SIM - Manajemen Rumah Sakit

Pengembangan SIM RS Berbasis
Open Systems
Strategi adopsi sistem informasi di rumah sakit nirlaba, RS
Pendidikan dan mekanisme dukungan komunitas
Guardian Y. Sanjaya
[email protected]
Outline
1. Cakupan sistem informasi rumah sakit
2. Adopsi sistem informasi di RS
3. Peluang Open Source SIM RS
4. Tatakelola sistem informasi internal RS
5. Sustainabilitas SIM RS & dukungan komunitas
Cakupan sistem informasi RS
Kegiatan Pendukung
Sarana Umum Pelayanan: Ex: Rekam medis, keuangan, manajemen
Sarana Khusus Tindakan Medis dan Rehabilitasi: Ex Ruang OK, Bersalin, ICU, Fisioterapi
Sarana Pelayanan Rawat Inap: Ex: Ruang perawatan
Sarana Pelayanan Farmasi: Ex: dispensing, Inventori barang “liquid”, stok obat
NILAI
TAMBAH
Sarana Pelayanan Radiodiagnostik: Ex: X-ray,
 Cepat
Kegiatan Utama
Sarana Pelayanan Laboratorium: Ex: Kimia Klinik
PELAYANAN
PASIEN
MASUK
-Registrasi
-Admisi masuk
PEMERIKSAAN
MEDIS
AWAL
•Riwayat
penyakit
•Vital sign
•Pemeriksaa
n fisik
DIAGNOSIS
•Diagnosa
klinik
•Diagnosa
keperawatan
PERSIAPAN
TINDAKAN
MEDIS
•Pemeriksaa
n penunjang
dan
skreening
 Efisien
TINDAKAN
MEDIS
REHABILITA
SI
•Tindakan
operasi
•Pemberian
obat-obatan
•Rehabilitasi
fisik
•Pola hidup
PELAYANA
N PASIEN
PULANG
•Discharge
Summary
•Rujukan
•Surat
keterangan
Adoption from Porter’s value chain
SIM RS & Pelayanan Kesehatan
SIM RS = EHR
Amatayakul, 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
Evidence-based
practice
Collector
Phase 1
Create
data/information,
Unidirectional
Goal: intention
Combine with
PHR
Documenter
Phase 2
Point-of-care data
capture,
Simple Alert
system,
Result
management
Goal: Efficiency
Helper
Phase 3
Partner
Longitudinal
record
Phase 4
DSS in acute
care and
ambulatory
Goal: efficiency,
patient safety
Waktu
GartnerGroup generation of EHR (Amatayakul, 2009)
Goal: Consumer
empowerment
Health Information
exchange
Goal: Integrated
health service
Mentor
Phase 5
Peluang Open Source
• Care2x
• OpenMRS
Lingkungan SIM RS
Infrastructure
SIM
Governance
Application
Peluang Open Source
Aspek
Tatakelola, Struktur
Organisasi
Pembiayaan
Siapa melakukan apa?
Komposisi tim SIM RS
(Tribal survey, 2009)
Periodic
Queries
Decision
Support
Strategic
Planning
4%
5%
14%
28%
Schedule,
On demand
reports
Management
System
Operational
Systems
Data
Transaction
Clinical and Administration
Management
Control
9%
5%
Operational
Control
35%
Senior manager
Knowledge Management
Clinical Coders
Clinical Informatics
Health Records
ICT
Information Management
Memperkuat sistem open
source
Gov.
Upaya
percepatan
adopsi (SIM RS
Generik, UHC)
Penyusunan
Regulasi (UU
PP, Permenkes,
Petunjuk Teknis,
Standardisasi)
Praktisi
Pengembangan
mandiri
(motivasi,
efisiensi)
Penggunaan
aplikasi open
source
Profesi
Penguatan
komunitas
melalui workingworking group
(SNI, standards,
Clinical
Informatics)
NETWORKING
Akademisi
Penelitian
pengembangan
sistem
Pendampingan
implementasi
Sosialisasi
pengalaman
(knowledge
sharing)
Industri
Customisasi/pen
dampingan
sistem
Support
community
development
Maps of health facilities in Indonesia, per April 2011
Why HIS training?
Source: BNPB and Ministry of Health, 2011
Proposed scaling up model
Capacity building
Piloting Hospitals (center of
excellences)
IS Staff
Capacity
building
Other
Hospitals
Technical support
Sister
hospitals
Advanced
Technical
support
Technical
support
Community Development
Open Source
SIM RS
Coordinate Development
NGOs
Puskesmas/DHO
Puskesmas/DHO
Puskesmas/DHO
Technical Staff
Technical
Staff
Non profit
Technical
Staff
Teaching Hsp.
Local
Local
Vendors
Local
Vendors
Initiator Group
(Core team)
Vendor
s
Partnership
Open Development and Support
NGOs
Universities
Universities
Universitie
s
Sampai mana RS mau mengadopsi
SIM RS?
Clinical and administration systems
Using Information
Technology
Tools
Knowledge
Networks
Rules
Terimakasih