This document discusses developing hospital information systems (SIM RS) based on open systems. It covers: 1. The scope of hospital information systems 2. Adopting information systems in hospitals 3. Opportunities for open source hospital information management systems 4. Governance of internal hospital information systems 5. Sustainability of hospital information systems and community support

1. Pengembangan SIM RS Berbasis
Open Systems
Guardian Y. Sanjaya
gysanjaya@gmail.com
Strategi adopsi sistem informasi di rumah sakit nirlaba, RS
Pendidikan dan mekanisme dukungan komunitas

2. 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

3. PELAYANAN
PASIEN
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
Kegiatan
Utama
PEMERIK-
SAAN
MEDIS
AWAL
•Riwayat
penyakit
•Vital sign
•Pemeriksaa
n fisik
DIAGNOSIS
•Diagnosa
klinik
•Diagnosa
keperawatan
PERSIAPAN
TINDAKAN
MEDIS
•Pemeriksaa
n penunjang
dan
skreening
TINDAKAN
MEDIS
•Tindakan
operasi
•Pemberian
obat-obatan
REHABILITA
SI
•Rehabilitasi
fisik
•Pola hidup
PELAYANA
N PASIEN
PULANG
•Discharge
Summary
•Rujukan
•Surat
keterangan
NILAI
TAMBAH
 Cepat
 Efisien
Kegiatan
Pendukung
Cakupan sistem informasi RS
Adoption from Porter’s value chain

4. SIM RS & Pelayanan Kesehatan
SIM RS = EHR
Amatayakul, 2009 (AHIMA)

5. Pertanyaan penting
• Apakah SIM RS mahal?
• Bagaimana strategi adopsinya?

6. Adopsi SIM RS di Amerika
Davis, 2009. HIMSS Analytics

7. Adopsi SIM RS di Korea

8. 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’

9. Road Map SIM RS
Collector
Phase 1
Documenter
Phase 2
Create
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

10. Peluang Open Source
• Care2x
• OpenMRS

11. Lingkungan SIM RS
Peluang Open Source
Application
Governance
SIM
Aspek
Tatakelola, Struktur
Organisasi
Pembiayaan
Infrastructure

12. Siapa melakukan apa?
Decision
Support
Management
System
Clinical and Administration
Strategic
Planning
Periodic
Queries
Operational
Systems
Data
Transaction
Management
Control
Operational
Control
Schedule,
On demand
reports
5%
28%
5%
4%
9%
35%
14%
Senior manager Health Records
Knowledge Management ICT
Clinical Coders Information Management
Clinical Informatics
Komposisi tim SIM RS
(Tribal survey, 2009)

13. 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/pen
dampingan
sistem
Support
community
development
Industri
NETWORKING

14. Why HIS training?
Source: BNPB and Ministry of Health, 2011
Maps of health facilities in Indonesia, per April 2011

15. Proposed scaling up model
Open Development and Support
Other
Hospitals
Piloting Hospitals (center of
excellences)
Sister
hospitals
IS Staff
Technical support
Capacity building
Initiator Group
(Core team)
Open Source
SIM RS
Advanced
Technical
support
Capacity
building
Community Development
NGOs
NGOs
Local
Vendors
Local
Vendors
Local
Vendor
s
Universities
Universities
Universitie
s
Puskesmas/DHO
Technical Staff
Puskesmas/DHO
Technical Staff
Puskesmas/DHO
Technical Staff
Non profit
Teaching Hsp.
Coordinate Development
Technical
support
Partnership

16. Sampai mana RS mau mengadopsi
SIM RS?
Clinical and administration systems
Tools Networks
Knowledge Rules
Using Information
Technology

17. Terimakasih