Pembangunan Sistem Informasi Rekam Medis Ramdani Skincare & Spa Malang dengan Metode Prototyping berbasis Web

"Cindy Cunday Cicimby, Pembangunan Sistem Informasi Rekam Medis Ramdani Skincare & Spa Malang dengan Metode Prototyping Berbasis Web Pembimbing: Denny Sagita Rusdianto, S.Kom., M.Kom. dan Randy Cahya Wihandika, S.ST., M.Kom. Ramdani Skincare & Spa ialah salah satu klinik kecantikan yang berada di Kota Malang, pengelolaan rekam medis di klinik kecantikan ini dipegang oleh Admin dan Dokter yang meliputi input data pendaftaran pasien, pendataan riwayat penyakit pasien hingga mengirimkan laporan kepada direktur utama, dan juga Direktur yang mengelola Admin dan Dokter. Permasalahan ditemukan pada proses pengelolaan rekam medis di Ramdani Skincare & Spa yang dilakukan secara manual menggunakan hardcopy, permasalahan yang menyebabkan pengarsipan data diri pasien tidak efektif dan tidak adanya keberlanjutan dari riwayat kunjungan pasien. Masalah lain yang ditimbulkan yaitu proses pelayanan dari mulai pendaftaran hingga pelaporan klinik sangat lambat, hal tersebut memicu ketidakpuasan pelanggan. Dari penjabaran permasalahan yang diperoleh, maka dibuatlah sebuah aplikasi web base agar pengelolaan rekam medis berjalan dengan cepat, tepat, dan akurat. Sistem rekam medis berbasis web adalah sebuah sistem yang memudahkan pelayanan, pancatatan, dan pengarsipan data diri pasien di sebuah layanan kesehatan guna mengurangi kesalahan yang sering terjadi. Pengembangan sistem di Ramdani Skincare & Spa Malang menggunakan metode prototyping yang meliputi tahapan analisis kebutuhan, implementasi, serta pengujian. Tahap analisis kebutuhan diperoleh empat puluh empat kebutuhan fungsional dari satu kali iterasi. PHP merupakan bahasa pemrograman yang digunakan saat tahap implementasi pada kerangka kerja CodeIgniter. Tahap pengujian meliputi pengujian fungsional serta non fungsional. Pengujian fungsional meliputi uji unit yang berhasil melakukan jalur testing berdasarkan tiga kasus uji dan uji validation menunjukkan 100% valid dari tujuh puluh tiga kasus uji. Pengujian non fungsional melalui compatibility menunjukkan hasil sistem dapat diterima oleh pengguna dan dapat berjalan baik pada web browser. Kata kunci: Ramdani Skincare & Spa, Rekam Medis, Pengembangan sistem, Prototipe, Website

Promotion and Marketing Communications

This edited Promotion and Marketing Communications book is an original volume that presents a collection of chapters authored by various researchers and edited by marketing communication professionals. To survive in the competitive world, companies feel an urge to achieve a competitive advantage by applying accurate marketing communication tactics. Understanding marketing communication is an essential aspect for any field and any country. Hence, in this volume there is the latest research about marketing communication under which marketing strategies are delicately discussed. This book does not only contribute to the marketing and marketing communication intellectuals but also serves different sector company managerial positions and provides a guideline for people who want to attain a career in this field, giving them a chance to acquire the knowledge regarding consumer behavior, public relations, and digital marketing themes

A Step Toward Improving Healthcare Information Integration & Decision Support: Ontology, Sustainability and Resilience

The healthcare industry is a complex system with numerous stakeholders, including patients, providers, insurers, and government agencies. To improve healthcare quality and population well-being, there is a growing need to leverage data and IT (Information Technology) to support better decision-making. Healthcare information systems (HIS) are developed to store, process, and disseminate healthcare data. One of the main challenges with HIS is effectively managing the large amounts of data to support decision-making. This requires integrating data from disparate sources, such as electronic health records, clinical trials, and research databases. Ontology is one approach to address this challenge. However, understanding ontology in the healthcare domain is complex and difficult. Another challenge is to use HIS on scheduling and resource allocation in a sustainable and resilient way that meets multiple conflicting objectives. This is especially important in times of crisis when demand for resources may be high, and supply may be limited. This research thesis aims to explore ontology theory and develop a methodology for constructing HIS that can effectively support better decision-making in terms of scheduling and resource allocation while considering system resiliency and social sustainability. The objectives of the thesis are: (1) studying the theory of ontology in healthcare data and developing a deep model for constructing HIS; (2) advancing our understanding of healthcare system resiliency and social sustainability; (3) developing a methodology for scheduling with multi-objectives; and (4) developing a methodology for resource allocation with multi-objectives. The following conclusions can be drawn from the research results: (1) A data model for rich semantics and easy data integration can be created with a clearer definition of the scope and applicability of ontology; (2) A healthcare system's resilience and sustainability can be significantly increased by the suggested design principles; (3) Through careful consideration of both efficiency and patients' experiences and a novel optimization algorithm, a scheduling problem can be made more patient-accessible; (4) A systematic approach to evaluating efficiency, sustainability, and resilience enables the simultaneous optimization of all three criteria at the system design stage, leading to more efficient distributions of resources and locations for healthcare facilities. The contributions of the thesis can be summarized as follows. Scientifically, this thesis work has expanded our knowledge of ontology and data modelling, as well as our comprehension of the healthcare system's resilience and sustainability. Technologically or methodologically, the work has advanced the state of knowledge for system modelling and decision-making. Overall, this thesis examines the characteristics of healthcare systems from a system viewpoint. Three ideas in this thesis—the ontology-based data modelling approach, multi-objective optimization models, and the algorithms for solving the models—can be adapted and used to affect different aspects of disparate systems

Enhancing outbreak early warning surveillance in resource-limited Pacific island countries and territories

Comprehensive, timely, and accurate health data are essential for the detection of outbreak-prone diseases. If these go unnoticed or are identified late, they pose significant risks to the health of a population. In the Pacific islands, a syndrome-based surveillance strategy, known as the Pacific Syndromic Surveillance System (PSSS), is employed for the early detection of outbreaks. The PSSS, implemented in 2010, has provided a mechanism by which resource-limited Pacific island governments have been able to perform routine surveillance activities and address many of their national and international health protection needs and obligations. Despite being a cornerstone of health protection for many Pacific islands, the surveillance system had not been comprehensively evaluated. Nor had behavioural, technical, or upstream health system factors that influence its performance been investigated. This thesis assesses whether the PSSS is meeting its stated objectives and produces evidence to augment technical and operational elements of the system. The thesis answers the following questions: (i) is the PSSS meeting its stated objectives? (ii) are algorithm-based approaches to outbreak detection appropriate in the Pacific island systems and context?; (iii) how can the PSSS be enhanced to meet information needs during public health emergencies?; and (iv) what factors enable and constrain surveillance nurses’data collection and reporting practice? The thesis found that the surveillance system is simple, well regarded, trusted, and context-relevant mechanism that Pacific island governments from across the development spectrum have been able to adopt and maintain with minimal external technical or financial support. Despite these positive findings, the research identified several statistical, procedural, and broader systems barriers to optimal performance, including chronic staffing and other resource constraints, insufficient data on which to base outbreak detection analysis, and poor integration of health information systems. Looking ahead, the thesis identifies practical opportunities for system improvement and highlights areas for further research

Feasibility of introducing pulse oximetry for identifying hypoxaemia among children with pneumonia in paediatric outpatient settings in Bangladesh: Generating evidence and synthesising knowledge for influencing policy, programme planning and practice

BACKGROUND: Pneumonia is the leading cause of childhood mortality, accounting for 16% of all under-5 deaths globally. Hypoxaemia is common among children with pneumonia and one of the strongest predictors of mortality. Since 2014, the World Health Organization has recommended introducing pulse oximetry for hypoxaemia identification and pneumonia classification in the Integrated Management of Childhood Illness (IMCI) services, which is a global strategy developed explicitly for outpatient management of common childhood illnesses, including pneumonia, in low-resource and high-burden settings by minimally trained health care providers. Unfortunately, there are few experiences of introducing pulse oximetry in paediatric outpatient settings and integrating it with IMCI services by adopting a health system strengthening approach. Bangladesh is one of the South Asian countries with high burdens of childhood pneumonia and hypoxaemia. Although Bangladesh has adopted the IMCI strategy and scaled up it nationally, pulse oximetry is neither recommended nor routinely used in IMCI services in Bangladesh. Successful introduction of a generic recommendation, technology, or device, like pulse oximetry, in routine services, demands an in-depth understanding of the problem and the context, followed by context-specific adaptations, demonstrations, and feasibility assessments. Also, it requires strategic and extensive engagement with policymakers and stakeholders to promote country ownership and government leadership, which are prerequisites for scalability and sustainability. OBJECTIVES AND METHOD: The overall goal of my PhD is to improve the management of childhood pneumonia by introducing and integrating pulse oximetry in routine IMCI services in Bangladesh. Furthermore, the aim is to support the Government of Bangladesh in taking an evidence-based decision in this regard. Hence, I was engaged in a series of discussions with the policymakers of the Ministry of Health and Family Welfare of the Government of Bangladesh to understand their perspectives on the existing evidence gaps and research priorities for making informed decisions regarding pulse oximetry integration. Based on these consultations, I identified my PhD objectives. RESULTS: A. Estimating the burden of hypoxaemia among children with pneumonia: I conducted a systematic review and meta-analysis by searching 11 bibliographic databases and citation indices. I reported pooled prevalence of hypoxaemia (SpO2<90%) by classification of clinical severity and by clinical settings by using the random-effects meta-analysis models. I identified 2,825 unique records from the databases, of which 57 studies met the eligibility criteria: 26 from Africa, 23 from Asia, four from South America, and four from multiple continents. The prevalence of hypoxaemia was 31% (95% CI, 26 to 36; 101,775 children) among all children with WHO-defined pneumonia, 41% (95% CI, 33 to 49; 30,483 children) among those with very severe or severe pneumonia, and 8% (95% CI, 3 to 16; 2,395 children) among those with non-severe pneumonia. The prevalence was much higher in studies conducted in emergency and inpatient settings than those conducted in outpatient settings. In 2019, we estimated that over 7 million children (95% UR, 5 to 8 million) were admitted to the hospital with hypoxaemic pneumonia. I also conducted a secondary analysis of data obtained from icddr,b-Dhaka Hospital, a secondary level referral hospital located in Dhaka, Bangladesh. I included 2,646 children aged 2-59 months admitted with WHO-defined severe pneumonia during 2014-17. On admission, the prevalence of hypoxaemia among children hospitalised with pneumonia was approximately 40% (95% CI, 38 to 42). Hypoxaemia was the strongest predictor of mortality (AOR = 11.1; 95% CI, 7.3 to 16.9) and referral (AOR = 5.9; 95% CI, 4.3 to 17.0) among other factors such as age, sex, history of fever and cough or difficulty in breathing, and severe acute malnutrition. Among those who survived, the median duration of hospital stay was 7 days (IQR, 4 to 11) in the hypoxaemic group and 6 days (IQR, 4 to 9) in the non-hypoxaemic group, and the difference was significant at p<0.001. B. Understanding the context of managing children with pneumonia, including hypoxaemia in Bangladesh: I conducted a secondary analysis using data from the 2017-18 round of the Bangladesh Demographic and Health Survey (BDHS), which adopts a nationally representative sample of households. I included 456 deaths among children under 5 years of age in our analysis. Descriptive statistics were used to present the causes, timing, and places of death with uncertainty ranges (UR). Pneumonia is the major killer (19%, 95% CI, 15.3 to 22.7), accounting for approximately 24,268 (UR, 21,626 to 26,695) under-5 deaths per year. Among children aged 1-11 months, pneumonia accounts for approximately 43% of deaths. I further conducted a secondary analysis of the Bangladesh Health Facility Survey 2017, which was conducted with a nationally representative sample including all administrative divisions and types of health facilities. More than 90% of the district hospital and sub-district hospitals and three-fourths of primary level health centres provide IMCI-based pneumonia management services. Pulse oximetry was available in 27% of the district hospitals, 18% of the sub-district level hospitals and none of the primary level health centres. Around 72% of the sub-district hospitals had the availability of one of any of the four oxygen sources (oxygen concentrators, filled oxygen cylinder with flowmeter, filled oxygen cylinder without flowmeter, and oxygen distribution system), followed by district hospitals (66%). Almost none of the primary level health centres had oxygen sources available on the day of the visit. C. Assessing the feasibility of introducing pulse oximetry in routine IMCI services: Based on literature review and expert consultations, I developed a conceptual framework, which guided the planning and implementation of a 4-step stakeholder engagement process for introducing pulse oximetry in routine IMCI services in Bangladesh. In the first step, a comprehensive desk review and key informant interviews were conducted to identify stakeholder organisations and score them based on their power and interest levels regarding IMCI implementation in Bangladesh. In the second step, two national level, two district level and five sub- district level sensitisation workshops were organised to orient all stakeholder organisations having high power or high interest regarding the importance of using pulse oximetry for pneumonia assessment and classification. In the third step, national and district level high power-high interest stakeholder organisations were involved in developing a joint action plan for introducing pulse oximetry in routine IMCI services. In the fourth step, led by a formal working group under the leadership of the Ministry of Health, we updated the National IMCI Implementation Package, including all guidelines, training manuals, services registers and referral forms in English and Bangla. Our engagement process contributed to the national decision to introduce pulse oximetry in paediatric outpatient settings and update the National IMCI Implementation Package demonstrating country ownership, government leadership and multi-partner involvement, which are steppingstones towards scalability and sustainability. However, our experience clearly delineates that stakeholder engagement is a context-driven, time-consuming, resource-intensive, iterative, and mercurial process that demands meticulous planning, prioritisation, inclusiveness, and adaptability. Based on WHO’s global recommendation in 2014, the National IMCI Programme of Bangladesh decided to introduce pulse oximetry in routine IMCI services in 2019 and developed a short training package for IMCI service providers. They decided to test the package in a relatively controlled setting for finalising the content and choice of pulse oximetry device before the demonstration in routine outpatient settings and subsequent scale-up. A cross-sectional study was conducted among children admitted to a rural district hospital. We employed 11 nurses and seven paramedics as assessors who received a one-day training on pulse oximetry. Each assessor performed at least 30 pulse oximetry measurements on children with two types of handheld devices. The assessors successfully established a stable SpO2 reading in all attempts (n=1478) except one. The median time taken was 30 seconds (IQR, 22 to 42), and within 60 seconds, 92% of attempts were successful. The median time was significantly (p<0.0001) higher among assessments conducted with a Lifebox device (36 seconds, IQR, 25 to 50) than those with a Masimo device (27 seconds, IQR, 20 to 35). Similarly, assessors aged >25 years are 4.8 (95% CI, 1.2 to 18.6) times more likely to obtain a stable reading within 60 seconds. Regarding patient-related factors, the odds of obtaining a stable SpO2 reading was 2.6 (95% CI, 1.6 to 4.2) times higher among children aged 12-59 months than among children aged 2-11 months. The National IMCI Programme of Bangladesh designed and developed a district implementation model for introducing pulse oximetry in IMCI services through stakeholder engagement and demonstrated the model in the Kushtia district by adopting a health system strengthening approach. Between December 2020 and June 2021, two assessment rounds were conducted based on WHO’s implementation research framework and outcome variables in 12 facilities involving 22 IMCI service providers and 1860 children presenting with cough/difficulty in breathing in the IMCI consultation rooms. WE OBSERVED THAT IMCI SERVICE PROVIDERS PERFORMED PULSE OXIMETRY ON ALMOST ALL ELIGIBLE CHILDREN, OF WHICH 99% OF ASSESSMENTS WERE SUCCESSFUL; 85% (95% CI, 83 TO 87) IN ONE ATTEMPT AND 69% (95% CI, 67 TO 71) WITHIN ONE MINUTE. The adherence to standards of procedures related to pulse oximetry was 92% (95% CI, 91 to 93), and agreement regarding identifying hypoxaemia was 96% (95% CI, 95 to 97). The median performance time was 36 seconds (IQR, 20 to 75), which was longer among younger children (2-11 months: 44 seconds, IQR, 22 to 78; 12-59 months: 30 seconds, IQR 18 to 53, p<0.001) and among those classified as pneumonia/severe pneumonia than as no pneumonia (41 seconds, IQR, 22 to 70; 32 seconds, IQR, 20 to 62, p<0.001). We observed improvements in all indicators in the second round of assessments. Caregivers showed positive attitudes towards using this novel technology for the assessment of children. CONCLUSION: Based on context-specific experience generated through these studies, the Government of Bangladesh decided to integrate pulse oximetry into routine IMCI services throughout Bangladesh. Furthermore, the learnings synthesised through these studies can also help convince the policymakers and managers of other LMICs with similar burdens and contexts to introduce pulse oximetry in routine settings providing outpatient-based paediatric services and contribute to achieving the target of averting all preventable childhood pneumonia deaths by 2025

Leveraging and adapting global health systems and programs during the COVID-19 pandemic

Overview -- Surveillance, Information, and Laboratory Systems -- Workforce, Institutional, and Public Health Capacity Development -- Clinical and Health Services Delivery and Impact -- Commentaries -- About the Cover.Overview: Partnerships, Collaborations, and Investments Integral to CDC\u2019s International Response to COVID-19 / R. P. Walensky -- Global Responses to the COVID-19 Pandemic / C. H. Cassell et al. -- Surveillance, Information, and Laboratory Systems: Lessons Learned from CDC\u2019s Global COVID-19 Early Warning and Response Surveillance System / P. M. Ricks et al. -- Enhancing Respiratory Disease Surveillance to Detect COVID-19 in Shelters for Displaced Persons, Thailand\u2013Myanmar Border, 2020\u20132021 / B. Knust et al. -- Leveraging International Influenza Surveillance Systems and Programs during the COVID-19 Pandemic / P. Marcenac et al. -- Incorporating COVID-19 into Acute Febrile Illness Surveillance Systems, Belize, Kenya, Ethiopia, Peru, and Liberia, 2020\u20132021 / D. C. Shih et al. -- Extending and Strengthening Routine DHIS2 Surveillance Systems for COVID-19 Responses in Sierra Leone, Sri Lanka, and Uganda / C. Kinkade et al. -- Leveraging PEPFAR-Supported Health Information Systems for COVID-19 Pandemic Response / M. Mirza et al. -- Contribution of PEPFAR-Supported HIV and TB Molecular Diagnostic Networks to COVID-19 Testing Preparedness in 16 Countries / E. Rottinghaus Romano et al. -- A Nationally Representative Survey of COVID-19 in Pakistan, 2021\u20132022 / S. Aheron et al. -- SARS-CoV-2 Prevalence in Malawi Based on Data from Survey of Communities and Health Workers in 5 High-Burden Districts, October 2020 / J. Theu et al. -- Determining Gaps in Publicly Shared SARS-CoV-2 Genomic Surveillance Data by Analysis of Global Submissions / E. C. Ohlsen et al. -- Comparison of COVID-19 Pandemic Waves in 10 Countries in Southern Africa, 2020\u20132021 / J. Smith-Sreen et al. -- Using Population Mobility Patterns to Adapt COVID-19 Response Strategies in 3 East Africa Countries / R. D. Merrill et al. -- Community-Based Surveillance and Geographic Information System\u2012Linked Contact Tracing in COVID-19 Case Identification, Ghana, March\u2012June 2020 / E. Kenu et al. -- The Future of Infodemic Surveillance as Public Health Surveillance / H. Chiou et al. -- Workforce, Institutional, and Public Health Capacity Development: Continuing Contributions of Field Epidemiology Training Programs to Global COVID-19 Response / E. Bell et al. -- India Field Epidemiology Training Program Response to COVID-19 Pandemic, 2020\u20132021 / S. Singh et al. -- COVID-19 Response Roles among CDC International Public Health Emergency Management Fellowship Graduates / S. Krishnan et al. -- Exploratory Literature Review of the Role of National Public Health Institutes in COVID-19 Response / A. Zuber et al. -- Adapting Longstanding Public Health Collaborations between Government of Kenya and CDC Kenya in Response to the COVID-19 Pandemic, 2020\u20132021 / A. Herman-Roloff et al. -- Effect of Nigeria Presidential Task Force on COVID-19 Pandemic, Nigeria / O. Bolu et al. -- Use of Epidemiology Surge Support to Enhance Robustness and Expand Capacity of SARS-CoV-2 Pandemic Response, South Africa / R. Taback-Esra et al. -- Building on Capacity Established through US Centers for Disease Control and Prevention Global Health Programs to Respond to COVID-19, Cameroon / E. Dokubo et al. -- Use of Project ECHO in Response to COVID-19 in Countries Supported by US President\u2019s Emergency Plan for AIDS Relief / J. Wright et al. -- Faith Community Engagement to Mitigate COVID-19 Transmission Associated with Mass Gathering, Uman, Ukraine, September 2021 / L. Erickson-Mamane et al. -- Clinical and Health Services Delivery and Impact: Effects of COVID-19 on Vaccine-Preventable Disease Surveillance Systems in the World Health Organization African Region, 2020 / J. Bigouette et al. -- CDC\u2019s COVID-19 International Vaccine Implementation and Evaluation Program and Lessons from Earlier Vaccine Introductions / H. M. Soeters et al. -- Effects of Decreased Immunization Coverage for Hepatitis B Virus Caused by COVID-19 in World Health Organization Western Pacific and African Regions, 2020 / H. J. Kabore et al. -- Past as Prologue\u2014Use of Rubella Vaccination Program Lessons to Inform COVID-19 Vaccination / M. G. Dixon et al. -- Leveraging Lessons Learned from Yellow Fever and Polio Immunization Campaigns during COVID-19 Pandemic, Ghana, 2021 / K. Amponsa-Achiano et al. -- Effectiveness of Whole-Virus COVID-19 Vaccine among Healthcare Personnel, Lima, Peru / C. S. Arriola et al. -- Leveraging HIV Program and Civil Society to Accelerate COVID-19 Vaccine Uptake, Zambia / P. Bobo et al. -- Adopting World Health Organization Multimodal Infection Prevention and Control Strategies to Respond to COVID-19, Kenya / D. Kimani et al. -- Infection Prevention and Control Initiatives to Prevent Healthcare-Associated Transmission of SARS-CoV-2, East Africa / D. J. Gomes et al. -- Effects of COVID-19 Pandemic on Voluntary Medical Male Circumcision Services for HIV Prevention, Sub-Saharan Africa, 2020 / M. E. Peck et al. -- Sexual Violence Trends before and after Rollout of COVID-19 Mitigation Measures, Kenya / W. Ochieng et al. -- Clinical and Economic Impact of COVID-19 on Agricultural Workers, Guatemala / D. Olson et al. -- Outcomes after Acute Malnutrition Program Adaptations to COVID-19, Uganda, Ethiopia, and Somalia / T. Shragai et al. -- Commentaries: Lessons from Nigeria\u2019s Adaptation of Global Health Initiatives during the COVID-19 Pandemic / C. Ihekweazu -- About the Cover: A United Response to COVID-19\u2014an Artist\u2019s Perspective / B. Breedlove et al