\\" and \\"IF < classification> THEN \\". Results Prescribing antibiotics in the IMCI program in the cough clinic particular child has not rational. Prescribing antibiotics in patients who cough is a single diagnosis of pneumonia as much as 39.39%. Treatment of patients with unstandar doses of antibiotics are at 71.66%. Misclassification to 20 health centers by 8.41%. This figure does not include 54.83% of data can not be analyzed because the respiratory rate (RR) patients not written in EMR. Application generates an electronic IMCI replace paper forms. The advantage of this application is could be done automatically that classification of cough, nutritional status, dose kotrimoksasole and amoksisillin, allergy alerts to antibiotics, immunization schedule reminders, and electronic prescribing. Clinical Decision Support Systems require integration with the clinical informa systems and clinical workflow support clinician in providing routine care to patients. Conclusion Electronic medical records do not support recording of IMCI and it's possible to be integrated with clinical decision support systems to improve the accuracy of IMCI classification and therapy."> \\" and \\"IF < classification> THEN \\". Results Prescribing antibiotics in the IMCI program in the cough clinic particular child has not rational. Prescribing antibiotics in patients who cough is a single diagnosis of pneumonia as much as 39.39%. Treatment of patients with unstandar doses of antibiotics are at 71.66%. Misclassification to 20 health centers by 8.41%. This figure does not include 54.83% of data can not be analyzed because the respiratory rate (RR) patients not written in EMR. Application generates an electronic IMCI replace paper forms. The advantage of this application is could be done automatically that classification of cough, nutritional status, dose kotrimoksasole and amoksisillin, allergy alerts to antibiotics, immunization schedule reminders, and electronic prescribing. Clinical Decision Support Systems require integration with the clinical informa systems and clinical workflow support clinician in providing routine care to patients. Conclusion Electronic medical records do not support recording of IMCI and it's possible to be integrated with clinical decision support systems to improve the accuracy of IMCI classification and therapy.">
Laporkan Masalah

SISTEM PENDUKUNG KEPUTUSAN KLINIS ANAK BATUK BERBASIS ALGORITMA MTBS

MAMIK ENDANG EKAWATI, dr. Ida Safitri Laksono, SpA

2013 | Tesis | S2 Ilmu Kesehatan Masyarakat

Pneumonia adalah penyebab utama kematian anak-anak di seluruh dunia. Diagnosis memainkan peran penting dalam perawatan medis. Tantangan yang paling penting dalam manajemen pneumonia adalah diagnosis dini dan tepat. Algoritma MTBS adalah sebuah pendekatan dari WHO yang cukup kritis dalam memutuskan apakah anak-anak batuk karena pneumonia atau tidak karena sensitivitasnya mendeteksi pneumonia cukup tinggi (97%). Salah satu masalah kesehatan terbesar saat ini adalah medical error. Kesalahan pengobatan paling umum secara eksplisit didokumentasikan dalam rekam medis. Dan salah satu tujuan penggunaan rekam medis elektronik adalah mengurangi kesalahan medis. Clinical guideline bermanfaat untuk meningkatkan kualitas pelayanan yang diterima pasien. Mengintegrasikan pedoman klinis dalam format komputer dengan rekam medis elektronik dan sistem pendukung keputusan klinis (SPKK) menjamin meningkatnya kualitas pelayanan kesehatan. Tujuan penelitian Mengembangkan sistem pendukung keputusan klinik anak batuk untuk meningkatkan akurasi klasifikasi dan terapi pneumonia berbasis MTBS yang dikombinasikan dengan rekam medis elektronik bagi bidan di puskesmas. Metodologi Rancangan penelitian dengan pendekatan action research. Pengembangan prototipe sistem pendukung keputusan menggunakan rule based system dengan format “IF THEN ” dan “IF THEN ”. Hasil Peresepan antibiotik dalam program MTBS khususnya anak batuk di puskesmas belum rasional. Pasien yang diresepi antibiotik pada batuk bukan pneumonia sebagai diagnosis tunggal sebanyak 39,39%. Pengobatan pasien dengan dosis antibiotik tidak sesuai standar sebesar 71,66%. Kesalahan klasifikasi untuk 20 puskesmas sebesar 8,41%. Angka tersebut tidak termasuk 54,83% data tidak dapat dianalisa sebab respiratory rate (RR) pasien tidak tertulis di RME. Dihasilkannya aplikasi MTBS elektronik yang menggantikan formulir MTBS kertas, dengan keunggulan adanya SPKK yang mengotomatiskan klasifikasi anak batuk, status gizi, dosis kotrimoksasole dan amoksisillin juga alert alergi antibiotik, reminder jadwal imunisasi, dan peresepan elektronik. Kesimpulan Rekam medis elektronik belum mendukung pencatatan MTBS dan sangat memungkinkan untuk diintegrasikan dengan sistem pendukung keputusan klinik MTBS untuk meningkatkan akurasi klasifikasi dan terapi.

Pneumonia is the leading cause of death for children around the world. Diagnosis plays an important role in medical care. The most important challenge in the management of pneumonia is early diagnosis and appropriate. IMCI algorithm is known to be approach of WHO which is critical in deciding whether the children with cough due to pneumonia or not because of the sensitivity high enough to detect pneumonia (97%). One of the biggest health problems today is medical error. The most common medication errors are explicitly documented in the medical record. And one of the intended use of the electronic medical record is to reduce medical errors. Clinical useful guidelines to improve the quality of care received by patients. Integrating clinical guideline in a computer format with electronic medical records and clinical decision support systems (CDSS) to ensure improved quality of health services. Research purposes To developed a clinical decision support system for children with cough and improve accuracy of IMCI based classification pneumonia therapy in combination with the electronic medical record to the midwifes at the clinic. Methodology The design of the study with action research approach. Prototyping system development using a rule based system with the format \\"IF THEN < classification>\\" and \\"IF < classification> THEN \\". Results Prescribing antibiotics in the IMCI program in the cough clinic particular child has not rational. Prescribing antibiotics in patients who cough is a single diagnosis of pneumonia as much as 39.39%. Treatment of patients with unstandar doses of antibiotics are at 71.66%. Misclassification to 20 health centers by 8.41%. This figure does not include 54.83% of data can not be analyzed because the respiratory rate (RR) patients not written in EMR. Application generates an electronic IMCI replace paper forms. The advantage of this application is could be done automatically that classification of cough, nutritional status, dose kotrimoksasole and amoksisillin, allergy alerts to antibiotics, immunization schedule reminders, and electronic prescribing. Clinical Decision Support Systems require integration with the clinical informa systems and clinical workflow support clinician in providing routine care to patients. Conclusion Electronic medical records do not support recording of IMCI and it's possible to be integrated with clinical decision support systems to improve the accuracy of IMCI classification and therapy.

Kata Kunci : MTBS, pneumonia, anak batuk, rekam medis elektronik, sistem pendukung keputusan klinik


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