Health Information Supply Chain Untuk Mendukung Kinerja Dokter pada PROLANIS Diabetes Mellitus Tipe 2 (DMT2)

Rinda Nurul Karimah, Prof. dr. Hari Kusnanto, SU., Dr. PH.; dr. Lutfan Lazuardi, M.Kes., Ph.D.

2023 | Disertasi | S3 Ilmu Kedokteran dan Kesehatan

Latar belakang: Information Supply Chain (ISC) adalah jenis rantai pasokan yang digunakan untuk menyusun, merancang produksi, aliran, peningkatan, dan ketersediaan informasi. Penerapan rantai pasok di bidang kesehatan umumnya terkait logistik. Penelitian ini melihat sudut pandang lain dari rantai pasok untuk ketersediaan informasi medis pada pengelolaan diabetes di pelayanan primer. International Diabetes Management Practices Study (IDMPS) menyatakan upaya pencegahan komplikasi dini pasien diabetes sangat berperan dalam mengurangi beban klinis dan ekonomi. Kinerja dokter selaku koordinator pelayanan kesehatan penting untuk capaian program. Di Indonesia terdapat Program Pengelolaan Penyakit Kronis (PROLANIS) Diabetes Mellitus Tipe 2 (DMT2) untuk mencegah komplikasi. Program sudah berjalan baik, namun belum efektif. Perlu adanya perbaikan aliran informasi, khususnya untuk mendukung kinerja dokter selaku koordinator pelayanan kesehatan. Penelitian ini fokus pada ISC untuk mendukung kinerja dokter pada PROLANIS DMT2 di Puskesmas. Tujuan: Merancang model Health Information Supply Chain (HISC) PROLANIS DMT2 di Puskesmas beserta instrumen pengukuran kualitas informasi. Metode: Penelitian ini merupakan penelitian mixed method dengan pendekatan studi kasus. Penelitian terdiri dari 5 tahap: perancangan model dengan demand and supply-based operating modes, pembuatan instrumen pengukuran kualitas informasi dengan content evidence, response process, uji internal structure, pengembangan aplikasi berbasis native android, analisis keterjangkauan model dan analisis dampak implementasi model terhadap capaian indikator PROLANIS DMT2. Hasil: Penelitian ini menghasilkan model HISC DMT2. Pengukuran kualitas informasi diperoleh peningkatan signifikan. Analisis keterjangkauan uji inter rater reliability diperoleh nilai kappa 0,91 (excellent agreement) adalah enduring. Hasil analisis capaian implementasi model pada kelompok model dibanding kontrol terdapat perbedaan bermakna kadar HBA1C dan GDP. Kesimpulan: Model HISC DMT2 dengan fokus tiga faktor yaitu accesibility, safety, dan efficiency terbukti berperan pada peningkatan kualitas informasi yang mendukung kinerja dokter pada capaian PROLANIS DMT2 di Puskesmas.

Background: Information Supply Chain (ISC) is a framework used to structure and design the production, flow, enhancement, and availability of information. Typically, supply chains in the health sector are associated with logistics. However, this study takes a different perspective by focusing on the supply chain for the availability of medical information in the management of diabetes within primary care. The International Diabetes Management Practices Study (IDMPS) shows that early prevention of complications is crucial to alleviate the clinical and economic burdens. The effective performance of doctors as coordinators of health services plays a vital role in achieving program goals. In Indonesia, the Chronic Disease Management Program, known as PROLANIS is dedicated to preventing complications of Diabetes Mellitus Type 2 (DMT2). The program has been running well but has yet to be effective. There needs to be an improvement in the information flow, primarily to support doctors' performance as coordinators of health services. Therefore, this study specifically centers on ISC to support the performance of doctors involved in PROLANIS for DMT2 at Puskesmas. Objective: This study aims to design the Health Information Supply Chain (HISC) model for PROLANIS in managing DMT2 at Puskesmas, along with the development of instruments for measuring information quality. Method: This mixed-method study with a case study approach consisted of five stages, namely model design comprising demand and supply-based operating modes, development of information quality measurement instruments supported by content evidence, response process, internal structure testing, development of native Android applications, affordability model analysis, and evaluation of the impact of model implementation on achieving the PROLANIS targets for DMT2 indicators. Results: This study led to the development of the DMT2 HISC model. Furthermore, the measurement of information quality exhibited significant improvement. The analysis of the inter-rater reliability test yielded a kappa value of 0.91, indicating excellent agreement. When comparing the model group with the control group, the analysis of model implementation revealed significant differences in achieving HBA1C and fasting blood glucose level targets. Conclusion: The HISC DMT2 model, emphasizing accessibility, safety, and efficiency, has demonstrated the enhancement of information quality, thereby supporting the performance of doctors in achieving the goals of PROLANIS for DMT2 at Puskesmas.

Kata Kunci : Information Supply Chain, Kinerja dokter, Prolanis, DMT2, Puskesmas