SIMPUS Jojok and Indonesia Public Health Centers

SIMPUS JOJOK

AND

INDONESIA PUBLIC HEALTH CENTERS

by Albert Pratama Prayogo

wait, who's this Albert btw?

graduated from Electrical Engineering Gadjah Mada University (Information Technology minor) on 2002

working on various freelance website development projects, with clients abroad

developed a series of simple HIS products and some custom HIS for private clinics

coordinating SIMPUS development team, working closely with Raharjo

(1) PUSKESMAS AND INDONESIA HEALTH SYSTEM

(1) PUSKESMAS AND INDONESIA HEALTH SYSTEM

● Puskesmas (PUSat KESehatan MASyarakat) => Public Health Center, goverment owned and operated clinics

● Big country: 9422 PHCs, in 33 provinces, in 497 regencies/cities, many islands

Puskesmas at a glance:● Gaps in computer skills of administration staffs

PHC A

PHC B

Fluent in using computers and electronic gadgets: smartphones, blackberries, tablets

No one can use computers

(1) PUSKESMAS AND INDONESIA HEALTH SYSTEM

ILLUSTRATION

Puskesmas at a glance:● Differences in report content and format

9 age groups 12 age groups

paper digital

landscape report formportrait report form

(1) PUSKESMAS AND INDONESIA HEALTH SYSTEM

(2) PROBLEMS IN PUSKESMAS AND REGIONAL HEALTH OFFICE

● Differences in data dictionary

(2) PROBLEMS IN PUSKESMAS AND REGIONAL HEALTH OFFICE

● Who handles the data?

Regional health office A:planning section

Regional health office B:health services section

Regional health office C:administration staff

Regional health office D:Pharmacy section for

pharmacy data,Medical services section

for morbidity data,Finance section for patient fee data,

etc

(2) PROBLEMS IN PUSKESMAS AND REGIONAL HEALTH OFFICE

● Who is responsible for the information system?

Regency office of electronic data?

Data/information system section of regional health

office?

Voluntary PHC staff who is knowledgeable on IT?

PHC IT staff?

(2) PROBLEMS IN PUSKESMAS AND REGIONAL HEALTH OFFICE

● How if the head of regional health office were replaced?

● How important is data? Which is more important for the head of health office: valid data or just "good-looking" report?

(2) PROBLEMS IN PUSKESMAS AND REGIONAL HEALTH OFFICE

(3) SIMPUS

● SIMPUS: generic terminology● => Sistem Informasi Manajemen PUSkesmas● => PHC Management Information System● Many development teams (private companies,

regional health offices, MoH office)● Many version of SIMPUS, with their own

features● Product names can be different

(3) SIMPUS

(4) SIMPUS JOJOK

● Development started on 2001, originator: Raharjo● No unique name, SIMPUS "Jojok" is from the

users ● Active users community: FB group, created not by

us, but by one of Puskesmas staff

(https://www.facebook.com/groups/simpus/)● Two main version: desktop based (single user),

web based (multi user) => for Puskesmas● Brand new version: SIMPUS GizKIA (Nutrition

and Mother-Baby Health) => for midwifes

(4) SIMPUS JOJOK

SIMPUS Jojok development goal:● To provide an easy-to-use information system, which has

hardware and human-resources requirement as minimum as possible.

● To help Puskesmas staffs to do data processing and report delivery.

● To help Regional Health Office to build a regional health database system, using data from Puskesmas.

● To encourage Regional Health Office to form an information unit, who can support them to make good health policy decisions by supplying good quality health information.

So, it's not merely about developing and selling software.

● Our solutions:– minimum-hardware-requirement information

system● Desktop version can be run on PIII machine.● Web-based version can be run on PIV with

1GB RAM dedicated local network server (to serve 3-4 clients), and can be accessed from any connected machine as long as it can run browser application.

(4) SIMPUS JOJOK

– a simple interface

(4) SIMPUS JOJOK

one and only patient visit input form in desktop version

(4) SIMPUS JOJOK

Registration form of web-based version:● Only some fields are mandatory● Most of fields are auto-filled from

previous data/most selected options

So the registration staff only needs to fill little number of fields.

Medical examination form of web-based version:● Using auto-complete entry fields (code or description for

diagnoses, drugs, and procedures)● Minimize mouse usage

– simple application flow

registration

lab

pharmacy room

examination room

– maximum benefit for PHC staffs (more than 20 reports, including map-based reports)

(4) SIMPUS JOJOK

number of visits by week report

number of diagnose by area(colored map)

– data connection between PHCs and recency/city health office

(4) SIMPUS JOJOK

PHC

PHC

PHC

PHC

Regional Health Office

weekly/monthly data

for PHC with about 100 visits a day, monthly data sent to RHO is only sized about 100 kilobytes => can be sent via GPRS or transferred via USB flash, no big capacity internet needed

– encourage regional health offices to form a dedicated information system support units

(4) SIMPUS JOJOK

Sukoharjo (one regency in Central Java) health office formed one maintenance team to support PHCs' hardware maintenance.

Within working hour, they accept phone calls from PHC who has hardware problems. Then they will pick up the broken hardware to be repaired.

Sukoharjo health office also has similar support team for software.

A little bit more information about SIMPUS GizKIA:

● To help midwifes to collect and manage valid expectant mothers and babies data in her working area.

● To help Puskesmas manage maternal and child health data.

● To help Regional Health Office to provide maternal and child health regional profile.

● Indonesian midwifes can use SIMPUS GizKIA for free.

(4) SIMPUS JOJOK

Changes we bring:● from no whatsoever medical record to digital

medical record● deliver reports from real data, not based on

approximations/projections● no after-office-hour work needed to write reports● calculate medical services fee to the medical

staffs

(4) SIMPUS JOJOK

Challenges we face:● Staff rotations● Low awareness on data backup and hardware

maintenance importance● Discourses to push PHCs to use uniform "formal"

version SIMPUS, instead of pushing the discussion about health data standards

(4) SIMPUS JOJOK

(5) Some photos..

Semi formal SIMPUS JOJOK user training held at night, when the electricity was available. At one Puskesmas in Kalimantan (Borneo).Raharjo is the one with sarong.

SIMPUS JOJOK user training at Timika, Papua

Registration officer inputs patient data, using "highly secured" PC.

Paper-based medical records are still maintained.

Thank you!