)
•
To co
u icate ith others i order co plia ce to regulatio
Information output for organization
management
•
Information for decision making
•
Management of hospital resources (logistics drugs)
•
Human Resource management (capacity building, human resource planning)
•
Financial management (billing, claims, assets)
•
Payroll and remuneration
•
Routine reporting
Health systems management perspective
Essential Public Health management function
Health systems management perspective of
informatics
•
Sources of health data for the macro system (DHO, Ministry of
Health)
Electronic based health information systems
input
model
output
Database
Data Sources Data
Contoh: Output Laporan Rutin Rumah Sakit
•
Indikator pelayanan dasar: BOR, ALOS, TOI, Rata-rata kunjungan
•
Ketenagaan: Rasio perawat dengan TT, rasio dokter dengan jumlah kunjungan
•
Pelayanan RS
•
Pelayanan rawat inap: Jumlah kunjungan, pasien keluar hidup, pasien keluar meninggal (<48
jam dan >48 jam), lama dirawat, hari perawatan.
•
Pelayanan IGD: DOA, Meninggal di IGD, Jumlah pasien rujukan, dirujuk
•
Pelayanan Rawat Jalan, Penunjang Medis (Lab, Radiologi, Farmasi)
•
Morbiditas dan mortalitas
•
Data kunjungan pasien
•
10 besar penyakit rawat inap dan rawat jalan
Permenkes 1171/Menkes/SK/2011
Data Dasar
Data
Ketenagaan
Data Pelayanan
Morbiditas dan Mortalitas
Pengunjung RS
Data dasar rumah sakit
Indikator pelayanan rumah sakit Fasilitas tempat tidur rawat inap
Pelayanan rawat inap, Rawat darurat, Gigi dan mulut, Kebidanan,
perinatologi, Pembedahan, Radiologi, Laboratorium, Rehabilitasi medik, pelayanan khusus, Kesehatan Jiwa, KB, Pelayanan resep, dll
Data ketenagaan rumah sakit
Penyakit rawat inap Penyakit rawat jalan
Permenkes No. 75 Tahun 2014 tentang
Puskesmas
•
Pasal 43
1) Setiap Puskesmas wajib melakukan kegiatan sistem informasi Puskesmas.
2) Sistem Informasi Puskesmas sebagaimana dimaksud pada ayat (1) dapat
diselenggarakan secara eletronik atau non elektronik.
3) Sistem informasi Puskesmas paling sedikit mencakup:
a.
pencatatan dan pelaporan kegiatan Puskesmas dan jaringannya;
b.
survei lapangan;
c.
laporan lintas sektor terkait; dan
Permenkes No. 75 Tahun 2014 tentang
Puskesmas
•
Pasal 44
1) Sistem Informasi Puskesmas merupakan bagian dari sistem informasi
kesehatan kabupaten/kota.
2) Dalam menyelenggarakan sistem informasi Puskesmas, Puskesmas wajib
menyampaikan laporan kegiatan Puskesmas secara berkala kepada dinas
kesehatan kabupaten/kota.
3) Laporan kegiatan Puskesmas sebagaimana dimaksud pada ayat (2)
Information technology (informatics) in healthcare
eHealth as the
use of information and communication technologies (ICT) for health
. In its
broadest sense, eHealth is concerned with improving the flow of information, through
electronic means, to support the delivery of health services and the management of
health
syste s
(WHO-ITU)
....is a y o
i atio of
information technology
and people's activities using that
technology to support
operations
,
management
, and
decision-making
...
(Sebis, 2009)
•
… is o er ed ith
improvements
in a variety of human and organizational
problem-solving
endeavors through the design, development, and use of technologically based
systems and processes that enhance the
efficiency
and
effectivenes
s
of information in a
Components Description Examples
Individual electronic health information
Services that support the collection and storage of health information for an individual.
• Electronic health records (EHR)
• Electronic medical records (EMR)
• Personal health records (PHR) Health-care
communications and collaboration
Services that enable health-care providers electronically to communicate and share
information with other such providers as part of providing care to an individual
• Electronic referrals and specialist letters
• Electronic health event summaries, prescribing and test ordering
• Access to a i di idual s EH‘ a d test results
• Health-care provider and service directories
• Care plan management
• Appointment booking and management Health-care service
delivery tools
Services that support health-care providers in making diagnosis and treatment decisions, and in managing the delivery of care to an individual, whether electronically or in person.
• Medications management
• Prescription and test ordering decision support
• Clinical decision support
• Alerts monitoring and management
• Chronic disease management
• Real-time clinical data access and analysis
• Telemedicine (telehealth) and mobile health (mHealth)
Contoh: Sistem Informasi Manajemen RS
–
Permenkes No 82 Tahun 2013
•
Sistem Informasi Manajemen Rumah Sakit (SIMRS) adalah suatu
sistem teknologi informasi komunikasi yang memproses dan
mengintegrasikan seluruh alur proses pelayanan Rumah Sakit
dalam
bentuk jaringan koordinasi, pelaporan dan prosedur administrasi
untuk memperoleh informasi secara tepat dan akurat, dan
merupakan
bagian dari Sistem Informasi Kesehatan
.
•
Arsitektur SIMRS paling sedikit terdiri atas:
•
Kegiatan pelayanan utama (front office);
•
Kegiatan administratif (back office); dan
Permenkes 82 Tahun 2013 Tentang SIMRS
Pendaftaran
•
Pendaftaran
• Pendaftaran Melalui Telepon
• Pendaftaran Bayi Baru Lahir
•
Daftar Data Pasien
•
Daftar Kunjungan Pasien
•
Asuransi
•
Laporan
• Rekap Pendaftaran Pasien Rawat Jalan
• Pencarian Data Asuransi
Pembayaran/Billing
•
Bill
Rawat Jalan
•
Deposit Rawat Inap
•
Bill
Rawat Inap
•
Depo Rawat Jalan
•
Gizi Rawat Jalan
•
Laporan
•
Laporan Rawat Jalan
•
Laporan Rawat Inap
Permenkes 82 Tahun 2013 Tentang SIMRS
Laboratorium
• Daftar Order Lab
• Daftar Pemeriksaan Lab
• Hasil Pemeriksaan Lab
• Daftar Aps
• Daftar Pasien Rawat Inap
• Daftar Pasien Rawat Jalan
• Sisipan
• Laporan
• Register Pelayanan
• Jaspel
• Pencarian Data Asuransi
Radiologi
•
Daftar
Order
Radiologi
•
Daftar Pemeriksaan Radiologi
•
Daftar Aps
•
Daftar Pasien Rawat Inap
•
Daftar Pasien Rawat Jalan
•
Laporan
•
Register Pelayanan
•
Jaspel
Permenkes 82 Tahun 2013 Tentang SIMRS
Rawat Inap
• Daftar Pasien Rawat Inap
• Permintaan Makan
• Data Kamar
• Pencarian Pasien
• Laporan
• Laporan Harian
• Laporan Harian Pasien Keluar
• Sensus Harian
• Buku Register
• Jaspel
• Pencarian Data Asuransi
Farmasi dan Logistik
• Pengeluaran
• Daftar Pengeluaran
• Permintaan
• Daftar Permintaan
• Pengambilan
• Daftar Pengambilan
• Perencanaan Pengadaan
• Daftar Perencanaan Pengadaan
• Laporan Bulanan
• Laporan Harian
Permenkes 82 Tahun 2013 Tentang SIMRS
•
Sistem Back Office
•
perencanaan,
•
pembelian/pengadaan,
•
pemeliharaan stok/inventory,
•
pengelolaan Aset,
•
pengelolaan SDM,
•
pengelolaan uang (hutang, piutang, kas, buku besar dan lainnya).
Contoh Penggunaan Informatika:
Electronic Medical/Health Records
•
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
.
Cakupan Fungsi EMR dari Price et al. (2011)
1. Health Information
Patient information, medical summary,
clinical documentation
2. Laboratory management
Order, review, result, interconnection,
shared
3. Diagnostic imaging
Order, review, interpretation,
interconnection, shared
4. Prescription management
Order, decision support, dispensing
5. Referrals
Internal and external transmission of data
6. Decision support
Point-of-care reminder, chronic disease
management
7. Electronic communication
Communication internal and external
organization
8. Patient Suppport
Data sharing with patient (PMR), individual
health promotion
9. Administrative processes
Scheduling, billing, tracing medical records
10. Practice reporting
Clinical Decision support Systems
Function
Example
Alerting
Highlighting out-of-range laboratory value
Reminding
Reminding the clinician to schedule mammogram
Critiquing
Rejecting an electronic order
Interpreting
Interpreting the electrocardiogram
Predicting
Predicting risk of mortality from a severity-of-illness score
Diagnosing
Listing the differential diagnosis for patient with chest pain
Assisting
Tailoring the antibiotic choices for liver transplantation and renal
failure
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
Personal Health Records
Emergency Medical Services
Health Information Exchange
PCEHR Australia
National E-Health Transition Authority (NEHTA) Australia
