SUPPLY CHAIN MANAGEMENT Of MEDICAL DEVICES IN

HOSPITAL X

Meitria Nur Sabrina

Postgraduate Study of Hospital Concentration Management

Adhirajasa Reswara Sanjaya University, Bandung, Indonesia
Email :meitrianurs @ gmail . com

Abstract

In the Medical Device Supply Chain there are several stages, namely the planning
stage, the purchase / execution stage and the distribution and utilization stage. The
undocumented implementation of the Medical Device Supply Chain through the
implementation of Physical DAK in addition to the manual system in the implementation of
the supply chain in the internal scope of the Hospital is something that must be changed in the
future, so that the use of Information and Communication Technology can provide
fundamental changes.

This study aims to determine the supply chain of medical devices and determine the inhibiting
factors in the medical device supply chain. Theoretically, this research is useful as a guideline
for conducting research that is specific to one stage of the supply chain and practically can be
used by Hospital DAK administrators or other Physical DAK administrators in understanding
the stages and regulations that must be met. This research is a qualitative research in the
category of case studies with descriptive narrative results and the results of data collection from
informants through interviews and other documents needed to complete the data needed in
this study. The results of this study are that there are three stages in the Medical Device supply
chain, namely Planning, Purchasing and Distribution and Utilization. The use of internal
applications by the Hospital in the implementation of the Supply Chain is very useful for
digital-based documentation steps in addition to the rapid completion of contracts that can meet
service needs in a timely manner. It can be concluded that this research is able to provide an
understanding of the Medical Device Supply Chain in general, can be an evaluation material
for the implementation of DAK-based Medical Device procurement.

INTRODUCTION

Obtaining health services is a human right as well as an invaluable investment. Health

development as a whole and continuously aims to increase awareness, willingness and ability
to live healthy for everyone so that the highest degree of health can be realized. To obtain
optimal health, humans must make preventive efforts that reflect a clean and healthy lifestyle,
while when sick humans will really need health services which are influenced by health human
resources, health facilities, health infrastructure and medical devices.

Parson (Asmadi, 2008) defines that health is the ability of an individual to carry out their duties
and roles effectively in optimal conditions, whileillnessis the assessment of each individual
related to their experience of suffering from anillness.

Management in healing sick patients is inseparable from the use of medical devices as medical
support, especially in terms of diagnosis enforcement, such as laboratory tests, radiology and
other supporting examinations. So that in determining illness or diagnosis, it must fulfill the
elements of patient history, physical examination and appropriate supporting examination, in
this case the function of medical devices will be needed at the stage of physical examination
and supporting examination. In addition, the existence of Medical Devices is also curative in
nature such as the use of anesthesia machines, surgical instruments, radiation devices and other
Medical Devices that are curative in nature. The challenge of the Hospital in providing
optimal health is very different from the existence of a Puskesmas which only relies on
promotive and preventive functions, namely the Hospital as a curative and rehabilitative
center. Puskesmas as a service center with preventive and promotive functions as the main
pillar prioritizes prevention and health improvement efforts such as posyandu activities, elderly
programs and other programs while in hospitals with the main focus on the function of
treatment and restoration of body functions. The above functions must obviously be supported
by the existence of reliable human resources, facilities, infrastructure and adequate medical
devices. So that the fulfillment of Medical Devices is the main thing in improving health
services.
 Health problems are increasingly complex with the changing lifestyle of the
community, especially those in West Sumbawa Regency, from traditional to modern,
especially changes in food serving patterns from self-processing to ready-to-eat food (Jung
Food). Another thing that emerges is the change in disease patterns from infectious diseases to
degenerative diseases such as diabetes, hypertension and other diseases that require
comprehensive therapeutic management. The provision of Medical Devices is the main pillar in
health services, especially those in Hospital X because the existence of Medical Devices is very
helpful in enforcing disease diagnosis, namely as a supporting tool (Laboratory and Radiology)
and is used in the management of disease therapy such as the use of anesthetic machines,
syringe pumps and so on. Procurement of Medical Devices at X Hospital is inseparable
fromsupply chain management of Medical Devices starting from planning, execution /
purchase, distribution and utilization. The process must be carried out in accordance with the
correct regulations and rules because it is related to the fulfillment of public services. Supply
chain management is the process of planning, designing and controlling the flow of information
and materials along the supply chain with the aim of fulfilling consumer desires in an efficient
way now and in the future (Schroeder, 2007). Digitalization in all areas of life including
hospitals is a challenge of change that must be faced with the readiness of competitive Human
Resources. Referring to the direction of the RPJMN 2020-2024 policy in the health sector that
efforts to improve health must be supported by innovation and utilization of technology and
strengthened by the Regulation of the Minister of Health (PMK) RI Number 3 of 2022
concerning operational guidelines for the use of DAK Fisik in the Health Sector which
describes the technical preparation and reporting in which there is the use of information
technology (Application), namely E-Renggar. The use of applications in various community
services has become a commonplace and must be able to be faced by various layers of
society.E-catalogue, E-Renggar, OMSPAN, and ASPAK. The application above facilitates the
process of procuring Medical Devices, which is a very long process, so the Hospital must be
able to answer the challenges of these advances by using applications in the planning process
and other stages in the Medical Device supply chain. The use of applications in the
implementation of the Medical Device supply chain nationally is common, for example in
planning to submit proposals for Medical Devices using the KRISNA Application, but its use is
not specific to the Hospital so that it requires the use of applications that are internally used
only by the Hospital. The existence of an internal Hospital Application can be a solution in
facilitating the planning process and other stages, namely the fulfillment of supporting data
inreal time, documenting the Medical Device supply chain process at all stages which have
been carried out through separate applications according to the stages carried out. Based on the
results of the initial research survey in July 2022 on the implementation of Medical Device
planning, it was found that the internal planning process was still conventional, meaning that
the collection of proposals is still used excel, word and pdf data from service units. With a
conventional system, the supporting data needed cannot be in real time because it must be
collected manually and with a conventional system it cannot contain a reporting and evaluation
system for the implementation of DAK Physical Health. Meanwhile, the use of a digitization
system or Information Technology can load supporting data and other documents inreal-
timeboth at the planning and evaluation stages. Another advantage of using an application
system is that all DAK Fisik Health Hospital administrators can access information in real time.
related to the implementation of DAK information at information Physical.

Health as well as enabling a secure data storage process and minimizing the use of
paper. The use of applications in the planning of Regional Apparatus Organizations has become
a commonplace, for example the Regional Government of West Sumbawa Regency in Regional
Planning uses the E-Renja, SIPD, and SIMDA applications while specifically planning for
Medical Devices uses the KRISNA application. The use of applications in all planning
sequences should be followed by the use of applications in the planning of Hospital Medical
Devices that can be used internally by being guided by more established planning applications
from the Ministry of Institutions, especially those related to the implementation of health DAK.
So that the design of the Hospital's internal application that is compiled will become a guideline
for making Hospital Applications in the implementation of the Health DAK with the advantage
that the application can summarize all stages of the Medical Device supply chain that has been
used so far separately according to the stage being performed.

Based on the description above, the researcher has an interest in researching "Medical
Device Supply ChainManagementat Hospital X".thethe thing that makes a difference in similar
studies is that this study will describe in depth the detailed planning process of Medical
Devices, as well as the regulations that accompany the process of procuring Medical Devices,
especially those in X Hospital. This research clearly has a level of difference and answers the
deficiencies of previous research which only focuses on analyzing the supply chain of
Consumable Medical Materials and Medicines whose suppliers are mostly domestic, while
Medical Devices are mostly imported goods. Then in the research, the application design will
be presented based on the exposure of the collection results from informants related to the
medical device supply chain.

RESEARCH METHOD

Place and Time of Research

This research was conducted at X Hospital as one of the Health DAK holders,
especially those related to Medical Devices.
Type of Research
According to Creswell (2009) qualitative methods are divided into five types,
namelyphenomenological research, grounded theory,ethnography,case studies,and narrative
research. And this research is a type of qualitative research in the CaseStudy category, which is
a type of qualitative research, where researchers conduct in-depth surveys of programs, events,
processes, activities, of one or more people (Sugiyono, 2015).
Data Analysis

Merriam (1988) and Rossman (1989) state that in qualitative research, data collection
must take placesimultaneously. There are two types of data collected in research, namely
primary data and secondary data. According to Uma Sekaran, primary data is data obtained
from the first hand by carrying out specific studies to obtain information objectives from the
data, while secondary data is data with information collection based on existing data. According
to Sugiyono, primary data is a data source in providing information directly to research data
collectors while secondary data is data that is used only as support for primary data. In this
study, the researcher determines that the type of research is qualitative so that the results of the
study will be presented in a descriptive-narrative manner where the researcher will describe the
results of the interview as a form of data findings that are intensive, reflective and detailed. Data
analysis is carried out inductively based on facts found in the field and then conceptualized into
hypotheses or theories (Sugiyono, 2015). The results of the data analysis will be a reference for
researchers in compiling the design of the application content that must be contained in making
applications and in the future can be used internally by units in the hospital. The design of
innovations related to the design of the Medical Device shopping application will explain the
benefits for the Hospital, namely the fulfillment of planning elements in application features
such as proposed tools, proposed results and reporting and evaluation of Hospital Health DAK.
In the Health proposal which contains the cost budget plan (RAB), justification of medical
devices, medical device pricing forms, medical device drawings ( The results of the data
analysis will be a reference for researchers in compiling the design of the application content
that must be contained in making applications and in the future can be used internally by units
in the hospital. The design of innovations related to the design of the Medical Device shopping
application will explain the benefits for the Hospital, namely the fulfillment of planning
elements in application features such as proposed tools, proposed results and reporting and
evaluation of Hospital Health DAK. In the Health proposal which contains the cost budget plan
(RAB), justification of medical devices, medical device pricing forms, medical device drawings
( The results of the data analysis will be a reference for researchers in compiling the design of
the application content that must be contained in making applications and in the future can be
used internally by units in the hospital. The design of innovations related to the design of the
Medical Device shopping application will explain the benefits for the Hospital, namely the
fulfillment of planning elements in application features such as proposed tools, proposed results
and reporting and evaluation of Hospital Health DAK. In the Health proposal which contains
the cost budget plan (RAB), justification of medical devices, medical device pricing forms,
medical device drawings ( The design of innovations related to the design of the Medical
Device shopping application will explain the benefits for the Hospital, namely the fulfillment of
planning elements in application features such as proposed tools, proposed results and reporting
and evaluation of Hospital Health DAK. In the Health proposal which contains the cost budget
plan (RAB), justification of medical devices, medical device pricing forms, medical device
drawings ( The design of innovations related to the design of the Medical Device shopping
application will explain the benefits for the Hospital, namely the fulfillment of planning
elements in application features such as proposed tools, proposed results and reporting and
evaluation of Hospital Health DAK.

DISCUSSION

Etymologically, the word management comes from Frenchmanagement, which means

the art of carrying out or organizing. While terminologically, experts define management
differently, namely: Follet as cited by Wijayanti (2008) defines management as the art of getting
work done through other people. According to Stoner as cited by Wijayanti (2008) management
is the process of planning, organizing, directing, and controlling the efforts of organizational
members and the use of other organizational human resources in order to achieve designed
organizational goals. Gulick in Wijayanti (2008) defines management as a discipline (science)
that seeks systematically to understand why and how individuals work together to achieve goals
and make the system more useful for humanity.

Management is a profession that requires professionalism characterized by the fact that

professionals make decisions based on general principles, professionals get their positions
because they achieve certain standards of work performance, and professionals must have.

The Supply Chain is a network of companies that simultaneously work to create and
deliver a product to the hands of the end user. These companies usually include suppliers,
manufacturers, distributors, retailers, and supporting companies such as logistics service
companies (Pujawan, 2005).

Supply Chain is a system in the organization that distributes production of goods and
services to its customers. This chain is a network of various interconnected organizations that
have the same goal (Indrajit and Djokopranoto, 2006).

This Supply Chain Theory refers to the three identified problems. Supply Chain is an
important process for a company. In their business activities, because this process is a
comprehensive process that every company has in running a business. from the procurement
process of raw materials for spare parts to the production of spare parts into finished goods, and
then the distribution process to the end consumer.

According to the case study of Intan Novita D., et al (2016) entitled Supply Chain
Analysis of Medical Consumables Procurement, theE-catalogueprocurement system is an
electronic information system that contains information about the name of drugs and medical
devices, types and technical specifications, unit prices and provider factories (Binfar Ministry
of Health, 2013). In the study, it was pointed out that there are differences in prices that vary
greatly depending on the provider, both local and imported, so further research is needed in
assessing price variations in product excellence.

Supply Chain Management is a complex process that requires the coordination of many
activities so that the delivery of goods and services from suppliers to customers is carried out
efficiently and effectively for all parties involved (Turban, et al., 2008).

From the definition above, it can be concluded that supply chain management is an
integration and coordination system in the planning process, Design and control the flow of
information and materials so that goods can reach consumers quickly and accurately.
 Based on the description above, in the implementation of the supply chain, especially
related to the procurement of Medical Devices, strategies and innovations are needed so that
their fulfillment is in accordance with the needs of quality health services. In the supply chain
of hospital medical devices, it is inseparable from the implementation of the Health Physical
DAK, in which there are long stages and the application of an adequate information system by
the central DAK guardian. Information systems in the implementation of DAK Fisik are related
to the use of various applications to facilitate planning implementers at the regional level in
preparing proposals, synchronizing data and evaluating competitive health development. At the
Regional Level, especially the Hospital, Exposure to the theory above by the Hospital as one of
the Regional apparatus organizations can maintain the availability of Medical Devices by
submitting proposals based on existing and unmet Medical Device data digitally through the
ASPAK application. The use of the application by the DAK Fisik guardian is a reference in
determining the budget allocation obtained by the Region which greatly affects the
sustainability of the Medical Device supply chain.

Stages of Medical Device Supply Chain Planning

The process of planning Medical Devices in the Hospital starts from planning the level
of existing units such as Outpatient, ER, Hospitalization, Operating Room, Laboratory, and
Radiology. The stage is to involve a Specialist doctor or DPJP (Doctor in Charge) in the unit. At
this stage, interested guardians assess the Hospital's need for the importance of Medical Devices
with the aim of improving services, meeting Hospital standards and replacing Medical Devices
that were previously damaged. Furthermore, the proposal will be submitted through the field of
direct coordination, namely the Division of Medical and Nursing Services and the Division of
Medical Support and Facilities. Based on the planning process above, it is explained by the
results of interviews with the planning sub-section that the proposals that have been collected
by the field of DAK will be submitted to the Hospital's planning and reporting sub-section to
be followed up through submission to the Center using the Special Allocation Fund. In
submitting proposals, it is important for the Hospital to be guided by existing regulations,
namely Minister of Health Regulation No. 3 of 2022 concerning operational guidelines for the
use of DAK Fisik for the Health Sector article 6 relating to technical preparation which refers to
the proposal document, the results of the proposal assessment, the results of the synchronization
and harmonization of the proposal, the results of the proposal on the aspirations of the House of
Representatives (DPR RI) and the allocation of DAK Fisik through the portal of the Directorate
General of Fiscal Balance listed in the presidential regulation regarding the details of the
APBN. The regulation is a reference that will be elaborated in detail through the extension of
the Ministry of Health, namely the Provincial Health Office through technical meetings on the
Special Allocation Fund for Health.

The submission of the Hospital proposal enters the initial stage after the process of receiving
proposals from the Coordination Division, namely inputting through a government approved
application under the Ministry of Institutions / Bappenas, namely the KRISNA application. It is
important for the Hospital to oversee the proposal both in the synchronization phase and the
phase of preparing the DAK RK (Work Plan) because in that phase the Hospital must be able to
meet the requirements. The completeness of the data requested by the center as a condition for
the fulfillment of the request for the proposed Medical Devices. The planning process for
Medical Devices in general in Government-owned Hospitals is relatively the same, namely in
general, by utilizing the Special Allocation Fund from the APBN, but it does not rule out the
possibility of using the General Allocation Fund (Local Government) and the Hospital BLUD
Revenue Fund for the purchase of Medical Devices of small value. The purchase of medical
devices is also slightly different in the distribution process because it is stored in advance by the
treasurer of goods in the storage warehouse.

Stages of Medical Device Supply Chain Purchasing

At the purchasing stage based on the results of interviews with computer operators
(Person in Charge / PIC KRISNA) and procurement of technical officials that the execution
process or stages of purchasing Medical Devices is carried out through two methods, namely
theE- Catalogue processand theNon E-CatalogueProcess, but on average the Hospital prefers
theE- Catalogueprocess which is safer because it is based on the application of information
Technology (Application). For theNon E-Cataloque processthe process is slightly different,
especially in the fulfillment of supporting data in the planning phase, namely there are offers
from two providers (Distributors) which in theE-Catalogueprocess only send screen
images of the proposed Medical Devices through the Application. The process of executing
Medical Devices according to regulations is to fulfill the DAK medical device procurement
contract and input through the OMSPAN application. Furthermore, if the hospital can
fulfill it, the purchase / execution process will be carried out. The results of the discussion
of interviews with the Hospital DAK guardian (OMSPAN/Finance Operator) that the
above series of actions are inseparable from the fulfillment of the details of expenditures in
the Hospital Budget Implementation Document which previously passed the stage of
preparing the DAK Physical expenditure contract which will be input through the
OMSPAN application consisting of the Medical Device provider, contract number, start
date of work implementation, end date of work implementation and ceiling value. After
this process runs, APIP through the Regional Inspectorate will conduct a review and the
results will be dispatched to the Regional Budget Agency to request the disbursement of
DAK funds through the State Treasury Service Office (KPPN) so that the distribution of
funds by the Center can be carried out. The results of this study are different from the
procurement of medical Consumables which can be done by the direct expenditure method,
although both types of expenses are different is still the responsibility of the Pharmacy
Installation.

Stages of Medical Device Supply Chain Distribution

The distribution process is something that cannot be separated from the process of
purchasing goods itself because there is a process of shipping goods to the storage phase in the
goods warehouse. The distribution process in a small aspect can also be interpreted as the
process of distributing goods / medical equipment at the internal level of the hospital, namely
distribution to user units both in Medical and Nursing Services and Medical Support and
Facilities.

This stage is the last stage of the Supply Chain, where the Medical Device after testing by the
Vendor / Provider then the Hospital staff in the relevant unit can use the Medical Device for
community services. This stage is very crucial because it is related to the operation aspect of
the tool, the maintenance aspect and theutilitiesof the Medical Device. In general, the
distribution process of Medical Devices in each Hospital is the same, but there are differences
in the distribution model with other types of pharmaceutical preparations such as Drugs
and Consumable Medical Materials which need to be stored in the Pharmacy Warehouse
which then distributed to the Hospital Pharmacy to be used according to the needs of the
community of health service users.

Supporting Factors in the Health Equipment Supply Chain

Based on the results of the exposure related to the stages of the medical device
procurement process starting from planning, purchasing medical devices and distribution, it
can be concluded that the supporting factors in the Medical Device Supply Chain are
continuously updating of ASPAK data, improving information on operational standards for the
use of Medical Devices, and using an integrated internal information system in the
implementation of the Health Physical DAK. In this case, it is very important to use the
Application as part of the Supply Chain Management Innovation, namely an Application that
can contain and document all stages of the Medical Device supply chain from planning to the
evaluation stage.units in thehospitals to submit proposals for medical devices and fulfill the
elements of information and documentation fulfillment at all stages of the Health Physical
DAK implementation.

Inhibiting Factors in the Medical Device Supply Chain Planning Stage

The planning stage is the main stage in the Medical Device supply chain cycle, this
stage requires a long time compared to other stages because it involves government
organizations both at the regional scale to the central / national scale. In the planning stage, the
Hospital must be able to collect detailed and comprehensive data related to the availability of
Medical Devices (ALKES) through the ASPAK application and the proposed Medical Devices
will affect the realization of proposals by the Ministry of Institutions. The condition that often
occurs is that there are differences in the factual conditions of the proposed medical devices,
namely medical devices that are in bad / damaged condition but in the ASPAK application the
input is still in good condition. The discrepancy between thereal conditions of the Medical
Device and the input data in the ASPAK application are an important part of the acceptance of
the proposal so that the Hospital must continuously improve the data according to the
conditions.

Furthermore, at the stage of determining the price of Medical Devices, the Hospital
must fulfill theE-Catalogueprice standard, shipping costs and a maximum estimated increase
of 15% (fifteen percent), this is also very crucial because there are several items of proposed
Medical Devices through the agreed provisions. Fornon-E-CatalogueMedical Devices must
fulfill two offers from two different vendors to be evaluated for Physical DAK planning by the
Hospital. Fulfillment of the supporting data for the Medical Devices mentioned above is often
an obstacle for the planning team if the DAK Hospital is late in fulfilling it.

Health Services in 2015. The Directorate of Medical Support Services and Health
Facilities and the output component of the implementation of medical device procurement
at Padang Pariaman Hospital are not fully in accordance with the needs of hospitals
andusers. In general, the process of procuring medical devices in hospitals owned by the
Regional Government in terms of planning is the same, it's just that each hospital must
innovate and improve its strategy so that its implementation runs optimally.

Inhibiting Factors in the Purchasing Stage of the Medical Device Supply Chain

Procurement of Hospital Medical Devices is different from shopping in general,

because there are regulations and provisions that limit it. After the issuance of the DAK RK
(Work Plan) through the KRISNA application, the hospital will follow up with

with the input of medical devices through the Regional Apparatus Organization
Budget Implementation Document as the basis for medical device expenditure. The
shopping process cannot necessarily be carried out until there is a distribution of funds
from the OMSPAN application and special shopping contracts related to shopping
contracts often take actions that are inconsistent with the ceiling value in the RK (Work
Plan) and are coupled with delays in completing the DAK contract. This is not a violation
because the difference is made to the type of Medical Devices at a lower price, but it will
affect the value of realization and delays in the realization of expenditures which will have
a negative impact on the realization of proposals and inputting evaluation of DAK
implementation through the E-Renggar application.

In general, the results of the study concluded that the obstacles in the purchasing
process are relatively low because they are related to the process of preparing contracts and
administering the distribution of funds sourced from the use of applications, while in terms
of the selection of shopping methods the Hospital only uses theE-catalogue / E-Purchasing
method which is more guaranteed legality administratively. However, the type ofnon-E-
Catalogueshopping is still possible to do if the Medical Device is not available inE-
Catalogue although this is rarely done by the Hospital. And this is different from the
results of previous studies related to shopping for drugs and consumable medical materials
that allow direct shopping other than E-catalogue shopping.

Inhibiting Factors in the Distribution Stages of the Medical Device Supply Chain

At this stage, the problems that are often faced are related to the registration of
equipment in service units that are not so strict. In addition, hospitals are faced with a large
number of health workers and a large number of users, allowing the productive age of the
equipment to decrease, plus the mobility of equipment by officers which affects the census
of medical devices and the input of the ASPAK the application ultimately updates the
process of planning medical devices for the next stage. The results of this study strengthen
previous research on the use of information systems inrealtimeinventory of goods which is
answered by the application of the contents of the Application design in the Medical
Device Supply Chain.

CLOSING

Conclusion

Supply Chain Management of Medical Devices at the X Hospital Pharmacy

Installation is used to maintain the continuity of services, especially medical devices and
ensure the safety and authenticity of products purchased from authorized distributors.
Supply Chain Management is a very important concept, especially for DAK holders related
to the procurement of medical devices because it is a reference in understanding the
systematics of the Supply Chain and the legal aspects and understanding of regulations in
accordance with predetermined provisions.

The implementation of the Medical Device Supply Chain consists of the planning,
purchasing and distribution and utilization stages. The Medical Device Supply Chain
process has followed good rules starting from the absorption of proposals tousers, the use
of Application media, shopping methods to function tests on Hospital service units.
Shopping for medical devices usesE-Catalogueandnon-E-Catalogueif the medical device
is not available inE- Cataloguewith a central funding source (DAK). However, shopping
fornon-E-Cataloguewith two offers as a condition of central approval is very rarely done
because the availability of Medical Devices is complete inE-Catalogue. In Hospital
procurement, the process will be illustrated through the Health Physical DAK planning
process in which there are planning stages, purchase/execution stages, distribution and
utilization stages. The Medical Device planning process follows the appropriate rules and
regulations, namely the proposal starts from the userunder the service unit and medical
support for further recapitalization by the Hospital planning subdivision and submission of
proposals through the KRISNA Application. Then the purchase stage is carried out
according to the results of the contract and RK-DAK is carried out by the budget user after
the financial administration through the OMSPAN application is completed. While the
storage process such as pharmaceutical preparations is not carried out because Medical
Devices are directly distributed to the unit that received the proposal.
 REFERENCES

Arikunto, et al. (2006). Prosedur Penelitian. Edisi Revisi VI. Jakarta: PT. Rineka Cipta.
Assauri, S. (2011). Manajemen Produksi dan Operasi. Jakarta: Lembaga Penerbit FEUI.
Budiman Evander. (2013). Evaluasi Kinerja Supply ChainPada UD. Maju Jaya Di Desa
Tiwoho Kabupaten Minahasa Utara. Jurnal : Fakultas Ekonomi dan Binsis, Jurusan
Manajemen Universitas Sam Ratulangi Manado.
Creswell, John W. (2016). Research Design : Pendidikan Metode Kreatif, Kuantitatif dan
Campuran. Edisi Keempat (Cetakan Kesatu).Yogyakarta: Pustaka Pelajar.
Heizer, J, et al. (2011). Principles of Operations Management. United States of America.
Pearson: 698.
Heizer, J, et al. (2005). Operations Management. th
7 Edition, Pearson
Education, Inc., Upper Saddle River, New Jersey.
Indrajit, RE, et al. (2022). Konsep Manajemen Supplay Chain : Cara Baru Memandang
Mata Rantai Penyediaan Barang. Jakarta: PT. Grasindo.
Intan Novita D, et al. (2016). Analisis Rantai Pasok Pengadaan Bahan Medis Habis Pakai
(Studi Kasus : RS Puri Asih Salatiga).
Istinganah, et al. ( 2006), Evaluasi Sistem Pengadaan Obat dari Dana APBD Tahun 2001-
2003 Terhadap Ketersediaan dan Efisiensi Obat, Jurnal Manajemen Pelayanan
Kesehatan, Vol. 09, No.1 Maret 2006, hal 31-41.
Kadir Abdul, et al. (2003). Pengenalan Teknologi Informasi. Yogyakarta: Andi.
Lena, A. (2017). Pengertian PHP dan MySQL. Retrieved from Ilmu Teknologi Informasi
Ilmuti.Org.
Magdalena, E (2005). Analisis kinerja Supply Chain Management pada PT. Sion Birdnest
di Surabaya. Tesis Pasca Sarjana, Universitas Kristen Petra, Surabaya.
Malin, JH (2006). Knowing the SCOR : Using business metrics to gain measurable
improvements, Journal Healthcare Financial Management, July 2006, pg.54,
Minneapolis.
Mc Leod, R. (2007). Management Informasi System.
New Jersey, USA: Pearson Prentice Hall.
Menteri Kesehatan RI. (2022). Peraturan Menteri Kesehatan Nomor 3 Tahun 2022 Tentang
Petunjuk Operasional Penggunaan DAK Fisik Bidang Kesehatan. Jakarta.
Menteri Kesehatan RI. (2017). Peraturan Menteri Kesehatan Nomor 62 Tahun 2017
Tentang Izin Edar Alat Kesehatan, Alat Kesehatan Diagnostik In Vitro dan
Perbekalan Kesehatan Rumah Tangga. Jakarta.
Neuman, W. Lawrence. (2016). Metode Penelitian Sosial : Pendekatan Kualitatif dan
Kuantitatif. Edisi Ketujuh (Cetakan Kedua). Jakarta: PT. Indeks.
Parray, SH, at al. (2007). Supply Chain Management in Healthcare Sector Role of Logistic,
Indian Journal for the Practising Doctor, India.
Poerwanto, R. (2009). Dasar-Dasar Hortikultura. Bahan Ajar. Departemen
Agronomi dan Hortikultura. Fakultas Pertanian. Institut Pertanian Bogor.
Prihandini, RE (2008). Pemodelan Proses Pengadaan Barang dalam Supply Chain
Management Rumah Sakit Umum (studi kasus : RS Advent Bandung), Tugas Akhir
Departemen Informatika, Institut Teknologi Bandung. Bandung.
Pudjaningsih, D (1996). Pengembangan Indikator Efisiensi Pengelolaan Obat di Farmasi
Rumah Sakit, Tesis Magister Manajemen Rumah Sakit. Universitas Gajah Mada.
Yogyakarta.
Pudjaningsih, D (2011). Patient Safety. Dalam : Peranan Teknologi Informasi dan
Komunikasi di bidang obat dan pengobatan dalam mendukung
perlindungan pasien, cetakan pertama, S Kusumadewi, A Fuad, dan E Budhiati.
Yogyakarta: Graha Ilmu.
Pujawan, I. Nyoman. (2005). Supplay Chain Management, Edisi Pertama. Surabaya:
Guna Widya.
Rosa AS, at al. (2013). Rekayasa perangkat Lunak Terstruktur dan Berorentasi. Jurnal
Informatika.
Setianingsih, Sunarti. (2009). “Faktor Kesesuaian Tugas–Teknologi dan Pemanfaatan
Teknologi Informasi serta Pengaruhnya Terhadap Kinerja Akuntan Publik”. Jurnal
Ekonomi, Keuangan, Perbangkan dan Akuntansi. Vol.1 No. 2.
Setiawan, A. (2009). Studi Peningkatan Kinerja Manajemen Rantai Pasokan Sayuran
Dataran Tinggi Terpilih di Jawa Barat. Tesis tidak dipubikasikan. Sekolah
Pascasarjana. Institut Pertanian Bogor.
Simichi-Levi, David, Philip Kaminsky and Edith Simichi-Levi. 2003. Desinging and
Managing The Supply Chain: Concept, Strategies and Case Studies. Irwin
McGraw- Hill, Singapore.
Sugiyono. (2008). Metode Penelitian Pendidikan Pendekatan Kuantitatif, Kualitatif dan
R&D. Bandung: Penerbit Alfa Beta.
Sugiyono (2011). Metode Penelitian Kuantitatif Kualitatif dan R&D. Alfabeta Alih
Bahasa Bob Sabran. Jakarta : Penerbit Erlangga.
Sugiyono. (2015). Statistik Non Parametris Untuk Penelitian. Bandung: CV.
ALFABETA.
Sukayana IM, at al. (2013). Rantai Nilai Komuditas Kentang Granola di Desa
Cindikuning Kecamatan Baturiti Kabupaten Tabanan. E- Jurnal Agribisnis dan
Agrowisata. 2(3):99- 108.
Sutarman. (2009). Pengantar Teknologi Informasi.
Jakarta: Bumi Aksara.
Trisantika Agus Ngakan. (2017). Analisis Kelayakan Finansial dan Strategi
Pengembangan Usaha Budi Daya Lebah Madu di Resort Malimbu. KPHL Rinjani
Provinsi Nusa Tenggara Barat. [Tesis]. Yogyakarta. (ID) : Universitas Gadjah Mada.
Tumuntuan, Nissia. (2013). Analisis Saluran Distribusi Rantai Pasok Sayur Wortel Di
Kelurahan Rurukan Kota Tomohon. Jurnal
EMBA : Vol.1 No.3 Hal.914-920 , Fakultas Ekonomi dan Bisnis, Universitas Sam
Ratulangi, Manado
Yuliansyah, H. (2014). Perencanaan Repleksi Basis data MySQL dengan Mekanisme
Pengamatan Menggunakan SSL Encrytion. Jurnal Informatika Vol. 8, No. 1