1-Pengantar Health Informatics GJL23 - 24

Pengantar Health Informatics
Pengenalan Dosen, Aturan, Komponen Penilaian, dan Tips Belajar
Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

1 Program Studi S-1 Teknik Informatika
Fakultas Teknologi Informasi
Data Dosen
Nama : Aulia Zahrina Qashri
Email : aulia.zq@maranatha.ac.id
Master’s Programme in Health Product Associate

Informatics United Nations Development
Karolinska Institutet Programme (UNDP)
Stockholm University
2021-
2021 Sekarang
2019 2021
Program Analyst Head of Product
Research Center for Care and Digital Transformation Office
Control of Infectious Diseases, FK Kementerian Kesehatan RI
UNPAD

Capaian Pembelajaran
1. Menguasai konsep dasar health informatics 1. Mendemonstrasikan penerapan evidence-based

2. Mendemonstrasikan kecakapan analisa masalah healthcare dalam health informatics
dan penemuan solusi dalam health informatics 2. Menguasai konsep sistem komunikasi dalam bidang
3. Menguasai konsep sistem informasi dalam bidang kesehatan
kesehatan 3. Mengenal konsep terminologi dalam bidang
4. Presentasi tugas besar 1 (pertemuan ke-7): kesehatan
Patient Journey Mapping 4. Mengenal konsep clinical decision support system
5. Ujian Tengah Semester 5. Mengenal penerapan sub-bidang health informatics
6. Presentasi tugas besar 2 (pertemuan ke-15): Digital
Care Pathway
7. Ujian Akhir Semester

Komponen Penilaian
● KAT 60% (Tugas Besar 1 dan 2 : 50% + 50%)
● UTS 20%: Teori (pilihan ganda)
● UAS 20%: Teori (pilihan ganda)
Klik di sini untuk join

Whatsapp Group
Perkenalan
mahasiswa Hello!
1. Nama
2. Asal Daerah
3. Hobi
4. Kenapa pilih jurusan IT
5. Kenapa ingin belajar health
informatics
5
Pembagian Grup
(10 Menit)
● Setiap grup terdiri dari 4 orang
● Tentukan ketua grup
● Tentukan nama grup
Masukkan informasi grup di
bit.ly/in29023
6
Tips Belajar: Teaching vs Learning
Be proactive!
Image: The Economics Network

Pengantar Health Informatics
Pertemuan 1 - Basic concepts in informatics

Basic concept in informatics: Models
Study of human health
a. Based upon a few foundational concepts such as the cell or the notion of disease
b. Core ideas are usually grounded in observations of the physical world
Informatics
a. Built upon the basic concepts of data, models, systems and information
b. Abstract ideas
For those used to the study of healthcare, informatics concepts often seem detached from the physical realities
of the clinical workplace.
(Coiera, 2015)

Data, Knowledge, Information
Data
● Data consists of facts. Facts are observations or measurements about the world.
● Example: For example, ‘today is Tuesday’, the ‘blood pressure is 125/70 mm Hg’ or ‘this drug is
penicillin’.
Knowledge
● Knowledge defines relationships between data.

● Example: The statement ‘penicillin is an antibiotic’ relates two data elements.
Information
● Information is the meaning obtained by the application of knowledge to data.

● Example: the datum that ‘blood pressure is 125/70 mmHg’ provides information only if it tells us
something new.

Information
“To act in the world we need to make decisions, and to make decisions we must have information that
distinguishes one course of action over another”
Information can indeed be linked to concepts of orderliness and novelty. For example, a patient’s medical
record can contain:
1. Patient’s personal information

2. Doctor’s assessment
3. Laboratory results Well structured information = easier to understand
4. Radiology results
5. Prescription

Computer can act as data stores
Data Interpretation
If the knowledge and data components of a decision

problem can be written down, then this problem can Database Medical Data
in principle be solved using a computer. For Repository of Data. Consist of images or
example: Data are organized physiological signals
according to a data taken from
● The computer may organize and consolidate model, so that the monitoring devices
origin of each datum (complex data)
data into a graphical presentation
is recognizable.
● The human then examines the processed data
to make a final interpretation
The databases that store complex data

from patients can be huge.

Health Systems?
1. Someone’s description of how he or she sees

healthcare, based upon observation of the world
2. Could be a proposal or plan for how healthcare
should work
3. Could be the physical collection of people, buildings
and infrastructure that collectively come together to
deliver healthcare.
____________
Let’s learn:
1. Health services in Indonesia

2. Systems

(1) Health Services in Indonesia
1. Layanan Kesehatan Primer: Puskesmas / Klinik / Dokter Praktik Mandiri

● Akses atau kontak pertama untuk setiap individu dalam mendapatkan
layanan kesehatan
● Menyediakan layanan kesehatan esensial untuk masyarakat
● Terdekat dengan masyarakat
2. Layanan Kesehatan Sekunder: Rumah Sakit

● Menangani masalah kesehatan yang lebih kompleks
● Terdiri dari layanan kuratif yang bersifat kompleks
● Disediakan oleh RS pada level kab/kota
● Rujukan tingkat pertama
3. Layanan Kesehatan Tersier: Rumah Sakit Spesialis

● Mengampu layanan super-spesialis
● Disediakan oleh RS pada level nasional
● Menyediakan program-program pelatihan
(Kementerian Kesehatan RI, 2023)

(2) Systems
1. A system is a collection of component concepts, processes or objects.

2. Systems transform inputs into outputs and may change their state in doing so.
3. Systems are arbitrary and purposive
a. There can never be something called ‘the correct’ definition of a system
b. Descriptions of a system are constructed with a function or purpose in mind
Information systems contain data and models, which include databases and knowledge bases that interact via
a communication channel.

Introduction to health informatics – the systems
science of healthcare
If physiology literally means ‘the logic of life’, and pathology is ‘the logic of disease’,
then health informatics is the logic of healthcare.
Health informatics is the study of information and communication processes and

systems in healthcare
(Coiera, 2015)

Health informatics at a glance~
Image: geekshumor.com

Health Computer
care Science
Information
What is Health Informatics? Science
The terms 'medical informatics' and 'health informatics' have been variously defined, but can be best
understood as the understanding, skills and tools that enable the sharing and use of information to
deliver healthcare and promote health.
'Health informatics' is now tending to replace the previously commoner term 'medical informatics',
reflecting a widespread concern to define an information agenda for health services which
recognises the role of citizens as agents in their own care, as well as the major information-handling
roles of the non-medical healthcare professions.
British Medical Informatics Society. (2000, June 5). http://www.bmis.org
18
Focus of health informatics
1. Understanding the fundamental nature of these information and communication

processes and describing the principles that shape them.
2. Developing interventions that can improve upon existing information and communication
processes.
3. Developing methods and principles that allow such interventions to be designed.
4. Evaluating the impact of these interventions on the way individuals or organizations work
or on the outcome of the work.
(Coiera, 2015)

Biomedical Informatics ~ Health Informatics

Why? To Improve the Quality of Healthcare Delivery
Institute of Medicine (IOM) Reports
The institute of medicine examines policy matters pertaining to the

health of the public and acts as an adviser to the federal government in
the USA. It identifies issues of medical care, research, and education.
To err is human is a report on systems failures in health care delivery

(poorly designed or broken care processes). Preventable medical errors
result in an estimated 98000 deaths per year in the USA.
Crossing the Quality Chasm reveals a wide chasm between the quality
of care the health system should be capable of delivering today, given
1999 2001 the astounding advances in medical science and technology in the past
half-century, and the quality of care most Americans receive.

Individual Task - Share your experience! 5 mins
Think of an incident you’ve experienced or heard of (as a

patient, provider, relative, friend or observer) where quality
of care was jeopardized in some way.
1. What went wrong?

2. In what way was quality of care affected?
3. How could the incident have been prevented?
Share your answer with the class!

Healthcare should be STEEEP!

Safe - Avoiding injuries to the patient
IOM, 2001, p. 45:
“In health care these errors include, for example, administering the wrong
drug or dosage to a patient, diagnosing pneumonia when the patient has
congestive heart failure, and failing to operate when the obvious (as
opposed to ambiguous) signs of appendicitis are present.”
“This standard of safety implies that organizations should not have

different, lower standards of care on nights and weekends or during times
of organizational change.”
“It is in inadequate handoffs that safety often fails first. Specifically, in a

safe system, information is not lost, inaccessible, or forgotten in
transitions.”

Timely - Reducing waits and harmful delays
IOM report, pg. 51:
“However, long waits are the norm in most doctors’

offices, in emergency rooms, on the telephone, in
responses to inquiries, in specialty care, on gurneys in
hallways waiting for procedures, and awaiting test
results, both in institutions and in the community.”

Effective - Based upon the best science knowledge
IOM report, pg. 47:
“Evidence-based practice requires that those who give care consistently avoid both underuse of
effective care and over- use of ineffective care that is more likely to harm than help the patient (Chassin,
1997).”
“Such evidence-based practice has been defined by Sackett and colleagues and is adapted here (Sackett
et al., 1996): evidence-based practice is the integration of best research evidence with clinical
expertise and patient values.”
“Evidence comes from four main types of research: laboratory experiments, clinical trials,
epidemiological research, and outcomes research, including analyses of systematically acquired and
properly studied case reports involving one or a population of patients (Agency for Healthcare Research
and Quality, 2000).”

Efficient - Avoid waste of time, money, resources
“In an efficient health care system, resources are

used to get the best value for the money spent
(Palmer and Torgerson, 1999).”
“The opposite of efficiency is waste, the use of

resources without benefit to the patients a system is
intended to help. There are at least two ways to
improve efficiency: (1) reduce quality waste, and (2)
reduce administrative or production costs.”

Equitable - Providing access to all in an equitable
manner
“The availability of care and quality of services should be
based on individuals’ particular needs and not on personal
characteristics unrelated to the patient’s condition or to the
reason for seeking care. In particular, the quality of care
should not differ because of such characteristics as gender,
race, age, ethnicity, income, education, disability, sexual
orientation, or location of residence
(Ayanian et al., 1999; Canto et al., 2000; Fiscella et al., 2000; Freeman and Payne,
2000; Kahn et al., 1994; Pearson et al., 1992; Philbin and DiSalvo, 1998; Ross et
al., 2000; Yergan et al., 1987).”

Patient-Centered - Providing care based on patient’s
individual preferences, needs and values
IOM report, pg. 49:
“Gerteis et al. (1993) have identified several dimensions of patient-centered care: (1) respect for patients’
values, preferences, and expressed needs; (2) coordination and integration of care; (3) information,
communication, and education; (4) physical comfort; (5) emotional support—relieving fear and anxiety;
and (6) involvement of family and friends.”
“The goal of patient-centeredness is to customize care to the specific needs and circumstances of each
individual, that is, to modify the care to respond to the person, not the person to the care.”

The 6 Quality Aims: STEEEP
Safe: The patient's safety comes first.
Timely: Patient care will be delivered in the most timely manner

possible.
Effective: Patient care will be based upon the best science available.
Efficient: Patient care will avoid waste of time, money, and

resources.
Equitable: Access to care will be provided to all in an equitable

manner.
Patient-Centered: Patients will participate fully in care decisions.

Three questions that matter in informatics
1. What is the problem that we are trying to solve?
2. How will we know when we have succeeded?
3. Is technology the best solution, or are there simpler alternatives?
(Coiera, 2015)

Health Informatics Challenge and Limitations

Three things to note in informatics intervention
Possibility reflects the science of informatics – what in theory can be achieved?
Practicability addresses the potential for successfully engineering a system or

introducing a new process – what can actually be done given the constraints of the
real world?
Desirability looks at the fundamental motivation for using a given process or

technology.
(Coiera, 2015)

Penerapan
Health
Informatics
di
Indonesia
34
Tugas Besar
1. Dikerjakan secara berkelompok berdasarkan studi kasus yang
dipilih:
1. Klinik
2. Puskesmas
3. Rumah Sakit
2. Pertemuan ke-3 untuk site visit, Pertemuan ke-6 untuk group work
2. Pertemuan ke-7 (sebelum UTS): Presentasi tugas besar part 1

a. Mengunjungi fasilitas kesehatan yang dipilih & melakukan pengamatan
sebagai pasien
b. Membuat Patient Journey Mapping
3. Pertemuan ke-15 (sebelum UAS): Presentasi tugas besar part 2

a. Membuat Digital Care Pathway
Pilih tema studi kasus dan masukkan di bit.ly/in29023 sebelum pertemuan ke-2

Referensi
1. Coiera, Enrico. Guide to health informatics (3rd ed.). CRC Press, 2015.
2. Kohn KT, Corrigan JM, Donaldson MS, eds. Washington, DC: Committee on Quality Health Care in
America, Institute of Medicine: National Academy Press, 1999.
3. Crossing the Quality Chasm : a New Health System for the 21st Century. Washington, DC:
National Academy Press, 2001.


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Pengantar Health Informatics

Pengenalan Dosen, Aturan, Komponen Penilaian, dan Tips Belajar

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

Master’s Programme in Health Product Associate

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

1. Menguasai konsep dasar health informatics 1. Mendemonstrasikan penerapan evidence-based

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

● UTS 20%: Teori (pilihan ganda)

● UAS 20%: Teori (pilihan ganda)

Klik di sini untuk join

Masukkan informasi grup di

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

Pertemuan 1 - Basic concepts in informatics

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

Study of human health

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

● Knowledge deﬁnes relationships between data.

● Information is the meaning obtained by the application of knowledge to data.

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

1. Patient’s personal information

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

If the knowledge and data components of a decision

The databases that store complex data

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

1. Someone’s description of how he or she sees

1. Health services in Indonesia

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

1. Layanan Kesehatan Primer: Puskesmas / Klinik / Dokter Praktik Mandiri

2. Layanan Kesehatan Sekunder: Rumah Sakit

3. Layanan Kesehatan Tersier: Rumah Sakit Spesialis

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

1. A system is a collection of component concepts, processes or objects.

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

Health informatics is the study of information and communication processes and

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

What is Health Informatics? Science

British Medical Informatics Society. (2000, June 5). http://www.bmis.org

1. Understanding the fundamental nature of these information and communication

3. Developing methods and principles that allow such interventions to be designed.

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

The institute of medicine examines policy matters pertaining to the

To err is human is a report on systems failures in health care delivery

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

Think of an incident you’ve experienced or heard of (as a

1. What went wrong?

Share your answer with the class!

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

IOM, 2001, p. 45:

“This standard of safety implies that organizations should not have

“It is in inadequate handoffs that safety often fails ﬁrst. Speciﬁcally, in a

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

IOM report, pg. 51:

“However, long waits are the norm in most doctors’

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

IOM report, pg. 47:

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

“In an efﬁcient health care system, resources are

“The opposite of efﬁciency is waste, the use of

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci

Aulia Zahrina Qashri, S.Kom., M.Sc., M.Med.Sci