Lampiran Terminologi Pelayanan Instalasi Gawat Darurat (IGD)

Matriks Skenario Peresepan dan Pengeluaran Obat

Keterangan : +
* NC : Non-compound (non racikan)
* SD : Give of such doses (dtd)
* EP : Divide into equal part (tablet dipecah).

Tabel 1. Matriks Skenario Peresepan dan Pengeluaran Obat
Use Case	Medication.code MedicationRequest	Medication.ingredient MedicationRequest	MedicationRequest	Medication.code MedicationDispense	Medication.ingredient MedicationDispense	MedicationDispense (Instruction)	Valid/Invalid
Obat Pakem Tunggal (NC)	R/ Paracetamol 500 mg
	93xxx	-	-	93xxx	-		Valid
	92xxx	-	-	93xxx	-		Valid (Dengan ketentuan kode 93 untuk Medication.code MedicationDispense sebaiknya merupakan turunan dari kode 92 di Medication.code MedicationRequest)
	91xxx	-	-	93xxx	-		Invalid
Racikan Non-dtd (EP)	R/ Paracetamol 500 mg 10 tab Vitamin B6 10mg 10 tab Dibuat 30 kapsul
	-	Paracetamol: Medication.ingredient.itemCodeableConcept → 93xxx Medication.ingredient.strength.num : 10/tab Medication.ingredient.strength.denominator : 30/kap	MedicationRequest.dispenseRequest.quantity → 30	-	Medication.ingredient.itemCodeableConcept → 93xxx Medication.ingredient.strength.numerator : 10/tab Medication.ingredient.strength.denominator : 30/kap	MedicationDispense.quantity → 30	Valid
	-	Vitamin B6:\ Medication.ingredient.itemCodeableConcept→ 92xxx Medication.ingredient.strength.numerator: 10/tab Medication.ingredient.strength.denominator: 30/kap	MedicationRequest.dispenseRequest.quantity → 30	-	Medication.ingredient.itemCodeableConcept→ 93xxx Medication.ingredient.strength.numerator: 10/tab Medication.ingredient.strength.denominator: 30/kap	MedicationDispense.quantity → 30	Valid
Racikan dtd (SD/ tidak ada sisa)	R/ Paracetamol 125 mg/ kapsul > perlu 5 tab (20 kapsul x 125 / 500mg) Vitamin B6 20 mg/ kapsul > perlu 40 tab (20 kapsul x 20 / 10mg) Dibuat 20 kapsul
	-	Paracetamol: Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 125/mg Medication.ingredient.strength.denominator: 1/kap	MedicationRequest.dispenseRequest.quantity → 20	-	Medication.ingredient.itemCodeableConcept→ 93xxx Medication.ingredient.strength.numerator: 5/tab Medication.ingredient.strength.denominator: 20/kap	MedicationDispense.quantity → 20	Valid
	-	Vitamin B6: Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 20/mg Medication.ingredient.strength.denominator: 1/kap	MedicationRequest.dispenseRequest.quantity → 20	-	Medication.ingredient.itemCodeableConcept→ 93xxx Medication.ingredient.strength.numerator: 40/tab Medication.ingredient.strength.denominator: 20/kap	MedicationDispense.quantity → 20	Valid
Racikan dtd (SD/ ada sisa)
Narkotika	R/ Morphine Hydrochloride 3 mg > perlu 7.5 tab (25 kapsul x 3 / 10mg) Diazepam 1 mg Tablet > perlu 12,5 tab (25 kapsul x 1 / 2mg) Dibuat 25 kapsul
	-	Morphine Hydrochloride Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 3/mg Medication.ingredient.strength.denominator: 1/tab	MedicationRequest.dispenseRequest.quantity → 25	-	Medication.ingredient.itemCodeableConcept→ 93xxx Medication.ingredient.strength.numerator: 7,5/tab Medication.ingredient.strength.denominator: 25/kapsul	MedicationDispense.quantity → 25	Valid (Penulisan di Medication.ingredient.strength.numerator Medication Dispense sesuai yaitu 7.5tab, tidak dilakukan pembulatan)
	-	Diazepam Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 3/mg Medication.ingredient.strength.denominator: 1/tab	MedicationRequest.dispenseRequest.quantity → 25	-	Medication.ingredient.itemCodeableConcept→ 93xxx Medication.ingredient.strength.numerator: 12,5/tab Medication.ingredient.strength.denominator: 25/kapsul	MedicationDispense.quantity → 25	Valid (Penulisan di Medication.ingredient.strength.numerator Medication Dispense sesuai yaitu 12.5tab, tidak dilakukan pembulatan)
Non-Narkotika	R/ Paracetamol 125 mg/ kapsul > perlu 7.5 tab (30 kapsul x 125 /500mg) Vitamin B6 12,5 mg/ kapsul > perlu 37,5 tab (30 kapsul x 12,5 / 10mg) Dibuat 30 kapsul
	-	Paracetamol: Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 125/mg Medication.ingredient.strength.denominator: 1/tab	MedicationRequest.dispenseRequest.quantity → 30	-	Medication.ingredient.itemCodeableConcept→ 93xxx Medication.ingredient.strength.numerator: 8/tab Medication.ingredient.strength.denominator: 30/kapsul	MedicationDispense.quantity → 30	Valid (Penulisan di Medication.ingredient.strength.numerator Medication Dispense adalah pembulatan ke atas yaitu dari 7.5 tab menjadi 8tab, tetapi yang digunakan tetap 7,5tab)
	-	Vitamin B6: Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 12.5/mg Medication.ingredient.strength.denominator: 1/tab	MedicationRequest.dispenseRequest.quantity → 30	-	Medication.ingredient.itemCodeableConcept→ 93xxx Medication.ingredient.strength.numerator: 37.5/tab Medication.ingredient.strength.denominator: 30/kap	MedicationDispense.quantity → 30	Valid (Penulisan di Medication.ingredient.strength.numerator Medication Dispense adalah pembulatan ke atas yaitu dari 37.5 tab menjadi 38tab, tetapi yang digunakan tetap 37,5tab)
Obat Minum (NC tidak sisa)	R/ Paracetamol 120 mg/5 mL Sirup Paracetamol 5 ml diminum 4-6 jam sekali bila demam selama 24 hari
	93xxx	Paracetamol Sirup Medication.ingredient.itemCodeableConcept → 91xxx Medication.ingredient.strength.numerator : 120 mg Medication.ingredient.strength.denominator : 5mL	-	93xxx	Paracetamol Sirup Medication.ingredient.itemCodeableConcept → 91xxx * Medication.ingredient.strength.numerator : 120 mg * Medication.ingredient.strength.denominator : 5mL	-	Valid
	92xxx	Paracetamol Sirup Medication.ingredient.itemCodeableConcept → 91xxx Medication.ingredient.strength.numerator : 120 mg Medication.ingredient.strength.denominator : 5mL	-	93xxx	Paracetamol Sirup Medication.ingredient.itemCodeableConcept → 91xxx Medication.ingredient.strength.numerator : 120 mg Medication.ingredient.strength.denominator : 5mL	-	Valid
Obat Minum (NC sisa)	R/ Paracetamol 120 mg/5 mL Sirup Paracetamol 5 ml diminum 4-6 jam sekali bila demam selama 30 hari 1 botol 60 ml maka diperlukan 5mlx30 / 60ml = 2.5
	93xxx	Paracetamol Sirup Medication.ingredient.itemCodeableConcept → 91xxx Medication.ingredient.strength.numerator : 120 mg Medication.ingredient.strength.denominator : 5mL	-	93xxx	Paracetamol Sirup Medication.ingredient.itemCodeableConcept → 91xxx Medication.ingredient.strength.numerator : 120 mg Medication.ingredient.strength.denominator : 5mL	-	Valid (Perlu catatan dari dokter obatnya harus dihabiskan atau tidak)
	92xxx	Paracetamol Sirup Medication.ingredient.itemCodeableConcept → 91xxx Medication.ingredient.strength.numerator : 120 mg Medication.ingredient.strength.denominator : 5mL	-	93xxx	Paracetamol Sirup Medication.ingredient.itemCodeableConcept → 91xxx Medication.ingredient.strength.numerator : 120 mg Medication.ingredient.strength.denominator : 5mL	-	Valid
Obat Suntik (NC tidak sisa)	R/ Insulin Human Analog (Rapid Acting) 100 IU/mL Injeksi (NOVORAPID, 3 mL) Suntik 3 kali sehari 10 Unit sebelum makan selama 30 hari - perlu 3 cartridge (100IU/ml x 3 mL / (3x10IU) = 10 hari 1 cartridge 30 hari maka perlu 30/10 = 3 cartridge
	93xxx	Insulin Human Analog: Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 100[U] Medication.ingredient.strength.denominator: 1/mL	-	93xxx	Insulin Human Analog : Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 3/cartridge Medication.ingredient.strength.denominator: 9/mL	-	Valid
	92xxx	Insulin Human Analog: Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 100[U] Medication.ingredient.strength.denominator: 1/mL	-	93xxx	Insulin Human Analog : Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 3/cartridge Medication.ingredient.strength.denominator: 9/mL	-	Valid
Obat Suntik (NC sisa)	R/ Insulin Human Analog (Rapid Acting) 100 IU/mL Injeksi (NOVORAPID, 3 mL) Suntik 3 kali sehari 8 Unit sebelum makan selama 30 hari - perlu 3 cartridge (100IU/ml x 3 mL / (3x8IU) = 12,5 hari 1 cartridge 30 hari maka perlu 30/12.5= 2.4 cartridge
	93xxx	Insulin Human Analog: Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 100[U] Medication.ingredient.strength.denominator: 1/mL	-	93xxx	Insulin Human Analog : Medication.ingredient.itemCodeableConcept→ 91/xxx Medication.ingredient.strength.numerator: 2.4 cartridge Medication.ingredient.strength.denominator: 7.2/mL	-	Valid (Perlu catatan dari dokter obatnya harus dihabiskan atau tidak)
	92xxx	Insulin Human Analog: Medication.ingredient.itemCodeableConcept→ 91xxx Medication.ingredient.strength.numerator: 100[U] Medication.ingredient.strength.denominator: 1/mL	-	93xxx	Insulin Human Analog : Medication.ingredient.itemCodeableConcept→ 91/xxx Medication.ingredient.strength.numerator: 2.4 cartridge Medication.ingredient.strength.denominator: 7.2/mL	-	Valid

Alur Pengiriman DICOM pada Rumah Sakit dengan MWL

Gambar 1. Alur Pengiriman DICOM

Alur Pengiriman DICOM pada Puskesmas dengan MWL

Gambar 2. Alur Pengiriman DICOM