Overview of the Implementation of Health Information Systems at District and Puskesmas Levels

Abstract

The development of a health information system (HIS) is a complex and continual process that necessitates a significant amount of resources. It is well-understood that HIS plays essential roles and makes up the National Health System (NHS). Hence, the government of Indonesia issued a national policy on the development and implementation of the National Health Information System (NHIS) nation-wide. The implementation of this policy has been faced with an array of issues around human resources, technology, management, organizational problems and work culture, including supporting facilities. Unfortunately, the implementation of HIS at the lower level of administration tends to be viewed as a technological advance rather than an intact information system. As such, the competition to develop a working HIS at provinces and districts level turns to the race to acquire the most sophisticate software from a vendor that often costly and creates some more problems. Under such a situation, control over data, data security, and the sustainability of the system are often compromised unintentionally. This article offers a number of solutions to the problems, including a revitalization of the existing human resources and organizational culture. Also, the data integrity and security should be reviewed and redirected to the implementation of the concept of interoperability (rather than forcing unification of softwares used) which should be re-designed and developed through bottom-up planning. The existing human resources should prepare for an advanced technology transfer from the software developers (vendors). Concerns of data security, control over data, and technology transfer should be regulated and implemented consistently to ensure the sustainability of the existing system.