Satu Database untuk Semua: Kalau MPI Error, Rekam Medis Nasional Ikut Lenyap ( Single Point of Failure pada MPI )

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Selamat Datang di Hajriah Fajar: Hidup Sehat & Cerdas di Era Digital

Satu Database untuk Semua: Kalau MPI Error, Rekam Medis Nasional Ikut Lenyap

“Hari itu, lampu indikator server warna merah… dan mendadak satu ruangan penuh IT di lantai 3 RS pusat mendadak senyap. Bukan karena belum ngopi. Bukan juga karena sang admin jago Futsal tiba-tiba mellow. MPI—Master Patient Index— si kumbang sehari-hari, tiba-tiba hang. Bayangkan: satu nadi pusat, tersumbat sepersekian detik, ratusan ribu rekam medis turn gray. Ini bukan adegan sci-fi; ini catatan log yang sempat saya curi lihat sambil pura-pura ngecek AC bocor.

Kita suka bangga, “Ah sudah ada SATUSEHAT, sudah standar HL7 FHIR, aman lah.” Padahal—kayak temen kosan yang bilang aman tapi atapnya bocor—standar itu baru permukaan. Single Point of Failure di MPI sama saja: kamu pasang CCTV 4K tapi kunci pintu kos masih karet gelang.

Jadi mari duduk, seduh kopi sachet (karena kantin RS belum buka), dan curhat bareng: Kenapa sih bikin identitas pasien satu basis data saja? Kenapa nggak dipecah kayak grup WA keluarga biar kalau satunya drama, satunya masih normal? Jawabannya sering klise: “biar gampang sinkronisasi.” Tapi kenyataannya? Gampang juga crash bareng-bareng.

Cerita Absurd #1 — File Excel & Simpul Leher Admin

Dulu, sebelum ada SATUSEHAT, RS tempat saya magang masih pakai Excel. Adminnya bangga: “Ini master file. Ada dua puluh ribu pasien, entri manual, tapi akurat kok!” Eh suatu malam file itu corrupt. Backup? Ada—di flashdisk, hilang ketelen sofa. Sekarang Excel diganti MPI terpusat. Lebih canggih memang, tapi kalau crash? Nggak bisa bilang “flashdisk ketelen sofa.” Semua klinik, Puskesmas, lab, farmasi, timeout bareng-bareng.

Kenapa MPI Jadi Nadi Pusat?

• FHIR & Identitas Unik – Tanpa ID tunggal, rekam medis kamu tercecer kayak struk belanja di dompet.
• Dirancang Enak Dipakai BPJS – Klaim cepat, audit cepat. Tapi ya itu, central choke point.
• Budget & SDM – Ngurus satu basis data lebih murah daripada 34 provinsi bikin versi masing-masing.

Risiko Saat MPI Meleduk

1. Pelayanan Klinis Berhenti Mendadak
Dokter IGD ngetik: “Pasien Alergi?”—spinner muter tak berujung. Larinya ke manual: “Tanya aja ke pasiennya deh.” Kalau pasiennya pingsan? Good luck.

2. Data Integrity Domino
Saat sistem balik hidup, antrean pesan tertunda numpuk. Ada lab result nyasar, ada resep ganda, ada pasien dobel identitas.

3. Ransomware di Pintu Gerbang
Penjahat cukup target satu node MPI. WHO bahkan menulis Digital Health Guidelines soal risiko “central registry compromise.” Bayaran tebusan? Bukan cuma duit—bisa nyawa.

4. Chaos Kepercayaan Publik
Sekali blackout, netizen bakal nyinyir: “Katanya era 4.0, kok nge-lag?” Rekam medis bukan like & share. Salah bentar, reputasi hilang lama.

Kutipan Orang Lapangan

“Kalau MPI down, kami terpaksa tulis diagnosa di kertas bekas. Besoknya entri ulang, dobel kerja, dobel pusing.” — Perawat IGD, RS Swasta Jatim (wawancara pribadi, 2024).

“Central index is efficient until it isn’t. Redundancy isn’t luxury; it’s first aid.” — U.S. Office of the National Coordinator for Health IT, Policy Brief, 2022.

Bagaimana Seharusnya?

• Sharding & Regional Replica – Bagi beban per pulau, replikasi real-time. Kalau Jawa mati suri, Sumatra masih jalan.
• Zero Trust, Zero Excuse – Tiap request diverifikasi ulang. Ya, ribet. Tapi lebih ribet kalau IGD gelap total.
• Disaster Drill Rutin – Bukan cuma table-top. Coba matikan node sengaja, lihat siapa yang panik.
• Transparansi Insiden – Publish log anonymized. Biar publik bisa nilai dan bantu audit.

Humor Pahit: “MPI Cuma Mati 5 Menit”

Lucunya, kadang pejabat bilang, “Crash kemarin cuma 5 menit kok.” Padahal 5 menit di IGD bisa setara 15 detik telat CPR. Jadi, 5 menit ludes, tapi dampaknya nancep lama. Ironi: di kantor pusat mungkin lanjut meeting sambil snack risol, di ruang operasi dokter pakai gut feeling.

Refleksi Pribadi

Saya pernah salah ketik nomor rekam medis pasien. Sistem menolak—baguslah. Tapi bayangin kalau MPI sedang lemot, lalu saya override manual, muncul pasien ganda. Besoknya dia dapat dua dosis obat. Satu lupa ditagih BPJS, satu overdosis. Kesalahan sepele, ekor panjang.

Tips (Separuh Serius) Buat Pejuang Data RS

• Simpan kopi log lokal – Tapi enkripsi dong, jangan di Desktop sebelah folder drama Korea.
• Pakai UPS beneran – Bukan USB hub dikira UPS mini.
• Dummy day – Jadwalkan satu hari latihan “MPI mati” tiap bulan. Hitung berapa keringat yang keluar.
• Tanya pasien langsung – Sesekali konfirmasi alergi manual itu sehat, memperkaya empati.

Bonus track: cek dokumentasi resmi SATUSEHAT, terutama bagian Playbook Introduction. Baca, tandai, lalu buat daftar apa saja yang belum dikerjakan di lapangan. Biasanya… panjang.

Penutup? Nggak Ada.

Karena besok, minggu depan, atau tahun depan, kasus MPI down bisa kejadian—dan cerita ini bakal berulang. Semoga pas terjadi lagi, kita semua sudah siap, atau minimal sudah ganti password “admin123456”.

Welcome to Hajriah Fajar: Living Smart & Healthy in the Digital Age

One Database to Rule Them All: When the MPI Chokes, National Health Records Flatline

“Red LED on the server rack… then silence.” That’s how the night shift nurse recalls the moment the Master Patient Index froze. No, nobody tripped over a cable. The single, glorious database at the heart of a nation simply decided it had had enough. Imagine your heartbeat pausing just to sneeze. Welcome to centralised health IT.

We keep bragging, “Hey, SATUSEHAT uses HL7 FHIR, relax!” Relax? Tell that to the ER doctor staring at a spinning wheel while a trauma patient bleeds. A single point-of-failure (SPOF) isn’t a fancy term; it’s a horror story with auto-save turned off.

Absurd Tale #1 — The Great Excel Crash

Before cool national platforms, my old hospital worshipped an Excel file. Twenty thousand rows, colour coded, living on one receptionist’s desktop. Then one stormy Thursday the file corrupted. Backup? On a flash drive swallowed by an antique sofa. Fast-forward: MPI is the new god. One crash now kills not a single hospital, but an entire country’s appointments.

Why Centralise in the First Place?

• Unique ID Paradise – No more duplicate “Siti A” vs “Siti A.” with a dot.
• Insurance Likes It – BPJS billing in seconds—until everything blinks offline.
• Cheaper Ops – One database is easier budget-wise than thirty-four provincial silos… until ransom day.

Dark Side of a Bright Idea

🚧 Clinical Paralysis
ER triage stalls; staff revert to guessing allergies like tarot cards.

🚧 Domino Data Chaos
Delayed messages pile up, lab results mismatch, duplicate IDs sprout.

🚧 Ransomware Welcome Mat
Target one node, ransom an entire nation. WHO’s digital health guideline flags exactly this threat.

🚧 Public Trust Dumpster Fire
Netizens meme your downtime in milliseconds; confidence recovers in geological epochs.

Voices from the Field

“When MPI stalls, we chart on candy-wrapper backs. Next day we re-type. Double work, double headache.” — ICU nurse, East Java (interview, 2024).

“Central index is efficient until it isn’t. Redundancy isn’t luxury; it’s first aid.” — ONC, Policy Brief, 2022.

How to Dodge the Bullet

• Shard & Replicate – Treat islands as fault domains, sync in near-real-time.
• Zero Trust, Zero Drama – Re-verify every call; paranoia is cheaper than lawsuits.
• Break Things on Purpose – Run monthly “MPI outage day”; track who sweats first.
• Incident Sunlight – Publish anonymised logs; crowdsourced audit beats hush-hush.

Bitter Joke: “Only Five Minutes Down”

Officials love saying, “Downtime was just five minutes.” Five minutes in an ER can equal a lifetime deficit. Somewhere, a conference room still enjoys pastel cakes while an operating room rolls dice with opioids.

Personal Rant & Typo

I once fat-fingered a patient ID. System refused—hallelujah. But if MPI lagged and I forced it, we’d birth a clone patient. Next morning you’d have double meds, half accountability. Typos are cheap; consequences invoice later.

Semi-Serious Survival Kit

• Local encrypted log copy — not a plain CSV on “Downloads/RandomStuff”.
• Real UPS please — not that plastic box that squeaks more than it charges.
• Ask the client — verifying allergy by voice still works when databases nap.
• Read the docs — Playbook Intro. Mark the gaps. Bet you’ll need extra sticky notes.

No Grand Finale

Outages will happen again. Maybe after lunch, maybe next Ramadan. Let’s hope by then we’ve moved beyond password “admin123456” and a single points-of-failure shrine. Otherwise, grab that candy-wrapper; we’ll be charting history on it—again.