Analisis Penerapan Rekam Medis Elektronik Pasien Rawat Jalan Di Puskesmas Ambacang Kota Padang Tahun 2025

UNIVERSITAS ALIFAH PADANG
Skripsi, Agustus 2025
Vionanda Maharani Putri

Analisis Penarapan Rekam Medis Elektronik Rawat Jalan Di Puskesmas Ambacang Kota Padang Tahun 2025
xii + 151 halaman, 15 tabel, 3 gambar, 14 Lampiran
ABSTRAK

Penerapan Rekam Medis Elektronik (RME) merupakan kebijakan nasional dalam upaya meningkatkan mutu pelayanan kesehatan dan tertib administrasi di fasilitas pelayanan kesehatan. Di Provinsi Sumatera Barat, sebagian besar dari 270 Puskesmas telah menggunakan RME, meskipun sekitar 10 Puskesmas belum mengimplementasikannya. Puskesmas Ambacang menerapkan RME sejak 1 Januari 2023 menggunakan aplikasi ePuskesmas, kemudian diperbarui menjadi ePuskesmas NG, dan sejak 1 Juni 2024 beralih ke ePuskesmas Klaster. Penelitian ini bertujuan menganalisis penerapan RME pasien rawat jalan di Puskesmas Ambacang Kota Padang Tahun 2025.
Metode penelitian menggunakan pendekatan kualitatif dengan desain deskriptif melalui wawancara, observasi, dan checklist. Informan penelitian berjumlah lima orang, terdiri dari kepala tata usaha, dokter, perawat, kepala unit rekam medis, dan petugas rekam medis. Penelitian dilakukan di Puskesmas Ambacang pada Maret–Agustus 2025. Analisis data dilakukan melalui triangulasi sumber dan metode.
Hasil penelitian menunjukkan penerapan RME di Puskesmas Ambacang berjalan cukup baik dengan keterlibatan seluruh tenaga kesehatan. Sarana prasarana dan kebijakan tersedia, namun masih terkendala jaringan dan server. Pendanaan tercukupi dan anggaran rutin. Proses pencatatan dan pelaporan dilakukan melalui aplikasi ePuskesmas Klaster, namun pencatatan manual masih digunakan saat sistem bermasalah, monitoring dan evaluasi rutin dilakukan. Output menunjukkan kelengkapan data pasien dalam RME baru mencapai 62,58%, sehingga belum memenuhi standar target nasional. Kendala yang dihadapi meliputi keterbatasan SDM, gangguan teknis, dan kelengkapan RME yang belum memenuhi target nasional.
Penerapan RME di Puskesmas Ambacang masih menghadapi tantangan, baik dari aspek teknis maupun sumber daya manusia. Disarankan peningkatan pelatihan berkelanjutan, penguatan infrastruktur teknologi, serta optimalisasi jaringan untuk menunjang efektivitas aplikasi ini secara berkelanjutan.
Daftar Bacaan : 38 (2008-2025)

Kata Kunci : Puskesmas, Rawat Jalan, Rekam Medis Elektronik.

ALIFAH UNIVERSITY PADANG
Skripsi, August 2025
Vionanda Maharani Putri

Analysis of the Implementation of Electronic Medical Records for Outpatients at the Ambacang Community Health Center, Padang City in 2025.
xii + 151 pages, 15 tables, 3 figures, 14 Attachments
ABSTRACT

The implementation of Electronic Medical Records (EMR) is a national policy aimed at improving the quality of healthcare services and administrative order in health facilities. In West Sumatra Province, most of the 270 Community Health Centers (Puskesmas) have adopted EMR, although around 10 Puskesmas have not yet implemented it. Ambacang Community Health Center has applied EMR since January 1, 2023, initially using the ePuskesmas application, later updated to ePuskesmas NG, and since June 1, 2024, migrated to ePuskesmas Cluster. This study aims to analyze the implementation of EMR for outpatient services at Ambacang Community Health Center, Padang City, in 2025.

The research method employed a qualitative approach with a descriptive design through interviews, observations, and checklists. The informants consisted of five people, including the head of administration, a doctor, a nurse, the head of the medical record unit, and a medical record officer. The study was conducted at Ambacang Community Health Center from March to August 2025. Data analysis was carried out using source and method triangulation.

The results showed that EMR implementation at Ambacang Community Health Center was running quite well with the involvement of all healthcare workers. Facilities, infrastructure, and policies were available, but network and server issues remained as obstacles. Funding was sufficient with a routine budget. Recording and reporting processes were carried out through the ePuskesmas Cluster application, although manual recording was still used when the system encountered problems, while routine monitoring and evaluation were conducted. The output indicated that the completeness of patient data in the EMR only reached 62.58%, which had not yet met the national target standard. Challenges encountered included limited human resources, technical disruptions, and incomplete EMR data that failed to achieve national targets.

The implementation of EMR at Ambacang Community Health Center still faces challenges, both technical and human resources-related. It is recommended to enhance continuous training, strengthen technological infrastructure, and optimize network systems to support the sustainable effectiveness of this application.

Reading List : 38 (2008-2025)
Keywords : Public Health Center, Outpatient, Electronic Medical Record.