Pengembangan SIM RS Berbasis Open Systems

Guardian Y. Sanjayagysanjaya@gmail.com

Strategi adopsi sistem informasi di rumah sakit nirlaba, RS Pendidikan dan mekanisme dukungan komunitas

Outline

1. Cakupan sistem informasi rumah sakit1. Cakupan sistem informasi rumah sakit

2. Adopsi sistem informasi di RS2. Adopsi sistem informasi di RS

3. Peluang Open Source SIM RS3. Peluang Open Source SIM RS

4. Tatakelola sistem informasi internal RS4. Tatakelola sistem informasi internal RS

5. Sustainabilitas SIM RS & dukungan komunitas 5. Sustainabilitas SIM RS & dukungan komunitas

PELAYANANPASIEN MASUK

-Registrasi-Admisi masuk

Sarana Pelayanan Laboratorium: Ex: Kimia Klinik

Sarana Pelayanan Radiodiagnostik: Ex: X-ray,

Sarana Pelayanan Farmasi: Ex: dispensing, Inventori barang “liquid”, stok obat

Sarana Pelayanan Rawat Inap: Ex: Ruang perawatan

Sarana Khusus Tindakan Medis dan Rehabilitasi: Ex Ruang OK, Bersalin, ICU, Fisioterapi

Sarana Umum Pelayanan: Ex: Rekam medis, keuangan, manajemen

Keg

iata

n U

tam

a

PEMERIK-SAANMEDISAWAL

•Riwayat penyakit•Vital sign•Pemeriksaan fisik

DIAGNOSIS

•Diagnosa klinik•Diagnosa keperawatan

PERSIAPAN TINDAKAN MEDIS

•Pemeriksaan penunjang dan skreening

TINDAKAN MEDIS

•Tindakan operasi•Pemberian obat-obatan

REHABILITASI

•Rehabilitasi fisik•Pola hidup

PELAYANAN PASIEN PULANG

•Discharge Summary•Rujukan•Surat keterangan

NILAI TAMBAH

Cepat

Efisien

Keg

iata

n P

end

uku

ng

Cakupan sistem informasi RS

Adoption from Porter’s value chain

SIM RS & Pelayanan Kesehatan

SIM RS = EHRAmatayakul, 2009 (AHIMA)

Pertanyaan penting

• Apakah SIM RS mahal?

• Bagaimana strategi adopsinya?

Adopsi SIM RS di Amerika

Davis, 2009. HIMSS Analytics

Adopsi SIM RS di Korea

Pola adopsi SIM RS

Cara adopsi Sisi baik Sisi kurang baik

Outsource - Instant- Brand name

- Relatif mahal- Susah dimodifikasi (closed

code)

In-house - Sesuai bisnis proses - Relatif lama- Sistem analist dan tim IT yang

handal

Open Source - Relatif cepat, customable, dapat menyesuaiakan bisnis proses

- Dukungan komunitas yang ‘labil’- Tim IT yang kuat

Mix - Customable - SDM yang ‘mumpuni’

Road Map SIM RS

Collector

Phase 1Documenter

Phase 2Create data/information, 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

Partner

Phase 4 Mentor

Phase 5

GartnerGroup generation of EHR (Amatayakul, 2009)

Waktu

Peluang Open Source

• Care2x

• OpenMRS

Lingkungan SIM RS

Peluang Open Source

ApplicationGovernance

SIM

Asp

ekS

osio

-tekn

is,

Kea

hlia

n,

pene

rimaa

n

Aspek

Keamanan,

privasi,Integritas,

aksesibilitas

AspekTatakelola, Struktur

OrganisasiPembiayaan

Infrastructure

Siapa melakukan apa?

DecisionSupport

Management System

Clinical and Administration

Strategic Planning

Strategic Planning

Periodic QueriesPeriodic Queries

Operational Systems

Data Transaction

Data Transaction

Management Control

Management Control

Operational Control

Operational Control

Schedule,On demand

reports

Schedule,On demand

reports

5%

28%

5%4%

9%

35%

14%

Senior manager Health RecordsKnowledge Management ICT

Clinical Coders Information ManagementClinical Informatics

Komposisi tim SIM RS(Tribal survey, 2009)

Memperkuat sistem open source

Penelitian pengembangan sistem

Pendampingan implementasi

Sosialisasi pengalaman (knowledge sharing)

Penguatan komunitas

melalui working-working group

(SNI, standards, Clinical

Informatics)

Pengembangan mandiri (motivasi, efisiensi)

Penggunaan aplikasi open source

Upaya percepatan adopsi (SIM RS Generik, UHC)

Penyusunan Regulasi (UU PP, Permenkes, Petunjuk Teknis, Standardisasi)

Gov. Praktisi Profesi Akademisi

Customisasi/pendampingan sistem

Support community development

Industri

NETWORKING

Why HIS training?

Source: BNPB and Ministry of Health, 2011

Maps of health facilities in Indonesia, per April 2011

Proposed scaling up model

Open Development and Support

Other Hospitals

Piloting Hospitals (center of excellences)

Sister hospitals

IS StaffTechnical support

Capacity building

Initiator Group(Core team)

Open SourceSIM RS

Advanced Technical support

Capacity building

Community Development

NGOsNGOs

Local VendorsLocal VendorsLocal Vendors

UniversitiesUniversitiesUniversities

Puskesmas/DHO Technical StaffPuskesmas/DHO Technical StaffPuskesmas/DHO Technical StaffNon profit

Teaching Hsp.

Coordinate Development

Technical support

Partnership

Sampai mana RS mau mengadopsi SIM RS?

Clinical and administration systems

Tools NetworksKnowledge Rules

Using Information Technology

Terimakasih