Saiful Hidayat Pemanfaatan ICT untuk Pengembangan Rumah Sakit Pendidikan implementasi Telemedicine dan Teleconsulting

Model Manajemen RS Pendidikan di daerah sulit dengan model Sister Hospital : Kebutuhan sarana pendukung; Fasilitas Fisik, Telekomunikasi, Telemedicine TELKOM’s e-health Initiative and Readiness Ir. Saiful Hidayat MT Direktur Pengembangan Bisnis PT. Administrasi Medika (Telkom Group) Seminar Pengembangan Rumahsakit Pendidikan di Daerah Terpencil Yogyakarta, 5 Maret 2011by Telkom Indonesia

E-Health Concept Telemedicine Overview Agenda Telkom Group Readinessby Telkom Indonesia

e-Health Value Chain Connecting The Key Stakeholders of Healthcare Insurance Operating Efficiency : Providers – Online Claims Healthcare Submission and Reimbursements with Providers Insurance Carriers  Connecting Patients and – Connects Multiple Doctors/ Physicians Suppliers and Buyers Specialist – Online posting of – One Stop Shopping – surgical procedures MedPool, Reverse including costs, and Auctions, Auctions sorting results Telemedicine Electronic Prescriptions  Remote Patient – Reduces Errors, Saves Monitoring Lives, Increases – Cardiac and Diabetic Vendors/ Efficiency Monitoring of Patients Patient – Online Pharmacy s& Supplier their – Targeted Marketing  Online Second Opinion Hospitals familie s B2B B2C Support Value Primary Value Pharmacy Processes Processes SUPPLIERS HEALTHCARE CONSUMERS ORGANIZATION 3by Telkom Indonesia Source : Georgia State University

Model dan definisi e-Health Key e-health Modules 1. Hospital/Clinic Information System Healthcare Providers 2. On Line Medical Report (dapat diakses oleh Patients pasien, docter / specialist dan lab) & their Doctors/ families Insurance Specialist Hospitals 3. Telemedicine: Penggunaan perangkat audio, Providers video dan telekomunikasi untuk memproses informasi terkait jasa pelayanan kesehatan atau membantu paramedis yang jauh dari lokasi pasien. 4. Personal Health Care System: Sistem pencegahan pendukung untuk mengawasi dan perawatan pasien secara individu (contoh: HotHealth) 5. Third Party Administrator: Penyedia jasa yang Network/Connection memberikan layanan kepada perusahaan asuransi dan TPA seperti Yakes dalam melakukan pengecekan dan validasi klaim dari pasien (contoh: AdMedika) 6. Supply Chain Management/On line distribution support system untuk obat dan/atau farmasi (contoh: Kimia Farma, Century, Guardian) 7. National Healthcare Management Sytem Pharmacy Vendors/ Laboratories untuk menyediakan infrastruktur dan aplikasi Supplier pelaporan data kesehatan nasional berupa Datawarehouse dan Decision Support System (SIKDA/SIKNAS)by Telkom Indonesia Source: Georgia State University & Internal Analysis

Stakeholder e-Health Indonesia Stakeholder dari e-Health di Indonesia dapat dikelompokkan sebagai berikut: 1. E-Health sebagai Service Support > Rumah Sakit dan Klinik > Praktek Dokter > Apotik dan Toko Obat 2. E-Health sebagai Decision support system and Research reference > Pemerintahan (Kementrian Kesehatan) > Perguruan Tinggi 3. E-Health sebagai Business Support > Asuransi dan Perbankan > Industri Farmasi dan Alat Kesehatan 4. E-Health sebagai Information of Healthcare services > Pasien dan Keluarga-nya > Publik: Impementasi Telemedicine 5

ICT Requirement for E-Health Infrastructure B • National Coverage, Reliability, Manageability, Scalable • Auditable • Disaster Management: (DRC, DRP, BCP) Security A C Business/ • CIA (Confidentiality, Operation Integrity, Availability) • Convenience • Audited by certified security auditor ICT • Shared services • Outsourcing • Comply to international Best Practices/standards Devices D Application • Smart E •Flexibility • Integrated •Modularity •Mobility •Multiplatform •Interoperabilityby Telkom Indonesia 6

E-Health Concept Agenda Telemedicine Overview Telkom Group Readinessby Telkom Indonesia

Telemedicine Penggunaan perangkat audio, video dan telekomunikasi untuk memproses informasi terkait jasa pelayanan kesehatan atau membantu paramedis yang jauh dari lokasi pasien. “Top Three” penggunan Telemedicine pada disiplin ilmu kedokteran : Teledermatologi Telepsikiatri Teleradiologi Telemedicine umumnya diimplementasikan untuk : Telekonsultasi Telekonferensi Tele-edukasi Telemonitoring Telesurgeryby Telkom Indonesia

Tipe Telemedicine Telemedicine diimplementasikan berdasarkan dua konsep: Real time (synchronous) Sesederhana panggilan telepon atau serumit operasi menggunakan remote robotic. Membutuhkan kehadiran kedua belah pihak pada saat bersamaan dan link komunikasi yang memungkinkan interaksi real-time. Video-conferencing adalah salah satu bentuk teknologi yang paling umum digunakan dalam telemedicine sinkron. Contoh peralatan : Tele-otoscope memungkinkan dokter terpencil untuk melihat telinga pasien Tele-stetoskop memungkinkan konsultasi dokter jarak jauh untuk mendengar detak jantung pasien Store-and-Forward (asynchronous) Pengiriman data medis (seperti gambar medis, biosignals dll) kepada dokter /spesialis Penilaian pada waktu yang tepat sehingga tidak memerlukan kehadiran kedua belah pihak pada saat bersamaan. Specialis Dermatologi, Radiologi, dan Patologi adalah penguna umum dari telemedicine asinkron.by Telkom Indonesia

Data Telemedicine Jenis Sumber Ukuran file Teks dan Laporan, rekam medik, < 10 KB numerik korespondensi Audio Pembicaraan konsultasi, 100 KB Stetoskop elektronik Gambar Hasil CT Scan, Foto rontgen, 1MB citra dermatologi Video Ultrasound fetus (30 sec) 10 MB Sumber: Johan Harlan, Pusat Studi Informatika Kedokteran, Universitas Gunardamaby Telkom Indonesia

Kebutuhan Bandwith aplikasi Telemedicine Sumber: Johan Harlan, Pusat Studi Informatika Kedokteran, Universitas Gunardamaby Telkom Indonesia

“Telemedicine” Vs Public Internet Video Conferencing Must Optimize Lower Priority Telemedicine Video Accuracy: Latency not - Full, Constant 30 frames/sec critical: Audio - Minimize Jitter primarily - Minimize transmission loss unidirectional - Loss Indicators Video Low Latency Can Interpolate Conferencing Video The Public Internet was NOT DESIGNED for VIDEO • Best Effort, NO PRIORITIES for Telemedicine: Packet Loss • Requires special video transport technologyby Telkom Indonesia http://www.bf-technologies.com

http://www.bf-technologies.comPACS : Picture archiving and communication systemDICOM Capable :• Digital Imaging and Communications in Medicine (DICOM) is a standard for handling, storing, printing, and transmitting information in medical imaging. It includes a file format definition and a network communications protocol..• DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format.• The National Electrical Manufacturers Association (NEMA) holds the copyright to this standard.[1] It was developed by the DICOM Standards Committee,• DICOM enables the integration of scanners, servers, workstations, printers, and network hardware from multiple manufacturers into a picture archiving and communication system (PACS). http://en.wikipedia.org/wiki/Digital_Imaging_and_Communications_in_Medicine

Kisah sukses Tele-consultation (Telemedicine) Kebutuhan terdefinisi dengan jelas Penggunaan teknologi yang relevan Kesiapan infrastruktur ICT Incorporation into medical practice ; (Kesiapan tenaga medis, kesiapan komunitas, aspek legal dan etika) Dukungan Pemerintah untuk regulasi dan pembiayaan http://jtt.rsmjournals.com/cgi/content/abstract/14/7/377by Telkom Indonesia

E-Health Concept Agenda Telemedicine Overview Telkom Group Readinessby Telkom Indonesia

Telkom Company Profile Our business portfolio (T.I.M.E) Telecom Product Media Portfolio  Fixed Wireline  Multi Channel TV  Fixed Wireless  Mobile/Cellular Information  Broadband Access  Satellite  IT Services & BPO/ KPO  Tower  E-Money Edutainment  Premises Integration  Portal  E-Commerce  Content *) Geography coverage Customers Portfolio BPO: Business Process Outsourcing for international KPO: Knowledge Process investment is basically  SME  Enterprise  Wholesale all over the world,  Consumer Outsourching however for the initial investment, Asia and Middle-East will be the priority. Domestic Geography* Internationalby Telkom Indonesia 16

TELKOM Group Integrated e-Health Solution Using Telkom e-Health Hub as a Shared Service Platform Personal Health Web portal IT Security Infrastructure Claim Processing System Gov institutions Routing & Telkom e-Health shared service platform Workflow Transformation Transformation service (e-Health Hub) Services Services Web service adapter Healthcare Providers Pharmacies Doctors/ Specialist Laboratories Hospitals Ailed health Clinics (Suppliers) Finance : ASGARA TELKOM e-Apotek Himbara Link & Other 32 & Other 52 Banks Insurance/ SIC TELKOM e-Hospital (HIS)by Telkom Indonesia Note : SIC (Self Insure company)

Admedika Solution : Third Party Administrator – Claim Processing System (TPA-CPS) Claims & treatment Services :  Online Provider Network Hospitals Insurance, Insurance Members &polyclinics  Personal Customer Service TPA &Corporate (1.5m by Nov’10) (+725) (34)  Medical Evacuation / Personal Assistant EDC /PC Services  Membership / Policy Administration 32 Partnering Hospital  Inpatient Case Monitoring (Malaysia & Singapore) Dial-up/GPRS/VPN-Instant/VPN-IP/Speedy  Online Claim Administration  Periodic or Adhoc online Reporting  Real time data access through = TPA (Third Party Administrator) web 3,000 insurance policies (with 500 unique benefits)  Online Utilization Review (alert system)  24 hours Call Centre manned Main roles by medical professional 1.Member Eligibility 2.Automated Outpatient Claims Processing 3.Inpatient Admission & Cashless Discharge 4.24 X 7 Call Center Assistanceby Telkom Indonesia

AdMedika National Network : Hospital/Clinic & Insurance No Region Hospital Clinic Sub Total Nasional 1 Bali 11 10 21 2 Banten 9 24 33 AdMedika Insurance Partners 3 Jabodetabek 222 144 366 4 Jawa Barat 45 27 72 5 Jawa Tengah 48 3 51 6 Jawa Timur 63 14 77 7 Kalimantan 18 2 20 8 Maluku 3 - 3 9 Aceh (NAD) 3 - 3 10 NTB 2 - 2 11 NTT - 1 1 12 Riau 16 4 20 13 Sulawesi 12 1 13 14 Sumatra 30 3 33 15 Papua 3 1 4 Total 487 234 721 International Partner 1 Malaysia 28 - 28 2 Singapura 4 - 4 Total 32 32by Telkom Indonesia

e-Hospitals (Cloud Computing – SaaS Model- Pay per Use) Module and Cloud Computing Configuration Benefit Hisys SaaS Business Model : • No Investment • Capex to Opex • Pay as Used • No Operational and Maintenance Cost • High level SLAby Telkom Indonesia10/06/10

Telkom Super Highway Topology National Backbone Capacity Songkhla Main IP Core Link : Total 5,3 TBps SATUN TIS (Thailand) Metro Ethernet International Link : IP Core Eastern Link : BANDA ACEH Medan 40 GBps PENANG 170 GBps MEDAN METRO -E AAG (Hongkong, USA) MANADO DMCS, SINGAPORE Metro Ethernet Metro SANGATA Ethernet PBR BATAM Banjarmasin TERNATE PADANG SAMARNDA Pakanbaru PONTIANAK PALU Metro SORONG JAMBI BALIKPAPAN Ethernet METRO -E KETAPANG METRO -E Jakarta BENGKULU PKL.BUN FAKFAK JAYAPURA PALEMBANG Metro MetroBATURAJA METRO -E PAREPARE BANJARMASIN Ethernet AMBON Ethernet TIMIKA Makassar Palembang BDR LAMPUNG JAKARTA MAKASAR SEMARANG METRO -E METRO -E SURABAYA BANDUNG DENPASAR ENDE DLI MERAUKE MATARAM Metro Metro Metro WAINGAPU Metro KUPANG Ethernet Ethernet Ethernet Ethernet Jawa Barat Jawa Jawa Timur Denpasar Tengah METRO -E METRO -E METRO -E METRO -E Softswitch AAG Consortium : Development of MSAN/DSLAMby Telkom Indonesia Internet Gateway 1.92 Tbp/s Capacity Asia-Amerika

Peta Connectivity BALI – NUSA TENGGARA Pembangunan jaringan Backbone Optic untuk menghubungkan Seluruh Kota Kabupaten di Bali dan Nusa Tenggara, termasuk Hub Denpasar dan Mataram . Pada tahun 2011 akan dibangun Fiber Optik Pulau Timor Region sampai dengan titik border dengan Timor LesteFO Coverage & Connectivity Per Kabupaten Kota Selesai Maret‘11: • Labuhanbajo • Ruteng • Bajawa • Ende • Maumere • Waingapu • Kupang Selesai Desember‘11: • Waikabubak • Soe • Kefamenanu • Atambuaby Telkom Indonesia

Telkom Group Fixed and Wireless Broadband Sumatra Utara Kalimantan Timur Maluku Maluku Papua && Papua  DSL Ports (~ 100K)  DSL Ports (~ 70K)  • DSL Ports (~ 7K)  Astinet  Astinet  • Astinet  Metro Ethernet  Telkomsel 3G / HSDPA  • 2.3 GHz WiMax  Wide Availability  Telkomsel 3G / HSDPA  3.3 GHz WiMax through pan-  3.3 GHz WiMax Indonesian coverage • 3 million DSL ports • 5 million HSDPA capacity Jabodetabek  DSL Ports (~ 900K) Bali & Nusa Tenggara Sulawesi Selatan  Ability to differentiate  DSL Ports (~ 30K)  Astinet  DSL Ports (~ 100K)  Astinet offering using  Metro Ethernet broadband portfolio :  Astinet  Metro Ethernet  Telkomsel 3G / HSDPA  Metro Ethernet  Telkomsel 3G / HSDPA Speedy, Flash, Metro-E,  3.3 GHz WiMax  Telkomsel 3G / HSDPA WiMaxSource: PT. Telkom, A.T. Kearney analysis

Speedy ViCon Powered by TELKOM 4 Langkah mudah penggunaan layanan Speedy ViCon adalah layanan sewa 1 2 3 4 berbayar yang menyediakan fasilitas komunikasi video conference melalui jaringan internet Telkom Panggilan Tentukan Susun Aktifkan Video Speedy Terminasi Perencanaan Layanan Conference Berlangganan layanan Speedy ViCon seperti berlangganan telepon seluler: Peralatan diusahakan secara terpisah oleh pelanggan dan Telkom menyediakan akses jaringan serta sistem komunikasinya.by Telkom Indonesia

 Fitur Aplikatif: Fitur  Point to Point Call (unlimitted)  Multipoint Cal ( 3 sites - unlimitted)  Dual Video (desktop sharing, video playback, ext camera, etc) Utama  Device Colaboration (ext display, sound system, electronic whiteboard) Speedy  Recording & Streaming  URL Domain Name ViCon  Fitur Perfomansif:  HD (High Definition) Video Quality up to 1080p@30fps  Stereo Audio Quality (20 KHz)  Firewall/NAT Traversal  Audio Conference Call  Zone User Policy  User Bandwidth Limitation  Operational & Support :  Web Portal Services (information, registration, booking, billing system)  Device Management  Monitoring  Reporting  Help desk (24x7x365) Speedy ViCon  Operational Technical Support Powered by TELKOMby Telkom Indonesia

Jenis Layanan TELKOM Speedy ViCon Standard Premium  ID Pengguna (User Account)  ID Pengguna Akses Layanan  Global Direktori  Global Direktori 1  Max call speed: 1.5 Mbps  Max call speed: 4.0 Mbps Speedy ViCon  Panggilan Point to Point  Mendukung panggilan Point to Point  Panggilan Multipoint (On Demand)  Panggilan Multipoint (Dedicated & On  Fasilitas gratis endpoint Vicon software Demand) MoVi  Fasilitas gratis endpoint ViCon software MoVi +  Fasilitas VAS (Value Added Services) MoVi EX60/EX90 C40 Codec2 Penyediaan Profile 42 Endpoint E20 C20 C20 plus ViCon Quick set (penyewaan) Layanan termasuk:  Instalasi & training  Operasional (optional)by Telkom Indonesia

Arsitektur Dasar Sistem Speedy ViCon ViCon Infrastruktur TELKOM TELKOMSEL Services Hot Spot FLASH Centre Provisioning Call Control, SBC, MCU, Mgmnt Directory Billing Cloud Service Speedy Network TELKOM VPN Customer ISDN & PSTN Customerby Telkom Indonesia

TELKOM TelePresence Perangkat video-conference yang mampu “menghadirkan” lawan bicara kita dalam ruang dan waktu yang sama secara real time dengan kualitas high definition Dengan Telepresence kita dapat mengadakan pertemuan dengan lawan bicara kita yang berbeda lokasi seolah-olah berada dalam satu ruang pertemuan melalui video conference

Definisi “High Definition”• High definition - ukuran pixel yang makin tinggi: • Gambar makin tajam • Dapat dipasang pada display yang makin besar. Standart Televisi HD Full HD • Video conference tradisional menggunakan standart dengan ukuran maksimum 480 x 720 pixel dengan BW Video dengan kisaran 256 kbps sampai dengan 2Mbps

Manfaat penggunaan TELKOM TelePresence 1. Pelaksanaan pertemuan “real” dapat dilakukan secara efektif dan efisien 2. Percepatan dalam pengambilan keputusan dalam kondisi kritis (crisis management) 3. Solusi dari keterbatasan ruang dan waktu dalam melaksanakan pertemuan 4. Interaksi dan diskusi dua arah dengan melibatkan data, suara dan gambar dalam waktu yang bersamaan 5. Sebagai salah satu media efektif dalam pengendalian pelaksanaan program strategis antara kantor pusat dan daerahCTS 500 series CTS 1000 series CTS 3000 series•Display 37 inci•Ideal untuk 1 – 2 orang •Display 67 inci • Display 3 unit @ 67 inci •Ideal untuk 1 – 4 orang • Ideal untuk 6 orang (ditambah 12 orang untuk tipe 2 lajur)

Model Penawaran Telkom Telepresence Leasing Model CAPEX Model Biaya 1 kali Implementation Cost* “Setup Fee” Biaya Pembelian “TP End Point + Biaya Bulanan Sewa Setup Fee” Perangkat Equipment Cost “Managed End Point Services” Central Component (alokasi)Biaya Bulanan/ Pemakaian Biaya Bulanan/ Pemakaian “Managed TP Maintenance & Warranty “Managed TP Connectivity Services” Connectivity Services” Bandwidth Charges Opsi 1: Model 2: Model Biaya Tetap Model Biaya per Pemakaian

Our Value One Stop Managed Solution Managed voice, application, Price Competitiveness data & converged network Manageable cost services including high Convenience, flexible business performance Data Center & model DRC Secured & Trusted TELKOM Consulting & Integrating Corporation: Group services: Stated Owned ICT Experienced team in plan & Company manage the design, build & public listed Solution deployment of Innovative Auditable solutions Compliance Coverage & Full Services: Improving Business Performance: Integrated infocom services Improved network utilization, availability, Nationwide reliability & performance enable the customers to focus on their businessby Telkom Indonesia 32

thank youby Telkom Indonesia Source : Orange Healthcare for Telco 2.0 Exec Brainstorm

Curriculum Vitae Saiful Hidajat • Lahir : Surabaya, 10 Februari 1970 Pendidikan: • MT in Information System and Technology, ITB • S1 in Telecomunication, Unibraw Jabatan : saifulh@telkom.co.id Saiful.hidayat@admedika.co.id • 2004-2006 : Manager e-Solution Divisi http://namakuiful.com Multimedia PT TELKOM • 2006-2007 : GM Operation PT. FINNET (Telkom Group) • 2007 – Sep 2010 : Head of IT Service Strategy PT. TELKOM • Sep 2010 – Now : Director of Business Development PT. Admedika (Telkom Group)by Telkom Indonesia

Saiful Hidayat Pemanfaatan ICT untuk Pengembangan Rumah Sakit Pendidikan implementasi Telemedicine dan Teleconsulting

by Saiful Hidayat on Mar 31, 2011

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Saiful Hidayat Pemanfaatan ICT untuk Pengembangan Rumah Sakit Pendidikan implementasi Telemedicine dan Teleconsulting — Presentation Transcript

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