PROPOSAL

DEVELOPMENT OF HOSPITAL INFORMATION SYSTEMS

IN BANJARMASIN HOSPITAL

I. INTRODUCTION
The demand for information services for patients in hospitals was increasing,
this service is equipped with the ease of accessing information needed by patients
and facilitating in various efforts such as registering for consultation with a doctor
or outpatient. To improve better service to patients in terms of data access services
and information needed about containers that can provide better services, therefore
Hospital Information System (HIS) is needed.
With HIS, activities are waiting in line and waiting for consultation with
doctors who spend a lot of time can be done, because this system give faster
transaction. In addition, doctors can access the medical record data of patients who
were previously invited by different doctors but still within the hospital
environment.
This system uses an integrated Database Management System based on
internet connection. The existence of this system is expected to provide better
patients service in the hospital, especially in outpatient clinics.
The ease of accessing information is absolutely necessary to provide better
service to consumers in need. The demand for information services and management
in an integrated manner is very important. Manual data processing becomes
ineffective because more data must be processed and the process to access a data or
information requires a long time, such as outpatient admission, check-up and
consultation that requires better data processing.
Hospital Information System (HIS) are beginning to attract many parties,
because it can improve information services better where information can be
accessed by anyone, anytime and anywhere in hospital without limited space and
time.

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 The problems that often occurs in Banjarmasin Hospital is complaints from
patients or families because of waiting too long in the admission. This happened
repeatedly, so that there were patients who threatened to "no longer want to visit to
Banjarmasin Hospital". Because the same problem often occurs, the Hospital
Quality Management Team conducts Root Cause Analysis (RCA) to find the root
of the protracted problem without resolution and to solve the problems.
Based on the background of the problems found in the hospital, an application
hospital information system is needed that supports hospital activities in handling
patient data that aims to facilitate access to information and to make time efficient.
This is very beneficial because it can reduce duplicate data and facilitate data search,
improve patient quality and safety, ensure data safety, staff safety, drug safety,
reduce waiting time, quality and coordinate care.
In addition, HIS also may result to more satisfaction to patients and their
families because they are managed treated well by doctors and nurses. Patient’s or
family’s satisfaction is an important thing that should be taken care of because they
are promoters who directly carry out promotions in the environment in which they
are located. Therefore, the Banjarmasin Hospital needs to improve and development
the existing system to support services to be better in the future.

II. AIM
Development an integrated Hospital Information System (HIS), automating
database processing to support and improve hospital services so that they are more
effective and efficient.

III. EVALUATION OF THE OLD SYSTEM

The service for consultation or outpatient is done manually, namely first of all
the patient comes to the hospital and enrolls in the designated clinic, the registration
process uses electronic / computer systems but also uses paper-based manuals, then
patients wait their turn to consult with a doctor.

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 The paper-based manually processed data is then stored in the form of an
archive in the medical record storage room. With the increase in the number of
patients, the paper-based data is also added, while the medical record storage space
available is not increased or limited. This resulted in the paper-based data piling up
in the storage room, so officers had difficulty finding data when needed. This often
occurs in patients who have not been treated for a long time.
Besides requiring a long time to access paper-based manual data, it also
consumes a lot of paper. Another disadvantage is that data is very vulnerable to
damage because of unexpected things such as: leakage, fire, and theft. In addition,
related to confidentiality, manual data can easily be accessed by unauthorized and
irresponsible people without the need for special skills.
These are several potential problems found, hopefully it can becomes a
consideration for hospital management in making decisions to develop Hospital
Information Systems (HIS) as an effort to improve the quality of hospital services.

IV. EXPECTED IMPACT FROM THE HIS

The expected impact of Hospital Information System is improving the quality
of Banjarmasin Hospital services and also convenience for the community.
o Impact on Hospital Organizational Structure
By implementing this information system, the organizational structure can be
doubled / grouped.
o Impact on Hospital Operations
The impact of the operation of the information system is certainly very influential
in hospitals, besides being able to facilitate the performance of medical
personnel, this system runs more effectively and efficiently because it only
requires a shorter time. Personally, this system certainly further improves the
quality of Banjarmasin Hospital.
o Impact on Hospital Resources
Hospital resources will have increasingly nimble performance and gain
knowledge and experience about the use of new information systems.

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V. HOSPITAL INFORMATION SYSTEM (HIS) RESEARCH PROJECT
The human resources needed, the tasks of each individual, and the estimated
time of the system research project will be summarized into one table.
Sub-Tasks Person in Estimated
Charge / PIC Time (Month)
1. Identify the needs, functions and uses of System Analyst 1.5
the hospital information system
2. Determine the work partner from the System Analyst 1.0
purchase of the hospital information
system
3. Prepare all documents Documentation 1.0
Staff, IT
4. Review documents Hospital 2.0
Manager
5. Communicate everything with work Communication 6
partners Staff
6. Approve the project Hospital 4
Manager
7. Adjust additional hospital information IT Hospital 1
systems with existing systems in the
hospital
8. Testing hospital information systems All unit 3
services
9. Prepare a data base Programmer 2
10. Running the project All unit -
services

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VI. COST ESTIMATION
No Specification Item Unit Price Total
(Rp) (Rp)
1 Software (cooperation with a 1 40.000.000 40.000.000
accredited companies).
2 Hardware:
- Computer Server 1 5.000.000 5.000.000
- Computer (Flat Monitor) 10 5.000.000 50.000.000
- Printer 10 1.000.000 10.000.000
3 Tenaga Ahli:
- System Analyst 1 40.000.000 40.000.000
- Designer 1 20.000.000 20.000.000
- Programmer 1 30.000.000 30.000.000
TOTAL 195.000.000

VII. GENERAL DEVELOPMENT PLAN

The development of Hospital Information System (HIS) at Banjarmasin
Hospital is made using the Network Channel Interface (NCI). In collaboration with
the NCI company to complete and expand existing and integrated systems
throughout the hospital.
a. The Framework:
o Continue to work with NCI or find other companies that are more trusted.
o Provide the software and hardware needed.
o Conduct training employees who will use the HIS system in stages and
regularly.
o Do a trial or system simulation before being enable or before using in the real
situation.
o Ensure that system can function properly before using.

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 b. The staff that will be involved in this project are:
o Staff of NCI company, who will control and coordinate the system activities.
o IT of Banjarmasin Hospital to assist the NCI staff
o User: all the employee who will use the hospital information system.

VIII. OVERVIEW
Hopefully, the Banjarmasin Hospital Information System will help in the
problems that occur caused by the existing information system is less integrated. In
addition, the development of hospital information systems is expected to improve the
quality of service at the Banjarmasin Hospital.

IX. ATTACHMENT:
1. Application Letter from the person in charge of Vice General Facility
2. RCA Process before making proposal.

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 1ST ATTACHMENT
APPLICATION LETTER FROM THE PERSON IN CHARGE OF
VICE GENERAL FACILITY

February 16, 2019

Number: Attachment 1 (one) set of proposal

Subject: Development of Hospital Information Systems

Mrs. Mirabela Fransisca

Banjarmasin Hospital’s Manager

With respect,
Lately there have been frequent complaints related the application of hospital
information systems that have not been integrated. Therefore, we request to add /
develop a Hospital Information System (HIS) to support health care which is
increasingly dedicated in providing health services to the community.
The proposal for developing a hospital information system has been attached.

Thank you very much for your attention and cooperation to improve service quality in
Banjarmasin Hospital.

Very truly yours,

Miss Elisabeth, ST
Vice General Facilities

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 2nd ATTACHMENT

ROOT CAUSE ANALYSIS BEFORE MAKING PROPOSAL

STEP 1: DETERMINE THE INCIDENT

Out Patients Complaining Because Of Waiting for Too Long in The Admission.

STEP 2: DETERMINE THE TEAM

Investigator’s Team :
1. Chair of Quality Hospital Services
2. Outpatient Clinic Coordinator

STEP 3: COLLECT DATA AND INFORMATION

I. Data : Chronology of The Incidence of Patients Complains
II. Interview :
Done to:
a. Admission officer
b. Nurses on duty at the time of incident
c. Patient the one who complain
III. Direct Observation in the Outpatient Care Admission.

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 STEP 4: CHRONOLOGY INCIDENT FORM / TABULAR TIMELINE
February 14, 2019
Time 07.30 Am 08.30 Am 08.35 Pm 08.40Am 09.05 Am 09.10 Am

Incident - Patients come - Patient registered The Officers - The officer Patient was The officer
to outpatient - Registration officer searched patient searched angry and was late
clinics. asked the patient’s electronic health patient threated not to finding the
- Patient in line identity card. records and found paper health come to the patient’s paper
to registration. the patient’s number. record. clinic anymore. health records.
Additional Patient forgot to
Information bring Patient’s
Identity Card.
Good Practice - - Another officer asked apologized
- Keep being polite and friendly.
- The officer promised to
immediately notify the hospital
management.

STEP 5: PROBLEM IDENTIFICATION AND ANALIZYS

No. IDENTIFICATION TOOLS
1. Patient was angry and threated not to come to the clinic anymore. 5 Why

2. The officer was late finding the patient’s paper health records.
3. Patient forgot to bring Patient’s Identity Card.

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 1st Problem:
Who: Admission Officer
When: February 15, 2019
Where: Admission in the outpatient clinic
What: Patient was Angry and Threated not to Come to the Clinic
Anymore.
WHY 1 Because of a long wait
Why patient was angry and threated not to come to the
clinic anymore?
WHY 2 Because officer was still looking for paper based patient health
Why do patient wait long? record.
WHY 3 Because it can’t find.
Why officer was still looking for paper based patient
health record?
WHY 4 Because it’s to much and piles up.
Why it can’t find?
WHY 5 Because of the shape of paper.
Why it’s to much and piles up?
WHY 6 Because the computer is only in admission, other area service is
Why still use paper? none.
WHY 7 Maybe the hospital can’t afford it.
Why the computer is only in admission?
WHY 8 I don’t know
Why can’t hospital buy it?
Waiting too Long

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 2nd Problem:
Who: Admission Officer
When: February 15, 2019
Where: Admission in the outpatient clinic
What: The Officer was Late Finding the Patient’s Paper Health
Records.
WHY 1 Because it’s too much and piles up.
Why officer was late finding the patient’s paper health
record?
WHY 2 Because the place is not enough.
Why it’s piles up??
WHY 3 I don’t know.
Why is the place is not enough?
A Paper Based Patient Health Record need a large place.

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 3rd Problem:
Who: Admission Officer
When: February 15, 2019
Where: Admission in the outpatient clinic
What: Patient Was Forget to Bring Patient’s Identity Card.
WHY 1 Because doesn’t remember
Why do patients forget to bring cards?
WHY 2 Because it was removed from the wallet.
Why doesn’t remember?
WHY 3 Because it was full
Why it’s removed from the wallet?
WHY 4 Because there are too many cards
Why is the wallet full?
WHY 5 -
Why many cards?
The Patient has many Identity Cards so Forget.

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 FOLLOW UP PLAN TO SOLVE THE PROBLEMS
NO PLAN DO STUDY ACTION PIC

HUMAN

1 Add the medical - Recruitment The medical record officer is There are no personnel HRD
record officer - Has posted a competent staff for applying.
according to the needs. advertisements admission.
for it.
2 Pay attention to officer Make training plans Pay attention to continuing 1. Recruiting medical HRD
qualifications for existing education and human record staff: there is
officers. resources development. no applying yet.
2. Training of admission
staff officer has not
been implemented.
MACHINE

1. - Establish an - Is making a To improve the quality of - Make an EHR Vice

integrated patient budget plan effective and efficient proposal. General
health record services, integrated patient Facility
system throughout health record system is
the hospital. needed.

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 METHODS

1. Review the protocol Revise the protocol Update the protocol is - Will be revised as soon IT,
as needed. important to guide officers in as HER system Medical
their work. becomes available. Record
Officer
MONEY

1. Prepare a budget for Make a budget Budget planning for provide - Already included in the Finance
provide and and maintenance is proposal.
maintenance of the important to ensure that
EHR system. EHR system can function
properly.
MATERIAL/ MEDIA

1. Provide the necessary Buy the necessary - The availability of the - Will be held if the Finance
equipment such as equipment required equipment proposal has been
printer, ink, paper, etc. according to the influences the approved.
needs. improvement of service
quality.

Note: If the proposal is not approved by the hospital managers then redesign.

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