PENILAIAN KEBERMANFAATAN DAN DAMPAK IMPLEMENTASI REKAM MEDIS ELEKTRONIK DALAM UPAYA MENINGKATKAN MUTU PELAYANAN DI RUMAH SAKIT DKT. DR. SOETARTO YOGYAKARTA

Regita Urbanantika, 3. Dr. Eng. Silmi Fauziati, S.T., M.T. ; 4. Dr. dr. Guardian Yoki Sanjaya, M.Health.Info.

2024 | Tesis | MAGISTER KEBIJAKAN DAN MANAJEMEN KESEHATAN

Latar Belakang: Kini perkembangan teknologi telah mendorong digitalisasi pelayanan kesehatan yang menjadikan pertimbangan bagi pemerintah agar rekam medis perlu diselenggarakan secara elektronik. Selain manfaat yang dirasakan, pada beberapa rumah sakit tetap masih ditemukan hambatan dan tantangan dari berbagai aspek. Oleh karena itu, peneliti ingin melakukan evaluasi guna sebagai upaya perbaikan terkait implementasi Rekam Medis Elektronik pada peningkatan mutu pelayanan serta langkah awal pertimbangan dalam penyesuaian perubahan kematangan digital tahap selanjutnya. Di Rumah Sakit DKT dr. Soetarto masih terjadi resistensi pengguna dengan alasan kurangnya rasa percaya terhadap keamanan penyimpanan data dan pemadaman listrik sehingga akan sangat berpengaruh pada kinerja pegawai. Adapun kendala pada jaringan yang sering putus ketika jam kerja berlangsung. Pencetakan Surat Eligibilitas Pasien (SEP) juga terkendala saat sistem Khanza berjalan dengan lambat sementara jumlah pasien dapat mencapai 300 hingga 400 orang dalam sehari. Selain itu, kurangnya pelatihan terhadap seluruh pengguna sedangkan pada lapangan selalu terdapat perubahan update fitur dalam sistem. Kekurangan dalam sistem ini juga berpengaruh dalam pengambilan data kebutuhan pelaporan. Seiring berjalannya waktu, pengembangan tetap dilakukan oleh pihak IT, namun belum pernah dilaksanakan evaluasi hingga saat ini. Sehingga peneliti ingin melakukan evaluasi guna sebagai upaya perbaikan terkait implementasi Rekam Medis Elektronik berdasarkan metode HOT-Fit pada peningkatan mutu pelayanan serta langkah awal pertimbangan dalam penyesuaian perubahan kematangan digital tahap selanjutnya. Disisi lain, kegagalan adopsi menyebabkan adanya ketidakefisienan penggunaan sumber daya dan menurunnya motivasi penggunaan. Melihat adanya kegagalan adopsi yang dapat terjadi, selain dilakukan evaluasi kebermanfaatan, maka perlu ditinjau dari sisi konsekuensi.

Tujuan: Penelitian ini bertujuan sebagai upaya perbaikan terkait implementasi Rekam Medis Elektronik pada peningkatan mutu pelayanan serta langkah awal pertimbangan dalam penyesuaian perubahan kematangan digital tahap selanjutnya.

Metode: Penelitian ini menggunakan desain mix methode deskriptif melalui tahapan sequential explanatory. Pada tahap pertama, pengambilan data secara kuantitatif menggunakan kuesioner HOT-Fit terhadap seluruh pengguna rekam medis dari bagian pendaftaran hingga penjaminan dan pengadaan barang di Rumah Sakit. Kemudian dilakukan pengambilan data secara kualitatif dengan wawancara mendalam dan observasi terhadap empat dimensi, diantaranya Human (manusia), Organization (organisasi), Technology (teknologi) dan Net-Benefit (manfaat). 

Hasil: Berdasarkan hasil pengujian hipotesis, dari ketiga komponen HOT-Fit, Technology dan Organization khususnya pada variabel Leadership dengan nilai T-Statistik > T-Tabel (1.96) memberikan pengaruh terhadap Net-Benefit. Selain kebermanfaatan, ditinjau pula konsekuensi adopsi inovasi seperti, ketergantungan terhadap sistem, kelelahan terhadap sistem dalam penggunaan maupun pengembangan, perubahan komunikasi, dan replikasi catatan riwayat kesehatan.

Kesimpulan: Seluruh variabel dalam komponen Technology dan Organization pada variabel Leadership memiliki pengaruh terhadap Net-Benefit pada Rekam Medis Elektronik di Rumah Sakit DKT dr. Soetarto Yogyakarta. Sebaliknya, pada hasil pengujian hipotesis, komponen Human dan Organization pada variabel Regulation nilai T-Statistik kurang dari T-Tabel sehingga tidak menunjukkan pengaruh terhadap Net-Benefit. Selain kebermanfaatan, ditinjau pula konsekuensi adopsi inovasi seperti, ketergantungan terhadap sistem, kelelahan terhadap sistem dalam penggunaan maupun pengembangan, perubahan komunikasi, dan replikasi catatan riwayat kesehatan.

 

Kata Kunci: Evaluasi, HOT-Fit, Mutu Pelayanan, Rekam Medis Elektronik, Rumah Sakit

Background: Now technological developments have encouraged the digitization of health services which has given the government a consideration that medical records need to be maintained electronically. Apart from the perceived benefits, in some hospitals there are still obstacles and challenges from various aspects. Therefore, researchers want to carry out an evaluation as an improvement effort related to the implementation of Electronic Medical Records to improve service quality as well as initial steps for consideration in adjusting to changes in digital maturity in the next stage. At DKT Dr. Soetarto Hospital, there is still user resistance due to a lack of trust in the security of data storage and power outages, which will greatly affect employee performance. There are problems with the network which often breaks down during working hours. Printing Patient Eligibility Letters (SEP) is also hampered when the Khanza system runs slowly while the number of patients can reach 300 to 400 people a day. Apart from that, there is a lack of training for all users while in the field there are always changes to feature updates in the system. Deficiencies in this system also affect data collection for reporting needs. As time goes by, development is still being carried out by IT, but no evaluation has been carried out until now. So researchers want to carry out an evaluation as an improvement effort related to the implementation of Electronic Medical Records based on the HOT-Fit method to improve service quality as well as initial steps for consideration in adjusting to changes in digital maturity in the next stage. On the other hand, failure to adopt causes inefficient use of resources and decreased motivation to use. Seeing the failure of adoption that can occur, apart from evaluating its usefulness, it is necessary to review it from the perspective of consequences.

Purpose: This research aims as an improvement effort related to the implementation of Electronic Medical Records in improving service quality as well as an initial step in consideration in adjusting to changes in digital maturity at a later stage.

Method: The method is a descriptive mix method with a cross-sectional approach through sequential explanatory stages (quantitative data collection using HOT-Fit questionnaires and supported by qualitatively with in-depth interview and observation) on four dimensions, including Human, Organization, Technology, and Net-Benefits. This research involved all users of the Electronic Medical Record system from poart of registration until health insurance and procurement of goods at the Hospital.

Results: Based on the results of hypothesis testing, of the three HOT-Fit components, Technology and Organization, especially the Leadership variable with a T-Statistic value > T-Table (1.96) have an effect on Net-Benefit. In addition to usefulness, the consequences of adopting innovation are also reviewed, such as dependence on the system, fatigue with the system in use or development, changes in communication, and replication of health history records.

Conclusions: All variables in the Technology and Organization components in the Leadership variable have an influence on Net-Benefit in Electronic Medical Records at DKT Hospital dr. Soetarto Yogyakarta. On the other hand, in the results of hypothesis testing, the Human and Organization components in the Regulation variable have a T-Statistic value less than the T-Table so that they do not show an influence on Net-Benefit. In addition to usefulness, the consequences of adopting innovations are also reviewed, such as dependence on the system, fatigue with the system in use or development, changes in communication, and replication of health history records.

 

Keywords: Electronic Medical Record, Evaluation, Hospital, HOT-Fit, Service Quality

Kata Kunci : Evaluasi, HOT-Fit, Mutu Pelayanan, Rekam Medis Elektronik, Rumah Sakit/ Electronic Medical Record, Evaluation, Hospital, HOT-Fit, Service Quality