KESANS: International Journal of Health and Science 2808-7178 / 2808-7380 http://kesans.
com/index.
php/kesans/index Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility 1Andri Elzar*, 2Rita Dian Pratiwi, 3Rini Dharmastiti, 4Aufaclav Zatu Kusuma Frisky Master of Applied Occupational Safety and Health Study Program.
Department of Health Services and Information.
Vocational School.
Universitas Gadjah Mada.
Indonesia*.
email: andrielzar@mail.
Department of Health Services and Information.
Vocational School.
Universitas Gadjah Mada.
Indonesia.
email: ritadianp@ugm.
Department of Mechanical and Industrial Engineering.
Faculty of Engineering.
Universitas Gadjah Mada.
Indonesia.
email: rini@ugm.
Computer Science and Electronics Department.
Faculty of Mathematics and Natural Sciences.
Universitas Gadjah Mada.
email: aufaclav@ugm.
*Correspondence Article Information Submitted: 09 May 2026 Accepted: 14 May 2026 Publish: 20 May 2026 Keyword: Digital Reporting.
Radiation Safety.
Oncology Radiology.
Safety Culture.
Safety Indicator.
Copyright holder: Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky Year: 2026 This is an open access article under the CC BY-SA license.
How to Cite
DOI
e-ISSN/p-ISSN Published by Abstract Introduction: Radiation safety reporting at the Radiation Oncology Facility of RSUD Dr.
Abdul Moeloek was still paper-based, causing incomplete data, delayed reporting, and fluctuating Safety and Security Indicator (IKK) scores.
Objective: This study aimed to develop and evaluate a smartphone-based digital reporting application to improve radiation safety reporting and safety culture.
Method: This Research and Development study used the ADDIE model with mixed qualitative and quantitative approaches.
The application was developed using the AppSheet low-code platform and validated by practitioners and media experts.
Evaluation applied a one-group pretest-posttest design involving 30 radiation workers.
Data were analysed using regression, paired t-test, and correlation analyses.
Results and discussion: The SPEKTRA application achieved a validation score of 94.
5% and was categorized as highly Post-implementation results showed significant improvements in perceived ease of use, perceived usefulness, intention to use, and safety culture .
< 0.
Perceived usefulness was the dominant predictor of intention to use ( = 0.
p = 0.
Application adoption also significantly improved safety culture .
= The projected IKK score increased from 75 in 2025 to 94 in 2026 through the integrated simulation feature.
Conclusion: SPEKTRA effectively improved technology acceptance, safety culture, and radiation safety reporting Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility/Vol.
No.
8, 2026
https://doi.
org/10.
54543/kesans.
2808-7178 / 2808-7380
CV.
Rifainstitut/KESANS: International Journal of Health and Science Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility Introduction The rapid development of radiation technology in healthcare, particularly in radiation oncology, has significantly improved cancer treatment services worldwide.
Indonesia, the increasing number of cancer cases and deaths, which reached 234,511 in 2020, has accelerated the utilization of ionizing radiation in medical facilities (Globocan.
Radiation oncology services are currently supported by 53 Linear Accelerator units distributed across hospitals in Indonesia (Badan Pengawas Tenaga Nuklir, 2.
Despite its therapeutic benefits, ionizing radiation also presents substantial risks to workers, patients, and the surrounding environment when safety standards are not properly implemented.
Several international radiation overexposure incidents have demonstrated that inadequate monitoring and reporting systems may contribute to serious safety failures in radiotherapy practice.
International organizations have emphasized the importance of strengthening radiation safety systems through digital innovation and continuous monitoring.
The World Health Organization highlighted that radiation protection should be integrated into healthcare quality systems to reduce unnecessary radiation exposure and improve patient safety (World Health Organization, 2.
Similarly, the International Atomic Energy Agency recommended the implementation of automated digital reporting and monitoring systems to improve radiation safety data management and accessibility (International Atomic Energy Agency, 2.
In Indonesia, radiation safety supervision is regulated by BAPETEN, which requires healthcare facilities to submit the Facility Safety Verification Report (LVKF) as part of regulatory compliance and performance evaluation (BAPETEN, 2.
The LVKF contributes directly to the Safety and Security Index (IKK), which measures institutional radiation safety performance based on licensing, human resources, dose monitoring, occupational health monitoring, environmental monitoring, safety equipment, and reporting system innovation (BAPETEN, 2.
However, many healthcare facilities still rely on manual paper-based reporting systems that create operational inefficiencies, incomplete documentation, and delayed reporting processes (Sari et al.
, 2021.
JUPETEN, 2.
These limitations show a gap between regulatory expectations and actual implementation of radiation safety management in clinical settings.
An effective incident learning and reporting system is considered one of the key elements of radiation safety culture in radiotherapy services.
Terezakis .
stated that radiation oncology safety strategies require integration between incident learning systems, technological innovation, and organizational safety culture.
According to the IAEA, radiation safety culture refers to attitudes, values, and behaviors that prioritize safety in all radiation-related activities (IAEA, 2.
Talcott et al.
further emphasized that high-performing radiation oncology programs require continuous safety improvement supported by efficient reporting systems and active staff participation.
Previous studies also showed that electronic incident reporting systems positively influence safety culture and near-miss prevention in radiotherapy environments (Deraniyagala et al.
, 2.
In Italy.
Stendardo .
developed an Internet of Thingsbased abnormal event reporting system that successfully improved reporting efficiency and encouraged more active incident reporting among healthcare personnel.
Nevertheless, the implementation of digital systems in radiation safety management still faces several barriers, including infrastructure limitations, workforce readiness, financial KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility constraints, legal concerns, and resistance to organizational change (Inampudi, 2024.
Kajyter, 2022.
Saragih, 2025.
Kesar & Joseph, 2.
The advancement of smartphone technology has created new opportunities for improving radiation safety reporting systems in healthcare facilities.
Indonesia recorded more than 370 million smartphone users in 2024, indicating strong potential for mobilebased healthcare applications (DataReportal, 2.
Smartphone applications allow realtime reporting, faster communication, and easier access to safety records compared with conventional paper-based systems.
Previous studies showed that digital healthcare systems contribute significantly to communication efficiency, organizational performance, and clinical management processes (Walzer, 2022.
Shoba & Gouri, 2.
The increasing adoption of technologies such as cloud computing.
IoT, blockchain, telemedicine, and big data further demonstrates the growing dependence of healthcare systems on digital innovation (Borse & Sharma, 2024.
Burrai, 2.
However, studies by Rodrigues et al.
found that most smartphone applications in radiology primarily focused on education and clinical support rather than radiation safety reporting and monitoring systems.
In addition.
Ford et al.
identified that errors in radiation oncology could occur at multiple stages of treatment planning and delivery, emphasizing the importance of integrated safety reporting systems to minimize risk.
The Radiation Oncology Facility at RSUD Dr.
Abdul Moeloek continues to face challenges in achieving optimal radiation safety performance, particularly regarding reporting and documentation management.
Institutional records showed fluctuating IKK scores, namely 65 in 2019, 68 in 2020 and 2021, 71 in 2022, 75 in 2023, and 70 in 2024.
The decline in 2024 reflected weaknesses in reporting systems, safety documentation, and innovation management.
The existing reporting process remained highly dependent on manual paper-based administration, resulting in delayed reporting, difficulties in record retrieval, and incomplete safety documentation.
Considering the hospitalAos strategic role as a provincial referral center for radiation oncology services, strengthening radiation safety management has become increasingly important.
Based on these conditions, this study aimed to develop a smartphone-based digital reporting application called SPEKTRA to optimize radiation safety reporting systems, improve safety culture, and support IKK achievement through integration with BAPETEN reporting standards.
Method This study used a Research and Development (R&D) approach with the ADDIE model consisting of Analysis.
Design.
Development.
Implementation, and Evaluation The study combined qualitative and quantitative methods with a One Group Pretest-Posttest design to evaluate the implementation of a smartphone-based digital radiation safety reporting application and its influence on Technology Acceptance Model (TAM) variables, radiation safety culture, and the Safety and Security Index (IKK).
The research was conducted at the Radiation Oncology Facility of RSUD Dr.
Abdul Moeloek from December 2025 to March 2026.
The population consisted of 30 radiation workers, including Radiation Protection Officers (RPO), radiation oncologists, medical physicists, radiographers, and nurses.
Purposive sampling was applied during the needs analysis stage involving four informants, while expert validation involved two medical physicists or Radiation Protection Officers and two media or information technology Total sampling was applied during the implementation and evaluation stages involving all respondents.
The intervention variable was the implementation of the KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility smartphone-based digital reporting application, while independent variables included Perceived Ease of Use (PEOU) and Perceived Usefulness (PU).
Dependent variables included Intention to Use (ITU), radiation safety culture, and optimization of the radiation safety system, while the outcome variable was the Safety and Security Index (IKK) based on BAPETEN standards.
The operational definitions of each variable are presented in Table 1.
Table 1 Operational Variables and Definitions Variable Digital Reporting Application Innovation (Interventio.
Perceived Ease of Use (PEOU) Perceived Usefulness (PU) Intention to Use (ITU) Radiation Safety Culture Optimization of Radiation Safety System Safety and Security Index (IKK) Operational Definition Implementation smartphone-based Degree to which users believe the application is easy to learn and operate Degree to which users believe the application improves reporting performance User tendency to continuously use the application for radiation safety reporting User values, and behaviors toward radiation safety User perception regarding improvements in reporting, documentation, and incident follow-up processes Quantitative describing radiation safety administrative compliance and safety readiness Measurement Outcome Data Scale Application implementation status:
Not Implemented or Implemented Nominal TAM-based perception score .
Ordinal/Interval TAM-based usefulness score .
Ordinal/Interval TAM-based intention score .
Ordinal/Interval Safety culture survey score .
Ordinal/Interval Optimization perception score .
Ordinal/Interval Simulated IKK score based on BAPETEN standards .
Ratio Research instruments included interview guidelines, expert validation sheets, and questionnaires developed according to the ADDIE stages.
Interview guidelines consisted of open-ended questions related to radiation safety indicators, reporting systems, and safety culture dimensions to identify reporting problems and user expectations regarding the digital application.
Expert validation sheets were used to assess application feasibility before implementation, involving medical physicists.
Radiation Protection Officers, and media experts.
Practitioner validation focused on compliance with BAPETEN regulations.
Facility Safety Verification Report (LVKF) procedures, and radiation safety content accuracy, while media experts evaluated usability, interface design, data security.
User Interface (UI).
User Experience (UX), responsiveness, workflow efficiency.
CRUD functionality, and device compatibility.
The validation instrument referred to the Information System Success Model by DeLone and McLean .
Safety Culture theory by Reason .
, and the Technology Acceptance Model by Davis .
Questionnaires adapted from Davis .
and Reason .
were distributed during KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility pre- and post-implementation phases to measure Perceived Ease of Use (PEOU).
Perceived Usefulness (PU).
Intention to Use (ITU), actual system use, radiation safety culture, and optimization of radiation safety reporting systems using a five-point Likert The research process followed the ADDIE framework beginning with field observations and needs analysis through in-depth interviews with Radiation Protection Officers, medical physicists, radiographers, and radiation oncologists to identify system requirements and application features.
The application prototype was developed using the AppSheet No-Code Development Platform integrated with Google Sheets or Excel databases, followed by expert validation, implementation, and field testing.
Qualitative interview data were analyzed thematically using NVivo software, while quantitative data were analyzed using JAMOVI statistical software.
Statistical analyses included ShapiroWilk normality testing, paired t-tests, multiple linear regression, simple linear regression.
Spearman correlation.
F-tests, and coefficient of determination (RA) analysis to evaluate the relationship between PEOU.
PU.
ITU.
Actual System Use, and radiation safety culture Hypotheses were accepted when p-values were less than 0.
05 with positive regression coefficients.
This study obtained ethical approval from the Health Research Ethics Committee of the Health Polytechnic of Yogyakarta under ethical clearance number No.
DP.
03/e-KEPK.
1/068/2026, and all respondents participated voluntarily with confidentiality protections applied throughout the research process.
Result and Discussion Result The SPEKTRA application was developed through three phases consisting of database preparation, interface and feature development, and system testing using the AppSheet platform integrated with Google Sheets.
Before development, a qualitative needs assessment was conducted through in-depth interviews with a medical physicist, radiation protection officer, radiographer, and head of installation as triangulation The interview data were analyzed using NVivo software to identify user needs and operational problems in the existing reporting system.
The thematic analysis results presented in Table 2 showed several major issues, including inefficient manual documentation, difficulty retrieving historical records, low incident reporting participation due to blame culture, and the need for a centralized smartphone-based reporting system with real-time monitoring and notification features.
These findings became the basis for developing the SPEKTRA application, which integrated all seven BAPETEN IKK parameters along with automatic IKK simulation.
PDF report generation, and reminder notifications.
The application was subsequently tested for functionality, access security, automatic calculations, and compatibility across Android and iOS devices before undergoing feasibility validation by two radiation safety practitioners and two media or software experts.
The validator profiles are shown in Table 3.
Table 2 NVivo Thematic Results of User Needs Assessment Main Theme Inefficiency Manual Reporting Interview Findings Manual documentation and re-entry processes consumed excessive time and increased the risk of human error KESANS.
Vol.
No.
8, 2026
Informants Radiation Protection Officer.
Medical Physicist Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility Difficulty Historical Data Retrieval Low Incident Reporting Participation Need for Real-Time Digital Reporting Requirement Centralized Database Need for Notification Monitoring Features Support for Radiation Safety Culture Institutional Support for Digital Innovation Historical radiation safety records were difficult to retrieve during inspections and Staff were reluctant to report near-miss incidents due to fear of blame and complicated reporting procedures Informants required a smartphone-based reporting system that could support rapid and real-time data entry Users expected a cloud-based centralized documentation and monitoring features Informants requested reminder notifications, dose monitoring alerts, and dashboard monitoring systems Anonymous reporting and simplified reporting workflows were considered important to improve safety culture and reporting participation Management supported the implementation of smartphone-based reporting systems and integration into operational SOPs Radiation Protection Officer.
Medical Physicist Radiographer All Informants Medical Physicist.
Radiation Protection Officer Head of Installation.
Radiation Protection Officer Radiographer.
Head of Installation Head of Installation Table 3 Validator Profiles Code Age Gender Male Female Male Male Education Professional MasterAos Degree Professional MasterAos Degree BachelorAos Degree BachelorAos Degree Expertise Medical Physicist Medical Physicist and Radiation Protection Officer Programmer Front-End Developer The practitioner validation was conducted to evaluate the suitability of the SPEKTRA application from the perspective of radiation safety standards and regulatory Validation covered ten indicators grouped into three aspects which are Content and Regulatory Quality.
Educational and Safety Culture Aspects, and Language Quality, shown in Table 4.
Table 4 Practitioner Expert Validation Results Assessment Aspect Content & Regulatory Quality Average Category Compatibility of input features with LVKF BAPETEN format Excellent Excellent Excellent Excellent Clarity of data entry instructions Good Alert feature for dose limit Excellent Completeness of data variables (Dose.
Exposure.
Equipmen.
Accuracy of radiation Compatibility of incident reporting workflow with SOP Indicator Educational & Safety Culture KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility Language Quality Relevance of notifications for increasing awareness Proper use of Indonesian Ease of understanding technical terminology by non-physicists Sentence structure within application menus Total Score Average Score Feasibility Percentage Good Good Fair Good Very Feasible Based on Table 4, practitioner validation results showed an average feasibility score 35 with a feasibility percentage of 87%, categorized as AuVery Feasible.
Ay The highest evaluations were obtained in the Content and Regulatory Quality aspect, indicating compliance with LVKF standards and BAPETEN reporting procedures, while the Language Quality aspect received relatively lower scores due to difficulties in understanding technical terminology by non-specialist users.
These findings showed the need for simplifying technical language within the application.
Media expert validation was conducted to assess the technical quality, usability, and performance of the SPEKTRA application through User Interface (UI).
User Experience (UX), and Performance indicators, with the detailed results in Table 5.
Table 5 Media Expert Validation Results Assessment Aspect User Interface (UI) User Experience (UX) Performance Indicator Average Category Layout and navigation Excellent Readability and contrast Consistency of icons and visual Excellent Excellent Logic flow simplicity Excellent Application responsiveness Efficiency of operational steps CRUD functionality Data security (Password/Encryptio.
System stability (Crash/Bug Handlin.
Screen compatibility (Responsive Desig.
Good Excellent Excellent Excellent Excellent Excellent Total Score Average Score Feasibility Percentage Very Feasible Based on Table 5, media expert validation showed that validator V3 obtained a score of 46 .
%) and V4 obtained 48 .
%), with a combined average score of 4.
7 and feasibility percentage of 94%, categorized as AuVery Feasible.
Ay The highest evaluations were found in User Interface and User Experience aspects, particularly layout, navigation.
KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility workflow, and operational efficiency, while application responsiveness received a slightly lower AuGoodAy rating, indicating a need for performance optimization.
Overall, the Performance aspect was rated highly, confirming that the SPEKTRA application is reliable, secure, and compatible across multiple smartphone devices.
A combined validation recap with practitioner results in Table 6.
Table 6 Validation Recapitulation Practitioner Assessment Aspect Content & Regulatory Quality Educational & Safety Culture Language Quality Average Combined Average Average Percentage Media Assessment Aspect Average Percentage User Interface User Experience .
Performance Based on Table 6, practitioner validation obtained an average score of 4.
0%),
while media expert validation reached 4.
0%), resulting in a combined score of 4.
5%) categorized as AuVery Feasible.
Ay Overall, both expert groups indicated that the SPEKTRA application met regulatory and technical requirements, with the highest performance in Content and Regulatory Quality, as well as Performance, while Language Quality was identified as the main area for improvement, particularly in simplifying technical terminology for non-specialist users.
The reliability test was conducted to assess the consistency of the questionnaire, with the results presented in Table 7.
Table 7 Questionnaire Reliability Test Variable Number of Items CronbachAos Alpha Minimum Standard Interpretation Reliable Reliable Reliable Reliable Perceived Ease of Use (PEOU) Perceived Usefulness (PU) Intention to Use (ITU) Safety Culture (SC) Table 7 shows that all research variables (Perceived Ease of Use.
Perceived Usefulness.
Intention to Use, and Safety Cultur.
had CronbachAos Alpha values above 60, indicating good internal consistency and reliability of the questionnaire.
The next stage involved descriptive statistical analysis of pre-and post-implementation data to examine changes in respondentsAo perceptions after the implementation of the SPEKTRA digital reporting system.
KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma
Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility Table 8
Descriptive Statistics of Pre-and Post-Implementation data for TAM Variables and Safety Culture Variable PreImplementation Mean
Min Max
PostImplementation Mean
Min Max
PEOU
(Perceived Ease of Us.
(Perceived Usefulnes.
ITU (Intention to Us.
SC (Safety Cultur.
Based on Table 8, all variables increased after SPEKTRA implementation:
Perceived Ease of Use (PEOU) rose from 2.
253 to 4.
240 with standard deviation decreasing from 0.
573 to 0.
Perceived Usefulness (PU) increased from 2.
427 to 4.
with standard deviation from 0.
483 to 0.
Intention to Use (ITU) showed the largest increase from 2.
011 to 4.
267, and Safety Culture (SC) increased from 2.
260 to 4.
003 with relatively stable variability.
Overall, mean differences ranged from 1.
743 to 2.
256 points across variables, indicating a consistent improvement in user perception and safety culture after implementation of the SPEKTRA application, and the post-implementation data were then used for classical assumption testing .
ormality, multicollinearity, and heteroscedasticit.
prior to multiple regression analysis.
Table 9
Normality Test
Variable PEOU
ITU
Shapiro-Wilk W p-value Interpretation Normal Normal Normal Based on Table 9, the Shapiro-Wilk test results show that all variables obtained pvalues greater than 0.
05, showing that the data were normally distributed and met the assumptions required for multiple regression analysis.
Table 10 Multicollinearity Test Variable PEOU Tolerance VIF Interpretation No multicollinearity No multicollinearity The results in Table 10, show that the VIF values for both independent variables were below 10.
00, confirming that no multicollinearity existed between the independent variables in the regression model.
KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility Table 11 Heteroscedasticity Test Test Breusch-Pagan Statistic p-value Interpretation No heteroscedasticity The Breusch-Pagan test results presented in Table 11.
show a p-value greater than 05, showing homogeneous residual variance and confirming that the regression model was free from heteroscedasticity problems.
After all classical assumptions were fulfilled, multiple regression analysis was performed to determine the influence of Perceived Ease of Use (PEOU) and Perceived Usefulness (PU) on Intention to Use (ITU).
Table 12 Coefficient of Determination of the Regression Model Model Adjusted RA Sig The RA value of 0.
270 shows that 27.
0% of the variance in ITU can be explained jointly by PEOU and PU, while the remaining 73.
0% is influenced by other variables outside the model.
Table 13
Multiple Regression Coefficients Predictor
Constant
PEOU
Lower 95% Upper 95% Sig.
Table 13 shows that every one-unit increase in PU increases ITU by 0.
494 units, assuming PEOU remains constant.
Meanwhile, every one-unit increase in PEOU increases ITU by 0.
078 units, assuming PU remains constant.
The PU variable emerged as the dominant predictor with a standardized beta coefficient of 0.
473, substantially higher than the contribution of PEOU ( = 0.
, showing that perceived usefulness is the primary determinant influencing usersAo intention to adopt the SPEKTRA application.
Table 14 Omnibus ANOVA Source PEOU_Post PU_Post Residual Sum of Squares Mean Square Sig.
Based on the multiple regression analysis, the simultaneous test produced an Fvalue of 5.
000 with a significance level of p = 0.
< 0.
, showing that PEOU and PU jointly had a significant effect on ITU.
Partially, the PU variable obtained a t-value of 424 with p = 0.
< 0.
, showing a positive and significant effect on ITU.
contrast, the PEOU variable showed a t-value of 0.
404 with p = 0.
> 0.
, showing no significant partial effect on ITU.
KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility Table 15 Paired Sample t-Test Post PEOU_Post PU_Post ITU_Post Pre PEOU_Pre PU_Pre ITU_Pre Statistic <0.
<0.
<0.
Based on Table 15, the paired t-test results revealed significant differences between pre and post implementation scores for all variables.
PEOU showed a significant increase after implementation .
= 27.
5, df = 29, p < 0.
, showing a substantial improvement in respondentsAo perceptions of application usability.
PU also showed a significant increase between pre- and post-implementation conditions .
= 22.
8, df = 29, p < 0.
, showing improved perceptions regarding the usefulness of the system.
Similarly.
ITU exhibited a significant difference before and after implementation .
= 23.
1, df = 32, p < 0.
showing that the implementation significantly influenced usersAo intention to adopt the The evaluation stage was conducted to assess the impact of the SPEKTRA application on safety culture and the optimization of the overall radiation safety system within the radiation oncology facility.
Table 16 Normality Test Variable Actual System Use (ASU) SC Pre SC Post Shapiro-Wilk W p-value Interpretation Normal Normal Normal The Shapiro-Wilk test results show that both variables used in the regression model fulfilled the assumption of normal distribution with p-values greater than 0.
Table 17 Heteroscedasticity Test Test Breusch-Pagan Statistic p-value Interpretation No heteroscedasticity The Breusch-Pagan test produced a p-value of 0.
098 (>0.
, showing that no heteroscedasticity problem existed in the regression model.
Table 18 Paired t-Test Results for SC Pre vs SC Post Variable SC Pre SC Post Mean Difference SE Diff Sig.
<0.
CohenAos d Based on Table 18, the paired t-test produced a t-value of 16.
696 with p < 0.
confirming that the increase in SC scores from pre- to post-implementation was highly The CohenAos d value of 3.
048 greatly exceeded the threshold for a large effect size .
Ou 0.
, showing that the implementation of the SPEKTRA application had a substantial and meaningful impact on safety culture within the radiation oncology facility.
After all assumptions were satisfied, simple regression analysis was conducted to examine the effect of Actual System Use (ASU) on Safety Culture (SC).
KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility Table 19 Coefficient of Determination of the Simple Regression Model Model Adjusted RA Sig The RA value of 0.
150 indicates that 15.
0% of the variance in Safety Culture scores could be explained by digital adoption variables, while the remaining 85.
0% was influenced by other factors outside the model.
Table 20
Simple Regression Coefficients Predictor
Constant
ASU
Lower 95% Upper 95% Sig.
Table 20 shows that every one-unit increase in Actual System Use (ASU) would increase the Safety Culture (SC) score by 0.
393 units.
The standardized beta coefficient ( = 0.
confirms a moderate positive relationship between the two variables.
further confirm the findings.
Spearman correlation analysis was performed.
Table 21
Spearman Correlation Test Results Variable 1
ASU
Variable 2 SC_Post Spearman A p-value Category Moderate Interpretation Significant The Spearman test showed a positive correlation (A = 0.
401, p = 0.
consistent with regression results.
The paired t-test indicated a significant increase in Safety Culture after implementation .
= 16.
696, p < 0.
CohenAos d = 3.
, while simple regression showed F = 4.
950, p = 0.
B = 0.
393, and RA = 0.
150, a modest but significant effect.
Table 22 Historical Trend of IKK Scores from BAPETEN Inspections .
Year IKK Score Category Fair Fair Fair Good Good Fair Good Excellent Description Routine BAPETEN assessment Routine BAPETEN assessment Routine BAPETEN assessment Routine BAPETEN assessment Routine BAPETEN assessment Routine BAPETEN assessment Routine BAPETEN assessment Assessment scheduled for August 2026 Based on Table 22, the IKK scores during the 2019-2025 period fluctuated and remained unstable.
The score declined from 76 in 2023 to 70 in 2024 before increasing again to 75 in 2025.
The decline in 2024 indicated weaknesses in documentation management, reporting systems, and radiation safety records, which are among the parameters assessed within the IKK evaluation.
KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma
Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility Table 23
IKK Assessment Parameters and Weighting Parameter Compliance of ionizing radiation utilization licensing conditions Competency of human resources in radiation safety Radiation dose monitoring Health monitoring of radiation workers Availability of radiation safety and security equipment Environmental radiation exposure monitoring Availability of innovation and updating of reporting, documentation, and record
management systems Total
Weight
(%)
The SPEKTRA application mainly contributed to IKK Parameter 7 .
nnovation in reporting and documentatio.
and indirectly improved radiation dose and worker health monitoring through real-time digital reporting.
Figure 1.
Display of the IKK Simulation Menu in the SPEKTRA Application The 2026 IKK simulation using the SPEKTRA application produced an estimated score of 94, an increase of 19 points from the 2025 score of 75.
This increase represents the most significant improvement in the facilityAos IKK history over the last five years.
Table 24 Comparative Analysis of IKK Achievement Scores per Parameter .
5 vs 2026 Simulatio.
Parameter Licensing compliance Competent human resources Radiation dose monitoring Worker health monitoring Availability of safety and security equipment KESANS.
Vol.
No.
8, 2026
Weight
(%)
Score Weighted Score 2025 Score Weighted Score 2026 Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility Environmental radiation exposure monitoring Innovation and updating of reporting, documentation, and Total Based on Table 24, the 2026 IKK achievement scores represent simulation results derived from self-assessment after the implementation of the SPEKTRA application, showing a projected increase of 19 points compared to the 2025 score.
The most significant improvement occurred in Parameter 7 related to innovation and updating of reporting systems, documentation, and records, increasing from 30% to 100% due to the transition from manual reporting to an integrated digital reporting system with real-time reporting, monitoring, onboarding, and training features.
Parameter 1 concerning licensing compliance improved from 86% to 100% through automatic reminder and notification features, while Parameter 2 regarding competent human resources increased from 84% to 100% due to structured digital recording of personnel competency and certification data.
Improvements were also observed in radiation dose monitoring and worker health monitoring through real-time and systematic digital recording functions integrated within the application.
In addition.
Parameters 5 and 6 related to radiation safety equipment and environmental radiation exposure monitoring showed moderate improvements, supported by the strengthening of radiation safety culture as indicated by the statistical analysis results (F = 4.
950, p = 0.
RA = 0.
Discussion The needs assessment showed that radiation safety reporting at the Radiation Oncology Facility of RSUD Dr.
Abdul Moeloek was still performed manually using paper-based documentation, resulting in incomplete data, delayed reporting, and difficulties in retrieving historical records.
This condition contributed to the decline of the Safety and Security Index (IKK) score from 76 in 2023 to 70 in 2024, showing that weaknesses in the reporting system directly affected radiation safety performance.
Similar findings have been reported in previous health information system studies, which identified manual reporting systems as a major source of inefficiency and data inaccuracy in healthcare services.
To address these problems, the SPEKTRA application was developed as a smartphone-based digital reporting platform to improve accessibility, reporting efficiency, and documentation management in radiation oncology facilities.
The application adopted a role-based access control system that classified users into Admin users consisting of Radiation Protection Officers and Medical Physicists, and User-level users consisting of radiographers and nurses.
In addition, the application integrated an IKK simulation feature to support self-assessment and continuous quality improvement before official BAPETEN inspections, while the use of the AppSheet low-code/no-code platform enabled rapid development and cross-platform accessibility on Android and iOS The expert validation results showed that the SPEKTRA application achieved a combined feasibility score of 4.
35 with a feasibility percentage of 87%, categorized as AuVery Feasible.
Ay These findings indicate that low-code/no-code platforms can produce digital systems with adequate technical quality and operational reliability for radiation safety management.
Media experts provided high evaluations regarding user interface.
KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility user experience, and system functionality, indicating that the simplified development approach did not reduce application performance.
However, the language quality aspect received the lowest score, particularly regarding the difficulty of understanding technical radiation terminology for non-specialist users such as nurses.
This finding highlights the importance of user-centered design principles in simplifying technical language to ensure better usability among multidisciplinary healthcare workers.
Conclusion This research developed an innovative smartphone-based digital reporting application called SPEKTRA, designed based on user needs analysis and aligned with BAPETEN regulatory standards and the operational requirements of radiation oncology The application achieved a combined expert validation score of 4.
73 or 94.
categorized as AuVery Feasible,Ay confirming the successful implementation of the Research and Development approach.
The implementation of SPEKTRA significantly improved Perceived Ease of Use (PEOU).
Perceived Usefulness (PU), and Intention to Use (ITU) with p < 0.
001 in paired t-tests, while multiple regression analysis showed that PEOU and PU simultaneously influenced ITU (F = 5.
p = 0.
RA = 0.
although only PU had a significant partial effect .
= 2.
p = 0.
, showing that perceived usefulness was the dominant factor influencing user intention.
Furthermore, the implementation of SPEKTRA showed a positive and significant relationship with the improvement of Safety Culture (F = 4.
p = 0.
RA = 0.
= 0.
with a very large effect size (CohenAos d = 3.
, and contributed to the increase of the Safety and Security Index (IKK) score from 75 in 2025 to a projected simulation score of 94 in 2026 through the IKK Simulation feature.
The most substantial contribution was observed in Parameter 7 concerning innovation and the updating of reporting, documentation, and record management systems.
KESANS.
Vol.
No.
8, 2026
Andri Elzar.
Rita Dian Pratiwi.
Rini Dharmastiti.
Aufaclav Zatu Kusuma
Frisky/KESANS Development of a Smartphone-Based Digital Reporting System to Optimize Radiation Safety Reporting in the Radiation Oncology Facility Reference