SIM-RS Vendor Clarification – Hexafara & Innova Medika

Participants, Context & Objectives

• Meeting Type: Zoom vendor‐clarification sessions recorded for formal evaluation.
• Host Organisation: RS Semen Gresik (Procurement, Logistics & User Team).
• Core Hospital Team
  • Meenita (Procurement & Logistics lead)
  • Dr Uun – Chair, SIM-RS procurement project
  • Ike, Hadi, Nanang (Finance/Acct), Yogi (IT), Ani, Sri, Abid, etc.
• Vendors Present
  • Session 1 – PT Hexafara Sena Teknologi (HSFara): Ahmad (Dir.), Kevin (PM/Presales)
  • Session 2 – PT Innova Medika (IM): Lastri (Biz Dev), Wawan (Implementation Leader), Desi (Support).
• Overarching Goals
  1. Clarify offered specifications & migration paths (not functional demo).
  2. Test feasibility of “go-live” target: mid-Dec $2024$ (≈ 4-5 months from Jul/Aug contract).
  3. Discuss contractual models, bridging with existing ERP, infrastructure, support & cost variables.

Vendor 1 – PT Hexafara (HSFara)

Proposed Timeline & Major Milestones

• Contract assumed signed in July; project “Day 0” in August.
• Total internal Gantt: 5 months, BUT commercial proposal counts only 4 because month-0 admin excluded.
  1. Month 1 (Aug) – Master-data setup & full migration
     • Patients, visits, transactions
     • Validation at end of month.
  2. Month 2 (Sep) – Training + Simulation
     • 2 weeks classroom (≤10-20 pax/class dependent on space)
     • Week 3 “double-input” field simulation on real patients (sample 10 – $ext{≈}20$ or $10\%$ of daily census).
     • Week 4 refresh, mitigation & comms.
  3. Month 3 (Oct) – Cut-off & Go-Live (front office + core modules)
     • Outpatient→Billing first; CASMI & some finance lag into next cycle.
  4. Months 4-5 (Nov–Dec) – Extend to logistics, inventory, full finance; project close by $31$ Dec.

Data‐Migration Logic

• Current landscape: Front-end “SIMR” on Cybase; Back-end on proprietary ERP.
• Needs two DB extractions.
  • “SIMR” tables: easier (patient & visit).
  • ERP: usually closed, but export menus exist (revenue, procurement, ledgers).
• Access requested: direct DB or exported CSV; Hexafara runs ETL & validates twice (post-load & pre-go-live).

Bridging & Transitional Strategy

• Hospital may keep existing ERP for 2H-2024 to avoid mid-year opening balance headaches.
• Hexafara supports restful/API or file push “bridging”. Level of detail (voucher, GL, inventory) to be jointly defined.
• Option to run dual systems for comparison:
  • Use ERP as book-of-record; simultaneously feed Hexafara finance in “shadow” mode.
  • Monthly cut-off snapshots proposed.

Training & Change-Management

• Role-based syllabus: Doctors, PPA, Non-medics.
• Schedule flexes around shifts (e.g., doctors only afternoons).
• Real-patient simulation fosters user confidence; cutover only after pass criteria.

Infrastructure Recommendation

• Concurrency: $100$ PCs (main hospital) + clinics (Tuban).
• Architecture:
  • 2 identical physical servers (Production & Hot-Clone) mirrored real-time.
  • 1 File-Server (≥ $8\,\text{TB}$).
  • Optional staging/cloud for DR.
• Node spec (per server): $20\,\text{vCPU}$, $64\,\text{GB RAM}$, $1\,\text{TB SSD}$, Ubuntu $22.04$.
• Proxy layer auto-routes if one node fails.
• Virtualisation on single chassis not advised for HA; prefer distinct hardware.

Contractual & Licensing Models

1. Standard “Buy - Putus”
   • Pay once; 1-year maintenance incl.; source code delivered immediately.
2. Sewa-Beli / KSO
   • $5$-year term, pay yearly; maintenance & all “nasional updates” (Kemenkes “Satu Sehat”, BPJS) free.
   • Source code handed over after full tenor (or yr-3/4 for KSO).
3. Credit system for custom work:
   • Package includes $80$ “credits”.
   • Rough rule: 1 credit = new form; minor revision ≈ $0.3!-<br /> 0.5$ credit; whole new module = variable (# forms).
   • Criteria to be fixed in PKS; extra credit → extra cost.

Open Balances & Finance

• If staying on ERP via bridging, $\text{Opening Balance}=0$ in Hexafara.
• If/when migrating finance, import journal + saldo once at year start; Hexafara prepared to run $\text{Import}<em>{JU}$ & $\text{Import}</em>{Saldo}$ twice.

Ethical / Data Points

• Database supplied to hospital even if service stops (after “grace period”).
• Hexafara locks source but not data; commitment to hand DB dump.

Vendor 2 – Innova Medika (IM)

Module Portfolio (≈ $43$)

Front Office (clinical & service)

• Antrian, Kiosk, Rawat Jalan/Inap/Darurat
• Penunjang: Lab, Radiologi, Bank Darah, ICU, MCU, Bedah Sentral & Anestesi, Rehab, Persalinan, Gizi, CSSD, Laundry
• Keperawatan, Farmasi & Billing
• Integrations: LIS interfacing, DICOM View, Hemodialisa, Ambulance Info, Mobile PATI/Doctor

Back Office (administrative & analytics)

• Finance/Accounting, HR, Payroll, Remunerasi, Budget, Asset, Gudang (Umum & Farmasi), Pengadaan
• SIE Dashboard, PMKP, PPI, RS Online, WA Gateway, SESA Admin, etc.

Implementation Methodology

1. Project Kick-off (wk-1).
2. Collect & Master Data 2-4 wks
3. Data Migration $\approx 4$ wks
4. User Training 1 mo.; class, workshop & ward-round models.
5. Trial Running 2-3 wks dual-system (\text{random sample} $=\,120$ cases).
6. Go-Live (Front Office first) – target Nov $2024$.
7. Pendampingan – Onsite 2 support + 1 analyst for remaining months.
8. Parallel Back-office roll-out after FO stable.

Timeline Illustration

Assuming contract signed $\text{Aug}<em>{01}$: $\underbrace{\text{Aug}}</em>{\small Kickoff+Collect}+\underbrace{\text{Sep}}<em>{\small Migration}+\underbrace{\text{Oct}}</em>{\small Training}+\underbrace{\text{Nov}<em>{1-3}}</em>{\small Trial}=\text{GoLive}_{Nov\,wk4}$
Meeting hospital’s mid-Dec target with \textit{one-month buffer}.

Infrastructure Requirements

• Internet: Dedicated $\ge50\,\text{Mbps}$, Telkom/CDN preferred for BPJS Trustmark.
• Network: Category-6 UTP, FO backbone, VLAN QoS, Gigabit switches, mandatory firewall (ISO $27001$ / Permenkes $24/22$).
• Client PC: Core i5, $8\,\text{GB RAM}$, SSD, Windows >7.
• Servers (recommended 3):
  • Application
  • Database
  • Backup (DB + PACS/RIS), plus UPS & physical server room standards.
• DR/Co-location per regulation: $\ge72\,\text{km}$ from primary.

Data Migration & Bridging

• Prefers DB-to-DB if hospital grants full SQL access ⇒ Collect + Migrate can run in parallel.
• If DB closed, template spreadsheets supplied.
• Bridging to existing Khas Micro ERP or any 3rd-party via open API/file; prerequisite: counterpart exposes interface.

Financial & Contract Schemes

1. 1-Year Buy-Out
   • Implementation $4!-<br /> 6$ mo + 6 mo onsite/remote support.
   • Onsite team: 2 Support + 1 Analyst (12 mo).
   • Entitlements: $20$ new-feature + $50$ improvement cases/year.
2. 3-Year Extended Ownership
   • Same initial deployment; payment = DP + monthly, inclusive of updates & support to $\text{YR}_3$.
3. KSO 5-Year (Build-Operate-Transfer)
   • Innova invests; hospital pays revenue/visit share.
   • All national updates (Kemenkes, BPJS) covered; larger annual improvement quota.
   • After $5$ yrs: full hand-over, data + code.

• Licensing: Echo Hospital brand remains IM; customised sub-modules belong jointly but RS-SG has exclusive use; second hospital requires new licence.

Customisation Governance

• Two buckets per year
  • Improvement: $50$ cases (modify existing feature/layout/report).
  • New Feature: $20$ cases (functionality absent in core system).
• Weighting decided via joint Change-Request (CR) doc signed by RS & IM.
• If quota exhausted: additional paid work possible (quote provided).
• Examples
  • Change Billing template ⇒ Improvement (1 case).
  • Add ESWL Penunjang module ⇒ New Feature (1 case + sub-forms counted individually).
  • Major structural changes cross-impacting multiple reports may count >1 after discussion.

Data Security, IP & Ethics

• NDA for organisation + individual staff; data remains solely hospital property.
• Licence limited to RS Semen Gresik; separate licence needed for external clinics/branches.
• On contract end:
  • Full DB dump supplied.
  • Bug-fix support continues via Help-Desk; enhancement needs new agreement.
• Compliance with Indonesian PDP Law, Permenkes, ISO, BPJS Trustmark.

Cross-Vendor & Strategic Considerations

• Both vendors willing to bridge with existing ERP to avoid mid-year finance migration; opening balances stay in ERP ⇒ zero reconciliation headaches.
• Hospital must decide:
  1. Front-office only vs full-suite adoption timeline.
  2. Buy-out vs multi-year vs KSO (cash-flow, IP rights, maintenance exposure).
  3. Custom credit sufficiency & early “bulk credit” request to handle gap analysis.
• Ethical / practical impacts
  • Ensure DR site $\ge72$ km (Innova reminds of regulation).
  • Source-code escrow timing affects long-term autonomy.
  • Data confidentiality contractually enforced; vendors provide DB access even if service ceases.
• Real-world relevance
  • National programmes (Satu Sehat, VClaim 3.0, RME regulation $\le2025$) drive urgency.
  • Finance bridging approach matches many Indonesian RS that migrated clinical first.

Numerical & Technical Quick-Ref

• Concurrent users: $\approx100$ (main RS) ; clinics additional.
• Server sizing (Hexafara): $20\,\text{CPU} \times 2$, $64\,\text{GB}$ RAM, $1\,\text{TB}$ SSD each, $8\,\text{TB}$ file-store.
• Dedicated Internet: $\ge50\,\text{Mbps}$ CDN Telkom.
• Timeline math example
  $\text{Start}<em>{\text{Aug}} + 4\,\text{mo} = \text{GoLive}</em>{\text{Nov}} \rightarrow \text{Buffer}_{\text{Dec}}$ (meets target).

Action Items for RS Semen Gresik Team

1. Decide preferred vendor short-list & contract scheme.
2. Provide vendors with
   • Current DB access credentials OR exported datasets.
   • Finalised list of modules (front/back) & bridging endpoints.
3. IT Dept: Finalise server procurement or allocate existing HW per spec; plan network VLAN & firewall.
4. Draft PKS clauses for
   • Credit definition & measurement
   • Dedicated onsite personnel
   • SLA & penalty for downtime
5. Schedule further negotiation sessions (pricing, credit extension, legal review).
6. Internal change-management plan: user champions, training rooms, cut-over comms.