Implementasi Rekam Medis Elektronik Berkontribusi pada Peningkatan Biaya Operasional di RSUP Surakarta
Resia Perwirani(1*)
(1) RSUP Surakarta
(*) Corresponding Author
Abstract
Latar belakang: Rumah Sakit termotivasi mengimplementasikan RME karena adanya harapan manfaat yang didapatkan termasuk RSUP Surakarta yang mulai menerapkan RME di Unit Rawat Jalan sejak April 2022. Implementasi RME memerlukan analisis mendalam berkaitan dengan dampak positif maupun negatif yang mengiringinya, dalam hal ini terkait dengan biaya operasional yang dikeluarkan sebagai sarana evaluasi dan pembelajaran yang bermanfaat untuk bahan pengambilan keputusan strategis.
Metode: Jenis penelitian bersifat deskriptif dengan pendekatan kualitatif, peneliti menggambarkan biaya operasional sebelum dan sesudah implementasi RME, kemudian memperkaya analisis dengan data kualitatif. Penelitian dilaksanakan di RSUP Surakarta, dengan waktu pelaksanaan April - September 2022. Cara pengumpulan data melalui telaah dokumen dan wawancara. Objek dalam penelitian ini adalah data besaran biaya yang dianggarkan pada unit rekam medis dan unit rawat jalan untuk rencana belanja tahunan. Subjek dalam penelitian ini adalah para pemangku kepentingan serta para pengguna yang terkait implementasi RME.
Hasil: Implementasi RME berkontribusi pada peningkatan biaya operasional di RSUP Surakarta dengan total sebesar 56%. Narasumber menganggap bahwa implementasi RME dapat menghemat penggunaan kertas. Temuan yang kontradiktif menunjukkan adanya lag-effect, yang dapat diartikan sebagai jeda waktu kemanfaatan implementasi teknologi dapat dirasakan. Strategi RSUP Surakarta dalam implementasi RME meliputi penggunaan OSS untuk penghematan biaya. Selain itu perencanaan pengembangan RME menjadi bagian tak terpisahkan dari Renstra Rumah Sakit, yang disusun dengan timeline waktu, sesuai kompleksitas rumah sakit.
Kesimpulan: RSUP Surakarta belum menginisiasi penghitungan cost-effectiveness analysis. Peneliti merekomendasikan RS melaksanakan penghitungan dengan metode yang paling memungkinkan, untuk mengetahui efektivitas biaya dalam implementasi RME, sehingga dapat digunakan untuk bahan perencanaan pengembangan RME kedepan.
Kata kunci: Rekam Medis Elektronik, Biaya Operasional, Analisis Efektivitas Biaya
Keywords
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[1] Kementerian Kesehatan RI, “Peraturan Menteri Kesehatan No.24 Tahun 2022 tentang Rekam Medis,” 2022.
[2] J. J. Perry et al., “Is there evidence of cost benefits of electronic medical records, standards, or interoperability in hospital information systems? overview of systematic reviews,” J. Am. Med. Informatics Assoc., vol. 1, no. 1, pp. 320–323, Dec. 2018, doi: 10.1016/j.procs.2010.12.193.
[3] P. T. Bunga, “Analisis Biaya Satuan (Unit Cost) Pada Pelayanan Kesehatan Unit Rawat Inap Rumah Sakit Umum Daerah Tora Belo Di Kabupaten Sigi Provinsi Sulawesi Tengah,” e J. Katalogis, vol. 5, no. 5, pp. 134–144, 2017.
[4] J. McDowell, A. Wu, J. M. Ehrenfeld, and R. D. Urman, “Effect of the Implementation of a New Electronic Health Record System on Surgical Case Turnover Time.,” J. Med. Syst., vol. 41, no. 3, p. 42, Mar. 2017, doi: 10.1007/s10916-017-0690-y.
[5] T.-Y. (Arron) Chuang, N. Yii, M. Nyandowe, and R. Iyer, “Examine the impact of the implementation of an electronic medical record system on operating theatre efficiency at a teaching hospital in Australia,” Int. Surg. J., vol. 6, no. 5, p. 1453, 2019, doi: 10.18203/2349-2902.isj20191865.
[6] CDW, “CDW Healthcare Survey: EHR Price Tag May Reach $120K Per Physician; Speeding Changes to Workflow Most Important Factor in Reducing Costs,” 2019. .
[7] Q. Health, “Queensland Health Digital Initiatives,” 2019. https://www.health.qld.gov.au/clinicalpractice/innovation/ehealth/queensland (accessed Apr. 08, 2023).
[8] M. Amin, W. Setyonugroho, and N. Hidayah, “Implementasi Rekam Medik Elektronik: Sebuah Studi Kualitatif,” JATISI (Jurnal Tek. Inform. dan Sist. Informasi), vol. 8, no. 1, pp. 430–442, 2021, doi: 10.35957/jatisi.v8i1.557.
[9] K. Kaneko, D. Onozuka, H. Shibuta, and A. Hagihara, “Impact of electronic medical records (EMRs) on hospital productivity in Japan,” Int. J. Med. Inform., vol. 118, pp. 36–43, 2018, doi: 10.1016/j.ijmedinf.2018.07.008.
[10] Z. S. N. Reis, T. A. Maia, M. S. Marcolino, F. Becerra-Posada, D. Novillo-Ortiz, and A. L. P. Ribeiro, “Is there evidence of cost benefits of electronic medical records, standards, or interoperability in hospital information systems? overview of systematic reviews,” JMIR Med. Informatics, vol. 5, no. 3, 2017, doi: 10.2196/medinform.7400.
[11] J. M. Holroyd-Leduc, D. Lorenzetti, S. E. Straus, L. Sykes, and H. Quan, “The impact of the electronic medical record on structure, process, and outcomes within primary care: A systematic review of the evidence,” J. Am. Med. Informatics Assoc., vol. 18, no. 6, pp. 732–737, 2011, doi: 10.1136/amiajnl-2010-000019.
[12] S. Michie, L. Yardley, R. West, K. Patrick, and F. Greaves, “Developing and evaluating digital interventions to promote behavior change in health and health care: Recommendations resulting from an international workshop,” J. Med. Internet Res., vol. 19, no. 6, 2017, doi: 10.2196/jmir.7126.
[13] J. Fernando, “Return on Investment (ROI): How to Calculate It and What It Means,” 2022. https://www.investopedia.com/ (accessed Apr. 05, 2022).
[14] Kasmir, Analisis Laporan Keuangan, 11th ed. Jakarta: Raja Grafindo Persada, 2018.
[15] B. Interactive, “Return On Investment (ROI): Pengertian, Manfaat, Kelebihan, Cara Menghitung,” 2022. https://badr.co.id/ (accessed Apr. 05, 2023).
[16] F. Lau, M. Price, J. Boyd, C. Partridge, H. Bell, and R. Raworth, “Impact of electronic medical record on physician practice in office settings: A systematic review,” BMC Med. Inform. Decis. Mak., vol. 12, no. 1, 2012, doi: 10.1186/1472-6947-12-10.
[17] S. J. Wang et al., “A cost-benefit analysis of electronic medical records in primary care.,” Am. J. Med., vol. 114, no. 5, pp. 397–403, Apr. 2003, doi: 10.1016/s0002-9343(03)00057-3.
[18] E. A. Pifer, S. Smith, and G. W. Keever, “EMR to the rescue. An ambulatory care pilot project shows that data sharing equals cost shaving.,” Healthc. informatics Bus. Mag. Inf. Commun. Syst., vol. 18, no. 2, pp. 111–114, Feb. 2001.
[19] D. L. Grieger, S. H. Cohen, and D. A. Krusch, “A pilot study to document the return on investment for implementing an ambulatory electronic health record at an academic medical center.,” J. Am. Coll. Surg., vol. 205, no. 1, pp. 89–96, Jul. 2007, doi: 10.1016/j.jamcollsurg.2007.02.074.
[20] R. M. Kamadjeu, E. M. Tapang, and R. N. Moluh, “Designing and implementing an electronic health record system in primary care practice in sub-Saharan Africa: a case study from Cameroon.,” Inform. Prim. Care, vol. 13, no. 3, pp. 179–186, 2005, doi: 10.14236/jhi.v13i3.595.
[21] W. M. Tierney, J. K. Rotich, F. E. Smith, J. Bii, R. M. Einterz, and T. J. Hannan, “Crossing the ‘digital divide:’ implementing an electronic medical record system in a rural Kenyan health center to support clinical care and research.,” Proceedings. AMIA Symp., pp. 792–795, 2002.
[22] J. K. Rotich et al., “Installing and implementing a computer-based patient record system in sub-Saharan Africa: the Mosoriot Medical Record System.,” J. Am. Med. Inform. Assoc., vol. 10, no. 4, pp. 295–303, 2003, doi: 10.1197/jamia.M1301.
[23] C. Allen et al., “Experience in implementing the OpenMRS medical record system to support HIV treatment in Rwanda.,” Stud. Health Technol. Inform., vol. 129, no. Pt 1, pp. 382–386, 2007.
[24] W. M. Tierney et al., “The AMPATH medical record system: creating, implementing, and sustaining an electronic medical record system to support HIV/AIDS care in western Kenya.,” Stud. Health Technol. Inform., vol. 129, no. Pt 1, pp. 372–376, 2007.
[25] P. Bergsjø, J. Mlay, R. T. Lie, E. Lie-Nielsen, and J. F. Shao, “A medical birth registry at Kilimanjaro Christian Medical Centre.,” East Afr. J. Public Health, vol. 4, no. 1, pp. 1–4, Apr. 2007.
[26] F. Noronha, “Developing Countries Gain from Free/Open Source Software,” 2003. www.linusjournal.com/article/6884 (accessed Apr. 09, 2023).
[27] B. Jawhari, D. Ludwick, L. Keenan, D. Zakus, and R. Hayward, “Benefits and challenges of EMR implementations in low resource settings: a state-of-the-art review.,” BMC Med. Inform. Decis. Mak., vol. 16, no. 1, p. 116, Sep. 2016, doi: 10.1186/s12911-016-0354-8.
[28] W. Raghupathi and V. Raghupathi, “Big data analytics in healthcare: promise and potential.,” Heal. Inf. Sci. Syst., vol. 2, p. 3, 2014, doi: 10.1186/2047-2501-2-3.
[29] R. Perwirani, “HIS Implementation in Small Hospital,” J. Inf. Syst. Public Heal., vol. 7, no. 1, p. 32, 2022, doi: 10.22146/jisph.71310.
[30] F. Williams and S. A. Boren, “The role of electronic medical record in care delivery in developing countries,” Int. J. Inf. Manage., vol. 28, no. 6, pp. 503–507, 2008, doi: 10.1016/j.ijinfomgt.2008.01.016.
[31] E. Tomasi, L. A. Facchini, and M. de F. S. Maia, “Health information technology in primary health care in developing countries: a literature review.,” Bull. World Health Organ., vol. 82, no. 11, pp. 867–874, Nov. 2004.
[32] H. S. F. Fraser, P. Biondich, D. Moodley, S. Choi, B. W. Mamlin, and P. Szolovits, “Implementing electronic medical record systems in developing countries.,” Inform. Prim. Care, vol. 13, no. 2, pp. 83–95, 2005, doi: 10.14236/jhi.v13i2.585.
[33] Kementerian Kesehatan RI, “Keputusan Menteri kesehatan No.1423 tahun 2022 tentang Pedoman Variabel dan Meta Data pada Penyelenggaraan Rekam Medis Elektronik,” 2022.DOI: https://doi.org/10.22146/jisph.72274
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