Sistem Informasi Rawat Jalan Berbasis Web Dengan Integrasi Data Skrining Mandiri Menggunakan Hybrid Database Dan Standar FHIR

Althafah, Naulia Sahya (2026) Sistem Informasi Rawat Jalan Berbasis Web Dengan Integrasi Data Skrining Mandiri Menggunakan Hybrid Database Dan Standar FHIR. Other thesis, Institut Teknologi Sepuluh Nopember.

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Abstract

Layanan rawat jalan memerlukan pencatatan tanda vital yang cepat, terstruktur, dan terintegrasi dengan rekam medis elektronik untuk mendukung kesinambungan pelayanan. Namun, pencatatan tanda vital masih banyak dilakukan secara manual sehingga memerlukan waktu dan berpotensi menimbulkan kesalahan pencatatan. Pemanfaatan health kiosk memungkinkan proses skrining dilakukan secara mandiri sehingga hasil pemeriksaan dapat dicatat secara digital dan diintegrasikan ke dalam rekam medis elektronik. Integrasi tersebut memerlukan dua pendekatan yang berbeda. Dari sisi penyimpanan data, data administratif seperti identitas pasien, appointment, dan encounter memerlukan konsistensi transaksi, sedangkan data observasi klinis berupa patient-generated health data memiliki karakteristik yang berbeda karena terdiri atas berbagai parameter pemeriksaan. Oleh karena itu, penelitian ini menerapkan arsitektur hybrid database menggunakan MySQL untuk menyimpan data administratif dan MongoDB untuk menyimpan data observasi klinis sesuai karakteristik masing-masing. Dari sisi interoperabilitas, sistem menerapkan standar HL7 FHIR R4 untuk merepresentasikan data pasien, kunjungan, dan hasil observasi dalam bentuk resource yang terstandarisasi sehingga dapat divalidasi sesuai standar FHIR dan dipertukarkan dengan sistem lain yang mengadopsi standar yang sama. Evaluasi dilakukan melalui functional black-box testing, pengujian konsistensi data hybrid, validasi resource FHIR, dan benchmark terhadap pendekatan SQL-only. Hasil pengujian menunjukkan seluruh skenario berjalan sesuai keluaran yang diharapkan dengan 12.401 dokumen observation tervalidasi tanpa orphan record. Pada percobaan dengan data skala besar, arsitektur hybrid database mencapai insert throughput sebesar 8.479 req/s atau sekitar 5,1 kali lebih tinggi dibandingkan SQL-only sebesar 1.673 req/s, sementara latensi penyajian resource FHIR tetap di bawah 40 ms. Hasil penelitian menunjukkan bahwa penerapan hybrid database dan HL7 FHIR R4 mendukung pengelolaan data administratif dan observasi klinis dalam satu sistem serta menghasilkan resource yang tervalidasi sesuai standar interoperabilitas.
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Outpatient care requires vital sign documentation that is fast, structured, and integrated with electronic health records to support continuity of care. However, vital sign documentation is still commonly performed manually, making the process time-consuming and prone to recording errors. The use of a health kiosk enables patients to perform self-screening so that examination results can be recorded digitally and integrated into electronic health records. This integration involves two distinct requirements. From the data storage perspective, administrative data such as patient identity, appointments, and encounters require transactional consistency, whereas clinical observation data in the form of patient-generated health data have different characteristics because they consist of various measurement parameters. Therefore, this study implements a hybrid database architecture using MySQL to store administrative data and MongoDB to store clinical observation data according to their respective characteristics. From the interoperability perspective, the system adopts the HL7 FHIR R4 standard to represent patient, encounter, and observation data as standardized FHIR resources that can be validated against the FHIR specification and exchanged with other systems implementing the same standard. The system was evaluated through functional black-box testing, hybrid data consistency testing, FHIR resource validation, and performance benchmarking against a SQL-only approach. The evaluation results show that all test scenarios were successfully completed, with 12,401 Observation documents validated without orphan records. Using a large-scale dataset, the hybrid database architecture achieved an insert throughput of 8,479 req/s, approximately 5.1 times higher than the SQL-only approach at 1,673 req/s, while FHIR resource presentation latency remained below 40 ms. These results demonstrate that the implementation of a hybrid database and the HL7 FHIR R4 standard supports the management of administrative and clinical observation data within a single system while producing FHIR resources that conform to interoperability standards.

Item Type:	Thesis (Other)
Uncontrolled Keywords:	FHIR, Health Kiosk, Hybrid Database, Patient-Generated Health Data, Rekam Medis Elektronik, Sistem Informasi Rawat Jalan, FHIR, Health Kiosk, Hybrid Database, Patient-Generated Health Data, Electronic Health Record, Outpatient Information System
Subjects:	T Technology > T Technology (General) > T58.6 Management information systems
Divisions:	Faculty of Intelligent Electrical and Informatics Technology (ELECTICS) > Biomedical Engineering > 11410-(S1) Undergraduate Thesis
Depositing User:	Naulia Sahya Althafah
Date Deposited:	30 Jul 2026 01:01
Last Modified:	30 Jul 2026 01:01
URI:	http://repository.its.ac.id/id/eprint/140267

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