Sistem Peresapan Elektronik pada Keselamatan Pengobatan Pasien

Abstract

AbstrakDalam banyak penerapannya, penggunaan sistem peresepan elektronik (computerized physician order entry, CPOE) dalam penulisan resep terbukti mampu menurunkan angka kesalahan peresepan obat (adverse drug event, ADE). Kesalahan pengobatan seperti kekeliruan penulisan nama obat, penentuan dosis, dan penggunaan jenis obat yang tepat untuk pasien dengan kondisi kesehatan tertentu di pelayanan kesehatan dapat ditekan. Namun, CPOE masih memiliki kelemahan seperti tambahan waktu untuk mengentri data pasien oleh para dokter ke dalam sistem. Untuk mengevaluasi dampak persepsi pengguna tentang penerapan CPOE terhadap keselamatan pengobatan pasien, suatu penelitian kualitatif telah dilakukan di Gadjah Mada Medical Health Center yang telah mengadopsi sistem ini selama sepuluh tahun. Data dan informasi dikumpukan dengan wawancara mendalam terhadap sembilan dokter (tujuh dokter umum dan dua dokter spesialis) sebagai informen pengguna CPOE menggunakan pedoman wawancara, alat perekam suara, buku catat, dan daftar centang observasi. Hasil studi menunjukkan bahwa sepuluh tahun CPOE telah mampu meningkatkan efektivitas dan efisiensi pelayanan kesehatan, tetapi potensi ADE masih terjadi akibat gangguan komunikasi pasien-dokter karena perlunya waktu tambahan untuk entri data. Disimpulkan bahwa sistem CPOE belum mampu mendukung pengambilan keputusan untuk mencegah ADE dalam pengobatan pasien.Kata kunci: Adverse drug event, computerized physician order entry, persepsi pengguna, keselamatan pasien, peresepan AbstractIn most of its applications, Computerized Physician Order Entry (CPOE) has been improved patient safety by reducing medication errors and subsequent adverse drug events (ADEs). Medication error such as elixir in writing, determination of dose, and correct drug type used for patient with certain health condition in health services can be reduced. But, the CPOE still has some weknesses such as additional time to entry the patient information by physician to the sistem. To evaluate the impact of end-user perception using CPOE sistem on patient safety medication, a qualitative research has been conducted at Gadjah Mada Medical Health Center which has adopted this sistem for ten years. Data and informations were collected by in-depth interviewing nine physicians (seven general docters and two specialists) as end-user informen using interview guide, tape recorder, notebook, and checklist observation tools. The results show that ten year CPOE implemention has improved the effectiveness and efficiency of medical health care, but potential adverse drug event (ADE) such as drug precription errors still occur as a result of patient-physician communication distraction due to additional time for data entry. It is concluded that CPOE sistem has not been able to support decision to prevent the ADEs in patient medication.Keywords: Adverse drug event, computerized physician order entry, enduser perception, patient safety, prescription PendahuluanKesalahan pengobatan (medication error) dapat terjadi di seluruh tingkat proses pengobatan,...

Users’ Perception of the Hospital Information System in a Maternity Hospital in Lampung, Indonesia

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“…1,2 Therefore, the assumption is that information system implementation only looks at the way the system is designed and purchased in its developmental stage. 3 It is very rare to pay attention to the level of acceptance by health care workers as end users during the development of an information system. Consequently, there are many cases of information system implementation failure because of users' resistance to use such information technology.…”

Evaluasi Peresepan Elektronik Di Departemen Ilmu Kesehatan Anak

“…Cakupan CDS meliputi alat komputerisasi dalam meningkatkan pelayanan kesehatan pada pasien yang terdiri atas sistem pengingatan (alert) dan nasihat dalam pemilihan obat, dosis, interaksi, alergi dan pelayanan selanjutnya yang dilakukan secara terkomputerisasi. 10 Rumah Sakit Dr Cipto Mangunkusumo (RSCM) sebagai rumah sakit pusat rujukan nasional melayani sekitar 1200 pasien per hari dengan jumlah resep tidak kurang dari 2000 per hari yang masuk ke Instalasi Farmasi. Sebelum diberlakukannya sistem peresepan elektronik di RSCM, angka kesalahan peresepan mencapai 18% per bulan.…”

Could We Derive Benefit From Implementing Electronic Medical Records In Hospital?: A Structured Evidence and Narrative Review

“…EMR systems have the potential to improve care quality and efficiency (Xue et al, 2012). Of present interest, systems of EMR and computerized provider order entry (CPOE) are two promising forms of health information technology (IT), whose success has been stalled in part from a beliefs elicitation study of health IT focusing on physicians' use of EMR and CPOE for inpatient and outpatient care (Asyary et al, 2013, Holden, 2010. EMRs are in widespread use around the world.…”