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SIMPUS JOJOK AND INDONESIA PUBLIC HEALTH CENTERS by Albert Pratama Prayogo

SIMPUS Jojok and Indonesia Public Health Centers

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presented via Webinar to Masters of Science in Health Informatics students of the University of the Philippines - Manila, September 10th, 2013

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Page 1: SIMPUS Jojok and Indonesia Public Health Centers

SIMPUS JOJOK

AND

INDONESIA PUBLIC HEALTH CENTERS

by Albert Pratama Prayogo

Page 2: SIMPUS Jojok and Indonesia Public Health Centers

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

Page 3: SIMPUS Jojok and Indonesia Public Health Centers

(1) PUSKESMAS AND INDONESIA HEALTH SYSTEM

Page 4: SIMPUS Jojok and Indonesia Public Health Centers

(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

Page 5: SIMPUS Jojok and Indonesia Public Health Centers

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

Page 6: SIMPUS Jojok and Indonesia Public Health Centers

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

Page 7: SIMPUS Jojok and Indonesia Public Health Centers

(2) PROBLEMS IN PUSKESMAS AND REGIONAL HEALTH OFFICE

Page 8: SIMPUS Jojok and Indonesia Public Health Centers

● Differences in data dictionary

(2) PROBLEMS IN PUSKESMAS AND REGIONAL HEALTH OFFICE

Page 9: SIMPUS Jojok and Indonesia Public Health Centers

● 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

Page 10: SIMPUS Jojok and Indonesia Public Health Centers

● 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

Page 11: SIMPUS Jojok and Indonesia Public Health Centers

● 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

Page 12: SIMPUS Jojok and Indonesia Public Health Centers

(3) SIMPUS

Page 13: SIMPUS Jojok and Indonesia Public Health Centers

● 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

Page 14: SIMPUS Jojok and Indonesia Public Health Centers

(4) SIMPUS JOJOK

Page 15: SIMPUS Jojok and Indonesia Public Health Centers

● 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

Page 16: SIMPUS Jojok and Indonesia Public Health Centers

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.

Page 17: SIMPUS Jojok and Indonesia Public Health Centers

● 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

Page 18: SIMPUS Jojok and Indonesia Public Health Centers

– a simple interface

(4) SIMPUS JOJOK

one and only patient visit input form in desktop version

Page 19: SIMPUS Jojok and Indonesia Public Health Centers

(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.

Page 20: SIMPUS Jojok and Indonesia Public Health Centers

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

diagnoses, drugs, and procedures)● Minimize mouse usage

Page 21: SIMPUS Jojok and Indonesia Public Health Centers

– simple application flow

registration

lab

pharmacy room

examination room

Page 22: SIMPUS Jojok and Indonesia Public Health Centers

– 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)

Page 23: SIMPUS Jojok and Indonesia Public Health Centers

– 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

Page 24: SIMPUS Jojok and Indonesia Public Health Centers

– 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.

Page 25: SIMPUS Jojok and Indonesia Public Health Centers

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

Page 26: SIMPUS Jojok and Indonesia Public Health Centers

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

Page 27: SIMPUS Jojok and Indonesia Public Health Centers

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

Page 28: SIMPUS Jojok and Indonesia Public Health Centers

(5) Some photos..

Page 29: SIMPUS Jojok and Indonesia Public Health Centers

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.

Page 30: SIMPUS Jojok and Indonesia Public Health Centers

SIMPUS JOJOK user training at Timika, Papua

Page 31: SIMPUS Jojok and Indonesia Public Health Centers

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

Page 32: SIMPUS Jojok and Indonesia Public Health Centers

Paper-based medical records are still maintained.