1. Tantangan Penerapan EHR di Indonesia
Fakultas Kedokteran
Universitas Gadjah Mada
Tantangan Penerapan EHR di Indonesia
Lutfan Lazuardi
Dipresentasikan pada acara Seminar Nasional Keperawatan SIM

2. FUNCTIONAL HEALTH SYSTEM
Leadership and Governance
Health Workforce
Health Service Delivery H E A L T F O R
FUNCTIONAL HEALTH SYSTEM
Healthcare is a very INFORMATION INTENSIVE industry. Dr Annie Stanley Thakore #CARE #elets_hlf
Health Information System
Access to Essential Medicines & Technologies
Health Financing

3. Apa itu EHR Sistem berbasis elektronik yang bertujuan:
Improves patient safety and quality
Increases efficiency
Reduces cost
Emphasizes privacy, security and confidentiality
IOM (1997)

4. Definisi EHR menurut IOM
Includes:
longitudinal collection electronic health information for and about persons, where health information is defined as information pertaining to the health of an individual or health care provided to an individual
immediate electronic access to person- and population-level information by authorized, and only authorized, users;
provision of knowledge and decision-support that enhance the quality, safety, and efficiency of patient care;
support of efficient processes for health care delivery.
IOM (1997)

5. Primary and secondary uses of EHR
Patient Care Delivery
Patient Care Management
Patient Care Support Processes
Financial and Other Administrative Processes
Patient Self-Management
Education
Regulation
Research
Public Health and Security
Policy Support
IOM (1997)

6. eHealth is the cost-effective and secure use of information and communications technologies in support of health and health-related fields (WHO)
"eHealth is the single-most important revolution in healthcare since the advent of modern medicine, vaccines, or even public health measures like sanitation and clean water”
Denise Silber (2003) at the European Commission
"eHealth is the cost-effective and secure use of information and communications technologies in support of health and health- related fields,
including health-care services
health surveillance
health literature
health education, knowledge and research
World Health Organization , Ninth plenary meeting, 25 May 2005
Committee A, seventh report

7. perubahan paradigma 70s – Billing dan administrasi
80s – sistem informasi klinis
90s – medical imaging, LIS
2000s – patient safety

8. perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented

10. Berhasilkah?

12. 30% decline in medication events
25% decline in complication of procedure, test, or treatment

16. Health Offices 554
Primary Health Centers 9799
Hospitals 2461

17. 1292 rumah sakit

20. Kompetensi
Perilaku
Regulasi
Perilaku organisasi
Infrastruktur
Standar mutu data
Maintenance

21. Perlu standar? Non Standard Standard Data demografi Data klinis pasien
Register
Klinisi
Manajemen RS
Klinisi
Manajemen RS
Register
Data Lab
Repositori
Data Lab
Repositori

22. Data Types Numerik Kode standar Kode Teks Terstruktur Image Signal
Interpretasi
Image
Signal

23. A New Socio-technical Model for Studying Health Information Technology in Complex Adaptive Healthcare Systems
Sittig et al. (2010)
Sittig, Dean F., and Hardeep Singh. “A New Socio-Technical Model for Studying Health Information Technology in Complex Adaptive Healthcare Systems.” Quality & safety in health care 19.Suppl 3 (2010): i68–i74. PMC. Web. 24 Aug

24. Top 10 reasons HER implementations are failing
Ryan Walker (2010) EMR/EHR Implementation Failure: A Summary

25. Berhasil atau gagal? Informatics factors (10%)
Socio-technical factors (90%)

26. Hospital Executive Information System

27. Sanjaya et al. (2012) No Kode ICD Adopsi Terminologi #Visit %
1 J00 Nasofaringitis akut
[common cold]
10,
2 J02 Faringitis akut 5,
3 M25 Kelainan-kelainan lain
pada sendi, tidak
terklasifikasi ditempat
lain 4,
4 K04.1 Nekrosis pulpa
5 L23 Dermatitis kontak alergi
6 K29 Gastritis dan duodenitis 2,
7 I10 Hipertensi esensial
8 R51 Sakit kepala (pusing)
9 R50 Demam tanpa diketahui
penyebabnya
10 K00.6 Gangguan-gangguan
erupsi gigi
Sanjaya et al. (2012)

28. Photo credit: Jojok

29. SIMKES Fakultas Kedokteran Universitas Gadjah Mada
SIMKES
Fakultas Kedokteran
Universitas Gadjah Mada