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Tinjauan Pelaksanaan Penyusutan Rekam Medis Di Rumah Sakit Umum Daerah Kembangan Intan Rusdiana Dewi; Lily Widjaja; Laela Indawati; Noor Yulia
Jurnal Rumpun Ilmu Kesehatan Vol. 3 No. 3 (2023): November: Jurnal Rumpun Ilmu Kesehatan
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/jrik.v3i3.2680

Abstract

Shrinkage is the reduction of medical records on storage shelves by moving inactive medical records to a different room from the active shelf seen from the last patient visit. The purpose of this study was to determine the implementation of shrinkage at the Kembangan Regional General Hospital. This research method uses a qualitative descriptive method by means of interviews and observations in the medical records unit. So it can be concluded from the results of the study that the Kembangan Regional General Hospital already has SOP related to shrinkage which is divided into SOP sorting, media transfer and destruction. In the implementation of shrinkage, officers carry out the process of sorting, transferring and transferring media every day. But officers do not conduct an assessment based on use value. The destruction process is carried out when the number of medical records has reached 2 tons by using a third party to make medical records in the form of pulp. The main obstacles to the implementation of shrinkage are officers who do not have a decree on duties and teams so that officers often delay the implementation of shrinkage, paper quality that makes it difficult for officers to see medical record sheets in the past year and scan machines that heat up quickly due to continuous use. Therefore, the Kembangan Regional General Hospital should complete the SOP related to shrinkage, make a decree of duties and conduct an assessment stage so that the implementation of shrinkage is carried out properly, and add a scan machine so that the implementation of media transfer is not delayed.
Motivasi Belajar Mahasiswa Rekam Medis pada Pembelajaran Online di Masa Pandemi Luthfiah Aulia Rachman; Rumana, Nanda Aula; Fannya, Puteri; Indawati, Laela
Edu Cendikia: Jurnal Ilmiah Kependidikan Vol. 1 No. 03 (2021): Artikel Riset Edisi Desember 2021
Publisher : ITScience (Information Technology and Science)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (550.191 KB) | DOI: 10.47709/educendikia.v1i3.1129

Abstract

Abstrak: Latar belakang: Dengan adanya pandemi ini segala kegiatan seperti pekerjaan, pendidikan dilakukan dirumah dengan cara online dan beribadah pun dilakukan dari rumah. Sehingga pembelajaran dilakukan secara online melalui zoom meeting,google meet, classroom, dan website. Dengan menggunakan media cetak (modul) dan non cetak (audio/video) serta menggunakan komputer dan internet. Tujuan: Mengetahui motivasi belajar mahasiswa Rekam Medis dan Informasi Kesehatan Universitas Esa Unggul pada pembelajaran online di masa pandemi covid 19 melalui lima indikator motivasi belajar yaitu ketekunan menyelesaikan tugas, kegigihan menghadapi kesulitan, ketajaman perhatian serta minat belajar, memiliki prestasi belajar, dan kemandirian pada belajar. Metode penelitian: Metode penelitian yang digunakan adalah deskriptif dengan pendekatan kuantitatif. Sampel dalam penelitian ini adalah 203 mahasiswa dari tiga angkatan berbeda yang diambil dengan teknik stratified random sampling. Hasil penelitian: Hasil penelitian dari 5 indikator yaitu Ketekunan Menyelesaikan Tugas 58% kurang baik, Kegigihan Menghadapi Kesulitan 59% kurang baik, Ketajaman Perhatian Serta Minat Belajar 60% kurang baik, Memiliki Prestasi Belajar 73% kurang baik, dan Kemandirian pada Belajar 59% kurang baik. Kesimpulan: Motivasi belajar mahasiswa rekam medis pada pembelajaran online di masa pandemi 47% motivasi tinggi dan 53% motivasi rendah.
Pemanfaatan Personal Health Record Dalam Mengontrol Kesehatan Individu (Literature Riview) Regina Yulianti T. S; Laela Indawati; Lily Widjaja; Daniel Happy Putra
Jurnal Medika Nusantara Vol. 2 No. 2 (2024): Mei : Jurnal Medika Nusantara
Publisher : Stikes Kesdam IV/Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/medika.v2i2.1126

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Individuals are authorized to access, maintain, and share their Personal Health Record (PHR), which is an electronic application, in a private, secure, and confidential setting. Using PHR will facilitate patient-provider communication. PHR has two-way communication that allows patients and providers to communicate with each other. The main effect of using PHR is that patients will be involved and take an active role in their health and disease prevention. The act of recording health information in PHR will increase patient awareness, such as weight, diet and glucose, and other health checks. Through PHR which stores health information, and consultations, patients feel safe knowing their health. The purpose of this writing is to determine the Utilization of Personal Health Record in controlling individual health. This study uses the Literature Review method. The results of this study are seen from the utilization and features of the Personal Health Record. Utilization of the Personal Health Record in controlling individual health can assist patients in accessing patient personal health information such as knowing blood sugar, blood pressure, laboratory results, and so on. The features used in the PHR have a main menu including health records, medical records, test results, medication reminders, health contacts, and education.
Gambaran Ketepatan Pengembalian Rekam Medis Rawat Jalan di Klinik Kebidanan dan Kandungan Rumah Sakit Permata Hati Tangerang Ayu Hardianti; Laela Indawati; Nanda Aula Rumana; Puteri Fannya
SEHATMAS: Jurnal Ilmiah Kesehatan Masyarakat Vol. 1 No. 4 (2022): Oktober 2022
Publisher : Yayasan Literasi Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55123/sehatmas.v1i4.877

Abstract

In order to obtain a quality medical record unit performance, the administration of medical records must be carried out properly, including the return of medical records. The standard for returning medical records at Permata Hati Hospital is 1x24 hours. Delays in returning medical records can disrupt the quality of medical services and hinder further activities such as coding. The purpose of this study was to obtain an overview of the return of outpatient medical records at Permata Hati Hospital, Tangerang. The method used is descriptive method. The type of research used is quantitative research. Data collection techniques in the form of interviews, observations and checklists. The results of the study on timely return of medical records were 64% and those that were not on time were 36%. Based on the results of this study, it is known that the return of outpatient medical records has not gone well. The delay in returning outpatient medical records was due to the lack of labor at the obstetrics and gynecology clinic so that there was no checking of borrowed medical records with those returned by clinic officers and medical record officers. Delays in medical records because clinic staff still do not understand and lack of socialization of SOPs related to returning outpatient medical records. One of the efforts made is to provide special training for clinic staff regarding the time limit for returning outpatient medical records.
Tinjauan Ketepatan Kode Diagnosa dan External Cause Kecelakaan Lalu Lintas di IGD RSIJ Pondok Kopi Aneu Rosliana; Laela Indawati; Puteri Fannya; Noor Yulia
SEHATMAS: Jurnal Ilmiah Kesehatan Masyarakat Vol. 2 No. 3 (2023): Juli 2023
Publisher : Yayasan Literasi Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55123/sehatmas.v2i3.1854

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Codification is the activity of classifying diseases based on certain criteria. Coding of disease diagnoses according to ICD-10 rules. One form of classification coding is using External Cause, which is a code used to classify the external cause of a disease caused by accidents, injuries, poisoning, burns, or side effects of drugs. This study was conducted at the Emergency Department of the Jakarta Islamic Hospital Pondok Kopi with the aim of the study to determine the percentage of accuracy of diagnosis and external cause codes and identify SPO related to classification coding. This study uses a quantitative descriptive method, with the technique of taking total sampling or saturated samples on 66 medical records for the period July 2022. The results of the research obtained with 66 samples related to traffic accident patients. Obtained the results of the accuracy of 66 appropriate injury diagnosis codes (100%) and 0 inappropriate (0%). The results of the accuracy of the external cause code obtained 66 (0%) external cause codes cannot be assessed because external cause coding activities have not been carried out. Only have SPO specifically for coding diagnoses in general, SPO specifically for external causes is not yet available. Of the 5 inhibiting factors studied, 3 inhibiting factors were obtained that caused the inaccuracy of external cause coding, namely Man, Money, and Material.
Prototipe Rekam Kesehatan Personal pada Pasien Diabetes Mellitus (Literature Review) Risma Ayu Fitriyani; Noor Yulia; Puteri Fannya; Laela Indawati
SEHATMAS: Jurnal Ilmiah Kesehatan Masyarakat Vol. 2 No. 4 (2023): Oktober 2023
Publisher : Yayasan Literasi Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55123/sehatmas.v2i4.2509

Abstract

Personal Health Record (PHR) is a collection of health-related data that is archived and managed by an individual or parties associated with the PHR. Its purpose is to provide a comprehensive and accurate summary of a person's health history that can be accessed online. This research is a Literature Review study which aims to determine the features and implementation of Personal Health Records in Patients with Diabetes Mellitus. The method used is the Literature Review method from 7 journals which uses several methods including the prototype method, qualitative methods, heuristic evaluation methods, applied development methods, participatory action research methods, and randomized controlled trial methods with data collection techniques through google scholar, direct science and pubmed. The results of the research are seen in the features and implementation of the Personal Health Record. The Personal Health Record feature for diabetes mellitus with dialysis measures has 25 features on the main page, the PHR feature for diabetes mellitus has 7 main features. PHR implementation allows users to access their personal health records anytime and anywhere. Thus, the PHR system can increase accessibility and allow users to access PHR without time restrictions and also the Personal Health Record can assist in monitoring the health condition of Diabetes Mellitus patients. Research conclusion According to the journals analyzed, PHR is effective because it can encourage patient participation in individual health controls, and can access information about diabetes mellitus through monitoring physical activity, diet, weight, and glucose levels.
Literatur Review : Pengelolaan Assembling Rekam Medis Rawat Inap di Rumah Sakit Noor Yulia; Erviana, Erviana; Laela Indawati; Muniroh, Muniroh
SEHATMAS: Jurnal Ilmiah Kesehatan Masyarakat Vol. 3 No. 1 (2024): Januari 2024
Publisher : Yayasan Literasi Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55123/sehatmas.v3i1.3157

Abstract

Assembling is an important part of medical records to examine the correctness of recording, control the use of medical record numbers and control the use of medical record forms. In order for assembling to be carried out well, the medical records unit creates Standard Operating Procedures (SOP) for the assembling section and medical records officers managing assembling must follow the SOP. The aim of the research is to find out the management of assembling inpatient medical records in hospitals using the Literature Review method or also called Narrative Review by collecting several journals using the Bolean System from the Google Scholar Database, to identify and conclude the analysis of the management of assembling inpatient medical records in hospitals From these journals, researchers obtained a sample of 16 journals. The results of the research showed that there were several factors in managing assembly in hospitals, namely: 40% of hospitals did not use medical record SOPs according to established regulations, 73% of medical record files were still incomplete in hospitals, 73% of medical record files were returned to the medical records room. in hospitals it is still not on time 100%, and the factor that causes Assembling not to be in accordance with SOPs using Fishbone theory which has the most influence is the Man factor which is related to the lack of discipline of Medical Records officers in hospitals as much as 100%.  
Tinjauan Sistem Pendaftaran Rawat Jalan di Puskesmas Kelurahan Klender Tahun 2023 Rizky Alfiansyah; Puteri Fannya; Daniel Happy Putra; Laela Indawati
Vitamin : Jurnal ilmu Kesehatan Umum Vol. 2 No. 4 (2024): October : Jurnal ilmu Kesehatan Umum
Publisher : Asosiasi Riset Ilmu Kesehatan Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61132/vitamin.v2i4.768

Abstract

Puskesmas is a functional health organization as well as a center for community health development. The Klender urban health center currently uses an online registration system and offline registration. This study aims to determine the online and offline outpatient registration system at the Klender Village Community Health Center in 2023. This research is a qualitative research. In this study, researchers directly observed the process of outpatient registration. Retrieval of research data is done by observation and interviews with registration officers. The results of the study found that online registration uses the Jaksehat application, patients do not need to come to the health center to register, patients come to the health center to validate queue numbers to the polyclinic only. Calling patients who register online is prioritized with a system of calling queue numbers 1-5, 11-15 and so on. Offline registration is done by having patients come directly to the puskesmas and queue to register. For calling patients, register offline after patients register online with queue numbers 6-10, 16-15, etc. The problems found in registration were the separate queues for patients who registered online and offline and there was a mismatch in calling patients according to the serial number of the queue. The conclusion in this study is that online registration of outpatients uses the Jaksehat application and offline registration is carried out using the system used by the puskesmas. It is expected that the puskesmas will separate the queues of patients who have registered online with patients who have registered offline.
EVALUASI SISTEM INFORMASI MANAJEMEN OPERASIONAL (SIMOP) DENGAN METODE HOT-FIT DI RUMAH SAKIT PELABUHAN JAKARTA Nadia Sintia; Siswati, Siswati; Indawati, Laela; Yulia, Noor
Jurnal Kesehatan Tambusai Vol. 5 No. 4 (2024): DESEMBER 2024
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jkt.v5i4.35060

Abstract

Evaluasi rekam medis elektronik adalah suatu usaha untuk mengetahui kondisi terhadap penyelenggaraan RME. Sistem yang digunakan di Rumah Sakit Pelabuhan adalah Sistem Informasi Manajamen Operasional (SIMOP). faktor yang masih menjadi penghambat SIMOP di Rumah Sakit Pelabuhan Jakarta, yaitu dibagian SIMOP memiliki fitur-fitur yang banyak pilihan namun tampilannya terlalu kecil sehingga menjadi kendala petugas untuk menginputnya kemudian pada sistem SIMOP yang digunakan terkadang down. Dampak dari down yaitu Dokter Penanggung Jawab Pasien (DPJP) dan petugas melakukan pekerjaan dua kali atau mengisi secara manual. Tujuan penelitian ini untuk mendapatkan gambaran mengenai evaluasi sistem informasi manajemen operasional (SIMOP) di Rumah Sakit Pelabuhan Jakarta. Desain penelitian ini menggunakan metode HOT-FIT dengan pendekatan kuantitatif, dengan populasi sebanyak 179 orang, sampel pada penelitian ini sebanyak 64 orang, dengan menggunakan teknik random sampling, variabel penelitian menggunakan variabel dependen dan independen, pengumpulan data pada penelitian ini menggunakan angket, dan teknik analisis data penelitian ini Skala Likert. Hasil pada penelitian ini menunjukkan bahwa dari aspek human 44 responden (69%) menyatakan baik dan 20 responden (31%) menyatakan tidak baik. Dari aspek organization 38 responden (59%) menyatakan baik dan 26 responden (41%) menyatakan tidak baik. Dari aspek technology 33 responden (52%) menyatakan baik dan 31 responden (48%) menyatakan tidak baik. Dari aspek net-benefit 40 responden (62,5%) menyatakan baik dan 24 responden (37,5%) menyatakan tidak baik. Kesimpulan penelitian ini adalah bahwa SIMOP di Rumah Sakit Pelabuhan Jakarta secara umum telah memenuhi harapan pengguna dan dapat memberikan manfaat, meskipun masih ada hal yang masih perlu dilakukan perbaikan lebih lanjut terutama dalam aspek teknologi.
Analisis Kebutuhan Perekam Medis dan Informasi Kesehatan dengan Metode Analisis Beban Kerja Kesehatan di Puskesmas Tambora Muhamad Fazriyansah; Lily Widjaja; Laela Indawati; Muhammad Rezal
Jurnal Manajemen Informasi dan Administrasi Kesehatan Vol. 7 No. 2 (2024): JMIAK
Publisher : Program Studi D3 Rekam Medis dan Informasi Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32585/jmiak.v7i2.5751

Abstract

Observasi awal di Puskesmas Tambora ditemukan dari 15 petugas, hanya satu yang berpendidikan rekam medis, menyebabkan beban kerja berat dan pengelolaan rekam medis tidak optimal. Penelitian ini bertujuan untuk memberikan gambaran hasil analisis kebutuhan perekam medis dan informasi kesehatan di Puskesmas Tambora dengan metode deskriptif kuantitatif yang menggunakan sampel jenuh dari total 15 petugas di unit rekam medis. Dari hasil penelitian yang dilakukan oleh peneliti didapatkan informasi bahwa Puskesmas Tambora memiliki SOP terkait perencanaan kebutuhan SDMK berdasarkan Permenkes No. 33 Tahun 2015. Hasil perhitungan kebutuhan perekam medis dan informasi kesehatan dengan metode analisis beban kerja kesehatan menunjukkan Puskesmas Tambora membutuhkan 16 petugas rekam medis, namun saat ini hanya ada 15 petugas, sehingga kekurangan 1 orang. Saran untuk penelitian ini yaitu dilakukannya penyesuaian jumlah perekam medis dan informasi kesehatan sesuai beban kerja dengan cara 4 orang pelaksana pendaftaran 24 jam lulusan SMA diberikan beasiswa untuk sekolah pendidikan DIII-RMIK di perguruan tinggi yang menyelenggarakan kelas karyawan dan merekrut 1 orang lulusan DIII-RMIK untuk memenuhi kekurangan 5 orang perekam medis dan informasi kesehatan (Manajemen pengelolaan rekam medis). Selain itu, 1 orang pelaksana pendaftaran BPJS lulusan SMA yang berlebih dapat dipindahkan ke bagian pendaftaran pasien yang kekurangan 1 orang petugas lulusan SMA.
Co-Authors Abdul Rokim Adelia Anggraini Adi Widodo Adijaya, Nuryansyah Ahmad Ripki Alex Sander Alfi Shiddiq Syafrian Almahshunatul Hanifah Amirah Syafiqah Zahra Amnur, Alvina Salsabila Aneu Rosliana Anggi Alpiyani Anggraini, Adelia Anisa Anisa Anisa Aprilia Anisa Dewi Wahyuni Anisa Dyah Irawati Annida Ariyani Annisa Nur Salsabila Aqshal Hidayatullah Arip Budiana Ariyani, Annida Athirah Iwani Rahman Athiyyah, Hanifatul Ayu Hardianti Azhar Muttaqin Azhar Muttaqin Bagas Saputra Bahlani Bangga Agung Satrya Bayu Fajar Ilhami Carono Daniel Happy Putra Daniel Happy Putra Debbie Friscilla Carolina Manalu Della Rati Saputri della Dessy Safutri Deta Nurfena Nurfena Devi Angeliana Kusumaningtiar Dewi, Deasy Rosmal Dewi, Deasy Rosmala Diah putri Ayu Islammia Dian Nur Muslimah Dina Sonia Dinda Melani Safitri Diva Sabina Dwi Chandrarika Putri Aulia Dwijayanti, Risma Mei Elina Intan Apzari Elvira Xandra Ximenes Harum Endika Rachmad Erviana, Erviana Fani Nur Azizah Fannya, Puteri Fauzan Habibilah Fauziah Irfany Fiqih Nurhidayah Fitria, Annah Gilang Dasa Dwi Mahendra Hanif Andini Hanum Milla Kurnia Harahap, Maulidiah Rizki Ilhami, Bayu Fajar Intan Rusdiana Dewi Iqbal, Muhammad Fuad Jeillia Jihan Swaradwibhagia Junata, Ilfan Kamalia, Farhah Karim, Hidayat Ramadhani Nuzulul Kevin Handynata Kurnia, Hanum Milla Kusumapradja, Rokiah Laras Sitoayu Lasmaria Simorangkir Liani, Emilia Karin Dwi Listania Aisyah Putri Luthfiah Aulia Rachman Luviany Gouw Manalu, Debbie Friscilla Carolina Maria Ferawaty Parera Mariyam, Mutia Maulidiah Rizki Harahap Mei Nur Khasanah Muammar Dzachwani Muammar Dzachwani Muhamad Endra Suriatno Muhamad Fazriyansah Muniroh Muniroh Muniroh, Muniroh Nadia Sintia Nanda Aula Romana Nanda Aula Rumana Nur Mawaddah, Nur Nurasiyah Nurfena, Deta Nurfena Nurkholifa, Eza Nurmalasari, Dinda Nurmalasari, Mieke Nusamina Pulungan Octa Rina Sari Putri Rafikasani Putri, Alifatul Aulia Sagita Putri, Listania Aisyah Putri, Nur Ratri Annisa Putri, Sisilia Rahayu, Ririn Rahmawati, Rena Maulina Regina Yulianti T. S Rezal, Muhammad Rianta Sari Gultom Rifda Ulfa Andini Rifqi Fauzan Ririn Rahayu Risma Ayu Fitriyani Rizal Ramadhan Rizky Alfiansyah ROKIM, ABDUL Rumana, Nanda Saarah Salsabila Putri Yadita Sabina, Diva Sadono Hadi Saputro Safitri, Dinda Melani Salsabila Putri Cahyani Salsabila, Annisa Nur Salsabillah, Shania Sansy Dua Lestari Shania Salsabillah Shania Salsabillah Silfa Haniasti Simorangkir, Lasmaria Siswati Siswati Siswati Siswati Siva Maulia Fauziah Sonaria Tambunan Sonia, Dina Sonia Tia Ivany Uli Shalatiya uli Viatiningsih, Wiwik Wantika, Chinta Fourdy Widjaja, Lily Widjaya, Lily Yulia, Noor Zalipa Wittri Zharifah, Naurah