Teleradiology Systems SPO Military Field Hospital In Disaster Areas
Lufti Hajri1*, Bedjo Santoso2, Ahmad
Hariri3, Gatot Murti Wibowo4, Siti Masrochah5
Politeknik
Kesehatan Kemenkes Semarang1,2,3,4,5
Email: luftihajri@gmail.com
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KEYWORDS |
ABSTRACT |
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Disaster, Teleradiology Standard
Operating Procedures (SPO), Military Field Hospital |
In disaster areas, medical care is often limited by
difficult access and logistics. Radiology services play a crucial role in providing
timely health services during emergencies. Telemedicine, including
teleradiology, enables patient-doctor communication via online platforms when
physical access is restricted. This research aims to develop and validate
Standard Operational Procedures (SOP) for teleradiology systems in military
field hospitals in disaster areas, using a mixed-method R&D design.
Expert validation involved three professionals: a field hospital commander, a
radiology specialist, and a radiographer. Six respondents, including
radiology specialists, radiographers, and administrators, assessed the
relationship between SOP feasibility and user satisfaction. The SOP model was
found feasible with a significant p-value of 0.007 (p < 0.05), and a
significant relationship between SOP feasibility and user satisfaction with a
Sig. (2-tailed) value of 0.034 (p < 0.05). In conclusion, the SOP model
for teleradiology systems is feasible for implementation in military field
hospitals, positively impacting user satisfaction. This implementation can
enhance radiology services in disaster areas, improving patient outcomes and
supporting medical personnel. |
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DOI: |
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Corresponding
Author: Lufti Hajri1*
Email: lutfihajri@gmail.com
INTRODUCTION
Indonesia has the longest
coastline in the world and is on the path of subduction of three earth plates,
this causes Indonesia to have high tectonic activity and harbors the potential
for earth echoes and tsunamis
Natural disasters can cause
casualties and serious injuries to communities. This can overwhelm healthcare
facilities with a high number of patients and urgent medical conditions. On the
other hand, hospitals, health centers, and other health facilities can be
severely damaged by disasters. This could interfere with public access to
necessary medical care. Disruptions to communication and transportation
infrastructure can hamper coordination between health facilities and aid
agencies. This could hamper the distribution of medical supplies and the
evacuation of patients who need further treatment.
Non-natural disasters, one
of which is the COVID-19 pandemic, is developing rapidly around the world, in
Indonesia the first case was officially announced on March 2, 2020. To reduce
the severity of COVID-19 infection, a "flattening of the curve" is
needed that aims to prepare the health system so that the capacity of hospitals
is able to treat patients and provide health care workers
Chest imaging using CT Scan
is the main diagnosis to identify patients with clinical respiratory diseases,
but in the case of COVID-19 patients is not yet the main choice for diagnosis,
this is influenced by the readiness of available equipment and human resources
Emergency hospitals are
usually prepared to handle victims in disaster areas because of the paralysis
of health facilities due to the impact of the disaster
Field hospitals are often
established by humanitarian organizations, the military, or relief agencies in
crisis or emergency situations to provide urgent medical care to those affected
by disasters or conflicts
Public health threats
always come whether caused by nature, non-natural, or intentional, these
threats can cause emergencies
Then in order to implement
optimal health services, it must be supported by an adequate communication
network
Radiological services in
disaster areas play an important role in providing fast and appropriate health
services in the midst of emergencies. Disaster areas, such as natural disasters
(earthquakes, floods, volcanic eruptions, etc.) or human disasters (industrial
accidents, terrorist attacks, etc.), often face emergency situations with many
victims requiring medical care.
In disaster areas, medical
care is often limited by difficult access and logistics. Mobile or portable radiology services allow
medical teams to perform scans at nearby locations, which can help with
evacuation decision-making and logistics management of medical resources.
Radiology also contributes
to facilitating communication and coordination between medical teams in the
field and teams in hospitals or disaster control centers. The scan results can
be quickly communicated for further decision-making.
It is important to remember
that in a disaster situation, radiology services must operate with affordable,
portable, and well-integrated equipment within the disaster management team.
Good training and preparation are also important so that radiology professionals
and medical teams can function effectively and efficiently in the midst of
emergency situations.
The internet network allows
health teams in the field to communicate quickly and efficiently with teams in
coordination centers, hospitals, and other medical institutions. Information on
patient conditions, supplies of medicines, medical equipment, and urgent needs
can be conveyed quickly, allowing for better coordination in disaster
management. In addition, the internet network allows healthcare practitioners
to provide telemedicine services through telemedicine.
In disaster situations
where physical access to medical facilities is limited, telemedicine allows
patients to communicate with doctors or medical personnel via video
conferencing or other
online platforms to obtain consultations, diagnoses, and treatment
recommendations. This includes teleradiology, which is radiological images,
such as X-ray results, CT scans, MRIs, and other radiological images, analyzed
and interpreted by a radiologist or radiologist located far from the place
where the images were taken. This is usually done using telecommunication
technology and computer networks, so that radiologists can receive these images
electronically and provide the results of their interpretation to the doctor or
other medical professional treating the patient.
In satellite communication,
it is known as a small earth station or more commonly called VSAT (Very Smal
Aperture Terminal). VSAT is widely used as a communication tool to reach areas
that are not reached by other communication devices. The main thing to consider
in satellite communication is the modem. Therefore, the setting of the
satellite modem must be correct and can be sure that it is connected. If the
satellite modem is already connected, it can be easily set to a personal
computer or to a mobile satellite
Currently, Mobile VSAT
(also known as Komob Car) is being developed which plays an important role in
disaster management. These cars are specialized vehicles that are equipped with
the necessary equipment and facilities to respond to and coordinate efforts in
emergency and disaster situations.
The Komob car functions as
a coordination center in the field. Disaster management teams can use it to
communicate with a variety of related parties, including government agencies,
rescue agencies, and relief organizations. With advanced communication equipment,
the car helps ensure that important information can be passed on quickly and
accurately.
In the field of health
services, Komob Cars have a significant role, especially in disaster areas.
With internet access and communication technology, medical teams can conduct
remote consultations with doctors or other specialists to get guidance in handling
complex cases. In the current development, the Military Field Hospital is
equipped with Komob Car facilities.
In the Field Hospital Title
Guidebook, there are no radiologist specialist personnel in the organizational
structure of the hospital
To obtain radiology
results, the radiology staff of the Military Field Hospital brought the
radiology tapes to the referral hospital to be printed and expertise by
radiologists. Of course, it can hinder the treatment of the victim, because the
DPJP has to wait a long time to get the radiology results. In addition, it is
possible for accidents to radiology
staff in carrying out delivery activities due to road damage due to disasters.
This research emerged based
on previous research that stated that teleradiology systems can be used for
radiology services in certain areas such as battlefields and remote areas. On
this basis, the researcher made a study to provide convenience and minimize
risks in radiology services at Military Field Hospitals in disaster areas with
the title "Standard Operational Procedures for Teleradiology Systems of
Military Field Hospitals in Disaster Areas".
METHODS
The research design used is
research and development or research and development methods. Research and
development research combines qualitative and quantitative approaches,
therefore it is called mixed method research (MMR). The research and
development procedure consists of 5 (five) main steps, namely: 1) information
collection, 2) product design, 3) expert validation and revision, 4) product
testing and 5) product results.
RESULTS and DISCUSSION
Standard Operating
Procedures for Telardiology Systems
The results of the
information collected resulted in the conclusion that radiology services in
military field hospitals require an innovation to facilitate the handling of
patients, especially in disaster areas, one of which is by making a Standard
Operational Procedure for Teleradiology Systems. Teleradiology is a medical
practice in which radiological images, such as X-rays, CT scans, MRIs, and
others are sent electronically from one location to another for interpretation
and diagnosis by a radiologist or skilled medical professional.
This teleradiology system
SPO can be a good solution to overcome obstacles in disaster areas such as
limited road access. This SPO can also improve field hospital health services
in disaster areas that require speed and accuracy in the treatment of disaster
victims. With teleradiology, medical images can be analyzed in a short period
of time, which speeds up the diagnosis and treatment process. This is important
in emergency situations where every second counts to save lives.
Medical facilities in
disaster areas are often overwhelmed with the number of victims. By
transferring medical images to other locations for analysis, the workload at
local hospitals can be reduced, allowing medical staff to focus on the
patient's immediate care. Teleradiology images and reports can be stored
electronically, which makes it easy to document medical and track patient care
history. This is very helpful in the long-term management of post-disaster
patients.
In disaster areas, the risk
of spreading infectious diseases is often high. With teleradiology, the need to
move patients to get a diagnosis can be reduced, which in turn reduces the risk
of spreading the infection. Overall, teleradiology is an invaluable tool in
medical response to disasters that helps to improve the quality and speed of
healthcare services in very critical situations. So that the SPO of this
teleradiology system is expected to be used as a guideline for radiology
services for military field hospitals in disaster areas.
Analysis
of the Application of SPO Teleradiology as an Effort to Improve the Quality of
Radiological Services in Military Field Hospitals in Disaster Areas
SPO
Respondents in implementing
the SPO teleradiology system were measured using a questionnaire with a total
of 3 questions using a likert scale, namely a score of 5 strongly agree, 4
agree, 3 hesitate, 2 disagree, 1 strongly disagree. The quality of the SPO of
the teleradiology system can be seen from the results of the SPO feasibility
test to be applied in the field. The average score of the feasibility test
conducted by validators who are experts in their fields was obtained with a
score of 83.33% with a
p-value of 0.007<0.05. This means that the SPO is suitable for use as a
guideline in radiology services for military field hospitals in disaster areas.
The feasibility of a
Standard Operating Procedure (SPO) is a process that is implemented to ensure
that operations or processes in an organization run efficiently, effectively,
and in accordance with established regulations and standards. Ensure all operations
comply with relevant laws, regulations, and standards. Assess whether
operations are executed in the most efficient manner, optimizing the use of
resources and time.
Guarantee that the products
or services produced meet the standards. Furthermore, SPOs can assess the
impact of operations on the environment and ensure sustainable practices are
implemented.
Relationship
between SPO Eligibility and user satisfaction
The feasibility of Standard
Operating Procedures (SPOs) has a significant relationship with user
satisfaction because an effective and efficient system can directly improve
user experience and satisfaction. SPO eligibility ensures that operational
processes run in accordance with established standards, which in turn results
in consistently high-quality products or services.
The Standard Operational
Procedure of the teleradiology system is meaningfully related to User
Satisfaction in Military Field Hospitals in Disaster Areas, proven to have a p-value of
0.034<0.05. An effective SPO helps identify and reduce errors and failures
in the radiology service process. Users who do not experience problems will
have a more positive experience, increasing their satisfaction.
SPO eligibility often
includes mechanisms for handling user complaints and issues quickly and
efficiently. The ability to handle complaints and resolve user issues quickly
can greatly increase their satisfaction.
CONCLUSION
Based on the results of the study, it can be
concluded that the Standard Operating Procedures (SOP) for the teleradiology
system are both feasible and significantly related to user satisfaction in
military field hospitals in disaster areas. The SOP for the teleradiology
system was found suitable for use in such environments, as evidenced by a
p-value of 0.007 (p < 0.05). Additionally, there is a meaningful
relationship between the SOP and user satisfaction, with a Sig. (2-tailed)
value of 0.034 (p < 0.05), indicating a significant correlation. These
findings support the implementation of the teleradiology SOP in military field
hospitals to enhance service efficiency and user satisfaction in disaster
situations.
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