PurposeThis study was aimed to evaluate the implementation of an integrated antenatal care (ANC) scheme through a retrospective document study using a checklist for measuring the adequacy of the cohort ANC register documented by midwives in an urban area and to describe the barriers for the midwives during the ANC record process.Design/methodology/approachAn exploratory descriptive study using a sequential mixed method was utilised where a quantitative method was employed by collecting secondary data of 150 entries of the cohort ANC register and followed by in-depth interviews among midwives and community health workers.FindingsThe results show that the cohort registry indicators for integrated care such as laboratory and management were poorly recorded. Several barriers were found and categorised during the implementation of the integrated ANC, namely (1) governance and strategy, (2) process of care, (3) organisation and management support.Research limitations/implicationsThe contribution of this present research is that it provides empirical data of the integrated ANC implementation in primary health care (PHC) which has the responsibility to deliver an integrated level of care for ANC using a cohort registry for pregnancy registration monitoring which facilitates the continuity and quality of care.Practical implicationsPractical implication of the finding is that functional integration such as the clinical information system to facilitate an efficient and effective approach during the implementation of integrated ANC in primary care should be considered to support the clinical, professional, organisational, system and normative integration.Originality/valueSince only limited studies have been conducted to assess the quality of the cohort ANC registry and to investigate the barriers against integrated ANC implementation in Indonesia, the research findings are valuable information for the national and local governments to improve the ANC service in Indonesia.
BACKGROUND: The Indonesian Ministry of Health requires hospitals to record and report all activities in the Hospital Management Information System (SIMRS). However, the disruptive use of software, hardware, and Brainware has reduced its effective management and usability, which has become a separate workload. Electronic Medical Record (EMR) is one of the important implementations of SIMRS because it relates to the ability to identify information, results, history taking, examinations, and records of all patients. Furthermore, it has become a current global trend for most hospitals and has also been used as a substitute for paper medical records. AIM: This study aims to collect and identify the user characteristic, technology used, and other variables influencing the acceptance and use of information and technology systems based on the unified theory of acceptance and use of technology (UTAUT) model. METHOD: Secondary data were obtained from scientifically published journals online in the form of original articles that are accessed in full text with the help of search engines such as Springer link, Proquest, PubMed, and Prospero. RESULT: It was found that the most dominant technology system in hospitals outside the use of HIS, Electronic Health Record (EHR), physician assistants, E-Prescribing, Telemedicine, extended producer responsibility, and Technology solution for tuberculosis was EMR. It had the largest influence variable in several studies based on the UTAUT model. The most dominant characteristics of users were women between the ages of 20 and 30 years with 0 and 5 years working experience, and also 60% were nurses. The result also showed that 17 other variables had influenced the use of information and technology systems in the UTAUT model. Conclusion: Literature study provides evidence that acceptance and use of health information technology systems, especially RME in hospitals influenced by the main variable UTAUT. Variables related to technical aspects, behavior, and user characteristics as new endogenous and new exogenous mechanisms. Management of health service providers in increasing acceptance and use of EMR needs to pay attention to the availability of infrastructure, user factors are also an important concern in helping to deal with problems in developing countries.
Angka Kematian Ibu (AKI) di Indonesia pada tahun 2015 sebesar 305 per 100.000 kelahiran hidup. Angka ini tertinggi jika dibandingakan dengan negara Asean lainnya. Bidan merupakan satu di antara tenaga kesehatan yang memiliki posisi penting dan strategis terutama dalam penurunan AKI dan AKB. Saat ini di Indonesia bidan dalam melakukan ANC harus mencatat pada beberapa formulir yaitu kartu ibu (rekam medis), buku KIA, register Kesehatan Ibu dan Anak (KIA), kohort ibu, dan laporan KIA, laporan imunisasi TT, dan laporan rujukan ANC. Kondisi ini dialami oleh bidan praktek mandiri (BPM) di Kebon Jeruk Jakarta Barat. Sejalan dengan hasil penelitian telah berhasil dirancang suatu aplikasi berbasis web dikenal dengan Electronic Integrated Antenatal Care (e-iANC) yang dapat diakses melalui www.e-ianc.net, maka program kemitraan masyarakat (PKM) ini bertujuan untuk meningkatkan kualitas pelayanan antenatal (ANC) dengan Digitalisasi Pencatatan dan Pelaporan Data ANC di BPM Kebon Jeruk Jakarta Barat. Mitra PKM sebanyak 4 BPM dengan total 6 orang bidan atas rekomendasi dari IBI Wilayah Kebon Jeruk. Beberapa kegiatan dalam PKM yaitu memberikan pelatihan dan bimbingan teknis penggunaan e-iANC. Pelatihan dilakukan secara virtual pada bulan 25 Juli -1 Agustus 2020 melalui tiga tahap yaitu, tahap pertama: pengenalan fitur dan fungsi e-iANC, tahap kedua: entry data dalam Master Patient Index dan e-Admission, dan tahap ketiga: skrining risiko kehamilan dan pelaporan ANC. Untuk mengetahui efektifitas pelatihan telah dilakukan pengukuran hasil pre-post test kepada peserta sebanyak enam orang dari empat BPM. Hasil pre-post test dengan uji Wilcoxon menunjukkan ada peningkatan secara signifikan pengetahuan mitra tentang e-iANC (p-value=0,046<0,05). Hal ini akan mempermudah tim PKM dalam memberikan bimbingan teknis bagi mitra.
The number of delays in the cause of inpatient medical records in Indonesia is still high, in the range of 45.45% - 100%. Where the highest delay in return is caused by incompleteness in filling out the medical resume, this can potentially cause losses to the hospital due to delayed claim collection. This study aims to analyze the causes of the problem to develop an inpatient medical record control system model using the waterfall model method, including Requirements, Analysis, and Design at Aqidah Hospital, Tangerang City. This case study uses a qualitative approach with in-depth interviews, FGD (Focus Group Discussion), Observation and Document Review of inpatient medical records for October – December 2021. The results showed that the delay in returning inpatient medical records in 2019 was 185 out of 280 (66.10%). In 2020 as many as 280 out of 410 (68.29%), and in 2021 as many as 228 out of 320 (71.25%). ) thus, the highest percentage of delays in returning inpatient medical records will occur in 2021. While the writing of the primary diagnosis only reached the percentage of 1.25%, and the secondary diagnosis only reached 0.93%. For this reason, the researcher proposes a solution to the problem of delaying the return of medical records at Aqidah Hospital to develop a medical record control system model to improve the medical record management process.
Sejak diberlakukannya pembayaran prospektif dengan pola case-mix berbasis Diagnosis Related Groups (DRG), maka keakurasian data koding klinis sangat penting. Besaran klaim yang dibayarkan dan disetujui tergantung dari ketepatan koding klinis yang dihasilkan. Ketepatan koding klinis dipengaruhi oleh pengetahuan dan sikap PMIK. Pengetahuan dan sikap merupakan bagian dari kompetensi PMIK. Saat ini ketiga RSU vertikal Kementerian Kesehatan Wilayah DKI Jakarta terdapat pengembalian berkas klaim sebesar 3,4 % atau sekitar 850 juta rupiah dikarenakan ketidaktepatan koding klinis. Tujuan penelitian ini untuk mengetahui pengaruh kompetensi PMIK terhadap kualitas koding klinis di RSU vertikal Kementerian Kesehatan DKI Jakarta. Penelitian ini menggunakan pendekatan kuantitatif dengan desain cross sectional. Populasi penelitian ini adalah sample jenuh dengan total 17 PMIK terdiri dari 6 orang RSUPN dr. Cipto Mangunkusumo, 6 orang RSU Fatmawati dan 5 orang RSU Persahabatan. Pengumpulan data menggunakan kuesioner dan analisis data dengan regresi linear sederhana. Hasil penelitian ini diperoleh rata-rata skor kompetensi PMIK 81,65 dan rata-rata kualitas koding yang dihasilkan 8. Hasil regresi linear sederhana diperoleh bahwa ada pengaruh signifikan antara kompetensi PMIK terhadap kualitas koding klinis (p-value 0,000<0,05) dengan persamaan kualitas koding klinis = -4,491 + 0,153 (kompetensi PMIK). Adapun arti koefisien, setiap kompetensi naik 1 poin, maka kualitas koding klinis naik 0,153
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