2017 Infokes Sesi 4 GYS Informatika pada fasilitas pelayanan kesehatan
Informatika pada Fasilitas
Pelayanan Kesehatan
Guardian Y. Sanjaya
gysanjaya.blog.ugm.ac.id
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
• Beberapa isu penggunaan informatika pada fasilitas kesehatan
Organizational model of health services
Essential Public Health management function
Lippeveld, Sauerborn. 2000. A framework for designing health information systems
Sistem Jaminan Kesehatan Nasional dan Daerah
Badan
Jaminan
Kesehatan
Peran Regulator:
1.
Regulasi sistem pelayanan
kesehatan (rujukan
bertingkat)
2.
Regulasi standar pelayanan
kesehatan, kompetensi
pelayanan masing-masing
level, standar obat dan alkes
3.
Monitoring sistem
kesehatan
Regulator
Puskesmas
Dokter Praktik
Memberi pelayanan
Peserta
Jaminan
Mencari pelayanan
Penyedia
Layanan
Klinik Pratama
Rumah Sakit
Apotik
Laboratorium
Client/Patient Management Perspective
Essential Public Health management function
Lippeveld, Sauerborn. 2000. A framework for designing health information systems
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
• Clinical research
Health Unit Management perspective
Essential Public Health management function
Lippeveld, Sauerborn. 2000. A framework for designing health information systems
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
(health insurance, referral systems, emergency medical services)
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
• Contributing to health systems monitoring and evaluation
Health systems management perspective
Essential Public Health management function
Lippeveld, Sauerborn. 2000. A framework for designing health information systems
Health systems management perspective of
informatics
•
•
Sources of health data for the macro system (DHO, Ministry of
Health)
Secondary use of data to assist in program planning, evaluation
and monitoring of the health system, research
Electronic based health information systems
Data Sources
Data
Management
Information
Tabuler
Maps
input
model
output
Reports
Specific
analysis
Database
Mon-Ev
Research
Usage
Health
profile
Compilation, integration
Visualization
Graphic
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), 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
• Kunjungan rawat jalan dan rawat inap
Permenkes 1171/Menkes/SK/2011
Data Dasar
Data dasar rumah sakit
Indikator pelayanan rumah sakit
Fasilitas tempat tidur rawat inap
Data
Ketenagaan
Data ketenagaan rumah sakit
Data Pelayanan
Pelayanan rawat inap, Rawat darurat, Gigi dan mulut, Kebidanan,
perinatologi, Pembedahan, Radiologi, Laboratorium, Rehabilitasi medik,
pelayanan khusus, Kesehatan Jiwa, KB, Pelayanan resep, dll
Morbiditas dan
Mortalitas
Penyakit rawat inap
Penyakit rawat jalan
Pengunjung RS
Pengunjung rumah sakit, Kunjungan rawat jalan
10 besar penyakit rawat inap dan 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.
b.
c.
d.
pencatatan dan pelaporan kegiatan Puskesmas dan jaringannya;
survei lapangan;
laporan lintas sektor terkait; dan
laporan jejaring fasilitas pelayanan kesehatan di wilayah kerjanya.
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)
merupakan sumber data dari pelaporan data kesehatan prioritas yang
diselenggarakan melalui komunikasi data.
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 problemsolving endeavors through the design, development, and use of technologically based
systems and processes that enhance the efficiency and effectiveness of information in a
ariety of strategi , ta ti al, a d operatio al situatio s . (McGraw-Hill Science &
Technology Encyclopedia)
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
• Medications management
making diagnosis and treatment decisions, and in • Prescription and test ordering decision
managing the delivery of care to an individual,
support
whether electronically or in person.
• Clinical decision support
• Alerts monitoring and management
• Chronic disease management
• Real-time clinical data access and analysis
• Telemedicine (telehealth) and mobile health
(mHealth)
WHO-ITU. 2012. National eHealth Strategy Toolkit
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
• Komunikasi dan kolaborasi
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
• Pencarian Data Asuransi
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
• Pencarian Data Asuransi
Permenkes 82 Tahun 2013 Tentang SIMRS
Rawat Inap
Farmasi dan Logistik
•
•
•
•
•
• Pengeluaran
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
• Daftar Pengeluaran
• Permintaan
• Daftar Permintaan
• Pengambilan
• Daftar Pengambilan
• Perencanaan Pengadaan
• Daftar Perencanaan Pengadaan
• Laporan Bulanan
• Laporan Harian
• Laporan Stok
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).
Payroll system
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.
WHO-ITU. 2012. National eHealth Strategy Toolkit
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
Secondary use of data for clinical
evaluation, routine reporting
Jha et al. 2009. Use of electronic health records
in U.S. hospitals.
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
Generating suggestions for adjusting the mechanical ventilator
Suggesting
Health Information Exchange
Finance/Bank
Telemedicine
Lab. Systems
Community
health
workers
Systems
Primary Care
Systems
Pharmacy
Systems
Hospital
Systems
Healthcare Providers
Emergency Medical
Services
Medical
Suppliers
Public
Insurance
Providers
Community/NGOs
Distribution
channel
Government
Private
Insurance
Providers
Pharmaceutical
company
Personal Health
Records
Payors
Supply Chain
Personal Health
Portal
Public
Health
Research
Others
Health Information Exchange
Client
Registry
https://ohie.org/
Health
Provider
Registry
Health
Facility
Registry
Terminology
Standard
Indicators
and Data
Elements
Shared
Health
Records
Health
Managament
Information
Systems
PCEHR Australia
National E-Health Transition Authority (NEHTA) Australia
www.nehta.gov.au
Kesimpulan
• Fasilitas pelayanan kesehatan memiliki peran penting dalam sistem
pelayanan kesehatan (individu, mikro dan makro)
• Kompleksitas ini mendorong fasilitas pelayanan kesehatan
menggunakan sistem berbasis elektronik
• Berbagai macam pendekatan TIK sudah digunakan di organisasi
kesehatan untuk mendukung:
• Pelayanan kesehatan perorangan
• Manajemen organsiasi
• Pelaporan rutin
Pelayanan Kesehatan
Guardian Y. Sanjaya
gysanjaya.blog.ugm.ac.id
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
• Beberapa isu penggunaan informatika pada fasilitas kesehatan
Organizational model of health services
Essential Public Health management function
Lippeveld, Sauerborn. 2000. A framework for designing health information systems
Sistem Jaminan Kesehatan Nasional dan Daerah
Badan
Jaminan
Kesehatan
Peran Regulator:
1.
Regulasi sistem pelayanan
kesehatan (rujukan
bertingkat)
2.
Regulasi standar pelayanan
kesehatan, kompetensi
pelayanan masing-masing
level, standar obat dan alkes
3.
Monitoring sistem
kesehatan
Regulator
Puskesmas
Dokter Praktik
Memberi pelayanan
Peserta
Jaminan
Mencari pelayanan
Penyedia
Layanan
Klinik Pratama
Rumah Sakit
Apotik
Laboratorium
Client/Patient Management Perspective
Essential Public Health management function
Lippeveld, Sauerborn. 2000. A framework for designing health information systems
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
• Clinical research
Health Unit Management perspective
Essential Public Health management function
Lippeveld, Sauerborn. 2000. A framework for designing health information systems
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
(health insurance, referral systems, emergency medical services)
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
• Contributing to health systems monitoring and evaluation
Health systems management perspective
Essential Public Health management function
Lippeveld, Sauerborn. 2000. A framework for designing health information systems
Health systems management perspective of
informatics
•
•
Sources of health data for the macro system (DHO, Ministry of
Health)
Secondary use of data to assist in program planning, evaluation
and monitoring of the health system, research
Electronic based health information systems
Data Sources
Data
Management
Information
Tabuler
Maps
input
model
output
Reports
Specific
analysis
Database
Mon-Ev
Research
Usage
Health
profile
Compilation, integration
Visualization
Graphic
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), 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
• Kunjungan rawat jalan dan rawat inap
Permenkes 1171/Menkes/SK/2011
Data Dasar
Data dasar rumah sakit
Indikator pelayanan rumah sakit
Fasilitas tempat tidur rawat inap
Data
Ketenagaan
Data ketenagaan rumah sakit
Data Pelayanan
Pelayanan rawat inap, Rawat darurat, Gigi dan mulut, Kebidanan,
perinatologi, Pembedahan, Radiologi, Laboratorium, Rehabilitasi medik,
pelayanan khusus, Kesehatan Jiwa, KB, Pelayanan resep, dll
Morbiditas dan
Mortalitas
Penyakit rawat inap
Penyakit rawat jalan
Pengunjung RS
Pengunjung rumah sakit, Kunjungan rawat jalan
10 besar penyakit rawat inap dan 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.
b.
c.
d.
pencatatan dan pelaporan kegiatan Puskesmas dan jaringannya;
survei lapangan;
laporan lintas sektor terkait; dan
laporan jejaring fasilitas pelayanan kesehatan di wilayah kerjanya.
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)
merupakan sumber data dari pelaporan data kesehatan prioritas yang
diselenggarakan melalui komunikasi data.
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 problemsolving endeavors through the design, development, and use of technologically based
systems and processes that enhance the efficiency and effectiveness of information in a
ariety of strategi , ta ti al, a d operatio al situatio s . (McGraw-Hill Science &
Technology Encyclopedia)
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
• Medications management
making diagnosis and treatment decisions, and in • Prescription and test ordering decision
managing the delivery of care to an individual,
support
whether electronically or in person.
• Clinical decision support
• Alerts monitoring and management
• Chronic disease management
• Real-time clinical data access and analysis
• Telemedicine (telehealth) and mobile health
(mHealth)
WHO-ITU. 2012. National eHealth Strategy Toolkit
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
• Komunikasi dan kolaborasi
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
• Pencarian Data Asuransi
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
• Pencarian Data Asuransi
Permenkes 82 Tahun 2013 Tentang SIMRS
Rawat Inap
Farmasi dan Logistik
•
•
•
•
•
• Pengeluaran
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
• Daftar Pengeluaran
• Permintaan
• Daftar Permintaan
• Pengambilan
• Daftar Pengambilan
• Perencanaan Pengadaan
• Daftar Perencanaan Pengadaan
• Laporan Bulanan
• Laporan Harian
• Laporan Stok
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).
Payroll system
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.
WHO-ITU. 2012. National eHealth Strategy Toolkit
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
Secondary use of data for clinical
evaluation, routine reporting
Jha et al. 2009. Use of electronic health records
in U.S. hospitals.
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
Generating suggestions for adjusting the mechanical ventilator
Suggesting
Health Information Exchange
Finance/Bank
Telemedicine
Lab. Systems
Community
health
workers
Systems
Primary Care
Systems
Pharmacy
Systems
Hospital
Systems
Healthcare Providers
Emergency Medical
Services
Medical
Suppliers
Public
Insurance
Providers
Community/NGOs
Distribution
channel
Government
Private
Insurance
Providers
Pharmaceutical
company
Personal Health
Records
Payors
Supply Chain
Personal Health
Portal
Public
Health
Research
Others
Health Information Exchange
Client
Registry
https://ohie.org/
Health
Provider
Registry
Health
Facility
Registry
Terminology
Standard
Indicators
and Data
Elements
Shared
Health
Records
Health
Managament
Information
Systems
PCEHR Australia
National E-Health Transition Authority (NEHTA) Australia
www.nehta.gov.au
Kesimpulan
• Fasilitas pelayanan kesehatan memiliki peran penting dalam sistem
pelayanan kesehatan (individu, mikro dan makro)
• Kompleksitas ini mendorong fasilitas pelayanan kesehatan
menggunakan sistem berbasis elektronik
• Berbagai macam pendekatan TIK sudah digunakan di organisasi
kesehatan untuk mendukung:
• Pelayanan kesehatan perorangan
• Manajemen organsiasi
• Pelaporan rutin