Analysis of the Readiness of Puskesmas Management in the Implementation of Telemedicine

Abstract

Telemedicine has the potential to improve access, efficiency, and quality of health services. Its implementation in first-level health facilities requires management readiness, namely human resources, facilities and infrastructure, policies and governance, and financing. This study analyzes the readiness of the management of the UPTD Puskesmas Gunungsitoli District in implementing telemedicine as well as its supporting and inhibiting factors. The research uses a qualitative approach with a case study design. Informants  2 key informants (Head of the Health Center and the Person in Charge of the Health Information Program/System) and 6 supporting informants (doctors, nurses, midwives, and medical record officers), data was collected through in-depth interviews, observations, and documentation, and then analyzed with the Miles and Huberman interactive model. The results showed that overall management readiness was not optimal. Human resources and infrastructure facilities are quite adequate, but still limited. Health workers have basic digital competencies and willingness to adapt, but have never received telemedicine training. Basic digital infrastructure such as devices, internet, Electronic Medical Records, and SATUSEHAT are available, although equipment is limited and internet connections are not stable. Policy, governance, and financing readiness is still lacking because there are no special operational procedures, clear implementation structures, monitoring and evaluation mechanisms, and special funds. The support and commitment of leaders are the main supporting factors. It is concluded that management readiness needs to be strengthened through increasing human resource capacity, strengthening digital infrastructure, formulating policies and SOPs, establishing clear governance, and allocating adequate budgets.