MAINTEKKES : The Journal of Management Information and Health Technology

ANALYSIS OF TELEMEDICINE IMPLEMENTATION CHALLENGES AT BALI MANDARA EYE HOSPITAL 2024

2025-06-18T15:50:24+00:00

Regulation of Health Minister No. 20 of 2019 on the Implementation of Telemedicine Services between Healthcare Facilities. Rumah Sakit Mata Bali Mandara (RSMBM) has plans to develop a comprehensive teleophthalmology network with referral hospitals and primary care facilities. The purpose of this study is to analyze the challenges in implementing telemedicine using the 5 M (Man, Money, Materials, Machines, Methods) approach. This study is a qualitative descriptive analysis using purposive sampling with a total of 7 respondents. The results of the study found that Rumah Sakit Mata Bali Mandara still requires specialized personnel such as ophthalmologists, support staff, and IT personnel to develop telemedicine services. The procurement of telemedicine services must go through a planning, submission, and realization process. Procurement of the required equipment must be proposed and recorded in the RKBMD and must meet TKDN requirements. There is also no determination of telemedicine service fees yet. RSMBM must have a consulting healthcare facility, facilities that can support communication aspects, and a telemedicine service cooperation agreement. The consulting healthcare facility must have at least basic and advanced eye examination equipment, communication technology equipment, and challenges related to the relatively high price of examination equipment and applications or software, network systems, and internet connections. There are no regulations regarding the legality of services and no regulations for determining telemedicine service fees.

ANALYSIS OF FACTORS CAUSING PENDING CLAIMS DUE TO CODING OF INPATIENT BPJS PATIENT FILES AT EYE HOSPITAL BALI MANDARA 2024

2025-06-18T15:50:25+00:00

Hospitals as advanced health facilities send monthly claims to BPJS Health to receive compensation for services to JKN participants, no later than the 10th of the following month. This claim is verified by BPJS Health to ensure the validity of service administration. This study aims to determine the factors causing pending claims for inpatient BPJS files at the Bali Mandara Eye Hospital in 2024. The specific objectives include the completeness of inpatient medical resumes, coders' perceptions in the data input process, and an overview of infrastructure in the coding process. The research was conducted qualitatively using a phenomenological approach in the Coding Room of the Medical Records Unit at the Bali Mandara Eye Hospital from January to April 2024. The research population was PMIK officers, with a sample of 4 PMIK officers and 2 teams of verifiers from the finance department. Data was collected through observation and in-depth interviews with informants selected purposively from January to March 2024. The results of the analysis show several factors causing pending claims including incomplete files, such as claim forms or medical records. Inaccurate coding of diagnoses or procedures. Lack of appropriate supporting examinations. required. Unavailability of adequate documentary evidence. There is no clear Standard Operating Procedure (SPO). To overcome this problem, it is necessary to create a special job description for coding officers.

THE EFFECT OF COMPLETENESS OF INFORMED CONSENT IN INPATIENT ROOMS ON THE QUALITY OF MEDICAL RECORDS AT RSAD TK. II UDAYANA

2025-06-18T15:50:25+00:00

The completeness of filling in the informed consent sheet in the medical record file is very important because it will affect the legal aspects of the medical record and the quality of the medical record so that filling in the complete data in the informed consent sheet needs to be done with maximum implementation. This study aims to determine the effect of completing the Informed Consent form in the inpatient room on the quality of medical records at RSAD Tk. II Udayana, Bali. The research method used is quantitative research with a cross sectional approach. The data collection technique used is by taking questionnaires, observation, checklists and case studies. The sampling technique was random sampling technique with a sample of 33 informed consents and 33 respondents. Based on the research results, the influence of completeness of informed consent in the inpatient room on the quality of medical records at RSAD Tk. II Udayana by 75%. The problems that occur are: (1) There are still incomplete informed consent forms, (2) There are unclear written actions, (3) Delays in returning incomplete medical records to the KLPCM department. The suggestions given are: (1) Conduct socialization on fixed procedures regarding filling out informed consent, (2) Medical records officers and other health workers must continue to remind each other about filling in complete informed consent, (3) Conduct training regarding the implementation of filling out informed consent forms.

RELATIONSHIP BETWEEN COMPLETENESS OF MEDICAL INFORMATION AND DIAGNOSIS ACCURACY CODES APPENDIX

2025-06-18T15:50:25+00:00

Health information has an important role in patient medical records, where medical information can facilitate patient care and as information needed by management in managing health service facilities, especially hospitals. Completeness of health information has an important role in assigning diagnosis codes to patient medical records, where complete medical information has a very important role in the accuracy of assigning patient diagnosis codes. Especially in the diagnosis of appendicitis in inpatients at RSU. Puri Raharja. This research was carried out by observing the forms in the patient's medical record, regarding the completeness of the patient's medical information and the accuracy of providing diagnosis codes in the patient's medical record. The results obtained are that there is a relationship between the completeness of medical information and the accuracy of the diagnosis code in the patient's medical record.

ANALISIS FAKTOR-FAKTOR YANG MEMENGARUHI KETIDAKAKURATAN KODE DIAGNOSIS PENYAKIT RAWAT JALAN DI PUSKESMAS DINOYO TAHUN 2023

2025-06-18T15:50:25+00:00

At Dinoyo Community Health Center, inaccurate diagnosis codes contained in medical record documents will affect monthly reports and data validation. Based on the results of a preliminary study, data obtained that the accuracy of diagnosis codes in outpatient medical record documents at the Dinoyo Community Health Center was 82% (41 DRM) and 19% inaccurate (9 DRM). This study aims to determine the flow of outpatient disease coding at Dinoyo Health Center in 2023, the percentage of accuracy and inaccuracy of outpatient disease diagnosis codes at Dinoyo Health Center in 2023, and the factors that influence their inaccuracy. The method used in this research is mixed methods with a retrospective approach where researchers use quantitative and qualitative methods simultaneously. This research was conducted in the medical records unit of the Dinoyo Community Health Center using a DRM population of 10,229. The sample in this study was 100 DRM outpatients with a sampling technique, namely simple random sampling and 1 medical records officer and 1 poly doctor as informants. Method of collection is by observing and interviewing. Data analysis was carried out using descriptive analysis and univariate analysis. The research results showed that the percentage of accuracy of diagnosis codes was 51% (51 documents) and the percentage of inaccuracy was 49% (49 documents). Factors that influence the inaccuracy of diagnostic codes are coders who have never received coding training, working period of less than 5 years, coding work that also coincides with other work, coding carried out by doctors, coding SOPs that have not been implemented properly, the ICD-10 book which is still the old version, there is no supporting dictionary book, namely the Dorland dictionary, the completeness and readability of the doctor's writing in anamnesis and patient assessment and there is no budget to involve coding officers in taking part in training and procuring Dorland medical dictionary books. To prevent inaccuracies in diagnosis codes, the health center needs to hold special coding training for medical record officers, officers who carry out coding according to their competence, namely a Medical Recorder to improve accuracy in determining diagnosis codes as well as procuring the latest ICD-10 books and Dorland medical dictionaries.