A Dampak dan Keefektivitasan Penggunaan Rekam Medis Elektronik dalam Pemantauan serta Manajemen Penyakit Pernapasan: Sebuah Tinjauan Literatur Sistematis
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Penyakit pernapasan kronis dan akut seperti asma, PPOK, COVID-19, ARDS, dan ISPA menimbulkan beban kesehatan global yang substansial. Sistem surveilans konvensional bersifat reaktif dan terbatas dalam deteksi dini. Rekam Medis Elektronik (RME) menawarkan potensi besar sebagai sumber data longitudinal untuk pemantauan dan manajemen penyakit pernapasan yang lebih efektif. Tinjauan sistematis ini bertujuan untuk mengevaluasi dampak dan keefektivitasan penggunaan RME dalam pemantauan tren penyakit, deteksi dini, serta optimalisasi manajemen klinis pada pasien dengan berbagai kondisi pernapasan. Tinjauan sistematis ini mengikuti pedoman PRISMA 2020. Pencarian literatur dilakukan pada basis data PubMed, Scopus, Web of Science, dan Google Scholar (2016--2025). Pertanyaan penelitian dirumuskan menggunakan kerangka PICO. Sebanyak 40 artikel yang memenuhi kriteria inklusi dianalisis secara tematik. Mayoritas studi berasal dari negara berpenghasilan tinggi (AS, Inggris, Denmark, Belanda, Spanyol, Australia), dengan desain yang beragam (kohort retrospektif 35%, pengembangan model 25%, RCT klaster 5%). Jenis intervensi RME meliputi sistem surveilans real-time, model prediksi berbasis NLP/AI, CDSS, serta evaluasi kualitas data. RME terbukti mendeteksi lonjakan kasus SARI hingga 8 hari lebih cepat, memprediksi ARDS dengan AUROC 0,84, menurunkan peresepan antibiotik tidak perlu 12--16%, serta mengekstraksi gejala asma dengan F1-score >0,95. Namun, tantangan kualitas data (kelengkapan <50% pada beberapa variabel) dan kesenjangan geografis (tidak ada studi dari Indonesia) masih signifikan. RME, terutama jika diintegrasikan dengan NLP dan kecerdasan buatan, terbukti efektif untuk surveilans, deteksi dini, dan manajemen klinis penyakit pernapasan. Namun, tantangan kualitas data dan keterbatasan bukti dari negara berkembang masih perlu diatasi. Diperlukan standarisasi data, investasi interoperabilitas, serta adaptasi teknologi untuk konteks lokal seperti Indonesia.
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Referensi
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