Assessment of Medical Record Management Information System on BPJS Outpatient Claims with Health Metric Network
DOI:
https://doi.org/10.53861/lontarariset.v6i1.522Keywords:
Health Information System, Health Metric Network, BPJSAbstract
Health information systems are a priority in supporting Universal Health Coverage (UHC). Yet 65% of WHO member states face challenges in health information system integration, causing losses of up to $300 billion per year. In Indonesia, 35% of BPJS claims are delayed due to incomplete documentation. This study aims to evaluate the Medical Record Management Information System (SIMRM) at West Bandung Private Hospital using the Health Metric Network (HMN) framework. The mix method design was used with a total sampling of 22 medical record staff. Data was collected through questionnaires, interviews and observations. The results show that SIMRM is in the category of "there is but inadequate" with a percentage of 59%. The evaluation showed weaknesses in the completeness of documentation and the accuracy of the diagnostic code. So it can be concluded that even though SIMRM helps speed up the documentation process, improvements are still needed in system integration and staff training to increase the effectiveness of outpatient BPJS claims, so that it can improve the quality of health services.
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Copyright (c) 2025 Hedie Kristiawan, Adi Anggoro Parulian, Yura Witsqa Firmansyah, Bhisma Jaya Prasaja

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