Objectives: This study explored health workers’ perceptions and experiences regarding the maternal and neonatal referral system, focusing on barriers of health information systems and technologies (IS/IT) at primary health centers (PHCs) in South Tangerang, Indonesia. Methods: This qualitative study was conducted using semi-structured interviews, which were conducted at the South Tangerang District Health Office and three PHCs. Interviews were conducted with nine participants responsible for maternal and neonatal referrals in their organizations. The data were analyzed using qualitative content analysis. Results: In South Tangerang, the Primary Health Care Information System (SIMPUS) is used to register patients and record data on medical treatment. To facilitate referrals, the PHCs currently use the Integrated Referral Information System (SISRUTE), P-Care, and the Integrated Emergency Management System (SPGDT). The following four IS/IT barriers to support maternal and neonatal referrals were found: technology, human resources, organizational support, and the referral process and implementation. Conclusions The barriers in technology, human resources, and organizational support cause problems in the maternal and neonatal referral process and in the implementation of referrals. Barriers to referrals can influence patients’ ability to receive appropriate care in a timely fashion and lead to inefficiency in maternal and neonatal referrals. This study contributes knowledge about IS/IT implementation in maternal and neonatal referral systems and provides recommendations to health regulators and application developers for the implementation of IS/IT in Indonesia.

Objectives: This study explored health workers’ perceptions and experiences regarding the maternal and neonatal referral system, focusing on barriers of health information systems and technologies (IS/IT) at primary health centers (PHCs) in South Tangerang, Indonesia. Methods: This qualitative study was conducted using semi-structured interviews, which were conducted at the South Tangerang District Health Office and three PHCs. Interviews were conducted with nine participants responsible for maternal and neonatal referrals in their organizations. The data were analyzed using qualitative content analysis. Results: In South Tangerang, the Primary Health Care Information System (SIMPUS) is used to register patients and record data on medical treatment. To facilitate referrals, the PHCs currently use the Integrated Referral Information System (SISRUTE), P-Care, and the Integrated Emergency Management System (SPGDT). The following four IS/IT barriers to support maternal and neonatal referrals were found: technology, human resources, organizational support, and the referral process and implementation. Conclusions The barriers in technology, human resources, and organizational support cause problems in the maternal and neonatal referral process and in the implementation of referrals. Barriers to referrals can influence patients’ ability to receive appropriate care in a timely fashion and lead to inefficiency in maternal and neonatal referrals. This study contributes knowledge about IS/IT implementation in maternal and neonatal referral systems and provides recommendations to health regulators and application developers for the implementation of IS/IT in Indonesia.

OBJECTIVES: The aim of this study is to explore the enabling factors associated with readiness in Electronic Health Record (EHR) implementation and to identify the barriers related to readiness regarding the situation of primary health cares in developed and developing countries. METHODS: A narrative review of open-source literature was conducted using the ProQuest, ScienceDirect, MEDLINE, and PMC databases to identify the enabling factors and barriers to EHR readiness. The keywords applied were ‘electronic health record’, ‘readiness’, ‘primary health care’, and ‘primary care’. RESULTS: Some barriers were found that may affect readiness, specifically individual barriers and organizational barriers. In developing countries, organizational barriers such as a lack of skilled manpower, insufficient senior management, and a lack of interaction among team members were the common barriers, while in developed countries individual barriers such as unfamiliarity with new systems and a lack of time to use computers were frequently found as barriers to readiness. CONCLUSIONS: This study summarized the enabling factors and barriers with regard to EHR readiness in developed and developing countries.
Causality ; Developed Countries ; Developing Countries ; Electronic Health Records ; Primary Health Care

OBJECTIVES: In this study an enterprise architecture (EA) was developed for a health referral information system (HRIS) for individual healthcare in Indonesia with reference to the Open Group Architecture Framework (TOGAF) 9.1. The HRIS includes patient referrals for vertical and horizontal references (internal and external), specimen referrals, and health personnel referrals. METHODS: This research was a qualitative study that used the interview and observation method of the Primary Health Care Information System (SIMPUS) application developed by the Agency for Assessment and Application of Technology (BPPT). The interviews were conducted at South Tangerang City Government Health Office with five resource persons who were responsible for conducting health referral processes. RESULTS: The EA of the HRIS includes the principles of architecture, business, application, data, and technology architecture. Twelve principles, four referral processes, and three application reference modules and centralized applications comprise the architecture of the HRIS. The HRIS is a centralized integrated application that uses application program interface (API) to integrate with SIMPUS. CONCLUSIONS: The proposed architecture was developed in an integrated and comprehensive manner for the individual healthcare referral process, which can be implemented by regulators and healthcare facilities. This architecture can also help regulators and healthcare facilities to standardize and integrate health referral data and related processes.
Commerce ; Delivery of Health Care ; Health Information Systems ; Health Personnel ; Humans ; Indonesia* ; Information Systems ; Local Government ; Methods ; Primary Health Care ; Referral and Consultation*