Services Innovation of Sikda Optima Program at Puskesmas Jaya Mukti Dumai City

The purpose of this research is to describe the innovation of optimal service at the Puskesmas Jaya Mukti Dumai city. By the aims to analyze the benefits of community services through Health Information System (Sikda) optima program, researchers use qualitative data analysis methods. Furthermore from the information and data obtained will be drawn conclusions that are ground. Where can be done inductively, that is with a term that starts from the things that are specific to things that are universal. The result of the research show that the innovation of optima service at Puskesmas Jaya Mukti Dumai city properly runs and in line with the society's expectation. But there is still the need for application development to be more optimal, and the government is downloading the old report inside the optima application. The advantages of optima optical innovation seen from the attribute of triability (recommended to try) is less than the maximum because there are still some who do not know the process. Therefore, Puskesmas uses online and television media in providing information besides conducted the socialization in the field. The service responsibilities felt by the Puskesmas employees is a better and culture than the community given by the Puskesmas.


Introduction
defines Public service as any form services, either public commodity service or public service which is principle is the responsibility and implemented by the central government agencies, in the region and the environment of state-owned or regional-owned enterprises in the effort of fulfilling the needs of society or implementation of the provisions of legislation.American Marketing Association (Hardiyansyah, 2011) states that the services are all activities offered by people to other people and are essentially intangible and do not result in things ownership, the production process has not linked a product physically.Meanwhile (Sinambela, Lijan Poltak, 2011) referred public term as the general, society, state.Based on the definition of service and public above, public service means an advantage activity in the society which offers the satisfaction and resultsfrom the product and service.
Public service is one of the important aspects which government focuses in order to fulfill the needs of socialconcern with the daily life.But in practice, there are many problems that caused complaints from the society related to public service they fell.Therefore, through the presidential regulation No. 81 year 2010 about Grand Design of bureaucratic reform 2010-2025 with a focus on the 8 areas of change is one of public service (President of the Republic Indonesia, 2010).
Regarding with the effort of speedlybureaucratic reform through public service, central government or regional should do service innovation.Innovation in the public service is a form to realize good service and appropriate with technology era and communication information.A public organization is required to be able to innovate in service to obtain public confidence and be able to compete.This is issued in Law No.23 of 2014 on Regional Government in chapter XXI about Regional Innovation in article 386-390 (President of Republic Indonesia, 2014).
Regional Government is one of the public services that receive reports of 2853 service complaints to Ombudsman 1 .The low quality of public services that given by the government apparatus is the bad image of government in the community.Some people who dealt with bureaucracy always complain and disappointed with the service that given.There are some people who still underestimate the bureaucracy performance (Saputra, 2016).
The aims of public service its self is to provide the improvement of the public service, benefit to the society, replicable and sustainable.With many problems of public service show that the implementation of public service is still faced with the government system that has not been effective and efficient and the quality of human resources apparatus that has not been adequate.This condition can be seen from the many complain of society either in direct or indirect through social media, such as complicated procedures, non-transparant requirements, unresponsive staff attitude, and other, which ultimately causes a bad image to the government (Zaenal Mustofa, 2017).
As the most reported agencies, society complained about the service provided by the local government.This is a public complain to the local government one of them shown by public service activities by Public Puskesmas (Puskesmas).Puskesmas as the implementation of public service in the firstlyfield of health.Puskesmas is the service organization, which is health service.As the health service organization, Puskesmas required to providing the quality public service, this is also the priority form of destination from the president of Republic Indonesia, therefore, a Puskesmas is very important in building public health to Indonesia healthy.

Literature Review
Innovation involves the re-creation or adaptation from the innovation in other location in certain time.West & Farr in (Basuki, 2013) argue that innovation as the introduction and deliberate application of the new ideas, processes, and procedures to implementing units, which design to provide the advantage for the individual, group, organization and the society.Furthermore, (Rogers, 2003) set forth innovation as an idea, practice or object which is considered new by individuals.It can be concluded that innovation is shifting meaning, principles, processes, procedures and old public service model to the new model and designed to benefit individuals, groups, organizations and the public.Some of the previous researcher about the innovation of public service as follows: (Yunita, 2017) review the innovation to encourage the performance of government agencies.Performance improvement depends on the innovation that has been built.This research uses qualitative and quantitative approach.The result is 28,57% respondents stated that there was high increase in outcome and output with innovation.Hence, it is necessary to optimize innovation in order to improve of agencies performance.The innovation is also the factor of development to adjust agencies requirement so that the optimization in solving the problem and improve the agencies performance.The reference sources used in this research are using books and journals.This analysis used the theory of innovation success factor according to Cook Matthews that is Leadership, management/organization, risk management, human capital, and technology.The result showed that Emaster service has been running well but there are still many problems and not perfect in the process.
(Zaenal Mustofa, 2017) conducted a research on the One Roof System (SAMSAT) and has created a service innovation for SamsatMini(SAMIN).The presence of SAMIN service caused of the practice of brokers, jockeys, and illegal fees.The method of this research is descriptive with a qualitative approach.The result from this researcher showed that SAMIN in Bojonegoro samsat can be said has been running well, but there are still some of lack and obstacle that occurs in service socialization that has not been optimally showed with taxpayer report in a little mini samsat service.Meanwhile for an obstacle is society as a taxpayer who does not know the schedule of SAMIN.
In addition, Jati (2011) has conducted the research on the public service innovation regarding a research of samsat public service in Yogyakarta, the method used are observation, the researcher conducting the engaged.The reference sources used are books, web, brochures and journal.The result of researcher showed that the implementation of new public management that conducted by the bureaucrat'sofficer of samsat through drive-thru the system.This is because of limited public service practices through that system, it is still controlled by the district or city samsat office.Besides that, public access is still limited for information openness that provided, therefore practices of new public management in local cannot be said to succeed fully because of bureaucratic culture in the implementation of public service.The impact of bad service will decrease the public trust in bureaucrats as the public service providers, so that can broke the quality in service delivery to the public.There is the gap that public perception about the service quality that accepted not aligned with service quality expected (Yudiatmaja, 2017).The data has been collected in various ways (observation, interview, the essence of the document) and when processed previously used (through notes, typing, editing, or stationary), but qualitative data still using words usually arranged into the expanded text".

Discussion
Community Puskesmas (Puskesmas) is a unity of functional organization that conducts health efforts that are comprehensive, integrated, equitable and acceptable and affordable by the community with active participation of the community and use the results of the development of science and technology appropriate, at a cost that can be borne by the government and the wider community to achieve optimal health status, without neglecting the quality of services to individuals (Health Department, 2009).
Puskesmasis a major pillar of health services to the social community, therefore the local government, especially Puskesmasmust be able to meet the needs of the community in the field of health, in line with it the development of information technology to make health services must adapt to the demands of the times, PuskesmasJaya Mukti is one of the Puskesmas that develop service innovation public, by developing a Sikdageneric application to the health information system (Sikda) Optima.
Generic Sikda itself is a program of the Ministry of Health designed for the management of regional health information, ranging from the process of collecting, recording, managing to the distribution of health information.The use of generic spots at the Puskesmas still uses the computerized system by manually inputting patient data, this causes the perceived service of the patient at the Puskesmasto be slow and long.
This problem also occurs in Puskesmas Jaya Mukti Dumai city, therefore Puskesmas Jaya Mukti develops applications based on android optima.This application is designed from a combination of computerized information systems and internet networks, so that data obtained accurately and quickly.The advantage of using optima electron is the direct reporting of the patient in BPJS, the data is safer because it is in direct backup from the health service, and the patient is more satisfied with the given public service.As for the mission and vision of Sikda Optima program are: Process innovation conducted by Puskesmas of Jaya Mukti Dumai city focuses on developing the quality of public service.The process of service delivery requires innovation, especially in terms of service efficiency and ease of access.
It can be seen table 1 on the innovation process conducted by Puskesmas Jaya Mukti in accordance with aspects that exist in innovation.Based on Table 2, the innovation of Sikda Optima conducted at Jaya Puskesmas Mukti has enough effect on the service patient.Such as patient waiting time can be faster due to the use of Optima application because each unit of service is integrated with the application.As seen in the registration service at the counter and the taking of drugs for patients who include ease of access.
This innovation of Optima service is initiated by the head of Puskesmas Jaya Mukti and doctor in the Puskesmas to make the application connected to the internet and can be used in Android.Then this proposal was brought to the Dumai city health officials to be reported to be the flagship program of Puskesmas in the innovation of public service, after which the head of Dumai city health officials issued a letter of appointment to the head of Puskesmas Jaya Mukti to run the application Sikda Optima.The creation of the Optima application uses the budget of the regional public service agency (BLUD) to purchase the server, equipment and applications to be used.This innovation is the first in launching April 1 2016 to describe the Innovation of Service Sikda Optima At the Puskesmas Jaya Mukti, Dumai City and the researchers use the theory of innovation attributes according to Rogers in (Basuki, 2013) consisting of five attributes of innovation, namely:

a) Relative Advantage
In the attributes of relative advantage (a relative advantage), an innovation must have superiority and value more than the previous innovation.The innovation of optima electronics service established by Puskesmas Jaya Mukti has superiority and value compared to previous innovation.The advantages that distinguish the previous innovation of optima service are fast service time so that patients do not wait long, accurate patient data and direct referral to the doctor without going through the counter.Community as patient of Puskesmas can perform service easily and quickly, the time required in service 5-10 minutes have been finished except for the action, and requirement asked by officer very easy that is enough by carrying identity card (KTP) or Social Insurance Administration Organization card (BPJS) and if only can use card e which is provided by Puskesmas Jaya Mukti for substitute of ID card and BPJS card.While the value of more than Sikda Optima service that is patient service is done using online system (Android) so patient medical record do not need to be searched manually and queue machine to wait to speed up service.So the community as a patient can perform services easily and quickly in the Puskesmas without having to wait long for the queue.With the innovation Satisfaction of public to the public organization is very important because of the relationof public trust.
According to (Pasolong Harbani, 2010), "The better the governance and the quality of service provided, hence the higher the public trust".Public trust will be higher if people get a good service and feel satisfied with the service.

b) Compatibility
In the attributes of compatibility, where an Innovation must have a compatible nature or conformity to the innovation it replaces.Sikda Optima service innovation established by Mukti Jaya Puskesmas has compatible nature or conformity with previous innovation.Innovation service of SikdaOptima has the same service requirements with Sikda Generic before.In addition, the presence of service innovation Sikda Optima has been adjusted the needs, desires, and expectations of the community as a patient.Sikda Optima service has a requirement that is by using ID card, BPJS card and latest addition by using e-Card Medication, service time of 5-10 minute, and procedure is done by taking queue number then to counter to indicate the intended poly patient and then directly to pharmacist for taking medication, all systems performed by Puskesmas staff use the online system to provide faster service compared to Sikda Generic. in line with that (Saputra, 2016) stated in the research of customer satisfaction survey on the implementation of public service revealed weakness of governmental institute in apparatus behavior and service time, caused by long service time by apparatus and not conformity with service standard given.So it can be concluded that the problem of service time can be overcome by Puskesmas Jaya Mukti by using this optima will accelerate the service time given to the community as the patient of the Puskesmas.

c) Complexity
In the attributes of complexity, an innovation is possible to have a level of complexity that may be higher than previous innovations.Sikda Optima service innovation established by Puskesmas Jaya Mukti Dumai city felt no significant complexity but to provide convenience to patients, especially in terms of treatment and referral.This is indicated by a service mechanism that uses the online system.The presence of Sikda Optima service has a service mechanism that is not complicated, just with three steps of service that is the registration of queue machinery in loket by showing the identity then to the poly and to the pharmacy for taking the medicine.So the patient can do it easily because it does not require a long time, the data provided by the loket will go directly to the patient's goal and the patient who treated the doctor can directly prescribe the medicine to the pharmacy to be taken by the patient.

d) Triability
In the attributes of triability, an innovation can only be accepted if it has been tested and proven to have more advantage or value than the old innovation.Opinion (Ancok, 2012) innovation is the implementation and adoption of new thinking by individuals within the organization.West and Farr in (Basuki, 2013) define innovation as the introduction and deliberate application of new ideas, processes, products and procedures to implement units designed to benefit individuals, groups, organizations and the broader community.So an innovation product has to go through a "public test" phase, where everyone or parties have the opportunity to test the quality of an innovation.Sikda Optima service innovation established by Puskesmas Jaya Mukti Dumai City has been done public testing phase.Innovation service Sikda Optima) is present through service trials and socialization in the sub-district and assisted by maternal and child health services (posyandu) member and midwives.But until now the socialization is still running about 60% so the community as a patient who has not known the existence of service trials and socialization about 40%, during the launching application is April 2016 socialization conducted once a week during lately 2017 and it is still being socialized 1month, and the Puskesmas also cooperate across sectors to socialize with the sub-district.

e) Observability
In the attribute of observability, an innovation must also be observable, in terms of how it works and produces something better.Innovation service Sikda Optima formed by Puskesmas Jaya Mukti Dumai city can be said easily seen or observed by others.Where in this case is indicated by the existence of standard operational procedures, requirements and mechanisms of easy service.Required requirement is KTP or BPJS card and replacement of lost or live card can use e-card medication and patient have been able to do health service at Jaya Mukti, as well as for procedure already stated in operational procedure standard of Puskesmas that specified from job description of employee and mechanism the existing service consists of three stages of taking number queue, toward to loket then go on to Poly and Pharmaceutical to take medicine.The service process provided by Puskesmas Jaya Mukti is a form of the solution given to accelerate the service time given in Puskesmas.
After conducting the innovation of optima service by Puskesmas Jaya Mukti directly give impact to employee as executor of innovation.This is illustrated by a better working culture at the Puskesmas Jaya Mukti with a shared commitment to improve the services provided by the Puskesmas and making an agreement signed by all employees.Then the community as a patient also feels the services provided to be easy and faster than previous innovation that has been conducted, this makes the community as a patient more confident with the health services provided by Puskesmas Jaya Mukti Dumai city.

Conclusion
Based on the explanation of the results and the existing discussion can be concluded that Sikda Optima Service Innovation at the Puskesmas Jaya Mukti in Dumai city can be said has been running well.This is based on the results of Rogers' attribute of innovation attribute theory in (Basuki, 2013) consisting of five attributes of innovation namely, relative advantages, in this case evidenced by the advantages and more value owned by Sikda Optima Services.Compatibility, in this case is indicated by the innovation of Sikda Optima Services established by Puskesmas Jaya Mukti Dumai city has compatible properties or conformity with previous innovations, and has been adapted to the needs, wishes and expectations of the community as a patient.Complexity, the presence of Service Sikda Optima feels no meaningful complexity but to provide convenience to patients, especially in terms of treatment.Triability, in the innovation of Sikda Optima Service comes through the service trials phase, as well as cross-sectoral socialization in support of the innovation.Observability, in Sikda Optima Service at Puskesmas Jaya Mukti in Dumai city can be easily observed by others and has succeeded in producing something better.While the obstacles in using the optima brush perceived by the Puskesmas staff is the time to download old reports due to large files, but in the use of the patient there is no significant constraint.
The impact felt by the Puskesmas staff after conduct the innovation is a good work culture, and have a commitment together in running the application, and directly the patient feel is the ease of service and time more efficiency, this makes patients more confident with the health services provided by the Puskesmas Jaya Mukti in Dumai city.

Suggestion
Based on the presentation of the results and discussion of existing research, the researcher has the following suggestions: (1) Media for socialization related to the implementation of service innovation Sikda Optima service at Puskesmas Jaya Mukti in Dumai city more reproduced so that the information can be through and delivered to the public as patient in Dumai city.(2) Develop features in optima applications so that applications can be used more benefits.
(3) Establish a schedule of socialization with certainty and scheduled so that people are more aware of services provided by Puskesmas.

(
Anggraeny, 2013) use descriptive analysis method, the researchers analyze the information through key informant in service innovation.The reference sources used in this research are using books, journals, and laws.The result of researcher shows the implementation by the Puskesmas is appropriate about what the Puskesmas wants.The innovation that conducted is a process of improving the system.According to Damanpour is new product o service innovation consisting of new service and process innovation which consist of one door payment service, registration service on queue box for vulnerable group, helper and hotline service.(RizalRochman Firmansyah, 2017) analyze the innovation of E-master service in the East Java Province staff agency.
Puskesmas user The service officer clicks the service button on the tablet to input the results of the examination, diagnosis, therapy and others.8 Service first on the tablet Puskesmas user Display of patient identity, patient electronic medical record history and family medical record history 10 Internal referrals Puskesmas user The officer inputs Internal or External referral in the referral form if it is required 11 Medical record storage Puskesmas user The officer processes the results of all checks using a PIN (instead of a signature) to save patient electronic medical records into an online optima server 12 Medical prescription Puskesmas user The medicine given by the officers of each poly will automatically come out at the prescription press machine at the pharmacy (prescription of medicine).13 Tablet of satisfaction Puskesmas user The officer instructs the patient to provide a choice of services provided by the service officer, on the patient's satisfaction tablet (Satisfied or Dissatisfied Source: Puskesmas Jaya Mukti, 2017

): 2319-7064 Index Copernicus Value (2016): 79.57 | Impact Factor (2017): 7.296 Volume 7 Issue 6, June 2018 www
Optima service is an online service which felt by Puskesmas user.This is created by Puskesmas Jaya Mukti, Dumai city and Health office in 2016.So, can be said that Puskesmas service is the new service innovation which conducted by Dumai government.
.ijsr.netLicensedUnder Creative Commons Attribution CC BY Public complaints mostly taken place within public service by the Puskesmas are related with the long waiting period of patient.In addition, the service problem which conducted by Puskesmas also located in Dumai city, where many people complain about the behavior of less friendly staff and long doctor referral procedure.With the existence of problems above, the puskesmasin Dumai city try to minimize those problems.In an effort to solving the problem, hence the Puskesmas of Jaya Mukti, Dumai city doing public service innovation through an optima application service which is the development of generic health ministry that supports health service in basic health service facilities, increasing the availability and quality of data and health information through information technology utilization.

2319-7064 Index Copernicus Value (2016): 79.57 | Impact Factor (2017): 7.296 Volume 7 Issue 6, June 2018 www
Nowadays it is still lack of research innovation of existing service in health service.The researcher assumption is still urgent of this research because health service as one of the element of public welfare that should be realized accordance with the ideals of the Indonesian nation.
Various research that has been conducted by previous researchers on the public service innovation.Most researchers regard the innovation service in district/city Paper ID: 1061819 DOI: 10.21275/1061819 ISSN (Online): .ijsr.netLicensed Under Creative Commons Attribution CC BY samsat.
To obtain the good result should be supported by accurate data inappropriate with what is desired, the data should be extracted from the related sources with the problem that analyzed.The data source in this research are (1) person/informan, that is the data source that can provide the data by interview or written and observation, which obtains from the research subject, that is head of Puskesmas Jaya Mukti, head of health officials in Dumai city and the user service.
(Haribowo & Wijaya, 2012) obtained through the interview related to public service innovation.(3).Paper/document which needed from literature, legislation, research proposal, mass media, and other sources related the research objective.This is needed as the reliable sources and legal legitimacy.The data analysis which used in this research is qualitative data(Haribowo & Wijaya, 2012)explain about qualitative data as follows: "the data in the form of words and not number.

Table 1 :
Sikda Optima Vision and mission

Table 2 :
Service Process Innovation in Puskesmas Jaya Mukti, Dumai city