Implementation of An Integrated Referral System (SISRUTE) At Bumi Panua Pohuwato Hospital

advanced level but the monitoring and evaluation system of these services is the data needed in planning future health development. This research aims to look at the implementation of an integrated referral system at Bumi Panua Regional Hospital. This research uses a qualitative descriptive design. The sample in this study was the service sector at Bumi Panua Regional Hospital, the Head of the Sisrute Team as the person in charge as the Key Informant and the Ordinary Informant, the doctor in charge, the Head of the medical services sector and members of the Sisrute team. The research results show that the Standard Operating Procedures (SOP) are running well, but several obstacles cause the SOP to go off the predetermined path. The referral process via SISRUTE is not yet supported by a clear and detailed SOP and flow. The application of SISRUTE has been running according to the flow set by the Ministry of Health, but there is a lack of human resources for SISRUTE operators or users at the Puskesmas, unfamiliarity with SISRUTE, accumulation of patients in the ER and errors in entering codes. In-application references cause SISRUTE flows to overlap. Conclusion: The SISRUTE application often experiences problems, routine maintenance that was suddenly carried out by the center without prior notification, server downtime, and hardware that had not been updated, which hampered referral services on the SISRUTE application and required offline or manual referrals.