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All Journal Kesmas Indonesia: Jurnal Ilmiah Kesehatan Masyarakat Journal of Public Health Research and Community Health Development (JPH RECODE) Jurnal Aisyah : Jurnal Ilmu Kesehatan Jurnal Kesehatan Tambusai J-REMI : Jurnal Rekam Medik dan Informasi Kesehatan BIOS : Jurnal Teknologi Informasi dan Rekayasa Komputer International Journal of Health and Information System (IJHIS) International Journal of Healthcare and Information Technology Jurnal ARSI : Administrasi Rumah Sakit Indonesia SEJAGAT : Jurnal Pengabdian Masyarakat Journal of Medical and Health Science
Nuraini, Novita
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Agriculture, Biological Sciences & Forestry Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Engineering Health Professions Library & Information Science Medicine & Pharmacology Nursing Public Health Social Sciences Veterinary Other

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Optimalisasi Manajemen Penanganan Klaim Pending Pasien Bpjs Rawat Inap di Rumah Sakit Citra Husada Jember Tahun 2018 Alfiansyah, Gamasiano; Nuraini, Novita; Wijayanti, Rossalina Adi; Putri, Fitriana; Deharja, Atma; Santi, Maya Weka
Kesmas Indonesia: Jurnal Ilmiah Kesehatan Masyarakat Vol 11 No 1 (2019): Jurnal Kesmas Indonesia
Publisher : Jurusan Kesehatan Masyarakat dan Fakultas Ilmu-Ilmu Kesehatan Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (87.268 KB) | DOI: 10.20884/1.ki.2019.11.1.1314

Abstract

Latar belakang: Perubahan paradigma pelayanan kesehatan harus disikapi oleh para pengelola rumah sakit. Peningkatan mutu dan patient safety menjadi faktor utama yang akan mempengaruhi peningkatan kinerja rumah sakit dalam era BPJS. Berdasarkan studi pendahuluan, ditemukan banyak formulir persyaratan klaim BPJS yang tidak lengkap dalam pengisiannya. Data menunjukkan masih ditemukan beberapa berkas klaim yang dikembalikan. Tujuan: melakukan optimalisasi manajemen dalam penanganan klaim pending melalui POAC. Metode: Penelitian ini merupakan penelitian kualitatif, dengan maksud menggali lebih dalam fungsi manajemen yang telah dilakukan. Penelitian dilakukan di Rumah Sakit Citra Husada Jember pada bulan Mei ? September 2018 dengan unit analisis adalah unit rekam medis di rumah sakit tersebut. Hasil: Proses penanganan claim pending berdasarkan aspek planning, organizing, actuating, dan controlling masih belum berjalan dengan baik. Hal tersebut diantaranya dikarenakan tidak adanya rincian pekerjaan dan job description, kurangnya motivasi dari pimpinan, dan tidak ada jadwal supervisi pimpinan yang jelas. Saran: Menyusun rencana kerja operasional dalam proses pengisian berkas persyaratan klaim BPJS, membuat susunan rincian pekerjaan dan job description dalam pengelolaan pengisian berkas persyaratan klaim BPJS rawat inap, menyusun SOP untuk memudahkan komunikasi antar petugas, dan menyusun jadwal supervisi pimpinan untuk mempermudah staf dalam melaporkan informasi yang harus dilaporkan. Kata kunci: Klaim Pending, BPJS, Manajemen
Factors Causing Delays in Submitting Inpatient BPJS Claims at RSU dr. H. Koesnadi Bondowoso Nuraini, Novita; Damayani, Desnia Sindi; Wijayanti, Rossalina Adi
Jurnal Aisyah : Jurnal Ilmu Kesehatan Vol 6, No 2: June 2021
Publisher : Universitas Aisyah Pringsewu

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1996.252 KB) | DOI: 10.30604/jika.v6i2.481

Abstract

The submission of BPJS claims by health care facilities according to the technical verification manual is at least on the 10th of the following month. Meanwhile, in October 2019, the process of submitting inpatient BPJS claims at RSU dr. H. Koesnadi Bondowoso exceeded the 10th of the next month which was 130 days delayed. The purpose of this study analyzes the factors that cause the delays in submitting inpatient BPJS claims. The Type of qualitative research by finding out causal factors based on personal factors, leadership factors, team factors, system factors and contextual/situational factors using Problem Tree Analysis. Data collection techniques are in-depth interviews, observation, documentation and brainstorming. The results showed a lack of knowledge related to the deadline for submitting a BPJS claim and a delay in file submission from inpatient rooms. Incomplete files for inpatient BPJS, internal verifier have multiple jobs and lack of guidance from chief nurse also causes of delay in submitting claims. There are no standard operating procedures, hospital information management system and scanner error, an increase of workload, and less supportive of work environment due to the Covid-19 pandemic. It is recommended to make standard operating procedures for submitting inpatient BPJS claims, discipline the employees, give rewards and add more employees for the Controller Installation.Abstrak: Pengajuan klaim BPJS oleh fasilitas pelayanan kesehatan berdasarkan buku petunjuk teknis verifikasi maksimal tanggal 10 bulan berikutnya. Proses pengajuan klaim BPJS rawat inap di RSU dr. H. Koesnadi mengalami keterlambatan dimana pengajuan bulan Oktober 2019 melebihi tanggal 10 bulan berikutnya yaitu terlambat 130 hari. Tujuan penelitian ini menganalisis faktor yang menyebabkan keterlambatan pengajuan klaim BPJS rawat inap. Jenis Penelitian kualitatif dengan mencari faktor penyebab berdasarkan personal factors, leadership factors, team factors, system factors dan contextual/situational factors menggunakan Problem Tree Analysis. Teknik pengumpulan data dengan wawancara mendalam, observasi, dokumentasi dan brainstorming. Hasil penelitian menunjukkan penyebab keterlambatan pengajuan klaim BPJS rawat inap yaitu kurangnya pengetahuan batas tanggal pengajuan klaim BPJS rawat inap, keterlambatan setor berkas klaim BPJS rawat inap dari ruangan, ketidaklengkapan berkas klaim BPJS rawat inap, verifikator internal double job, kurangnya bimbingan Kepala Ruangan, kerja sama belum maksimal, belum adanya SOP, SIMRS dan scanner eror dan beban kerja bertambah serta lingkungan kerja kurang mendukung karena pandemic Covid-19. Solusi yang dapat dilakukan yaitu membuat SOP pengajuan klaim BPJS rawat inap, pendisiplinan petugas, pemberian reward dan menambah petugas di Instalasi Pengendali.
STUDY OF LITERATURE RELATED TO STAFF PERFORMANCE FACTORS' LINKAGES TO INCOMPLETE MEDICAL RECORD DOCUMENTS IN PUBLIC HEALTH CENTER Wijayanti, Rossalina Adi; Zatin, Widian Almas; Nuraini, Novita
Journal of Public Health Research and Community Health Development Vol. 6 No. 2 (2023): March
Publisher : Fakultas Ilmu Kesehatan, Kedokteran dan Ilmu Alam (FIKKIA), Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jphrecode.v6i2.31050

Abstract

ABSTRACT Background:  Excellent and quality medical record services can be seen from the contents of the completeness of the file, timely, accurate and compliance with aspects of legal requirements.  The ideal standard for the completeness of medical record documents is 100%. However, based on a literature review, there are still medical record documents which weren't 100% complete. The incomplete filling of medical record documents is related to many things, including the delay in fulfilling the patient's rights to the contents of the medical record and reduction in the quality of medical record services. Purpose:  The study aims to analyze the factors causing the incomplete filling of medical record documents at the  public health center. Method:  Data collection was conducted by literature search from the Google Scholar database and the Garuda Portal, and 12 articles were reviewed. Result: The biggest factor identified was the individual factors, namely the skills factor (75%), then knowledge factor (50%), and the lowest percentage was the ability factor (16.67%). On the organizational and motivator variables, the identified factors were leadership (50%) and motivator (16.67%). Conclusion: There was a need for documentation procedures in the form of Standard Operating Procedure that were socialized to health workers.  There is also a need for leaders to provide communication forum between health personnels, and a form of evaluation and control in good and correct documentation of medical records combined with rewards and punishment system. It is also necessary to provide seminars and trainings to health workers regarding correct medical record filling. Health workers who have limited time to fill out, can arrange a good work plan.  
Analisis Prediksi Kebutuhan Kapasitas Media Penyimpanan RME dengan Metode Least Square RSUPN Dr. Cipto Mangunkusumo Jakarta Wulandari, Savira Puteri; Rahagiyanto, Angga; Nuraini, Novita
BIOS : Jurnal Teknologi Informasi dan Rekayasa Komputer Vol 5 No 2 (2024): September
Publisher : Puslitbang Sinergis Asa Professional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37148/bios.v5i2.133

Abstract

The implementation of electronic medical record services is supported by PMK RI Number 24 of 2022, Article 3, Paragraph 1, which mandates that every health service facility must organize Electronic Medical Records (EMR). Therefore, hospitals need to transition from manual to electronic records. One necessary step is determining the storage capacity needed for the server. Additionally, according to Article 39, EMRs must be stored for 25 years, requiring a prediction of storage needs over that period. This study discusses predicting the storage capacity needs for EMRs using the Least Square method, which analyzes time series data trends. Hospital data shows 130,712 medical records with a size of 261,424 MB from September 2022 to March 2023. The predicted storage needs from April to December 2023 are 781,490 MB, and for the next 25 years (until 2048) is 8,974,669 MB or 9 TB. The accuracy of the prediction, tested using MAPE, is 6.34%, which is considered very good. RSUP Nasional Dr. Cipto Mangunkusumo has provided 6 TB of server storage and 71 TB of NAS as backup. With 80 GB used per month as of March 2023, the hospital is advised to provide storage according to the prediction. Additionally, the maximum upload size in the HIS needs to be increased beyond 2 MB per medical record to maximize scanning quality and efficiency
The Optimization of Pharmacy Waiting Time Using the Lean Healthcare Method Nuraini, Novita; Wijayanti, Rossalina Adi
International Journal of Healthcare and Information Technology Vol. 1 No. 1 (2023): July
Publisher : P3M Politeknik Negeri Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25047/ijhitech.v1i1.3915

Abstract

The waiting time for prescription services at dr. M. Suherman Clinic, a primary healthcare clinic with pharmacy services, did not meet the standard. It was about 15 minutes for the maximum waiting time for non-concoction prescriptions and 30 minutes for concoction medicines. A pre-liminary study of 100 patient visits in a day revealed that 15 non-concoction prescriptions and 20 concoction prescriptions exceeded the waiting times standard. It explicated the inefficiency in pharmacy services. The purpose of this research was to make the waiting time for pharmacies became more efficient. This research used lean healthcare method by using fishbone and 5M management elements. The data were collected by interviews, observation, and brainstorming. This study found that waiting time for pharmacy services approximately 36 minutes, with the Non-Value-Added ratio 56,7 %. It is concluded that the condition of pharmacy services had been inefficient. The units which contributed most waste were polyclinics and pharmacies. This research will produce a definite solution using the brainstorming method. The clinics need to standardize the deadline for doctors to input prescriptions, update the medical drug formulary, add new computers and drug blenders, add the number of staffs as human resources, and rearrange the clinic rooms.
BPJS Pending Claim Settlement Strategy In Hospital With Management Approach (Planning, Organizing, Actuating, Controlling) Wijayanti, Rossalina Adi; Dewi, Riskha Dora Candra; Farlinda, Sustin; Nuraini, Novita
International Journal of Healthcare and Information Technology Vol. 1 No. 1 (2023): July
Publisher : P3M Politeknik Negeri Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25047/ijhitech.v1i1.3917

Abstract

The pending claim incident at Citra Husada Hospital Jember reached 33 files in December 2021, impacting health services' sustainability. This study aims to formulate a strategic policy review in the settlement of BPJS pending claims in hospitals with the Planning, Organizing, Actuating, and Controlling management approach. This research is qualitative. Data collection techniques using observation, interviews, documentation, and brainstorming. Test the validity of the data using source triangulation and technique triangulation. Based on the study results, the BPJS pending claim settlement strategy at Citra Husada Hospital Jember was implemented with a Planning, Organizing, Actuating, and Controlling management approach. Planning is carried out by preparing the quality of human resources and SOPs. Implementation of Organizing through coordination between officers and between fields, but there are still incomplete files and different interpretations between fields. Actuating is constrained by the system, while controlling is carried out through scheduled supervision.
Optimizing Nutrition Care Management at Nutrition Care Center (NCC) Wijayanti, Rossalina; Dewi, Riskha Dora Candra; Farlida, Sustin; Nuraini, Novita
International Journal of Healthcare and Information Technology Vol. 1 No. 2 (2024): January
Publisher : P3M Politeknik Negeri Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25047/ijhitech.v1i2.4578

Abstract

In nutrition care services, the creation and storage of medical records at the Nutrition Care Center (NCC) are still relatively simple and paper-based or manual. Additionally, management challenges, in the form of system constraints, are one of the obstacles to healthcare management at NCC. Therefore, there is a need for optimizing healthcare management at NCC. The aim of this study is to optimize nutrition care management at the NCC clinic through the use of EMR (Electronic Medical Records) facilitated by QR Codes and the implementation of a Whatsapp Bot. The results indicate that optimizing Nutrition Care Management through the Implementation of EMR with QR Codes and Whatsapp Bot simplifies nutritionists' access to previous client allergy and therapy history in one view and facilitates clients in accessing their medical record number without a physical card. This research has also designed a system that can be used both through web and mobile platforms
Analisis Sistem Penyelenggaraan Rekam Medis di Instalasi Rekam Medis RS “X” Tangerang Periode April-Mei 2015 Nuraini, Novita
Jurnal ARSI : Administrasi Rumah Sakit Indonesia Vol. 1, No. 3
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

This study aims to analyze the medical records implementation system (input, process, output, feedback and control) in the "X" Hospital Tangerang period from April to May 2015. This research is a mixed method. The data collected by observation, interview, documentation. Results: The medical record system implementation was not running optimally so this is due to produce output completeness of medical record file is only 55.2%, while the timeliness of the provision of medical record file is only 31%. This relates to the control and the process does not complete the analysis of the file. Suggestion: Hospital activate Control Committee of medical records and set a completeness analysis activities outpatient medical record.
Improvement Strategy to Reduce Delay in Returning Inpatient Medical Record at Jenggawah Primary Health Center in 2023 Nuraini, Novita; Febriyanti, Bella Amalia; Wijayanti, Rossalina Adi
International Journal of Health and Information System Vol. 2 No. 2 (2024): September
Publisher : Indonesian Journal Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47134/ijhis.v2i2.44

Abstract

Delay return of inpatient medical records still occur at Jenggawah Primary Health Center with an average percentage 52,15%. This situation leads to misfiled records, potentially causing disruptions and errors in patient care. The purpose’s research was to develop a strategy to reduce delay return of inpatient medical records using action research. This research methodology is quasi-semi-experimental methodology, incorporating interviews, observations, documentation, and discussions for data collection. Results in diagnosing action, the delay in returning the medical record of inpatient was caused by the officers' lack of medical record knowledge and their lack of medical record training, the contents of the SOP, which required evaluation, and the tracer's inadequate work. Planning action to plan strategy which are hold medical record training, reviewing returning medical record’s SOP and redesigning tracer. Taking action to implement strategy during 3 month. There is the evaluation action, which includes 4 success parameters. Overall, it is considered successful if the percentage of delays in returning inpatient medical records is dropped to a maximum of 50% per month. Evaluating action to evaluate taking action were carried out properly because the percentage of delays in returning inpatient medical record was reduced below 50%. It’s hoped medical recorder always monev and remind each other regarding the return of inpatient medical records. And it’s hoped Jenggawah Primary Health Center will hold in house training, hold socialization of SOP and budgeting funds for supporting facilities.
Evaluasi Pelepasan Informasi Kesehatan Kepada Pihak Asuransi di RSUD Dolopo Madiun Menggunakan: Process and Product method amalin, Atika Mima; Nuraini, Novita
JOURNAL OF MEDICAL AND HEALTH SCIENCE Vol. 1 No. 1 (2023): Juli
Publisher : Universitas Muhammadiyah Sidaorjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21070/anamnetic.v1i1.281

Abstract

Informasi kesehatan dapat diberikan kepada pihak ketiga oleh dokter atau dokter gigi. Pihak ketiga diantaranya yaitu pihak kepolisian, penegak hukum, pihak asuransi kesehatan, serta peneliti. Pelepasan informasi kesehatan kepada pihak ketiga memerlukan prosedur yang melibatkan pasien dalam prosesnya dengan pengadaan surat kuasa, karena segala yang tertuang dalam berkas rekam medik merupakan rahasia pasien dan sepenuhnya milik pasien. Surat kuasa merupakan surat pelimpahan wewenang yang dapat mewakili pihak pemberi wewenang. Tujuan penelitian ini untuk mengetahui kesesuaian kegiatan pelepasan informasi kesehatan mulai dari perencanaan kegiatan, strategi yang digunakan dalam mencapai tujuan, proses kegiatan pelepasan informasi dan keberhasilan kegiatan pelepasan informasi kesehatan. Penelitian ini menggunakan metode evaluasi CIPP yaitu mengevalusi kegiatan pelepasan informasi dari aspek contect, input, process dan product. Pengumpulan data dilakukan dengan observasi,wawancara serta dokumentasi. Hasil penelitian menunjukkan bahwa adanya ketidak sesuaian kegiatan pelepasan informasi dengan peraturan menteri kesehatan. Ketidaksesuaian tujuan pelepasan informasi yang hanya untuk asuransi, pada kegiatannya ditemukan tidak ada surat kuasa dalam melakukan permintaan informasi kesehatan 44%, tidak terdapat nama terang dokter 12,5% dan tidak ada keterangan waktu pengisian 36,5%. Keputusan yang didapat dari hasil evaluasi adalah memodifikasi tujuan, sasaran serta trategi mencapai tujuan. Keputusan akhir dari evaluasi pelepasan informasi kesehatan di RSUD Dolopo adalah melanjutkan kegiatan pelepasan informasi dengan merevisi SOP. Solusi yang hasilkan dari hasil diskusi adalah SOP pelepasan informasi kesehatan yang dapat digunakan untuk pihak ke tiga secara umum. Revisi SOP pelepasan informasi yang telah ada dengan penambahan poin tentang surat kuasa dan kelengkapan pengisian.
Co-Authors Adi Prasetyo Alfiansyah, Gamasiano Anelia, Zaifatul Atika Mima Amalin Damayani, Desnia Sindi Deharja, Atma Dewi, Riskha Dora Candra Farlida, Sustin Febriyanti, Bella Amalia Kiromah, Siska Ainul Maemunah Maemunah maya weka santi, maya weka Muflihatin, Indah Nurwijayanti Olidela, Imanuel Nikson Putri, Fitriana Rachmawati, Ervina Rahagiyanto, Angga Rahmadanti, Ainun Safira Sustin Farlinda, Sustin Swari, Selvia Juwita Vestine, Veronika Wijayanti, Rossalina Wijayanti, Rossalina Adi Wulandari, Savira Puteri Zatin, Widian Almas