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| Advisor(s) | TAMPUBOLON, ELMINA | |
| Author(s) | SURBAKTI, BRIGITA NATALIA BR | |
| Issued Date | 2026 | |
| Abstract | The digitalization of the BPJS Kesehatan (Indonesia's National Health Insurance) claims process through Electronic Medical Records (EMR) forms part of Indonesia's healthcare digital transformation, requiring comprehensive evaluation from both technical and user-perception perspectives. RSUD R. Moh. Noh Nur Leuwiliang, the first hospital to receive BPJS Kesehatan's 5-Star award, has implemented a Digital Claim system; however, no formal evaluation of the system has ever been conducted, despite data indicating a rising trend in pending claims. This study aims to evaluate the digitalization of the BPJS Kesehatan claims process based on user perception using the DeLone and McLean (2003) Information Systems Success Model, which encompasses six dimensions: system quality, information quality, service quality, use, user satisfaction, and net benefits. This research employed a qualitative approach with a single case study design. Data were collected through in-depth interviews and observation involving eight informants (the head of the casemix installation, a casemix physician, casemix staff, medical record coders, and a system vendor) and were analyzed using Miles and Huberman's (1994) interactive model, with data trustworthiness maintained through source triangulation, method triangulation, and member checking. The findings indicate that system, information, and service quality were rated positively and mutually reinforced one another, driving intensive system use and high user satisfaction. Net benefits in the form of work efficiency were substantially realized. Nevertheless, pending claims are still encountered, primarily due to factors beyond the application's functionality, such as the completeness of clinical documentation in the EMR and the verification process based on the regulations of the Indonesian Ministry of Health (Kementerian Kesehatan). In this context, the Digital Claim system continues to provide added value by facilitating faster and more systematic tracking of the underlying causes of pending claims. This study concludes that the success of claims digitalization is socio-technical in nature, indicating that future development should be accompanied by strengthened documentation governance and infrastructure, rather than application refinement alone. | 1 |
| Item Type | Skripsi | |
| Keywords | Digital Claim, BPJS Kesehatan, Rekam Medis Elektronik (Electronic Medical Record), DeLone and McLean Model, Studi Kualitatif (Qualitative Study) | 1 |
| Collection | Fakultas Kesehatan Masyarakat, D4-Manajemen Informasi Kesehatan | |
| Publisher | INSITUT KESEHATAN DELI HUSADA | |
| Submitted Date | 20-10-2026 | |
| Updated Date | 20-10-2026 | |
| URI | No URI | |
| File |
SKRIPSI BRIGITA NATALIA BR SURBAKTI - 25199009.pdf
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