HoT (HOSPITAL on TABLET) Digital Hospital for Effectiveness, Efficiency, Transparency, Accountabili
Jember Chest Hospital (RS Paru Jember)

A. Problem Analysis

 1. What was the problem before the implementation of the initiative?
The Rome was not built in one night. So do Digital Hospital was had by Jember Chest Hospital. It took 12 years to bulid the system used today. Jember Chest Hospital or JCH is Technical Implementer Unit of Health Service of East Java Province that is located in Jember District. JCH is typical hospital for Lung disease especially Tuberculosis (TB). Most of TB patient are poor society. Therefore JCH is known poor hospital that served needy community. JCH service area includes five districts, which are Jember, Lumajang, Bondowoso, Situbondo and Banyuwangi. According to East Java Province Regulation No. 37 year 2000, JCH was transferred in management to East Java Province as one of Technical Implementer Unit of Health Service. As a new organization that was not managed well before, hospital activity and management were not held optimally yet. Among them, included patient care uncertainty, service inaction, information recording uncompleteness, finance management weakness, income loss, illegal fee collection, etc. JCH public service is not transparent and accountable. The main cause is the absence of complete, accurate, and real time data. Before 2005, data management was done manually and unintegrated. There is no data synchronization between service provider at administration, medical service and supporting service (laboratory, radiology, pharmacy, and nutrition). There was still duplication in data entry and process. So that, service process was not effective and efficient. It can cause hospital service become sluggish. This inaction of service affected quality and scope of JCH medical service. The effect was low patient visit and hospital income also low and still became poor hospital. JCH data before innovation, it was found elevated number of medical record uncompleteness, long duration of administration service, hospital income did not reach the target and medical action was not realtime. It is needed the adequate solutions to produce complete, accurate and real time data. JCH management, eventhough lack of budget, dare to do ambisious movement by improving digital hospital. Digital hospital is information and communication technology utilization in JCH public service implementation. Digital hospital produces complete, accurate and real time data. Through this innovation can improve effectiveness and efficiency of medical service. And also can promote transparency, accountability and integrity in JCH public service.

B. Strategic Approach

 2. What was the solution?
To solve management issues, JCH implemented digital hospital that is information and communication technology utilization as hospital management information system. Digital hospital integrate all hospital service interconnectedly, real time and openly for public. JCH digital hospital got in difficulty and be able to re-apply after be modified using tablet electronic divice, so that this innovation is named as HoT (HOSPITAL on TABLET), Digital Hospital for Effectiveness, Efficiency, Transparency, Accountability and Integrity in Public Service.

 3. How did the initiative solve the problem and improve people’s lives?
JCH did not have accurate, complete and realtime data. Digital hospital was the solution to produce accurate, complete and realtime data. The key steps of HoT (Hospital on Tablet) improvement are, first step : idea affirmation. The idea affirmation of HoT (Hospital on Tablet) improvement started from JCH Director. The idea was delivered in Jember Chest Hospital Development Symposium on 2005 at Surabaya. The symposium was attended by JCH stakeholders, academic community, service consumers and also from Independent Society Board of tuberculosis observer. The idea receive input and affirmation from symposium attendants. The second step : institutional innovation motivator of HoT (Hospital on Tablet). In order to make movement of HoT (Hospital on Tablet), it was formed JCH Information System Unit. JCH Information System Unit was supported by employee number and good qualification of informatics education. The third step : innovation implementation of HoT (Hospital on Tablet). The innovation implementation was started with selection of information technology vendor. The Memorandum of Understanding with selected vendor, and then vendor built application system that suitable with the JCH local requirement. On July 2005 Jember Chest Hospital built 20 computer integrated networks. Implementation of HoT (Hospital on Tablet) commonly proceeded well. Facing problems but operationally did not interfered. The forth step : innovation implementation evaluation monitoring and supervision. In 2009-2010 innovation implementation was felt running in place. Electronic medical record of inpatient service system could not be beneficial. All the system arrangement became unintegrated. Finding the issue source, why electronic medical record of inpatient service became undone. The fifth step : follow-up plan and development. Jember Chest Hospital Director, on June 2011 made MoU (Memorandum of Understanding) with new information technology vendor. Beside application improvement, it proceeded modification of electronic medical record using tablet electronic device. The aim of this strategy was to proceed electronic medical record correctly, completely and real time. The next system development was involving society or public. Through public accessibility system, the society received information access of type and quality of given service certainty. The society received information access of service tariff certainty. The future development of public access system process is payment system using magnetic card, self registration, registration via internet and application integrated website. Through public accessibility system, society is pushed to be actively involved in control JCH public service. JCH digital hospital was developed since 2005. Improvement if HoT (Hospital on Tablet) is capable of producing the integrity of JCH public service, interconnectivity of program linking and available access of public information. Integrity can unite or link all service unit in one pattern of health service that have one function in common Interconnectivity make it possible for exchange data of linking program via on-line. Available access of public information make everyone, everytime and everywhere possible to receive complete, accurate and real time data based on his/her authority. Integrity, interconnectivity and available access of information promote transparency and accountability in JCH public service. Transparency and accountability produce certainty of tariff and JCH public service. Creating worker integrity, preventing corruption/ bribe and give equality of service to all consumers of JCH. However, in 2009 digital hospital encountered period of not be able to run as it wished. Service intergration, interconnectivity of program linking and available access of public information distracted. In 2011 digital hospital was able to be re-run after being modified via mobile using tablet computer divice. Then JCH digital hospital is named HoT (Hospital on Tablet). The result of digital hospital development through HoT (Hospital on Tablet) can be operated via mobile without border in time and space. It affects to effective and efficient medical service.

C. Execution and Implementation

 4. In which ways is the initiative creative and innovative?
Utilization of information technology may not be separated from many aspect of life, including health. Utilization of information technology is obtained a lot at hospital and primary care in Indonesia, however this innovation is unique because of JCH is the only hospital in Indonesia that brave enough to apply paperless application at all of service unit. The system is creatively modified by mobile using tablet of electronic device. Hospital data in huge amount can be accessed just only using electronic device which can be carried around easily (tablet). JCH is Hospital on Tablet. The innovation gets more unique because of service information can be accessed by everyone, everytime, and everywhere based on his/her authority. JCH is borderless hospital. Jember Chest Hospital introduces new concept, brave enough to become pioneer of medical record paperless application at all service unit by mobile of medical record electronic in Indonesia. Jember Chest Hospital bravely becomes the pioneer of available access of public information that improve worker integrity and prevent corruption/bribe.

 5. Who implemented the initiative and what is the size of the population affected by this initiative?
HoT (Hospital on Tablet) motivator is the staff of JCH Information System Unit that consist of : a) information technology programmer with formal education qualification of Bachelor of Informatics Technology (1 person) and qualification of Diploma of Informatics Management (2 persons); b) Information Technology Technisian with formal education qualification of Diploma of Computer or Network Technique (3 persons) and be assisted by Electrics High School Graduate (2 persons); and c) medical record employee with formal education qualification of Diploma of Medical Record (2 persons) and be assisted by High School Graduate employees (5 persons). All of this innovation motivators receive particular workshop and accompaniment from vendor of information technology consultant. From employees number, formal education obtained, particular workshop and accompaniment that be received from vendor so all innovation motivators have adequate expertise to move the application system that integrated with HoT (Hospital on Tablet). Improvement of HoT (Hospital on Tablet) gives benefit for, first : health providers take rate and accurate patient medical data. Patient medical data is needed for making decision of medical implementation. Patient medical data rate and accuracy will improve medical service quality. Second : Jember Chest Hospital Management obtain hospital data rate and accuracy. Hospital data help management to make managerial decision correctly. Third : Jember Chest Hospital stakeholders obtain information correctly. Correct informations determine stakeholder policy in development of Jember Chest Hospital. Forth : Jember Chest Hospital consumers receive access to JCH public service information. All of society element receive qualified medical service.
 6. How was the strategy implemented and what resources were mobilized?
The chronology of innovation implementation of digital hospital was: it is started with delivering idea in Jember Chest Hospital Development Symposium on 2005 at Surabaya. Then forming JCH Information System Unit as innovation motivator. Through tight selection, in choosing information technology vendor. In the same year, vendor developed template billing system. JCH Management provided 20 computer units that integrated with system. After socialization, workshop and accompaniment by vendor, billing system application can be proceeded. In 2006 vendor developed template inventory system and electronic pharmacy template. After socialization, workshop and accompaniment by vendor, inventory system and electronic pharmacy application can be proceeded. In 2007 vendor developed electronic medical record and supporting medical template. After socialization, workshop and accompaniment by vendor, radiology and laboratory application can be proceeded. Then it was followed by outpatient electronic medical record and emergency service application. Inpatient electronic medical record was not proceeded yet. In 2008 JCH digital hospital was sertified with ISO 9001: 2008. However until 2010 JCH Digital hospital was walked in place. Inpatient electronic medical record application still can be proceeded. The aim of digital hospital development was to reach effectiveness and efficiency of service can be fulfilled. Even JCH management had double burden in preparing manual and electronic medical record. In 2011 the development of electronic medical record application system was adapted as Medical Board wish. In 2012 inpatient electronic medical record system was started. In order to give comfortness in application filling, server capacity renew was held. In 2013 digital hospital was modified with using computer divice (tablet) and be named HoT (Hospital on Tablet). Digital Hospital was able to proceed completely, accurately, and real time. In 2013 JCH Management took policy to withdraw manual medical record. In 2013 JCH was the only one hospital in Indonesia who barvely enough to apply paperless system*. Since 2014, JCH was become learning and comparison study center for electronic medical record. Some of hospitals who visit were : Jember dr Soebandi Government Hospital, Jakarta Persahabatan Government Hospital, Bali Badung Government Hospital, Yogyakarta Lung Health Service, Kertosono Government Hospital, Situbondo Abdul Rohim Hospital, Surabaya Menur Psychiatry Hospital, Bondowoso Koesnadi Government Hospital, Bali Klungkung Government Hospital and Mojokerto Prof Dr Soekandar Government Hospital. In 2015, JCH enrolled Public Service Innovation Competition and got Top 99. The JCH enrolled m-Health Competition : Innovation for Sustainable Health (sHealth) 2015 and be awarded as the champion for Asian Region. Through digital hospital, JCH received award as hospital with best public service in East Java region. Besides, JCH also received award as hospital with integrity zone of free corruption in East Java region. In 2016 the development of application system for public accessibility and application was suitable with KARS accreditation version 2012. Still in progress of development are : electronic accrual accounting system, payment system using magnetic card, self registration system via internet and application integrated website system. Financing source of HoT (Hospital on Tablet) innovation development, digital hospital promote transparency, accountability and integrity in public service for capital expenditure and maintenance use ex routine APBD fund. Meanwhile for software and hardware development uses functional APBD fund. For electronic device purchasing as supporting integrated application implementation is facilitated by vendor. HoT (Hospital on Tablet) innovation, has been planned from financial element via APBD, and it was part of Strategic Bussiness Plan and JCH Governance System. System development is proceeded gradually and continually. The expense that be spent for every system development (billing system, inventory, electronic pharmacy, electronic medical record and public accessibility) is not less than Rp. 200.000.000,-. Routine accompaniment cost by information technology consultant vendor is Rp. 60.000.000,- every year.

 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
Involved stakeholders in innovation implementation consist of idea initiators, motivator and main characters and also information technology consultant vendor. Idea initiators of HoT (Hospital on Tablet), Digital Hospital Promote Transparency, Accountability, and Integrity in Public Service is Director of Jember Chest Hospital. Innovation motivator is JCH Information System Unit. Innovation main character is medical doctors. Beside filling in electronic medical record, medical doctor through Medical Board also is involved in application system development along with information technology consultant vendor. Information technology consultant vendor is consultant of application system developer and routine companion in HoT (Hospital on Tablet) implementation. Information technology consultant vendor was selected through tough selection that involving JCH stakeholders and academic community. Vendor must have commitment in developing application system based on public access continually and be suitable with JCH local requirement. Innovation motivator and person receive workshop and accompaniment in system implementation gradually by consultant vendor.

 8. What were the most successful outputs and why was the initiative effective?
Public service is proceeded effectively, accountable and transparent (SDGs #16.6). The effectivity of public service before and after innovation can be seen through response time of patient admission service before innovation was done ± 2 hours, after innovation it is shortened to 30 minutes. Incomplete medical record before innovation was above 10%, after innovation became less than 2%. Another outcome is paper utilization efficiency, one inpatient patient in one day needs minimum 20 paper sheets for manual medical record, after innovation it does not need paper anymore (paperless). The rate and accuracy of patient data affect improvement of patient safety. Innovation outcome is reduction in the length of hospital stay, before innovation length of stay (LOS) is 14 days, after innovation reduces 3-4 days. After HoT (Hospital on Tablet) innovation appears openness of public information. The society can control, monitor and give feedback to the service. After innovation, there is certainty of service and tariff. Reducing corruption and bribe in any form (SDGs 16.5). Before innovation, corruption appears in any towing fees out of procedures, financial data manipulation, tariff discrepancy with service type that be given and payment slip forgery. Bribe appears in gratification form of JCH item purchasing. Corruption and bribe can happen because of financial transaction data was done manually at every service unit and not integrated. After innovation, financial transaction data is recorded in integrated application system. Corruption and bribe in any forms is not appeared because of JCH or individual worker performances are measured and recorded in digital hospital. Improving information and communication technology utilization in order to empower women (SDGs #5.b). HoT (Hospital on Tablet) development is a effort to improve information and communication technology utilization. HoT (Hospital on Tablet) empowers society including women to get information access of JCH public service.

 9. What were the main obstacles encountered and how were they overcome?
Generally innovation issues are budgeting and legal assurance, however for JCH, it is not the main issue. Legal regulation is in : UU No. 11/2008 about Information and Electronic Transaction, UU No. 44/2009 about Hospital, UU No. 36/2009 about Health, UU No. 29/2004 about Medical Practice and Health Ministry Regulation No. 269/MENKES/III/2008 about Medical Record. Clause 5 subsection (1) in Regulation of Information and Electronic Transaction mentions that electronic information and/or electronic document and/or its print out are legal evidence. The main issue of digital hospital implementation at Jember Chest Hospital is doctors unwillingness to fill in electronic medical record application, completely, correctly and on time. The strategy that be done is finding causative factors doctors unwillingness. It was found 2 causative factors, which are first : doctors were hesitate that electronic medical record have more benefit and whether capable of recording all patient condition. Second : doctors felt that electornic medical record filling in of inpatient patient was difficult. The effort that be taken by JCH management was convincing that electronic medical record have a lot benefit. Giving facility to ease for the doctors in applying the system. Management facilitate intense communication between Medical Board as user with application composer vendor, together they composed application system that are comfortable and easy to be used by doctors. The easiness of data application filling in was modified by mobile via tablet. With this strategy, appears doctors willingness to fill in electronic medical record correctly and completely so that electronic medical record can be proceeded.

D. Impact and Sustainability

 10. What were the key benefits resulting from this initiative?
The main benefit of HoT (Hospital on Tablet) innovation , in public service is promoting transparency, accountability abd integrity. Improvement if transparency, accountability and integrity in public service affect to society trust. Improvement of society trust to JCH public service is recorded in Society Satisfaction Survey, there is improvement of Society Satisfaction Index (SSI). For five years, from 2012-2015 there was SSI improvement trend. Consistent with trust improvement, there was JCH income improvement. In 2004 JCH income was Rp. 751.700.912,-, ever since digital hospital be applied, one year later JCH income reached Rp. 1.544.345.565,- (in one year increased >100%). And it kept increasing until in 2014 JCH income was Rp. 17.288.000.000,-, even though there was no increase in amount and type of service. HoT (Hospital on Tablet) development, gives access openness of public information. It appears transparency and transformation of bureaucracy administration. Transparency means promoting society directly to monitor JCH public service so that be able to control, monitor and gice feedback to service that have been given. Society realize certainty of cost they have to pay and type of service thet have been received. Transformation of bureaucracy administration is marked by improving efficiency, giving work easiness, improving work culture and system comprehension wholely. Digital hospital also brings out collaborative culture between JCH workers. Transparency and transformation of bureaucracy administration JCH can improve workers integrity. Digital hospital promotes coordination and integrity between service units, improves data rate and accuracy so that improving accountability. Accountability can measure institution and individual performances. All institution and individual performances are measured and be accountable. Accountability prevents corruption. Accountability make it possible for workers service fees allocation can be measured based on recording performances in system. Patient willingness is to recover and receive equal service easiness. Through HoT (Hospital on Tablet), patients will not face difficult bureaucracy for getting medical service. Even they are rich or poor, every patients receive equal service. It is not considering economic status, rich or poor patients. All patients are served based on emergency condition and patients queue. Poor patients receive equal service and treatment. Supporting Attachment Data can be downloaded at www.rspjember.jatimprov.go.id

 11. Did the initiative improve integrity and/or accountability in public service? (If applicable)
HoT (Hospital on Tablet) development, gives access openness of public information. It appears transparency and transformation of bureaucracy administration. Transparency means promoting society directly to monitor JCH public service so that be able to control, monitor and gice feedback to service that have been given. Society realize certainty of cost they have to pay and type of service thet have been received. Transformation of bureaucracy administration is marked by improving efficiency, giving work easiness, improving work culture and system comprehension wholely. Digital hospital also brings out collaborative culture between JCH workers. Transparency and transformation of bureaucracy administration JCH can improve workers integrity. Digital hospital promotes coordination and integrity between service units, improves data rate and accuracy so that improving accountability. Accountability can measure institution and individual performances. All institution and individual performances are measured and be accountable. Accountability prevents corruption. Accountability make it possible for workers service fees allocation can be measured based on recording performances in system.

 12. Were special measures put in place to ensure that the initiative benefits women and girls and improves the situation of the poorest and most vulnerable? (If applicable)
HoT (Hospital on Tablet) development can give openness public information access. Information access openness give easiness society in receiving JCH service. Society receive certainty of service standard and tariff. Poor patients are no more have to pay out of procedure. Patient willingness is to recover and receive equal service easiness. Through HoT (Hospital on Tablet), patients will not face difficult bureaucracy for getting medical service. Even they are rich or poor, every patients receive equal service. All patients want to receive equality of service. Poor patients often fell be ruled out ot untreated well compared to rich patients. Through openness of information access, all patiens are served equally. It is not considering economic status, rich or poor patients. All patients are served based on emergency condition and patients queue. Poor patients receive equal service and treatment. HoT (Hospital on Tablet) gives information openness that promotes equality of public service. Poor society will receive service equality at JCH.

Contact Information

Institution Name:   Jember Chest Hospital (RS Paru Jember)
Institution Type:   Local Government  
Contact Person:   Sigit Kusuma Jati
Title:   Health Promotion  
Telephone/ Fax:   081233843628
Institution's / Project's Website:  
E-mail:   kusumajatisigit@gmail.com  
Address:   Kalimantan Street I/67 Jember
Postal Code:   68112
City:   Jember
State/Province:   East Java
Country:  

          Go Back

Print friendly Page
video porno.. brasileiros xxx xhamster