Tesis

“Telaah Pemanfaatan Telemedicine DoVIA Dalam Skrining Kanker Serviks Oleh Praktisi Medis Di Indonesia” = "Review of the Use of DoVIA Telemedicine in Screening of Cervical Cancer by Medical Practitioners in Indonesia"

Latar Belakang : Kanker serviks merupakan ancaman bagi kesehatan reproduksi perempuan di Indonesia. Dengan metode skrining yang cost effective kanker serviks dapat dicegah, sehingga angka morbiditas dan mortalitas kanker serviks dapat diturunkan. Maka diperlukan metode alternatif yang lebih sederhana dan mampu laksana sebagai metode penapisan yang dapat mencakup lapisan masyarakat dengan sumber daya terbatas. Dengan prosedur skrining IVA atau VIA (Visual Inspection with Acetic Acid), diperkirakan mengurangi risiko kanker serviks seumur hidup sebesar 25%. Kekurangan IVA adalah bahwa metode ini bersifat subjektif dan interpretasi dapat bervariasi dari operator ke operator. Oleh karena itu, timbul pemikiran untuk melakukan dokumentasi IVA menggunakan kamera Smartphone yang disebut DoVIA (Documentation Visual Inspection with Acetic Acid). Bermodalkan dokumentasi IVA ini, dapat dilakukan konsultasi dan komunikasi dengan cara mengirimkan melalui aplikasi dan rangkaian kegiatan disebut TeleDoVIA (Telemedicine Documentation Visual Inspection with Acetic Acid) Tujuan : Evaluasi pemanfaatan Portal TeleDoVIA oleh tenaga medis dalam kegiatan skrining kanker serviks dengan metode IVA. Metode : Penelitian ini merupakan penelitian deskriptif. Dilaksanakan dalam periode Juli 2018-Januari 2019 dengan mengikut sertakan 82 orang Praktisi Medis yang mengirimkan 177 foto Dokumentasi IVA Hasil : Praktisi Medis yang terlibat 59 orang (72 %) adalah bidan, 23 orang (28 %) adalah Dokter Umum yang bertugas di Puskesmas (92.7 %) dan Klinik Swasta (7.3%). Praktisi Medis yang berkonsultasi pada portal TeleDoVIA telah mencakup wilayah provinsi paling barat (Aceh) hingga Provinsi di Timur Indonesia (Papua Barat). Ketajaman gambar foto serviks dikatakan tajam sebesar (89.27%), hanya sebesar (10.73%) foto yang dikatakan kurang tajam. Mayoritas praktisi medis menerima jawaban dari konsultan dalam waktu > 6-24 jam sebesar (44.1%). Praktisi medis yang mengaku paham sebesar (100 %) dan mengaku puas (100 %). Alasan praktisi medis melakukan konsultasi dengan alasan Konfirmasi (47.6%), Ragu (29.3%) dan Diskusi kasus (23.2%). Ketepatan diagnosis antara praktisi medis terhadap diagnosis konsultan sebesar (88.1%) Kesimpulan : Dengan Telemedicine Dovia dapat memudahkan praktisi medis mengirimkan dokumentasi IVA sebagai bahan diskusi dan konsultasi jarak jauh yang efektif.
Kata Kunci : Tele Dovia, Skrining Kanker Serviks, Praktisi Medis, IVA


Background: Cervical cancer is a threat to women's health in Indonesia. With the screening method that is cost effective cervical cancer can be prevented, so that the cervical cancer morbidity and mortality can be reduced. Then an alternative method that is simpler and more feasible as a screening method that can cover a layer of people with limited resources is needed. The screening procedure with IVA or VIA (Visual Inspection with Acetic Acid) has been estimated to reduce the risk of lifetime cervical cancer by 25%. The disadvantage of IVA is that this method is subjective and interpretation can vary from operator to operator. Therefore, the idea arises to conduct documentation VIA using a Smartphone camera. This examination is called TeleDoVIA (Telemedicine of Documentation on Visual Inspection with Acetic Acid). With this VIA documentation, consultation and communication can be done by sending through applications and these activities called TeleDoVIA (Telemedicine Documentation Visual Inspection with Acetic Acid) Objective: Evaluation review of the use of TeleDoVIA Portal by medical personel in the Screening of cervical cancer using the IVA method. Method: This study is a descriptive study and was conducted in the period July 2018 - January 2019 by including 82 medical practitioners who sent 177 IVA Documentation photos Results: Medical practitioners that involved as much 59 people (72%) were midwives, 23 people (28%) were general practitioners who served in Public Health Center (92.7%) and private clinics (7.3%). The closest home town of medical practitioners is Central Jakarta (24.4%) and the furthest from Fakfak in West Papua (1.2%). The sharpness of cervical photographic images is said to be sharp at 89.27%, only by 10.73% photos that are not sharp enough. The majority of medical practitioners receive answers from consultants within > 6-24 hour is 44.1%. the accuracy of diagnosis between medical practitioners and consultant diagnosis is 88.1%. Medical practitioners who claim to understand (75.6%) and claim to be satisfied (76.8%). Medical practitioners consulted the TeleDoVIA portal for reasons of confirmation (47.6%), doubtful (29.3%) and discussion of cases (23.2%). Conclusion: With the presence of Telemedicine Dovia, it can make it easier for medical practitioners to send IVA documentation as a more effective discussion and consultation material even from remote area.
Keywords: TeleDovia, Cervical Cancer Screening, Medical Practitioners, VIA