Business Process Automation of Document Filing Based Alfresco for Referral BPJS Patient (Case Study: BPJS Center of Dharmais Cancer Hospital)

2016 International Conference on Informatics and Computing (ICIC)

Nurhayati, Diana Fitrisari [email protected], [email protected] Department of Informatics Engineering, Faculty of Science and Technology Syarif Hidayatullah State Islamic University (UIN) Jakarta, INDONESIA

get to the action, based on a set of rules of procedure. From Abstract- PT. BPJS (Persero) is a State Owned Enterprise the perspective of workflow, participants can be a person, (SOE) are specifically assigned by the government to hold application, machine or other process or workflow engine health insurance for civil servants, civil servants Pension [1]. Recipients, and other business entities. The health insurance got from PT. BPJS (Persero). The participants must submit Document management is the automation of the control some documents as requirements. Broadly speaking, the of the electronic document, document images, word process to get bail on health insurance is a government health processing documents, and other complex documents, the agency referral and information filing patient medical records life cycle of the document within an organization. Document from health centers and hospitals that have cooperated with PT. BPJS (Persero). Dharmais Cancer Hospital is one of management provides several advantages, among others, are hospitals in cooperation with PT. BPJS (Persero). The process enabling organizations to use a large control on the of referral and information filing medical records, patient manufacture, storage, and distribution of documents, health insurance participants in the Cancer Hospital Dharmais resulting in greater efficiency in the use of return have not a computerized document management system. Filing information, including document workflow process control, referral and medical record information is still performed and reduce the cycle time of the product [13]. manually by the patient's health insurance participants. In addition, there are many patients who do not know the health Alfresco Software is an Enterprise Content Management insurance participants filing referral procedure. Seeing the System (ECMS) open source that can provide high problems occurred, the author intends to automate the process modularity and adequate performance. Alfresco is higher- of filing documents business BPJS patient referral based quality software more quickly and at a cost that is lower. alfresco. A system development method used by the author is The Alfresco can be used as a content management for the Business Process Methodology. The procedure used in this documents, web, records, images and collaborative study using the referral procedure that had been running on development environment [9]. BPJS Dharmais Cancer Center Hospital. Finally, this system is expected to facilitate the process of filing and referral of patients’ health insurance can improve the efficiency of time and cost.

Keywords— automation, business process management, alfresco, models

I. INTRODUCTION

Referring to the Big Indonesian Dictionary (KBBI), automation is the replacement of human labor by machine labor / technology that automatically performs and directs the work.

Business process management (BPM) includes the Figure 1. Architecture of Alfresco [9] concepts, methods, and techniques of science to support the design, administration, configuration, setup and analysis of Business Process Modeling Notation (BPMN) is the new business processes. The cornerstone of business process standard model of business process and web service flows. management is a business process is a clear representation Created by the Business Process Management Initiative of the activities of the organization and implementation (BPMI), the primary goal of BPMN is to provide a readable boundaries between them. One-time business processes are notation understandable by all business den users. This defined, they are subject to analysis, enhancement and includes business analysts that create Intial drafts of the arrangement [10]. process to the technical developers responsible for Workflow Management Coalition's Dictionary explains implementing the technology that will perform those that the workflow is the automation of a business process, in processes. [3, 12] whole or in part, for documents, information, or task has Dharmais Cancer Hospital is one of hospitals in been bypassed by a participant to the other participants to cooperation with PT. BPJS (Persero). Based on the

observation of the writer, referral submission and medical B. Workflow Document Procedure for Thesis Proposal record information is still performed manually by the with Alfresco Enterprise Content Management patient's health insurance participants. Patients also had to Research conducted by [11], they create applications do some health insurance bureaucracy to get verification system can give information of students, supervisor. It used phase’s referral. Currently, the documents used form sheets Extreme Programming and simulation result shown the of paper. They have been risk of missing and damaged. The system can running 466 hours. It proven the research can rejection of the patient due to lack of required documents. short the steps, but It have disadvantage the system did not The patient should be found the documents. The patients have have to wait long to get referral. It is a lot of constraining and very time-consuming. In addition, there are patients who do not know the participants BPJS patient care III. PROPOSED SOLUTION procedures guarantee PT. BPJS (Persero) in the Cancer Hospital Dharmais that sometimes patients have to return Based on explanation that has been described in the empty-handed due to incomplete requirements document. previous chapters, the writer wants to Business Process The number of patients guarantees PT. BPJS (Persero) who Automation of Document Filing Based Alfresco for Referral register at Cancer Hospital Dharmais make document BPJS Patient with the following steps: management process more difficult and time-consuming. Therefore, we need a document management system for A. Surveys managing the patient, the health insurance document which This stage, the documentation on primary data obtained can be well controlled to facilitate and accelerate the process from the observation. At this stage also carried out modeling of managing patient care healthcare PT. BPJS (Persero). of the business processes running.. Automation of business processes to manage the patient, health insurance documents that can be realized with the B. Design development of computerized workflow (workflow) in a The stage makes design and analysis of business document management system (document management processes to be developed. The stages in this phase are: system). The business process will handle the submission a. Business Process Environment, all data relating to process document patient health insurance participants with the business processes are designed and presented parties related to the process and the monitoring of the in tabular form as a function of the system. At this running system. stage, the user and group design, space and user Business process is essential in the process of filing access. documents and medical records of the patient referral health b. Simulation System with the a few models insurance for participants in the process required verification simulation. We make three simulation scenario and approval from the relevant parties [2]. and simulation model, are:

Based on the above, it can be formulated issues to be Table 1. Simulation Scenario and Model Name Scenario Model discussed in this research are: Simulation 1 In this simulation Mapping of a. How to develop a business process on a document only the patient business processes management system for managing patient referral can visit a clinic or according to the document filing health insurance? get one action in a scenario single day. simulation 1 using b. How to simulate the process of filing the referral of a flowchart. patients BPJS for manual procedures and document Simulation 2 In this simulation Mapping of business process using the system? all patients can business processes c. What percentage increase in system parameters visit the clinic as according to the needed and get a scenario manually by the system business process? maximum of two simulation 2 using actions in one day. a flowchart. Simulation 3 In this simulated Mapping of From the formulation of the problem that has been patients received a business processes maximum of three according to the written above, limit the issues to be made, namely: actions in a single scenario 3 This paper using Business Process Methodology as a day. simulated using a method of system development, Alfresco as the software to flowchart. be developed and Activiti as a software designer. c. Analysis of Business Process Simulation (cost and time). For time analysis, we willl counting Arrival II. RELATED WORK Rate and Service Rate before performing the analysis with Microsoft Excel add-ins. While cost A. BPMN for Healthcare Processes analysis is done by calculating the total cost of Research conducted by [6], they create automation using employee salaries is necessary in one day the BPMN to make easy process of document filling but according to the procedure in the manual they have disadvantage in this result of research they did not simulation and procedure of simulation system that make implementation system has been created.

2016 International Conference on Informatics and Computing (ICIC)

d. Election Platform for tools and technology, at this 2. Technology stage we make the selection of the platform will be In terms of technology, this system was used. Voters chose to use the Alfresco Enterprise developed with web-based; it can be Content Management (ECM). The steps are: accessed by clients with various types a. Determining Tools and Technology of browsers, such as Mozilla Firefox, Based on platform selection [4, 5, 7], Google Chrome, Opera, and Internet determined that the technology used is Explorer. While the server side, the Alfresco Community Edition version 4.2d application is developed using Java as the application to be developed. In programming language is multi- addition, the server is required to run platform so it can run on Windows- Alfresco java in this case XAMPP version based operating systems and Unix. 1.8.2 consisting of Apache 2.4.4, Tomcat 7.0.41 and MySQL database server 3. Cost version 5.4.16 Community. Moreover, the Business system processes the authors use the Java JDK 7u25 for document to be developed using open windows and MySQL 5.1.25 Java source tools and technologies and Connector for Alfresco and Activity freeware, where developers do not connect with MySQL and Java. need to pay to get a license from the tools and technology used. b. Feasibilty Study 1. Resources e. Implementation and Testing. This phases will be In the terms of feasibility study on the explanation in next chapter resource system, the developed system requires resources which include IV. ANALISYS AND SIMULATION RESULT humans, servers, computer network, as well as the tools needed. The three simulation models which have been made, the author describes the three comparisons with a simulation model of the system simulation model manually into the table 2.

Table 2. Comparison of Simulation Model

Comparison Model Manual Simulation Model Simulation Model 1 Simulation Model 2 Simulation Model 3 (One Day One Task) (One Day Two Task) (One Day Three Task) Care Cycle Applied to patients who Applied the maximum Applied a maximum of Applied a maximum of have / already have status, one care in a day for two care in a day for three care in a day for yet / already get a patients who have / patients who have / patients who have / diagnostic check, and yet / already have status, yet / already have status, yet / already have status, yet / already healing treatment already get a diagnostic already get a diagnostic already get a diagnostic check, and yet / already check, and yet / already check, and yet / already healing treatment healing treatment healing treatment Number of Stages 21 12 15 15 Users Number of - 6 4 4 Automatic Stages Time 348 Minutes 151 Minutes 205 Minutes 240 Minutes Cost Rp. 18.633.333,00 Rp. 16.033.333,00 Rp. 18.033.333,00 Rp. 18.033.333,00 Arrival Number of 1 Time 4 Times 2 Times 1 Times Patients / Week Storage Space (Ruangan) Digital Repository Digital Repository Digital Repository Workflow History No Yes Yes Yes

Analysis results of Business Process Simulation are showed in table 3.

Table 3. Comparison of Simulation Model

Name Conclusion Description Simulation Model 1 This model can save time up to 56%, costs up to 13% and 43% in stages Worst Case until one day, but this model is too difficult for the patient and slow the healing process because it has the patient arrival rate to 4 times a week can have an impact on the decrease in the number of patients Simulation Model 2 This model can save time up to 41%, costs up to 3% and stages up to 29% Average Case in one day, but this model has the patient arrival rate to 2 times a week Simulation Model 3 This model can save time up to 31%, costs up to 3% and stages up to 29% Best Case in one day, this model has a maximum rate of 1 patient arrival times in one week. This model allows patients, can improve customer satisfaction and accelerate the healing process 2016 International Conference on Informatics and Computing (ICIC)

From the results of the comparison table above, the E. Workflow Task Model authors chose the three simulation models (One Day Three Workflow Task Model is a metadata or properties Task) to be implemented in the system. Next step are of each task in the workflow document no. implementation and testing. F. Process Definition 1. Implementation At this stage, the application of a simulation model in three designs the Activity Designer. A. Installation and Configuration a. Installing and Configuring Alfresco G. Workflow Resource Bundle Development of this system should certainly Workflow resource bundle is a file containing a be doing the installation and configuration of message that will be displayed on the web-client as Alfresco Community Edition 4.2d with a substitute for the task name of the task model and MySQL. Both with a standard installation. the transition of the process definition name.

b. Users and Groups H. Configuring the Web Client This stage uses the administrative console of Configuration is done for registering a web client the menu with the Alfresco login as display workflows in alfresco web. administrator (user: admin and password: admin). I. Spring Framework Configuration for the Spring framework is used to c. Space integrate the model extension project Based on the design of space that has been created, the implementation of the space 2. Testing created on the Company's directory page after login as administrator. In this phase of testing is done using the technique of alpha testing, where the programmer who perform d. Access Security direct testing of the system. Implementation of security access to space is done by using the menu to manage user space a. Deployment after login as admin. For process definition deployment process can be done directly using the Activity Modeler B. Integration upload process definition bar in Activity Once the implementation phase is done, the Explorer. integration is then performed on the server Alfresco extension project. b. User Acceptance Test (UAT) This phase is testing of the system by the user. C. Creating Home Testing was conducted using black-box. a. Creating a JSP File Getting file-started.jsp display useful information on the research conducted, which V. CONCLUSION AND SUGGESTION is placed as the front page of Alfresco Explorer. Conclusion

Based on the previous chapters, the authors can draw D. Content Model conclusions from this study, that: a. Business process development at Alfresco cm:versionable cm:content Enterprise Content Management (ECM) can be performed automatically using Activiti Software that can produce a document filing system provides information referral and generate movement reference document used for patient data and patientDetails doc medical record data verification. nomorPA b. Simulation askes patient referral submission namaPA process can be simulated into three models: one day one task, one day two tasks, and three one-day task. Figure 2. Document Content Models BPJS c. The simulation model 3 is applied to the document filing referral system of business process health A content model in Figure 2 is a property of a insurance patients can save time up to 31%, saving model health insurance document (doc). cost up to 3% and savings step up to 29%.

2016 International Conference on Informatics and Computing (ICIC)

Suggestion

Based on the exposure to the development of systems in the previous chapter, the author can provide suggestions as follows: a. In the next development is expected to be deployed directly using the Internet b. Integrating the system with SJP publishing applications and other applications c. It is expected that further development of the system do the business processes in order to cover the entire business process of the Cancer Hospital Dharmais and overall business processes in PT. BPJS (Persero)

REFERENCES

[1] Fischer, Layna. 2002. Workflow Handbook. Florida : Future Strategies Inc. [2] Griffith, John. 1987. The Well-Managed Community Hospital.: Health Administration Press .Michigan [3] Juric, Matjaz B, Pant, Kapil. 2008. Business Process Driven SOA using BPMN and BPEL. 2008. Birmingham : Packt Publishing. [4] Gabrick, Kurt A. & Weiss, David B. 2002. J2EE and XML Development. Greenwich : Manning Publications Co. [5] McLaughin, Brett. 2001. Java & XML, 2nd Edition. Canada : O’Reilly [6] Muller, Richard, Rogge-Solti, Andreas. 2011. BPMN for Healthcare Processes. Berlin : CEUR Workshop Proceedings. [7] Potts, Jeff. 2009. Alfresco Developer Guide. Birmingham: Pack Publishing. [8] Rademakers, Tijs. 2012. Activiti in Action. Shelter Island : Manning Publications Co. [9] Syarif, Munwar. 2013. Alfresco 4 Enterprise Content Management Implementation. Birmingham: Packt Publishing. [10] Weske, Mathias. 2007. Business Process Management Concepts, Languages, Architecture. Berlin : Springer. [11] Wahyudianto. 2010. Pengembangan Sistem Alur Kerja (Workflow) Dokumen Prosedur Pengajuan Proposal Skripsi Dengan Alfresco Enterprise Content Management (Studi Kasus: Program Studi Teknik Informatika UIN Jakarta). Jakarta : UIN Jakarta [12] White, Stephen. A. 2004. Business Process Modeling Notation (BPMN). BPMI.org [13] Turban, Efraim, McLean, Ephraim, & Wetherbe, James. 2001. Information Technology for Management: Transforming Business in the Digital Economy 3rd Edition. New York : John Wiley & Sons Inc.