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All Journal Journal of Social Research Jurnal Indonesia Sosial Teknologi
Winarsih, Sharah Aulia
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Humanities Computer Science & IT Economics, Econometrics & Finance Education Environmental Science Law, Crime, Criminology & Criminal Justice Social Sciences

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THE INCREASE OF BPJS CLAIMS AT HOSPITAL AFTER CHANGING TO E-MEDICAL RECORDS: CASE ANALYSIS AND MITIGATION STRATEGY Winarsih, Sharah Aulia; Widjanarko, Bagoes; Agushybana, Farid
Journal of Social Research Vol. 3 No. 2 (2024): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v3i2.1911

Abstract

With the advancement of digital transformation, EMR has become an important step towards operational efficiency and better care. Through Permenkes No.24 of 2022, all health facilities in Indonesia are expected to have implemented the EMR system by the end of 2023. This is a mixed-methods study that combines primary data from interviews with 5 respondents and secondary data regarding BPJS claims during the period before and after EMR implementation, from January to August 2023. Secondary data analysis will be conducted using tables, graphs, and descriptive statistics such as mean, median, and standard deviation to detail and explain changes in BPJS claims patterns before and after EMR implementation. Qualitative data will be analysed. The results showed that EMR implementation increased the number of cases (11.27%) and the nominal amount of BPJS claims (15.04%). In addition, this study identified several factors that became challenges after the change to EMR. These factors include data errors, lack of staff training, technical constraints, and changes in operational processes that have not been fully integrated with the EMR system. Mitigation strategies include staff training, periodic monitoring and evaluation, internal claim audits, improvement of claim business processes, and monitoring and evaluation from management. Based on the results of the study, it can be concluded that the change to electronic medical records (EMR) at Sultan Agung Islamic Hospital has increased starting from the number of patients, the number of cases and the nominal amount of BPJS claims. Despite the increase in the nominal amount of BPJS claims, there are still challenges and problems that need to be overcome after the implementation of EMR.
The Impact of Electronic Medical Records on BPJS Claims and Physician Performance Winarsih, Sharah Aulia; Widjanarko, Bagoes; Agushybana, Farid
Jurnal Indonesia Sosial Teknologi Vol. 5 No. 8 (2024): Jurnal Indonesia Sosial Teknologi
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/jist.v5i8.1207

Abstract

With the digital transformation, Electronic Medical Records (EMR) have become crucial for operational efficiency and better healthcare. By the end of 2023, all Indonesian healthcare facilities are expected to implement EMR (Regulation No. 24, 2022). However, challenges with BPJS claims often arise post-EMR implementation. This study analyzes EMR's impact at RS A on BPJS claims and physician performance, aiming to identify mitigation strategies for these issues. Using mixed methods, this study combines primary data from 5 respondent interviews and secondary data on BPJS claims pre- and post-EMR implementation at RS A (Jan-Aug 2023). Secondary data analysis employs tables, graphs, and descriptive statistics (mean, median, and standard deviation) to detail BPJS claims patterns. The Chi-Square test is used to analyze the relationship between physician performance and BPJS claim document completeness. EMR implementation increased cases by 11.27% and nominal BPJS claims by 15.04%. Physician performance analysis showed no significant relationship between variables and BPJS claim document completeness (p > 0.05). Challenges post-EMR included data errors, lack of staff training, technical constraints, and incomplete integration of operational processes with EMR. Mitigation strategies include staff training, periodic monitoring, internal audits, process improvements, and management evaluation. EMR implementation at RS A increased cases and BPJS claims. However, challenges persist post-implementation. Effective mitigation strategies can enhance efficiency and BPJS claim quality.
Co-Authors Bagoes Widjanarko Farid Agushybana