The Study of E-Catalogue System on the Performance of Medical Equipments Procurement at West Bandung District (KBB) Health Services 2017

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International Seminar on Global Health (ISGH) 2017 Stikes Jenderal Achmad Yani Cimahi

The Study of E-Catalogue System on the Performance of Medical Equipments Procurement at West Bandung District (KBB) Health

Services 2017

1Ayu Laili Rahmiyati, ²Gunawan Irianto

1,2 Public Health Science Dept, Stikes Jenderal Achmad Yani Cimahi E-mail: [email protected]

Abstract

E-catalogue system is an electronic information system accommodating certain list, sort, technical specification and price of goods and services from various government goods and services provider.

This e-catalogue system supports the process of implementation of medical equipments procurement. The realization of it has been implemented in 2015 based on the regulation of Government Procurement of Goods and Services Agency number 14 of 2015. The success of e- catalogue implementation on the realization of medical equipments procurement is marked by human resources that have competence and corresponding certificate of goods and services procurement as well as budget policy, adequate facilities, and procurement method which is accordance with the required medical equipments specification. The aim of this research is to know the description of e-catalogue system application towards the performance of medical equipments procurement in accordance with government regulations in order to increase health services at West Bandung District. The method used in this research was qualitative method. Qualitative approach was acquired with interview on the parties related to the management of medical equipment in West Bandung District Health Office. The subjects of this research were Health Office of West Bandung District, Batujajar Public Health Centre and Jaya Giri Lembang Hospital. There were some supporting and inhibiting factors on the implementation of e-catalogue system to procurement of health equipments. The supporting factors were the competent human resources at Health Office and adequate budget. Whereas the inhibiting factors were human resources in health service unit that have not been exposed to training as well as inadequate procurement certificate of goods and services, budget constraints, and internet connection. However, those limitations did not hamper the implementation of e-catalogue system on medical equipments procurement since it was managed well by e-catalogue executive team, monitored and evaluated periodically by Head of West Bandung District Health Office.

Keywords: Qualitative, E-Catalogue, Medical Equipment Procurement

Introduction

Health development is carried out with involvement of various service elements, from the availability of manpower, infrastructure, health budget, implementation methods and applicable laws and regulations. This has an impact for local government to continuously and sustainably improve health development. Along with rapid health development activities, the needs of equipments that support the implementation of health service operations are increasing. Thus it requires a reliable logistics management system. Logistics management system is needed to support health service activities.

E-catalogue system is an electronic information system accommodating certain list, sort, technical specification and price of goods and services from various government goods and services provider. Medical equipments are equipments needed to support health services. There are medical equipments that have high investment value, for example: surgical lighting, radiology equipments, and medical equipments supporting medical activities, such as: tweezers, stethoscope, etc. Medical equipments managed by West Bandung District Health Office are investment medical equipments whose source of funding comes from amended state budget (APBN-P) and amended state budget or regional government budget (APBD). Procurement system of medical equipments uses e-catalogue system.

The management of investment medical equipments at West Bandung District Health Office is an activity to fulfil health service needs at the Hospital and Public Health Centre is West Bandung District. The goods administered have to be carried out with appropriate procurement of

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goods and planning system in supporting health services to the community. Based on 2010 and 2014 researches it is mentioned that the completeness of primary service infrastructure facilities is only 70%.

Based on this matter, Public Health Centre as primary health care centre needs to get medical equipments supporting health services. Public health center requests medical equipments to West Bandung District Health Office, which in its implementation, health equipments procurement is carried out by Procurements Service Unit. The enforcement of medical equipments procurement before 2015 has not used e-catalogue system thoroughly, so that it still used to apply direct auction/

procurement system, with the result that procurement took a long time, was less effective, and potentially had allegation of fund inflation. Therefore, by 2016, the implementation of medical equipments procurement with e-catalogue system is fully implemented, based on presidential regulation (perpres) number 4, 2015 on procurement of goods and services, and Government Procurement of Goods and Services Agency number 14, 2015.

The purpose of this research is to know the description of the performance of logistic management of medical equipments with e-catalogue system for improvement of health service with the specific purpose of knowing the description of supporting and inhibiting factors of the implementation of medical equipments management with e-catalogue system.

Method

The method used in this research was qualitative method. Qualitative approach was acquired with interview on the parties related to the management of medical equipment in West Bandung District Health Office. The subjects of this research were Secretariat Field, Head of Sub Personnel and general, and coordinator of goods executing at Health Office, Public Health Centre, and Hospital in West Bandung.

The variable in this research was the implementation of e-catalogue system in management of medical equipments logistic at West Bandung Health Office. The stages of analysis performed are as follows:

Input Process Output

1. Human resources Procurement Performance of medical equipments 2. Money/Budget of medical equipments procurement

3. Method with e-catalogue system

4. Material 5. Infrastructure

Fig 1. Implementation of e-catalogue system

The data collection in qualitative research is done naturally. Primary data source and more data collection technique also take part (participation observation), in depth interview, and documentation (Sugiyono, 2008; 403).

The procedure and data processing used in this research using triangulation is expected to obtain accurate data by studying the data obtained in order to establish justification on the theme/ topic of research coherently (interrelated logically) (Creswell, 2009; 1994).

Results

1. Human Resource

Human resource is an individual who works as activator of an organization both institutions and companies and serves as an asset whose abilities must be trained and developed. Human resource is the most important asset and is a tool to gain competitive advantage which, if managed properly, will provide many contributions that result in organizational effectiveness (Kaswan, 2010). Management of health equipments at West Bandung District Health Office is carried out by Commitment Making Official (PPK), ordering official, procurement official elected by West Bandung District Health Office. In the management of medical equipment, all government agencies are required to comply with the Minister of Home Affairs Regulation number 19 of 2016 governing the guidelines on the management of regional property and guidelines on the procurement of goods and services.

Commitment Making Official (PPK) takes a strategic role on goods and services procurement, among them is to determine the own price forecasts and determine the specification of the required

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Here are some phrases from resource persons on the availability of Human Resource on the process of planning and implementation of goods management.

“There are 1 treasurer of goods and 3 procurement officers who already have certification of procurement of goods and services” ….(Health Office informant)

“The treasurer of the goods at Public health center is held by the midwife, so it is not in accordance with the educational background, there are double jobs”…. (Public health center informant)

“The treasurer of the goods at the hospitals is held by one person, with limited energy and limited space, hard to store large medical equipment”…. (Hospital informant)

2. Money or Budget Policy

Budget is the amount of money spent in a certain period to implement a program. There is no single company has an unlimited budget, so the budgeting process is important in a planning process.

“The implementation of medical equipments procurement in West Bandung District Health Office consists of three ways of procurement; First: Through e-catalogue, where the e-catalogue is the output of Government Procurement of Goods and Services Agency (LKPP) and done on-line;

second: conducted by auction, if the goods are not contained in e-catalogue and the price is more than Rp. 200.000.000,-; third: through direct appointment if the goods are worth less than Rp.

200.000.000,-, - and not listed in the e-catalogue” …. (Health Office informant)

“Medical equipment expenditures come from National Health Insurance (JKN) and regional government budget (APBD). At Public health center, for medical equipment purchased from National Health Insurance (JKN) budget, the procurement is directly done by Public health center, while the spending of medical equipments funded from regional government budget (APBD) is done by Health Office” …. (Public health center informant).

“The source of budget for the procurement of health equipments is from Health Operating Cost (BOK), regional government budget (APBD), and National Health Insurance (JKN). The problem is that in one purchasing activity there should be no double budget, and Corporate Social Responsibility (CSR) plans with private parties for additional funds in health equipment procurement. For example, the procurement of medical equipments at Cililin Hospital and Rongga Public Health Centre (Public health center) construction last year and construction of Cipongkor Public Health Centre (Public health center) this year. And there is more funds from profit sharing fund of tobacco excise (DBHCT) or cigarette excise tax which is used for the procurement of ambulances. Cigarette excise tax is also used for health promotion.”

3. Method

Based on the interview, the method for carrying out the goods management activities is done according to government regulations, as said by the informant as follows:

“The method used for the management of goods is based on government regulations, for procurement/ purchasing uses e-catalogue, while the distribution is directly from the supplier to Public health center, later on the ones from Public health center accepted by the treasurer of goods and signed the proof of stuffs out” (Health Office informant).

Planning needs of medical equipments are submitted from each unit at Public health center, then recapitulated by the treasurer of goods to submitted to the Health Office (Public health center informant) and also there are aids from Ministry of Health, like 32 vaccine carriers came last week, in accordance with number of health centres in West Bandung District. Based on the results of the above interviews, the process of medical device management at each public health center begins by collecting and registering the needs of each unit in the public health center, then submitted to the health office, and some are from the Ministry of Health.

4. Material

Information on the process of planning of medical equipment to distribution of goods, in addition to in-depth interviews, researchers conducted a document review. From the result of document review in the appendix, it is found that from the inventory document still using manual recording, does not have operational standard yet in operationalizing medical equipments. Healthcare

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facilities management at KBB Health Department is sufficient, the facilities are: computer, internet, but there is no special room for medical equipment warehouse.

5. Machine or infrastructure

Procurement activities and management of medical goods / devices cannot run maximally if not supported by supporting facilities and infrastructures. Here is the information obtained related to infrastructure:

“We have limited space for facilities and infrastructure, no place for temporary storage of medical devices. There is internet disruption with e-catalogue procurement system” (health office informant).

“Public health center does not have a medical equipment warehouse ... internet is not optimal ..."

(PKM informant).

"The storage of medical devices in hospitals is limited, so that directly distributed to the unit.

(Hospital informant)

6. Description of Implementation of Medical Equipment Management with E-catalogue system in West Bandung District

Implementation of health equipment management activities by Activity Technical Activity Officers (PPTK), in terms of policies and regulations on medical equipment management in the government environment of West Bandung Health Office, are as follows:

"In fulfilling the needs of medical equipment in the environment of Public health center and Hospital, West Bandung District Health Office, based on Presidential Regulation no. 4 of 2015, on the procurement of goods and services. "

"Every medical equipment procurement, West Bandung District Health Office, issued a decree for KDP, PPHP, and PPTK, the letter of duty is signed by the Head of Service, in the implementation, letter of duty issued are two, the first is to handle about Procurement in the form of goods and the other is to handle of construction. "

"Each member is a person who has attended training on goods and services and has been certified, but still served in the Health Office of West Bandung, because it is an assigned task."

The decree is issued with a period of 1 year, and in contains the duties, responsibilities, authority, and about benefits provided. Regarding the mechanism of medical equipment management in West Bandung District Health Office, based on interviews in West Bandung District Health Office, namely:

"The implementation of medical equipment procurement in West Bandung District Health Office consists of three ways of procurement: First: Through e-catalog, where the e-catalog is the output of LKPP and done on-line. Second: Conducted by Auction, if the goods are not contained in e- catalogue and have value more than Rp. 200.000.000, -, Third: Through direct appointment if the item is worth less than Rp.200.000.000, - and not listed in the e-catalogue. "

Commitment making official (PPK) has a strategic role in the procurement of goods and services, among them is to determine the HPS (own estimated price), and determine the specification of the required goods. "

"The determinant to choose which distributor will be appointed is the authority of the procurement officer, where in West Bandung District there is the ULP (Procurement Services Unit), is a unit in the form of SKPD which is headed by the Head of ULP, and its members are representatives of each SKPD Which already has a certificate of goods and services. "

There are the strengths and weaknesses on the implementation of electronic catalogue according to informants, namely:

"The implementation of e-catalogs helps improve the procurement performance online, but there are still many medical devices that are not listed in e-catalogue, especially Dental Poly, there are none in the e-catalog required by the dentist, so the goods have not been fully fulfilled. (Public health center Informant)“

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The weakness of e-catalog system is that the errors often occur and the updated prices often change, while the advantages are the system is easy to operate and not too complicated. (Hospital informant)

Human Resources managing the system do not have an administrative background, but there are nurses, midwives, sanitarians, etc. (Public health center Informant).

Internet network in remote areas of west Bandung District is still not good, even though the health service has made a station transmitter in some areas, but still not good. (Health Office informant)

There is lack of knowledge about medical devices to be purchased, both in terms of benefits and specifications. (Health Office informant)

Discussion

1. Human Resource

Based on the results of the above interviews, the information appears that the human resources in the management of goods is not a competent administrative officer in the field, but held by a health professional, so they do double work. It is necessary to improve the qualification of goods management by involving training and certification of goods and services management.

The recipient of a medical device at the Public health center is a treasurer of goods who is a midwife.

Planning/ submission of medical equipment to the health office based on the submission of each room then summarized and submitted to the Head of Public health center to be submitted to the West Bandung Health Office. While the recipient of medical equipment at the hospital held by one person that is treasurer of goods. Goods that come are checked and tested for its feasibility function.

The determinant to choose which distributor to designate is the authority of the procurement official.

The procurement officer in West Bandung District is the ULP (Procurement Services Unit), is a unit in the form of SKPD which is headed by the Head of ULP, and its members are representatives of each SKPD that already has a certificate of goods and services.

2. Money and Infrastructure

Based on the results of the above interviews it can be concluded that, in terms of funds, health equipment spending comes from APBD, and JKN. Expenditure of the same medical equipment should not get a double budget, so that the financing is adjusted. If it is already funded by APBD, then it cannot be budgeted in JKN. The budget provided by the Health Office for medical equipment expenditure is issued in accordance with the previous year's budget program.

Procurement of medical equipment can be obtained from 3 sources namely APBD, BOKK and JKN.

The allocation of funds obtained is sufficient and adjusted to the priority activities. For activities that are still lack of funds, the public health center / hospital can work together with the private sector by doing CSR (Corporate Social Responsibility).

3. Method

Methods of management of goods, especially medical devices in accordance with applicable laws and regulations. In fulfilling the needs of medical equipment in the environment of Public health center and Hospital, West Bandung District Health Office based on Presidential Regulation no. 14 Year 2015, concerning the procurement of goods and services. In the management of medical devices, all government agencies are required to comply with the Minister of Home Affairs Regulation no. 19 of 2016, which regulates the guidelines on the management of regional property.

Based on the policy of the Head of Government Procurement of Goods and Serviced Agency number 14 of 2015 procurement of goods must be done by E-catalogue system in E-Purchasing. Where the E-Purchasing method is still constrained, as price updates change, the list of necessary medical devices is limited/ not in e-catalog, often error, internet network connection is sometimes weak.

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4. Material

Internet network has not been maximized, whereas the system of procurement of equipment must be done with e-digital. Likewise in Public health center and hospitals, the facilities are still limited and the warehouse of medical equipment is not available. The device is an information network, network capital, asset network, and data network whose use is for the purposes and common interests of Health Office, Public health center, Hospitals and suppliers.

5. Machine/ Infrastructure

Based on the interviews there are some information obtained as follows: infrastructure facilities are needed to carry out activities of management of goods such as internet for procurement of goods with e-catalog, as well as facilities such as report forms, form submission tools, etc. Standard of Operating Procedures (SPO) is required as a guide in carrying out activities, as well as technical guidance is required to provide an overview of activities planned by the Health Office and as the basis for planning of medical equipments. The medical equipment warehouse room is indispensable for the goods storage activities before being distributed to the unit in need. Healthcare facilities management facility in West Bandung District Health Office is sufficient, there is computer, internet, but there is no special room of medical equipment warehouse. Internet network has not been maximized, whereas the system of procurement of equipment must be done with e-digital. So also in health centers and hospitals, the facilities are still limited and the warehouse of medical equipment is not available.

6. Description of Implementation of Medical Equipment Procurement Management with E- catalogue system in West Bandung District

Based on the interviews it is found that there is a need for cooperation both cross-program and cross- sector cooperation to plan and implement medical equipment procurement. The authority of the commitment making official and the implementation of the procurement and planning of medical goods/ equipment is carried out in accordance with the laws and regulations.

Tabel 1. Description of Supporting and Inhibiting Factor of E-catalogue system Implementation in West Bandung District in 2017

Activity Executive System Supporting Factor Inhibiting Factor Planning Executive Unit Online form of Budget available Limited budget needs

medical

of (Public health center,

submission of medical devices equipments Hospital)

Procurement of medical equipments

Receiver/Use r

Commitment making official (PPK), Ordering officials, procurement officials

Treasurer of Health Service Unit Goods

E-catalogue Regulations of

Government

Procurement of Goods and Services Agency

Checking Conformity of goods specifications

Limitations of facilities, internet signals, frequent errors, fluctuate price updates, limitations on the specifications of medical

equipments Human Resource qualification, Difficult to checking of specification

order

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Conclusion

Implementation Procurement of medical devices with E-catalog system based on the regulations of Government Procurement of Goods and Services Agency No. 14 of 2015 in West Bandung District was just implemented around 2015. Of course there are many factors that support and obstruct the implementation. Factors that support the existence of human resources in West Bandung District Health Office that have expertise and certificates of procurement of goods and services, the appropriate budget, internet facilities and other supporting facilities, while the factors that hamper the human resources in the health service units (health centers and hospitals) are those who has not had a procurement certificate of goods and services, budgets that are not in accordance with the required product specifications, internet connection limitations, and limitations on the list of medical devices in E-catalogue. Benefits of E-catalog Systems in the provision of medical devices in health services is to accelerate the procurement process, reduce the defraud of mark-up price, the existence of standard provisions and specification of medical devices used for health services, so it is necessary to conduct human resources training in health service units in the implementation of E- Purchasing, adequate facilities, and cooperation between health offices, users (health care units such as public health center, hospitals), and suppliers in improving the implementation of the E-catalogue system in accordance with government policies and regulations. Suggestions of further research are increase the objects of the research, such as suppliers of medical equipments against the response of the implementation of E-catalogue, describe more details about the types of medical equipments that can be included in the list of E- catalogue.

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