KESIAPAN PENERAPAN REGISTER IMUNISASI ELEKTRONIK NASIONAL DI PROVINSI BANTEN DAN MALUKU UTARA

Pama Rahmadewi, Lukman Heryawan, S.T., M.T., Ph.D.; dr. Lutfan Lazuardi, M.Kes., Ph.D.

2023 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Latar Belakang: program imunisasi terbukti efektif dan efisien dalam pemberian layanan kesehatan, namun dalam pelaksanaannya banyak tantangan yang masih ditemui antara lain terkait capaian target imunisasi dan peningkatan pelayanan imunisasi. Pandemi Covid 19 membuat sistem kesehatan nasional Indonesia bertransformasi diantaranya transformasi teknologi kesehatan yang salah satunya diwujudkan dengan digitalisasi data kesehatan. Pada program imunisasi, Tahun 2022 Kementerian Kesehatan R.I. meluncurkan aplikasi SehatIndonesiaKu (ASIK) sebagai Register Imunisasi Elektronik (RIE) nasional. Penilaian kesiapan perlu dilakukan pada penerapan RIE nasional agar optimal.

Tujuan: mengeksplorasi kesiapan dalam penerapan RIE nasional di Provinsi Banten dan Maluku Utara.

Metode: merupakan penelitian deskriptif, menggunakan desain kualitatif dengan metode Rapid Assessment Procedures (RAP). Informan penelitian adalah pengelola program imunisasi di Provinsi Banten dan Maluku Utara. Penelitian ini menggunakan kerangka konsep dengan mengadopsi teori Readiness Assessment of Electronic Health Records Implementation untuk mengeksplorasi kesiapan aspek budaya organisasi, manajemen dan kepemimpinan, operasional, dan teknis. Instrumen yang digunakan untuk pengambilan data yaitu Kuesioner Skrining, Panduan FGD, Daftar Pertanyaan Wawancara, dan Lembar Observasi. Informasi tentang kesiapan penerapan RIE nasional diperoleh melalui Focus Group Discussion (FGD) dan diskusi wawancara pada kunjungan lapangan. Data kemudian dianalisis secara kualitatif.  Proses analisis konten untuk menentukan kode, kategori dan tema pada penelitian ini menggunakan perangkat lunak OpenCode 4.02.

Hasil: Kesiapan penerapan RIE nasional pada aspek budaya organisasi dapat dilihat dari penerimaan ASIK sebagai aplikasi RIE nasional dan ada strategi adopsi yang dipilih di 2 provinsi tersebut. Pada aspek manajemen dan kepemimpinan penjagaan kualitas data imunisasi telah dilakukan melalui monitoring, konfirmasi, validasi, dan evaluasi. Kesiapan aspek operasional terlihat dari implementasi ASIK yang dimulai dengan piloting nasional untuk pelaksanaan BIAN 2022 dilanjutkan piloting ASIK untuk imunisasi rutin di beberapa provinsi terpilih salah satunya di Provinsi Maluku Utara. Sedangkan pada aspek teknis adanya inovasi aplikasi terkait imunisasi di daerah menunjukkan daerah cukup berpengalaman dengan sistem informasi imunisasi. 

Kesimpulan: Kesiapan untuk penerapan RIE nasional cukup potensial, namun perlu dukungan lebih dari kepala daerah, regulasi, SOP dan alur kerja sebagai acuan penerapan RIE nasional, penyempurnaan pada aplikasi RIE nasional dan kendala lain diluar sistem, serta peningkatan keterampilan digital bagi pengelola imunisasi untuk mengatasi permasalahan dan menjaga keberlangsungan sistem. Strategi penerapan RIE nasional direkomendasikan untuk mendukung keberhasilan program.

Background: Immunization programs have proven to be effective and efficient in providing health services, but in practice, many challenges are still encountered, among them those related to achieving immunization targets and improving immunization services. The COVID-19 pandemic has transformed Indonesia's national health system, including the transformation of health technology, one of which is realized by digitizing health data. In the immunization program, in 2022, the Ministry of Health of the Republic of Indonesia launched the SehatIndonesiaKu (ASIK) application as a national Electronic Immunization Register (EIR). Readiness assessment needs to be carried out on the application of national RIE so that it is optimal.

Objective: explore readiness for implementing national EIR in Banten and North Maluku Provinces.

Methods: is a descriptive study using a qualitative design with the Rapid Assessment Procedures (RAP) method. Research informants are immunization program managers in Banten and North Maluku Provinces. This research uses a conceptual framework by adopting the theory of readiness assessment of electronic health records implementation to explore the readiness aspects of organizational culture, management and leadership, operational, and technical. The instruments used for data collection were screening questionnaires, FGD guidelines, interview questionnaires, and observation sheets. Information about the readiness to implement national RIE was obtained through focus group discussions (FGD) and interview discussions during site visits. The data was then analyzed qualitatively. The content analysis process used to determine codes, categories, and themes in this study uses OpenCode 4.02 software.

Results: The readiness to implement national EIR in terms of organizational culture can be seen from the acceptance of ASIK as a national EIR and the adoption strategies chosen in the two provinces. In the aspect of management and leadership, maintenance of the quality of immunization data has been carried out through monitoring, confirmation, validation, and evaluation. The readiness of the operational aspect can be seen from the implementation of ASIK, which began with national piloting for the implementation of BIAN 2022, followed by ASIK piloting for routine immunization in several selected provinces, one of which is in North Maluku Province. On the technical aspect, there are application innovations related to immunization in the regions, indicating that the regions are quite experienced with immunization information systems.

Conclusion: The readiness for implementing national EIR is quite potential, but it needs more support from regional heads, regulations, SOPs, and workflow as a reference for implementing national EIR, improvements to national EIR applications, and other constraints outside the system, as well as increasing digital skills for immunization managers to overcome problems and maintain system continuity. A national EIR implementation strategy is recommended to support the program's success.

Kata Kunci : Readiness Assessment, Electronic Immunization Registry, Electronic Health Record, Imunisasi, Implementasi