HIS Notes

March 27th, 2010

This page and the related links is not only about his notes, but notes on HIS (hospital or health information systems) especially in Indonesia.

In Indonesia, health informatics/health information management is increasingly becoming necessary to support health management, especially following the growing use and penetration of information and communication technology. While, – as usual – the health sector is lag behind other business, many health facilities are continuously investing on hardware, software, infrastructure and training on this subject. But again, there are some lack of coordination and limitation to fulfill the needs of health organizations and users to select, use, maintain and evaluate their investment. Nationally, the Ministry of Health has put “information systems and surveillance” as the second of their 4 grand strategies. However, its Center of Data and Epidemiological Surveillance (echellon 2 unit in the MOH) has not quite strong to carry out the effective function to coordianate with other stakeholders. Even, in the internal MOH, this unit is hardly to coordinate island of information (as well as HIS project) in the 6 directorates: CDC, medical services, public health services, drug and pharmaceuticals, general secretary and general inspectorate. The other limitation is especially to coordinate with provincial and district level. Since the enactment of health decentralization policy in 2001, there are right now 34 province and about 500 districts dispersed in Indonesia. With 230 million populations, different fiscal capacity between districts and provinces, geograpihical characteristics, and varied capability of humanr resource, all bring the problem become complicated.

However, several districts have been tried to innovate successfully on adopting ICT to support heatlh programs. One of the district in East Java province, called Ngawi, has developed their own software for primary health centers and then asked by other districts to installed and giving training for them to adopt the systems. With different application, district of Purworejo has successfully implemented a real time district health information sysems connecting 20 primary health center in wide area network. But, that’s true, several initiatives became fail and forgotten rapidly. There are also many of primary health centers invested software without coordination with the district level. My colleage, working in a software house, claimed that with his team the have installed and currently is maintaining about 450 primary health centers around Indoenesia. However, this is only s small part of total nearly 8000 primary health centers in Indonesia. Some vendors also doing the same thing but nothing has happened to initiate standardization and integration between them.

In hospital level, the story is quite similar. There are about 1300 hospitals with different categories. Most of them are not yet implemented hospital information systems. But, some private hospital (usually with international affiliation) in Jakarta have implemented expensive software for their HIS. Again the issue of data exchange, standardization and integration is something that happened on blogs, and seminar. The discourse about this was called by academicians, experts who are very limited. There are only 3 universities providing particular master program on health information management/systems/health informatics, eg: University of Indonesia (since 1998), Universitas Diponegoro (2003),  Universitas Gadjah Mada (2005). In the the first and second institution, the master program was managed by the Faculty of Public Health, while in UGM it was managed by the Faculty of Medicine.  Institute Technology Bandung also offer similar master program but the name is Biomedical Engineer. Actually, there are many vocational programs of health record management (three years program). However, to continue their professinal degree, the alumnis should receive bachelor degree from other institution (mostly in public health or computer science). Health record  administrators are extremely needed by many hospitals, primary health offices and district health offices as well for doing health information management activities. The MOH has put this health staff categories with specific career track and incentives. They have  also their professional association called Indonesian Medical Record Association. Another related organization is the assocition of Medical Record Training Program Association. However, such association/consortium  for master degree program has not yet established.

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