EVALUATION OF ELECTRONIC MEDICAL RECORD FORMAT AND SECURITY SYSTEM IN DENTAL CLINIC OF THE GENERAL HOSPITAL IN BATAM CITY

Penulis

DOI:

https://doi.org/10.30659/medali.4.1.1-10

Kata Kunci:

Dental electronic medical record, Complete format, Security system

Abstrak

Background: Electronic medical records in dentistry are the latest implementation in the health sector, especially dental health history to the services needed by patients by health care facilities and affect the format of dental medical records and electronic medical record security systems. This study aimed to review the completeness of the medical record format and the electronic medical record security system of the dental polyclinic of the General Hospital in Batam City.
Method: This study used a descriptive cross-sectional observational design with two samples. Processing of data in the form of tables and texts as well as conclusions as a result of research.
Result: The results showed that there were incomplete dental electronic medical record formats at Hospital A such as patient identity, required medical data, odontogram, intraoral examination, and treatment chart while Hospital B such as patient identity, required medical data, intraoral examination, treatment chart, and appendix. In the electronic medical record security system, the two samples did not meet the integrity and non-repudiation aspects.
Conclusion: There is an incomplete dental electronic medical record format and security system in both samples according to the Indonesian Dental Medical Record Guidelines.

Biografi Penulis

  • Aurellia Vinta Aryanti Bintoro, Universitas Islam Sultan Agung
    Program Pendidikan Dokter Gigi Fakultas Kedokteran Gigi Universitas Islam Sultan Agung
  • Erdianto Setya Wardhana, Universitas Islam Sultan Agung
    Department of Dental Public Health
  • Erna Dwi Agustin, Universitas Islam Sultan Agung
    Department of Dental Psychology

Referensi

Kemenkes RI. Panduan Rekam Medis Kedokteran Gigi. 2015. 70 p.

Murniwati M. Peran Rekam Medik Gigi Sebagai Sarana Identifikasi. Maj Kedokt Andalas. 2012;36(2):163.

Karimah RN, Nurmawati I. Kualitas Informasi Terkait Penerapan Hasil Desain Rekam Medis Gigi Di Klinik Sakinah Kabupaten Jember. J Ilm Inov. 2016;16(2):109–15.

Nugraheni SW. Aspek Hukum Rekam Medis Elektronik di RSUD Dr Moewardi. 2018;1:92–7.

Budiyanti RT, Herlambang PM, Nandini N. Tantangan Etika dan Hukum Penggunaan Rekam Medis Elektronik dalam Era Personalized Medicine. J Kesehat Vokasional. 2019;4(1):49.

Ningtyas AM, Lubis IK. Literatur Review Permasalahan Privasi Pada Rekam Medis Elektronik. Pseudocode. 2018;5(2):12–7.

Samandari NA, Chandrawila S W, Rahim AH. Kekuatan Pembuktian Rekam Medis Konvensional Dan Elektronik. Soepra. 2016;2(2):154–64.

Erawantini F, Nugroho E, Sanjaya GY, Hariyanto S. Rekam Medis Elektronik: Telaah Manfaat dalam Konteks Pelayanan Kesehatan Dasar. 2013;1(1):1–10.

Liu K, Acharya A, Alai S, Schleyer TK. Using Electronic Dental Record Data for Research: A Data-mapping Study. J Dent Res. 2013;92(May 2013):S90–6.

Komisi Akreditasi Rumah Sakit. Instrumen Survei Standar Nasional Akreditasi Rumah Sakit. Ed 1. 2018;

Joint Commision International. Standar Akreditasi Rumah Sakit Jt Commision Int Ed 5. 2014;(April).

Trisnowahyuni, Rahim AH, Doloksaribu EI. Rekam Medis Odontogram Sebagai Alat Identifikasi Dan Kepentingan Pembuktian Di Pengadilan. Soepra. 2017;3(1):117.

Murniwati M, Machmud R, Rahmasari S. Gambaran Pengetahuan Dokter Gigi Tentang Rekam Medik Gigi. Andalas Dent J. 2019;1(1):57–70.

Agung Prasetya Gunawan. Gambaran rekam medis gigi puskesmas bahu kota manado ditinjau dari standar nasional rekam medik kedokteran gigi. e-GIGI. 2012;1, No 2:1–7.

Konsil Kedokteran Indonesia. Manual Rekam Medis - Konsil Kedokteran Indonesia. Buku Man Rekam Medis [Internet]. 2006;23.

Armanda Dian K. Urgensi Penerapan Mekanisme Informed Consent Untuk Mencegah Tuntutan Malpraktik Dalam Perjanjian Terapeutik. Priv Law. 2013;2(1):164465.

Unduhan

Diterbitkan

2022-03-07

Terbitan

Vol 4 No 1 (2022): Media Dental Intelektual March 2022

Bagian

Articles

Lisensi

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