Panduan Pelepasan Informasi Medis

DETASEMEN KESEHAT KESE HATAN AN WILAYAH WILAYAH 02.04.04 RUMAH SAKIT Tk.IV 02.07.02 LAHAT

Lampiran : SK Karumki Tk.IV 02.07.02 La!a N"m"r : Tan##a$ :

PANDUAN PELEPASAN INFORMASI DAN KERAHASIAAN INFORMASI PASIEN

MANUAL PELEPASAN INFORMASI MEDIS

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S&i S&ia ap in'" in'"rm rma( a(ii )an# an# *&r( *&r(i' i'a a m&+ m&+ik )an# )an# +im +imi$ik i$ikii rum ruma! (ak (aki i+ i+ak *"$&! *"$&! +i(&*a +i(&*arka rkan n "$&! "$&! p&#a, p&#a,ai ai ruma! ruma! (aki (aki iu- k&ua$ k&ua$ii *i$a *i$a pimpin pimpinan an ruma! (aki iu m&n#i/inkan. Ruma Ruma! ! (aki (aki i+a i+ak k *"$& *"$&! ! +&n# +&n#an an (&k (&k&! &!&n &n+a +akn kn) )a m&n# m&n##u #una naka kan n r&ka r&kam m m&+i( m&+i( +&n#an +&n#an ara ara )an# )an# +apa +apa m&m*a! m&m*a!a)a a)akan kan k&p&n k&p&nin# in#an an pa(i&n pa(i&n-k&ua k&ua$i$i /ika /ika ruma! ruma! (aki (aki iu (&n+ir (&n+irii akan akan m&n## m&n##una unakan kan r&kam r&kam m&+i( m&+i( &r(&*u *i$a p&r$u unuk m&$in+un#i +irin)a aau m&,aki$n)a. 1ara 1ara a(i a(i( (&n &n +an +an +"k +"k&r &r )an )an# # *&r *&ran an## ##un un# # /a,a /a,a* * *"$& *"$&! ! +&n +&n#a #an n *&*a *&*a( ( *&rk" *&rk"n(u n(u$a $a(i (i +&n#a +&n#an n *a#ian *a#ian r&kam r&kam m&+i( m&+i( +&n#a +&n#an n aa aaan an )an# )an# a+a a+a !u*un#an +&n#an p&k&r/aann)a. An+aikaa a+a k&ra#ura#uan +ipi!ak (a' r&kam m&+i( maka p&r(&u/uan ma(uk k&&mpa r&kam m&+i( iu *"$&! +i"$ak +an p&r("a$ann)a !&n+akn)a !&n+akn)a +i(&ra!kan k&pa+a k&puu(an pimpinan ruma! (aki. 3a#aimanapun (a$inan r&kam m&+i( i+ak *"$&! +i*ua anpa p&r(&u/uan k!u(u( +ari k&pa$a *a#ian r&kam m&+i( )an# akan akan *&rmu( *&rmu()a, )a,ara ara! ! +&n#a +&n#an n pimpin pimpinan an ruma! ruma! (aki (aki /ika /ika a+a k&ra#u k&ra#u ra#uan. Ti+ak (&"ran#pun *"$&! m&m*&rikan in'"rma(i $i(an aau &ru$i( k&pa+a "ran# +i $uar "r#ani(a(i ruma! (aki anpa p&r&u/uan &ru$i( +ari pi!a pi!ak k pimp pimpin inan an ruma ruma! ! (aki (aki 1&r 1&rk& k&u ua$ a$ia ian n : m&n# m&n#a+ a+ak akan an +i(k +i(ku( u(ii m&n#&nai k&ma/uan +ari pa+a ka(u( +&n#an k&$uar#a aau ,a$i pa(i&n )an# m&mpun)ai k&p&nin#an )an# ()a!5. D"k&r i+a i+ak *"$&! $&! m&m*&rik rikan p&r(&u/uan k&pa+a p&ru(a!aan a(uran(i aau *a+an $ain unuk m&mp&r"$&! r&kam m&+i(. 3a+an *a+an ("(ia$ ia$ *"$&! m&n#&a!ui i(i +aa ("(ia$ ia$ +ari r&kam m&+i(- apa*i$a m&mpun)ai a$a(ana$a(an )an# ()a! unuk m&mp&r"$&! in'"rma(i namun unuk +aa m&+i(n)a &ap +ip&r$ukan (ura p&r(&u/uan +ari pa(i&n )an# *&r(an#kuan. 1&rm 1&rm"! "!"n "nan an pa( pa(i&n i&n unu nuk m&mp m&mp&r &r"$ "$& &! in'" in'"rm rma a(i m&n m&n#&n #&nai aa aaa an n +irin)a +i(&ra!kan k&pa+a +"k&r )an# *&ru#a( m&ra,an)a. 1&rm 1&rm"! "!"n "nan an (&ar &ara a $i( $i(anan- p&rmi &rmin naan aan in'" in'"rm rma( a(ii (&*a &*aikn ikn)a +i" i"$ak$akkar&na ara p&rminaan !aru( &ru$i(. In'" In'"rm rma( a(ii r&kam r&kam m&+ m&+i( !an !an)a +ik +ik&$ &$ua uark rkan an +& +&n#an n#an (ur (ura a kua( ua(a )an )an# +ian+ +ian+a a an#an an#anii +an +an +i*&ri +i*&ri an##a an##a$$ "$&! "$&! pa(i&n pa(i&n ,a$in ,a$in)a )a /ika /ika pa(i&n pa(i&n &r(&*u (&ara m&na$ i+ak k"mp&&n5- aau k&$uar#a &r+&ka k&ua$i  /ika a+a k&&nuan $ain +a$am p&rauran. Sura kua(a !&n+ak$a! /u#a +ian+a an#ani +an +i*&ri an##a$ "$&! "ran# )an# m&n#&$uarkan r&kam m&+i( +an +i(impan +i +a$am *&rka( r&kam m&+i( &r(&*u.

9.

In'"rma(i +i +a$am r&kam m&+i( *"$&! +ip&r$i!akan k&pa+a p&r,a$ian ruma! (aki )an# ()a! unuk m&$in+un#i k&p&nin#an ruma! (aki +a$am !a$!a$ )an# *&r(an#kuan +&n#an p&ran##un# /a,a*an. %0. In'"rma(i *"$&! +i*&rikan k&pa+a ruma! (aki $ain- anpa (ura kua(a )an# +ian+a an#ani "$&! pa(i&n *&r+a(arkan p&rminaan +ari ruma! (aki iu )an# m&n&ran#kan *a!,a (i pa(i&n (&karan# +a$am p&ra,aan m&r&ka. %%. D"k&r+"k&r +ari $uar ruma! (aki )an# m&nari k&&ran#an m&n#&nai pa(i&n pa+a (uau ruma! (aki- !aru( m&mi$iki (ura kua(a +ari pa(i&n &r(&*u. Ti+ak *"$&! (&"ran# *&ran##apan *a!,a kar&na p&m"!"n (&"ran# +"k&r ia (&"$a!"$a! $&*i! *&r!ak unuk m&mp&r"$&! in'"rma(i +ari p&m"!"n )an# *ukan +"k&r. Ruma! Saki +a$am !a$ ini akan *&ru(a!a m&m*&rikan (&#a$a p&$a)anan )an# pana( k&pa+a +"k&r $uar- &api (&$a$u *&ru(a!a $&*i! m&mp&r!aikan pa(i&n +an ruma! (aki. %2. K&&nuan ini i+ak !an)a *&r$aku *a#i 3a#ian R&kam M&+i(- &api  /u#a *&r$aku *a#i (&mua "ran# )an# m&nan#ani r&kam m&+i( +i 3a#ian 1&ra,aan- *an#(a$*an#(a$ +an $ain$ain. %. R&kam m&+i( )an# a($i i+ak *"$&! +i*a,a k&$uar ruma! (aki- k&ua$i *i$a aa( p&rina! p&n#a+i$an- +&n#an (ura kua(a k!u(u( &ru$i( +ari pimpinan ruma! (aki. %4. R&kam m&+i( i+ak *"$&! +iam*i$ +ari &mpa p&n)impanan unuk +i*a,a k&*a#ian $ain ruma! (aki- k&ua$i /ika +ip&r$ukan unuk ran(ak(i +a$am k&#iaan ruma! (aki iu. Apa*i$a mun#kin r&kam m&+i( ini !&n+akn)a +ip&rik(a +i*a#ian (&iap ,aku +apa +ik&$uarkan *a#i m&r&ka )an# m&m&r$ukan. %6. D&n#an p&r(&u/uan pimpinan ruma! (aki- p&makaian r&kam m&+i( unuk k&p&r$uan ri(& +ip&r*"$&!kan. M&r&ka )an# *ukan (a' m&+i( ruma! (aki- apa*i$a in#in m&$akukan ri(& !aru( m&mp&r"$&! p&r(&u/uan &ru$i( +ari pimpinan ruma! (aki. %. 3i$a (uau r&kam m&+i( +imina unuk +i*a,a k& p&n#a+i$an (&#a$a ik!iar !&n+ak$a! +i$akukan (upa)a p&n#a+i$an m&n&rima (a$inan '"" (aik r&kam m&+i( )an# +imak(u+. Apa*i$a !akim mina )an# a($i- an+a &rima !aru( +imina +an +i(impan +i '"$+&r (ampai r&kam m&+i( )an# a($i &r(&*u k&m*a$i. %7. aka *a!,a (&"ran# ma/ikan &$a! m&m*a)ar aau &$a! m&n)&u/ui unuk m&m*a)ar "n#k"( ruma! (aki *a#i (&"ran# p&#a,ain)a- i+ak +apa +i/a+ikan a$a(an *a#i ruma! (aki unuk m&m*&rikan in'"rma(i m&+i( p&#a,ai &r(&*u k&pa+a ma/ikan a+i anpa (ura kua(a ; p&r(&u/uan &ru$i( +ari pa(i&n aau ,a$in)a )an# ()a!. %8. 1&n#&(a!an unuk m&m*&rikan in'"rma(i !&n+ak$a! *&ri(i in+ika(i m&n#&nai p&ri"+&p&ri"+& p&ra,aan &r&nu. Sura kua(a ; p&r(&u/uan iu !an)a *&r$aku unuk in'"rma(i )an# &rma(uk +a$am /an#ka ,aku ; an##a$ )an# +iu$i( +i+a$amn)a.

PROSEDUR PELEPASAN INFORMASI KEPADA PIHAK KETIGA NON PENGADILAN

1r"(&+ur p&$&pa(an in'"rma(i k&pa+a pi!ak k&i#a n"n p&n#a+i$an &r+iri +ari p&$&pa(an in'"rma(i #una k$aim a(uran(i +an p&rminaan resume  m&+i(. 1r"(&+ur )an# &$a! +i&apkan unuk +apa m&n#am*i$ p&m&rik(aan p&nun/an# aau resume m&+i( #una k$aim a(uran(i )aiu apa*i$a pi!ak k&i#a m&rupakan p&u#a( a(uran(i )an# m&n/a+i mira k&r/a(ama +ari pa(i&n- !aru( m&m*ua (ura i/in (&ara &ru$i( aau (ura !ak kua(a i+ak +&n#an $i(an aau kuian(i p&m*a)aran5 )an# +ian+a an#ani "$&! pa(i&n )an# *&r(an#kuan- /ika *ukan pa(i&n &r(&*u )an# m&n#am*i$ 'ami$i aau "ran# $ain5. 3i$a pa(i&n i+ak +apa aau *&$um m&m*ua (ura i/in (&ara &ru$i(- maka pi!ak Ruma! Saki akan m&n)&+iakan (ura i/in &r(&*u )an# +i#ani +&n#an (ura p&rm"!"nan. S&&$a! p&m"!"n m&n#a/ukan p&rm"!"nan p&$&pa(an in'"rma(i +&n#an m&m*a,a (ura kua(a p&$&pa(an in'"rma(i R&kam M&+i( pa(i&n k&pa+a p&u#a( p&$a)anan (&ra m&n#i(i (ura p&rm"!"nan p&$&pa(an in'"rma(i R&kam M&+i( +ari Ruma! Saki *&(&ra p&r()araann)a- (&p&ri Karu Tan+a 1&n+u+uk- Karu K&$uar#a- Sura Ru/ukan- ""k"pi karu p&(&ra a(uran(i+$$. S&$an/un)a p&u#a( m&n&rima (ura p&rm"!"nan )an# +ia/ukank&mu+ian m&naa (ura p&rm"!"nan &r(&*u k& +a$am *uku &k(p&+i(i- $a$u k&mu+ian m&n#am*i$ *&rka( R&kam M&+i( pa(i&n pa+a ruan# p&n)impanan *&rka( pa(i&n k&mu+ian m&m&rik(a *&rka( R&kam M&+i( pa(i&n &r(&*u.  Apa*i$a +aa ("(ia$ +an +aa m&+i( pa(i&n )an# *&r(an#kuan (u+a! $&n#kapmaka p&u#a( R&kam M&+i( m&m*ua +an m&n#i(i +ra' p&rm"!"nan p&$&pa(an in'"rma(i R&kam M&+i( &r(&*u. Akan &api- apa*i$a +aa ("(ia$ pa(i&n +a$am *&rka( R&kam M&+i( *&$um $&n#kap- maka p&u#a( R&kam M&+i( m&$&n#kapi +aa ("(ia$ &r$&*i! +a!u$u. S&+an#kan apa*i$a +aa m&+i( pa(i&n )an# *&$um $&n#kap- maka p&u#a( R&kam M&+i( m&nari +"k&r  )an# m&ra,a unuk m&$&n#kapi +aa m&+i( pa(i&n &r(&*u- k&mu+ian p&u#a( R&kam M&+i( m&m*ua +an m&n#i(i +ra' p&rm"!"nan p&$&pa(an unuk +i*uakan (ura p&n#anar p&n#a/uan k$aim k&pa+a 1T.A(uran(i +imana pa(i&n m&n/a+i an##"a +ari a(uran(i &r(&*u. )an# +i(&+iakan "$&! Ruma! Saki. Di+a$am ruan# R&kam M&+i(- p&u#a( m&n#i(i '"rmu$ir p&rminaan (a$inan R&kam M&+i( )an# nanin)a akan +i"p)- +i$&#a$i(ir +an +i$ampirkan "$&! pi!ak p&u#a( p&$a)anan in'"rma(i k&(&!aan (&ra m&mina rinian *ia)a p&ra,aan (&*&$umn)a. K&mu+ian p&u#a( m&mina au&ni'ika(i k&pa+a +"k&r )an# m&ra,a unuk m&n#i(i +an m&nan+aan#ani '"rmu$ir k$aim maupun (ura ? (ura !ukum $ain #una m&n+apakan p&r(&u/uan +"k&r. S&&$a! m&n+apa an+a an#an +"k&r )an# m&ra,a- k&mu+ian p&u#a( p&$a)anan in'"rma(i k&(&!aan m&mina p&m"!"n unuk m&n#i(i +an m&nan+aan#ani *uki (&ra! &rima (a$inan R&kam M&+i( aau m&nan+aan#ani *uku p&rn)aaan p&$&pa(an in'"rma(i- m&mina m&$an/ukan p&m*a)aran pa+a *a#ian a+mini(ra(i $a$u p&u#a( m&m*&rikan "p) (a$inan R&kam M&+i(- resume m&+i( (&ra m&m*&rikan p&rinian *ia)a p&$a)anan )an# (&*&$umn)a &$a! +ipin/am. K&mu+ian R&kam M&+i( a($i *&riku *uki p&rminaan (a$inan +an *uki (&ra! &rima (a$inan R&kam M&+i( +i(impan k&m*a$i "$&! p&u#a( )an# *&r,&nan#.

Dari !a(i$ ,a,anara )an# &$a! +i$akukan- +ik&a!ui *a!,a +a$am p&$&pa(an in'"rma(i R&kam M&+i( *a#i pa(i&n pri*a+i )an# in#in m&n#&a!ui ri,a)a pa(i&n iu (&n+iri aaupun pi!ak k&$uar#a )an# +imina $an#(un# "$&! pa(i&n- p&n##unaan i@in (&ara $i(an +apa +i$akukan p&mr"(&(an anpa !aru( a+a p&r(&u/uan i/in (&ara &ru$i( aau anpa m&m*&rikan (ura kua(a. Ha(i$ p&nun/an# m&+i( (&p&ri !a(i$Ultrasonography US5 aaupun !a(i$ R"n#&n +i*&rikan pa+a (aa p&m&rik(aan. 3a#i pi!ak a(uran(i )an# *&rkaian +&n#an p&m*a)aran k&uan#an- unuk "p) $a*"ra"rium aau "p) r&(&p p&n#"*aan- pa(i&n !aru( m&m*a,a rinian *ia)a p&ra,aan ra,a inap maupun ra,a /a$an. Unuk i(i +ari R&kam M&+i( )an# *"$&! +i*&rikan a+a$a! r&(um& m&+i( +an !a(i$ p&m&rik(aan p&nun/an# La*"rauriumRa+i"$"#i- US- +$$5. 1&$&pa(an in'"rma(i k&pa+a pi!ak a(uran(i (&*&$umn)a &$a! a+a i/in &ru$i( +ari pa(i&n- )akni (ura kua(a p&r(&u/uan anara pa(i&n (&*a#ai an##"a a(uran(i +an pi!ak a(uran(i (&n+iri )an# m&rupakan p&r()araan ,a/i* p&n#a/uan k$aim. Unuk (ura i/in &r(&*u- !an)a *&r$aku 0 !ari (&&$a! an##a$ p&m*uaan. Ha$ ini (&*a#ai *uki *a!,a pi!ak pa(i&n &$a! m&m*&rikan ,&,&nan# k&pa+a pi!ak a(uran(i unuk m&n#am*i$ R&kam M&+i(n)a #una k&p&r$uan k$aim a(uran(i. K&$&n#kapan $ain )an# +ia/ukan "$&! a(uran(i (&p&ri k,ian(i pan/an# *&rma&rai maupun *$ank" p&n#i(ian +ari 1T. A(uran(i- (&m&nara p&n#i(ian '"rmu$ir +i$akukan "$&! pi!ak Ruma! Saki. PROSEDUR PELEPASAN INFORMASI KEPADA PIHAK KETIGA DALAM LINGKUP PENGADILAN

1r"(&+ur 1&$&pa(an In'"rma(i k&pa+a pi!ak k&i#a +a$am $in#kup p&n#a+i$an &r+iri +ari p&$&pa(an in'"rma(i #una k$aim
FAKTOR

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FAKTOR YANG MENDORONG PELEPASAN

INFORMASI

REKAM MEDIS KEPADA PIHAK KETIGA DI RS TK.IV 02.07.02 LAHAT

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K&pa$a Ruma! Saki Tk. IV 02.07.02 La!a-

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