User Interface Design for Detecting Potential BPJS Patient Fragmentation at Bhayangkara Level I Hospital, PUSDOKKES POLRI

Abstract

Fragmentation of BPJS patient data is a problem arising from inconsistencies in visit records, particularly repeat visits occurring within seven days, which may result in fragmented service episodes, administrative discrepancies, and complications in the BPJS claim process. This study aimed to identify the potential fragmentation of BPJS patient visits and to design a user interface prototype as a supporting solution. A cross-sectional approach was applied through observation, interviews, and documentation, while system development used the Prototype method involving registration, casemix, and Hospital Management Information System (SIMRS) personnel. The findings showed that fragmentation was influenced by repeated visits, the absence of automated validation, and limitations of the existing system in detecting repeat visits within seven days. These conditions may affect data accuracy, service efficiency, and the smooth processing of BPJS claims. The proposed prototype incorporates integrated patient-history retrieval, automated validation, an early warning system, and claim-monitoring functions. Further testing and development are required before implementation so that the prototype can support the prevention of BPJS patient-visit fragmentation and improve claim administration.