FINAL ASSIGNMENT

2016
PROJECT MANAGEMENT OF IMPLEMENTATION OF HOSPITAL
INFORMATION SYSTEM FOR RADIOLOGY INSTALLATION IN SILOAM
HOSPITALS BALIKPAPAN

Radiology service activities in Balikpapan SHBP treated in three separate areas,

namely IGD, Integrated Clinic and Clinic Executive. ER handle emergency patient
care, patient referral and hospitalization while integrated Clinic and Polyclinic
Executive handling outpatients. based procedures of patient services in SHBP ,
then visit patients divided into two, namely:
a. During business hours
1. The patient towards the registration booth at the clinic integrated or
clinic executive then directed the patient choose the clinic in question.
2. In patients do anamnese and referred to investigations (the x-ray /
radiology) which necessary for the enforcement of diagnosis.
3. The patient returned to the clinic after completion investigations (the x-
ray / radiology) for get a diagnosis.
4. The patient has been checked and get diagnostic resultsthen routed to
the pharmacy to get drug or medical rehabilitation when needed for
outpatient care, whereas for hospitalization of patients was
immediately taken to the ward inpatient appropriate patient selection
desired.
b. Outside working hours, or patients in urgency
1. Patients are directed to the ER
2. The patients were given the anamnesis and first handling when
circumstances allow patients referred to be investigated (the x-ray /
radiology).
3. For patients who are ambulatory upheld the diagnosis and directed to
the pharmacy for taking drugs, being for hospitalization of patients was
immediately taken to the inpatient ward appropriate selection of the
desired patient
4. One Day Care (Day Care Overnight) is a service emergency with a view
to carry out monitoring of patients with urgency conducted in 1 (one)
day 1 (one) night at the emergency unit, for implementation of referral
outpatient or inpatient according to the results of observation.
5. The Care observation is monitoring the implementation of the patients
with urgency for six hours on the installation of emergency department
to inpatient referral is then executed or the patient may return if the
conditions allowed.

INFORMATION SYSTEMS

1. Data and Information

Data is the reference to the facts either numbers, text, documents,
images, charts, sound representing descriptive verbal or specific codes
and such. so the data is still raw form that can not be recalled much that
needs to be processed further. Therefore the data filtered and processed
through a treatment system have been meaning and value to a person or
organization that it can be regarded as an information. In detail
information, defined as a collection of data that has been processed and
prepared in a systematic for informative purposes, drawing conclusions,
argumentation and as the basis for forecasting and decision.
Information can be useful for the wearer or may not useful at all. It
depends on the quality of information. The resulting information will be
useless if the quality is good. Poor quality of information is influenced by
 three determinants, ie information content, time and form of information
presentation. For more The following details the description of some of the
information quality requirements:
a. Availability
The fundamental requirement for an update is available Opera- itself.
Information must be obtained for the people who want to use it.
b. Easily understandable (comprehensibility)
Information should be easily understood by decision makers, be it
information concerning routine work and decisions of a strategic nature.
c. Suitability (relevante)
In the context of the organization, the necessary information is completely
in accordance with the problems, the mission and goals organization.
d. Completeness
The adequacy of the information if it is used as a material for making a
decision. Completeness does not mean more better.
e. Timeliness
The best time in providing information is on the time required to make a
decision, usually at the time analysis will be done.
f. Ease of Access (Accessibility)
Closely linked with flexibilities how to obtain the data or information (easy
to get).
g. Accurate (accuracy)
This provision requires that the information be free of errors and error. It
also means that the information must be clear and reflect on the meaning
contained supporting data.
h. Consistent
Information should not be a contradiction in presentation, and refers to the
amount of information should be displayed (without exaggeration) as this
is an essential condition for the basis of decision making.

MANAGEMENT INFORMATION SYSTEM HOSPITAL

Hospital management is a series of management activities from the planning

phase to the evaluation phase oriented in the aspect of input (customers,
doctors, facilities, infrastructure and equipment), process (medical services) and
output (patient satisfaction) .
Hospital information system (SIRS) is an institution dealing with data collection,
data management, presentation information, analysis and inference of
information and delivery information needed for hospital operations. Information
System of Hospitals include: clinical information systems, information systems of
administration and management information systems. SIRS major role is in
support of quality control of medical services, assessment productivity,
utilization analysis and forecast needs, planning and evaluation of programs,
simplify the service, as well as the clinical assessment and education.
Hospital information management system (SIMRS) is a set of activities and
procedures that organized and mutual related and interdependent and are
designed in accordance with the plans in an effort to present information that is
accurate and timely in hospital. In addition, this system is useful for supporting
the process of the functions management and decision-making in giving health
services in hospitals. The system, currently devoted to support the functions of
planning and evaluation of work performance hospitals among others is the
quality assurance hospital services
concerned, financial control and improvement of the work of the house
Problem Analysis
At the stage of problem analysis are the basic steps have to do is to identify the
problem, understand the system and identify information systems that run
before
the development model of the new system:

Identifying the problem

Data management activities on radiological installations will produce data and

information in the form of indicators will be used as an evaluation of hospital
services. However, data management activities that are currently running are
still there some of the problems that the input (data written patient by the
counter clerk radiological installation is not complete), process of data
management is still done manually and not using the DBMS so that the resulting
information is not accurate. Output (reports / information) is generated only in
the form reports revenue per type of action and mode of payment for patients,
there are no reports of service performance is one of the indicators of evaluation
services in radiology installations. This matter is resulting in the evaluation of
services performed by manager becomes stunted. Problems faced by the system
which exist primarily on managerial reports to the home sick sometimes have to
wait, as the result of quote.

The information system on the installation of radiological outpatient to support

the evaluation of services in Siloam Hospitals Balikpapan, there are three
processes, namely:
a. Documenting Process
In this process the counter clerk radiology installation filling of patient
data, the data radiographers, physician data, the data size of the movie,
the data type of action, the data of district / city and a data model of
payment
b. Transaction Process
In the process of patient registration process of the transaction at the
counter at the same radiology installation of data recording, examination
results, at the installation radiology service provide checking on the
patient.
c. Reporting Process
In this process is the manufacturing activity undertaken daily, monthly and
yearly containing report for service evaluation form: Income report,
patient statistics report, performance report, service and report the use of
x-ray film.

Process data collection, whereas in this process there are eight processes,
namely:
a. Patient Data Collection Process
In this process the patient identity data recorded and stored in the file of
patient data.
b. Documenting Process technologist
In this process the data is recorded and the attendant radiographer stored
in a data file clerk radiographer.
c. Documenting Process Type Actions
In this process the data types of actions are recorded and stored in the
data file type of action.
d. Documenting Process of Payment Method
 In this process the data is recorded and how payment stored in a data file
mode of payment.
e. Documenting Process of Rontgen Film Size
In this process the film size data recorded and stored in the data file size
of the movie.
f. Documenting Process Treatment Method
In this process the data is recorded and how treated patients stored in a
data file how to seek treatment.
g. Documenting Process of Doctor
In this process the data recorded the patient's referring physician and
stored in a data file doctor.
h. Documenting Process of District/Cities
In this process the original data districts / cities patient was recorded and
stored in a data file districts / cities

In the reporting process described in the DFD Reporting level 1 there are four
processes, namely:
a. Process Statement of Earnings
The activities undertaken in this process is the making installation earns
reports from daily census, monthly and yearly.
b. Process of Statistics Report Patients
Activities undertaken in this process is the making statistical reports from
the Census patients daily, monthly and yearly.
c. Process of Services Performance Report
Activities undertaken in this process is the making installation service
performance reports in a daily format and monthly
d. Using of Film-Making Process Reports
Activities undertaken in this process is the making report the use of the
film in a monthly format.

Draft of Output and Input

1. Output Design
The design of the output is the product of an information system that can
be seen. based on observation and interviews with users of the obtained
needs
2. Input Design
It Aims to provide design of input forms input on the document and on the
screen to the information system. Input is an initial step the
commencement of the information process. The raw material of
information is data that happens to transactions carried out by the
organization. The data results of the transaction is an input to the
information system. Entering the data into the information system of a
new computerized, required input tools. In general of the device is a
keyboard and mouse. Design of input adapted to process the input directly
consists of two (2) main stages, namely: data capture using basic
documents so that in this process requires the design of the form and the
data entry into computer so that this process requires design.
3. Interface Design
Input on the design of information systems installation outpatient
radiology include input design in counter installation of radiology. The
following table of input design for information system of outpatient
radiology installations.
4. Draft Interface
 The design of the dialog interface is designed wake-up dialog between
users of the system with computers. The false one way of making a
computer screen dialogue is with using of menu. The menu contains
several alternative programs or options presented to the user. One menu
is used for the design dialog interface of this research is a pull-down
menu, which consists of a menu bar that are preferred and can be
selected by moving the cursor left, right, top and bottom. The interface is
shown in the form of master data, transaction and reports.
5. Database Draft
Database design is intended to facilitate or efficiency in storage, alteration
and reading data. A database that is built should be reliable with data
storage that have high integration for increase the confidence of the user
data. Designing of databases, analysts need to define in advance the files
required by sistem.The stages are carried out in further research is the
design of the database for the system outpatient radiology installation
information.
The steps in the process of database design radiology information system
for outpatient installation as follows :
1. Approach E-R Data Model (Entity-Relationship)
E-R data model is generally described as diagram of E-R (Entity-
Relationship Diagram = ERD). The stages in the manufacture ERD
consists of:
a. Identify and define the entire set of entities who will be involved and
determine the key attributes of the each set of entities. With DAD
and analyzing user view that involved in the system, it can be found
entities database in-patient radiology information system
installation way to support the evaluation of services in SHBP
Balikpapan. These entities is new early identification and should be
analyzed further to the implementation of table
b. Determination of the key attributes of each entity set whether these
attributes can actually be used as a key or not required test phase,
using dependence functional
c. Completeness set of entities and a set of relations with descriptive
attributes (non-key). Entities that are made between entities ERD
described in the above is not equipped with a detailed description of
a picture of an entity. For describing in detail the entity set, then
equipped with a descriptive attribute. these attributes shows its
function as the characteristics (properties) attached to an entity.

Implementation of Model Data to Table

Entities obtained from the modeling process by using the ERD must be
transformed into a base of physical data in tabular form (data files) which is the
main components forming the database. then atribute attached to each set of
entities and a setting of relations will be declared as the fields of tables
accordingly.
From the results obtained from the relationship diagram E-R then needs to be
analyzed whether the relationships formed will generate a new table or just an
addition / inclusion relationship attributes to the table representing one of a set
of entities. It can be seen from the cardinality relationships are formed. A set of
relations formed above can be analyzed, as follows :
a. UCC patients - the clerk is many to many
b. Entities patient - personnel radiographers are many to many
Because the cardinality of each relationship is many to many then the relation
should be implemented into a new table. Whereas for ;
a. UCC type of action - the size of the movie is one to one
b. Entities patients - how payment is many to one
Because the cardinality of the relationship is one to one and many-to-one then
implemented into
new tables.

Design Normalization

Tables were obtained in implementing the above is the first step in designing a
database. The next stage is the design of normalization which is the final draft. In
this process will analyze table preconceived in an effort to obtain a a database
table with a good structure in a way applying a number of rules and standard
criteria for each tables that are members of the database.
A table can be categorized as good (efficient or normal) if it meets three criteria:
if there
decomposition (decomposition), the table should decomposition secured
(Lossless-Join Decomposition), the maintenance functional dependence upon
data changes (Dependency Presertation), does not violate the Boyce-Code
Normal Form (BCNF). The technique used in this normalization is functional
dependence (KF). The principle of this technique is each table is used only the
functional dependency. A table that has more of the KF, certainly not a good
table. This normalization process can be done by checking / testing of each table
that has been obtained, whether it Normal forms meet all three (3-NF) or not. If it
does not meet the form of 3-NF it should be decomposed. The 3-NF requirements
are: The table must fulfill the 2-NF and each of key attribute is not does not
depend functionally of the other key attributes not in the table.

Final Draft of ERD

Testing of functional dependency on normalization process, it can be described

relations between
final entity with a diagram

File Structure Design Database

Results from the table in the form of data files on the design of the next
normalization designed the structure of the database files. The structure of the
database file describes the fields in your data file with a data type

Phase of Building New System

The purpose of this phase is to build and testing a system according to the needs
and specifications design, implement interfaces between systems proposed by
the existing system. The description of each of destination described as follows:
a. Programming
This stage aims to convert the resulting of design logic into the operations of
coding using a programming language so that logic concept that has been
designed can be translated into the program functions that can be used by the
user of easily and ensure that all functions or program modules can be created
and run correct. In this study, considering the limited time program, the
installation of information systems for radiology outpatient support service
evaluation undertaken investigators assisted by a programmer. The program is
made based design including:
1. Creation of Database
In the design of the database starting from the designing models use a
context diagram and DAD, then modeled by ERD to obtain tables. The
result is then normalized to obtain tables are free of redundancies. Table
database created with My SQL database tools with component row and
columns.
2. Preparation of Input Form
Input Form is made in accordance with the design of input and made
directly with the programming language PHP.
3. Reporting
Reports are generated with each of the tables relatef contained in the
database and the end result of charts and tables.
4. Making the main menu interface
The main menu interface is made in accordance with
a. Process has been designed on the DAD.
b. Validity System By programer
The validity of the system starting from the installation process of the program is
done by connecting the language PHP programming with My SQL database,
hereinafter in the process of testing the system / program. The testing phase
that aims to test or testing for all program modules are made, so that when
implemented later ascertained goes well. In testing program
will use the following order:
1. The testing grounds, namely testing at the module is the smallest, so that
certain parts the running properly and efficiently
2. Testing group, which is a test for groups so that interactions between the
basic module modules can be run well.
3. Testing the function of conducting tests for testing the functions of the
group so that interactions between the group can goes well.
4. Testing of the system, namely the testing system as a whole, so that the
system can work as with expectations and the actual function.

Implementation Phase

Implementation of an activity to obtain and integrate physical resources and

conceptual produce a system that works. In the implementation phase. There is
a system conversion activity which is the process to put the new system to be
ready for using. Implementation of information systems for outpatient radiology
installations support the evaluation of services in Balikpapan SHBP use parallel
approach, the approach taken by operate the proposed system together with the
system who long for a certain period of time. Both of these systems operated
jointly to ensure that the system proposed has actually operated successfully
before the old system was stopped.

Implementation of information systems for outpatient radiology installations

support service evaluation is done according to the design of research (Single
user). The procedure is as follows:
Patients registered a counter part to the installation of radiologica. Then patients
go to the radiology installation services to get an inspection by officers
radiographer. The concierge service providers can just click the registration
number and or the patient's medical record number, then the officer
radiographers perform due diligence measures on demand. After that,
Radiographers handed x-rays to the doctor in radiology installation to fill the
examination results then the examination results were handed back to the doctor
who referring.
After a specified time, the administration radiology installation recap events that
have occurred for example in a month reported some reports given the head of
the radiological installation to evaluate how services performed as well as to
follow up.

Limitations on the installation of radiological information systems outpatient. The

information system on the installation of radiological outpatient can present data
daily, monthly and yearly nevertheless. The researchers realize there are
limitations and shortcomings on the proposed information system, including:
1. The information system is yet able to monitor the number of films were
broken.
2. The information system is yet able to calculate mathematically great fare
to be paid patient Chunks Service Charge
3. The system still displays information generated default the date when the
computer is open to any display form or reports.
4. The system-generated information is still not able to save old patient data
(if there is a change in the filling of new data has managed data, patient
data longer automatically follow to change)

CONCLUSION

Based on the research that has been undertaken, obtained the following
conclusions:
1. The information system of outpatient radiology installation to support
evaluation of services that run on SHBP Balikpapan before the
development of a new information system is still issues such as: in the
input data (data written by the patient the clerk at the registration booth
no radiological installations complete), process (data management is still
done manually and not using DBMS) and output (reports / information
revenue is generated only reports based installation a roster spot, method
of payment the patient and the type of action only) so that the activities of
service evaluation conducted by the managerial hospitals to determine
the level of productivity installation services in outpatient radiology
become obstructed.
2. Reports / information to support evaluation of services in installation
outpatient radiology SHBP Balikpapan required by the managerial
hospitals are included:
a. The report is based on a list of income and how to pay patient
b. Statistical reports of patients by way of visits, types actions and how to
pay patients
c. Service performance reports
1. Average of patient visits per day
2. Average new patient visits per day
3. The ratio of new patient visits per total visits
4. The ratio of patient visits with radiographers
5. Percentage of specialist services
6. Report the use of a film based on the film stock, the number of
movies used and the number of films
3. The database in the radiology information system installation outpatient
developed in SHBP Balikpapan include: patient, officer of radiographer,
 type of action, method of payment, the size of the film, the officer of
administration, deal registration and examination of transactions. The
Process that occurs in this information system is the processing of data
from Data source and type of data into information in the form of reports
(daily, monthly and yearly). The output of : Earnings reports, statistical
reports of patients, the performance report of service and report the use of
x-ray film.
4. The results of trials of the proposed information system, can be overcome
issues relating to the quality of the system information, namely: the ease
of information access, accuracy information, the timeliness, completeness
and appropriateness of information. One example is the applied on the
indicator ratio of the number of visits by the radiologist. If every day ratio
always increases or tends to increase workload means officers of
Radiographers heavier so that it can take a decision to propose increasing
the number of officers on the working period which will come.
5. Quality information of the proposed system is better than the system of
the old information. It can be seen from the responder. the ease of access
to information, the accuracy of the information, timeliness, completeness
and appropriateness of information. The response can be seen through the
average of recapitulation overall weighted data show an increase results
from 1.95 to 3.40 with a weighted average margin 1.45 overall. The
Quality information also have differences significant is evident from the
results of statistical tests Sign Test with a probability value of 0.0001 (p
<0.05), which means there are differences the quality of information
between the old system with the system proposed.

B. RECOMMENDATION

1. Development of radiology information systems in the future sought

displaying the registration form more easily used by user so that the user
does not trouble in its operation.
2. Development of radiology information systems in the future sought display
a warning system on the film stock data so that the film does not limit the
numbers.
3. If the proposed model of information system's outpatient radiology
installations SHBP applied, it needs to be adapted to the system already
underway (the programming language and database) and must provided
facilities / tools that support.

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