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"Tesis ini membahas implementasi Sistem Informasi Rujukan Terintegrasi (SISRUTE) yang dinilai dari hubungan faktor manusia (human), faktor organisasi (organization), dan faktor teknologi (tekhnology) dengan manfaat bersih (net benefit) dalam kerangka evaluasi sistem model HOT-Fit untuk mendapatkan analisis optimalisasi waktu respon dan gambaran hambatan-hambatannya. Faktor manusia (human) dinilai dari pengaruh penggunaan sistem (system use) dan kepuasan pengguna (user satisfaction). Faktor organisasi (organization) dinilai dari pengaruh struktur organisasi (structure organization), lingkungan organisasi (environment organization), dukungan manajemen (management support). Faktor teknologi (tekhnology) dinilai dari pengaruh kualitas sistem (system quality), kualitas informasi (information quality), dan kualitas layanan (service quality). Penelitian ini adalah penelitian kuantitatif cross sectional dengan penguatan hasil penelitian dengan mendapatkan informasi melalui metode wawancara. Hasil penelitian menyatakan bahwa terdapat pengaruh secara positif faktor faktor manusia (human), faktor organisasi (organization), dan faktor teknologi (tekhnology) dengan manfaat bersih (net benefit),selain itu juga didapatkan gambaran hambatan implementasi SISRUTE yaitu, beberapa Rumah Sakit Daerah tidak memiliki petugas khusus yang mengoperasikan SISRUTE, kurangnya pemahaman petugas kesehatan terhadap keunggulan SISRUTE dengan sistem informasi rujukan lainnya terkait keamanan data, kurangnya kepatuhan untuk melakukan log in kembali saat akun petugas ter log out , kualitas sistem yang belum baik karena SISRUTE masih sering eror, fitur yang belum dianggap memudahkan dan terbatas, ketidakseragaman atau ketidaklengkapan informasi yang ditampilkan, belum ada layanan pengguna atau PIC dari pemilik sistem yang dapat dihubungi bila terjadi gangguan, belum ada SOP khusus dalam implementasi SISRUTE, terdapat kanal rujukan lain yang dianggap lebih cepat dan memudahkan.

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The focuss of this study is the implementation of the Integrated Referral Information System (SISRUTE) as assessed by the relationship between human factors, organizational factors, and technology factors with net benefits within the HOT-Fit system evaluation framework to obtain an analysis of response time optimization and an overview of its obstacles. Human factors are assessed based on the influence of system use and user satisfaction. Organizational factors are assessed based on the influence of organizational structure, organizational environment, and management support. Technology factors are assessed based on the influence of system quality, information quality, and service quality. This research is a quantitative cross sectional study with the strengthening of research results by obtaining information through the interview method. The results show that there is a positive influence of human factors, organizational factors, and technology factors on net benefits. In addition, it was also found that the obstacles to the implementation of SISRUTE are that some Regional Hospitals do not have special officers to operate SISRUTE, a lack of understanding among health workers regarding the advantages of SISRUTE compared to other referral information systems related to data security, a lack of compliance to log back in when the officer's account is logged out, poor system quality because SISRUTE is still often experiencing errors, features that are not considered easy and limited, inconsistencies or incompleteness of information displayed, no user services or PIC from the system owner that can be contacted if there are disturbances, no specific SOPs in the implementation of SISRUTE, there are other referral channels that are considered faster and easier."

"Pandemi COVID-19 menjadi tantangan dalam kapasitas sistem kesehatan dimana sistem kesehatan yang ada harus memastikan pasien COVID-19 dapat mengakses layanan kesehatan sekaligus menangani pandemi di masyarakat. Rekomendasi yang dikeluarkan WHO dalam menghadapi tantangan kapasitas sistem kesehatan diantaranya menambah jumlah rumah sakit rujukan dan mengupayakan sistem rujukan yang memadai terhadap lonjakan kasus COVID-19. Di Indonesia, pemerintah menggunakan Sistem Informasi Rujukan Terintegrasi (SISRUTE) dalam rujukan kasus COVID-19, meski dalam praktiknya masih bervariasi di berbagai daerah. Penggunaan SISRUTE sebelum COVID-19 dinilai masih belum optimal, sementara saat pandemi sangat sedikit pasien COVID-19 yang diterima melalui SISRUTE. Oleh karena itu, penelitian ini bertujuan memperoleh gambaran terkait efektivitas penggunaan SISRUTE dalam kasus COVID-19 di Semen Padang Hospital sebagai rumah sakit swasta pertama di Kota Padang yang menjadi rumah sakit rujuikan COVID-19 selama periode April 2020 hingga Oktober 2021. Penelitian ini merupakan penelitian kualitatif dengan proses pengumpulan data dilakukan dengan analisis data sekunder, wawancara mendalam kepada tujuh orang informan yang dipilih secara purposive sampling dan telaah dokumen. Dari penelitian ditemukan bahwa SISRUTE digunakan oleh dokter umum di UGD dan isolasi COVID-19 dan terdapat penggunaan SISRUTE berulang pada pasien yang sama karena penolakan dan rujukan yang tidak direspon. Selain itu, respon time rujukan via SISRUTE sangat lama disebabkan tidak adanya dokter yang khusus bertugas mengecek SISRUTE dan panjangnya alur konsultasi penerimaan rujukan. Banyaknya penolakan rujukan via SISRUTE disebakan oleh penuhnya ruangan, tidak tersedianya fasilitas seperti kamar operasi dan persalinan khusus COVID, ventilator mekanik dan alat hemodialisa. Selain itu, kendala dari kualitas SISRUTE yang tidak menampilkan kapasitas dan fasilitas yang tersedia, versi mobile yang tidak mudah, perlunya penambahan beberapa fitur serta belum tersedianya pencarian otomatis menyulitkan dalam melakukan rujukan. Dapat disimpulkan bahwa penggunaan SISRUTE dalam kasus COVID – 19 tidak efektif karena kemungkinan pasien diterima lewat SISRUTE jauh lebih kecil dibandingkan dengan pasien datang sendiri ke UGD.

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COVID-19 pandemic is a challenge in the capacity of the health system where the existing health system must ensure that COVID-19 patients can access health services as well as handle the pandemic in the community. Recommendations issued by WHO in facing health system capacity challenges include increasing the number of referral hospitals and seeking an adequate referral system for spikes in COVID-19 cases. In Indonesia, the government uses the Integrated Referral Information System (SISRUTE) in referring cases of COVID-19, even though in practice still varies in different regions. The use of SISRUTE before COVID-19 was considered not optimal, while during the pandemic very few COVID-19 patients were accepted through SISRUTE. Therefore, this study aims to obtain an overview regarding the effectiveness of using SISRUTE in cases of COVID-19 at Semen Padang Hospital as the first private hospital in Padang City to become a referral hospital for COVID-19 during the period April 2020 to October 2021. This research is a qualitative, data collection process was carried out by secondary data analysis, in-depth interviews with seven informants selected by purposive sampling and document review. From the study it was found that SISRUTE was used by general practitioners in the ER and COVID-19 isolation and there was repeated use of SISRUTE in the same patient due to rejection and referrals that did not respond. In addition, the response time for referrals via SISRUTE was very long due to the absence of a doctor who was specifically tasked with checking SISRUTE and the long flow of consultations for receiving referrals. Many rejections of referrals via SISRUTE are caused by full rooms, unavailability of facilities such as special COVID operating and delivery rooms, mechanical ventilators and hemodialysis labs. In addition, the constraints of the quality of SISRUTE which do not display the available capacity and facilities, the mobile version which is not easy, the need to add several features and the unavailability of automatic search make it difficult to make referrals. It can be concluded that the use of SISRUTE in the case of COVID-19 is not effective because the possibility of patients being admitted via SISRUTE is much smaller compared to patients who come alone to the ER."