Saiful Hidayat : Telkom ehealth Cloud, Infrastruktur Cloud Computing Untuk Rekam Medis Elektronik

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adalah materi presentasi yang samaya sampaikan pada acara ASM (Annual Scientific Meeting) Fakultas Kedokteran Universitas Gajah Mada Yogyakarta Maret 2012 …

adalah materi presentasi yang samaya sampaikan pada acara ASM (Annual Scientific Meeting) Fakultas Kedokteran Universitas Gajah Mada Yogyakarta Maret 2012
Dengan Topik bagaimana kesiapan dunia kesehatan untuk implementasi Rekam Medis secara Elektronik dengan menggunakan teknologi Cloud Computing

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  • 1. The  world  in  your  hand   SAIFUL  HIDAYAT   EHealth  Project  Director     PT.  Telekomunikasi  Indonesia  .  Tbk   Annual  Scien3fic  Mee3ng  2012   Yogyakarta,  10  Maret  2012  SICP   Corporate  Strategic  Planning  
  • 2. Curriculum  Vitae  :   SAIFUL  HIDAYAT     Educa1on  :   -­‐  MT  in  InformaEon  System  and  Technology,  ITB   -­‐  S1  in  TelecomunicaEon,  Unibraw     Working  Experiences  :   -­‐  2004-­‐2006    :  PT.  Telekomunikasi  Indonesia,  Tbk      :  Manager  e-­‐SoluEon  Divisi  MulEmedia     -­‐  2006  –  2007    :  PT.  Finnet  (Telkom  Group)      :  General  Manager  of  OperaEon   -­‐  2007  –  2010  :  PT.  Telekomunikasi  Indonesia,  Tbk      :  Head  of  IT  Service  Strategy   -­‐  2010  –  2011  :  PT.  Admedika  (Telkom  Group)      :  Director  Of  Business  Development   -­‐  2011  –  Now  :  PT.  Telekomunikasi  Indonesia,  Tbk      :  Project  Director  Of  Ehealth  Business  Project   Corporate  Strategic  Planning    
  • 3. The  world  in  your  hand   Digital  Trend  &  EHealth  Issues   EHealth  Trend  &  Expectation   Information  System  For  EHealth     Telkom  Cloud  For  EMR  SICP   Corporate  Strategic  Planning  
  • 4. DIGITAL  TREND  &  EHEALTH  ISSUES  SICP   Corporate  Strategic  Planning  
  • 5. TODAY THE WORLD IS GETTING NARROW AND THINGS ARE CONNECTED, CLOSER,   MOBILE AND PERSONAL  SICP   Corporate  Strategic  Planning  
  • 6. WWW: WHOEVER AND WHEREVER WE ARE  SICP   Corporate  Strategic  Planning  
  • 7. Now  :  Almost  Everything  is  in  the  cloud     Corporate  Strategic  Planning  
  • 8. All  Goes  Digital   Teknologi digital akan banyak mengubah gaya hidup kita melalui berbagai macam layanan digital, termasuk untuk music, video, games, books, magazine, HEALTH RECORD ….?SICP   Source: The Future of Media, Gerd Leonhard, 2009 Corporate  Strategic  Planning  
  • 9. HOW’S HEALTH GOES DIGITAL?SICP   Corporate  Strategic  Planning  
  • 10. EHEALTH IS A CARING BUSINESS     NO MATTER HOW HIGH-TECH YOU ARE    SICP   Corporate  Strategic  Planning  
  • 11. HEALTH IS ONCE ABOUT CARING.   NOW IT WILL BE MORE CARING USING TECHNOLOGY FOR BETTER & EASIER APPLICATION  SICP   Corporate  Strategic  Planning  
  • 12. Challenges  :  Health  Problems  &  Barrier   Health  &  Healthcare  Problems   •  Cost   •  Quality  of  care   •  Consistency  of  care   •  ConEnuity  of  care   •  Disaster/Emergency  response   •  Isolated,  piecemeal,  inaccessible  records   •  Medical  care  separated  from  health,  life  &  prevenEon   Barriers  to  EMR  AdopEon   •  Co$t     •  Poor  usability   •  Nerdy  GUI  (Graphical  User  Interface)   •  Workflow  disrupEon   •  Poor  leadership  for  innovaEon  and  change  management   Corporate  Strategic  Planning  
  • 13. Solusi  e-­‐Health  Indonesia  :       Saat  ini  masih  parsial     Profil solusi e-Health di Indonesia masih parsial: •  Implementasi silo-silo •  Tidak terstandarisasi:Hospital (1.722) Asuransi Jiwa (46) •  Interoperabilitas, sulit dikembangkan(BUK) (Bapepam) •  Konsolidasi data sulit dilakukan (multi format dan standrat) •  Kelengkapan data lemah karena jangkauan kecamatan s.d pusat masih terbatasPuskesmas (9.005) Apotek (21.852)Bankdata Pusdatin IAI •  Akses Informasi Publik terbatas: atas indikator dan informasi kesehatan.   è Membutuhkan  Integrated    Shared  Service   Industri Farmasi (260) Pla`orm  Praktek Dokter(115.155) Corporate  Strategic  Planning  
  • 14. Corporate  Strategic  Planning   Source :
  • 15. E-­‐HEALTH  TREND  &  EXPECTATION  SICP   Corporate  Strategic  Planning  
  • 16. Healthcare  Trend  :  Improving  Stakeholders  Interac3ons  and  Benefits   MOH   Ensure Quality of Care and Patient Safety Corporate  Strategic  Planning  
  • 17. Healthcare  Trend   Corporate  Strategic  Planning  
  • 18. Basic  Management  Expecta3on     of  Healthcare  System   Need  Of  Healthcare  OrganizaEon   Note : HIS (Hospital Information System) is fundamental of digitalization in medical sector, and enables hospitals to meet the needs of “Efficiency, Quality Service & Capability” Corporate  Strategic  Planning  Source : SKT
  • 19. Informa3on  System  Support     for  Healthcare  Services  Business  Process   Healthcare  services  business   process  required  Informa3on   Insurance/Payors Suppliers System  Support  :   •  E-­‐PMS  (Pa3ent  Management  System)   •  EMR  (Electronic  Medical  Record)/EHR   (Electronic  Health  Record)   Laboratoium •  E-­‐Claim  (Insurance  Applica3on)   Pasien Loket/UGD/Admin •  E-­‐Referral  System   •  E-­‐Prescrip3on   •  E-­‐Pharmacy/e-­‐Apotek   •  E-­‐Laboratory   •  CRM  (Customer  Rela3onship   Diagnosa Poli Rawat Inap Warehouse Management)  Rawat Jalan •  Telemedicine   •  E-­‐SCM  (Supply  Chain  Management)   •  HRIS  (Human  Resource  Informa3on   System)   RS Rujukan Apotek •  Accoun3ng/Financial  System   •  EIS  and  CDSS   Corporate  Strategic  Planning   •  etc  
  • 20. Key  Success  Factors    For  Successful  Healthcare  System  Implementa3on  •  Strong    Commitment  from  C’s   Level  /  High  Level  Management   •  StandardizaEon   of   Healthcare  •  Acceptance  &  Technology  AdopEon   Business  Process  •  ConEnuous    HR  Training  and   •  C o m p l i a n c e   w i t h   Development   I n t e r n a E o n a l   S t a n d a r d /   Process   AccreditaEon     (KARS,   ISO   9001,  JCI)   Successful     E-­‐Health   Technology   People   ImplementaEon   •  Integrated    and    Interoprable  SoluEon  (eg  :  support    MOH  e-­‐ ReporEng,  e-­‐Referral,  e-­‐Claim  and  e-­‐Bill  to  Insurance,  etc)     •  Easy  to  implement,  simple,  modularity,  mulEpla`orm   •  Security  (CIA)     •  Reliable,  Auditable,  Manageable   •  DRC,DRP,BCP   Corporate  Strategic  Planning  
  • 21. Implementa3on  Creden3al  :     Lesson  Learn   3  Main  Considera3on  :  1.  Matched  between  e-­‐health  soluEon  with  Vision,  Mission  and   Business  Strategy  of  Healthcare  2.  Acceptance  &  Technology  AdopEon  (Doctors,  management,   medical  staff  and  all  Stake  Holder)  3.  Stages  and  Success  Criteria   5  Cri3cal  Components  on  E-­‐Health  Implementa3on   1.   Strong    Commitment  (C’s  Level)   2.   Internal  Team  Readiness     3.   Readiness  and  Sustainability  of  SoluEon  Partner   4.   OrganizaEonal  Readiness  and  Proper  Change  Management   5.   Good  Project  Management   Corporate  Strategic  Planning  
  • 22. INFORMATION  SYSTEM  FOR  E-­‐HEALTH  SICP   Corporate  Strategic  Planning  
  • 23. Kompleksitas  Sistem  Aplikasi  Saat  ini  Contoh  :  Proses  Bisnis  Rumah  Sakit   MarkeEng   Kesusteran   Ruang  Operasi   Administrasi   Paper   MySQL   MySQL   MySQL   In  House  Development   Pendakaran   ApoEk   Rawat  Inap   Laboratorium   MSAcc DBF   MySQL   MySQL   ess   Heavy  Infrastructure   Difficult  to  integrate   Arsip  Medis   IGD   Fas.  Penunjang   Billing  &  Claim   Paper   MSSQL   MySQL   MySQL   Fasilitas   Poli  A   Poli  B   Pelaporan   Penunjang   Oracle   Paper   Paper   MySQL   Keuangan   SpreadSheet   Kepegawaian   GL   MSSQL   MSAcc *.xls   Oracle   ess   Corporate  Strategic  Planning  
  • 24. Integra3on  :  Simplify  The  System   E-Health Cloud Services Corporate  Strategic  Planning  
  • 25. Cloud  Compu3ng  :  Defini3on  &  Key  Characteris3cs   Corporate  Strategic  Planning   References : Gartner Research
  • 26. Why  Cloud  Now  ?    -­‐-­‐Demand  Side  Efficient  àEffec3ve  à  Innova3on   •  Cost  Pressure,  CAPEX  to  OPEX:  Metered  by   New  Economics   Used,  Accelerate  Speed  to  Value   Reduce   •  no  patching  /maintenance,  faster   development,  robust  mul3  layer  security,   Management   reliability  &  fault  tolerance   Redifining   •  latest  so_ware,    internet  collabora3on,   Produc3vity   anywhere  access,      instant  self  provisioning  …  by  2012  80%  of  Fortune  1000  will  use  some  of  cloud  compu:ng  services,  20%  of  business  will  own  no  IT  asset  (Gartner)  The  boEomline  :  Early  Adopters  are  finding  serious  benefits,  meaning  that  cloud  compu:ng  is  real  and  warrant  your  scru:ny  as  a  new  set  of  plaJorm  for  business  applica:on  (Forrester)   Corporate  Strategic  Planning   References : Microsoft, Gartner Research, Forrester
  • 27. Cloud  Security  Implementa3on  Security In The Cloud1. Secure  Access  into  the  Cloud    2. Secure  Access  to  Web  Apps  3. Server  VirtualizaEon   •  MiEgate  risk  towards  the  hypervisor   •  Secure  the  OS   VM VM VM •  Inter-­‐VM  traffic  visibility  and  security   •  Secure  (shared)  file  systems  4. Secure  Standard  OperaEon  &  Procedures  5. Secure  System  Development  Life  Cycle  Procedures   Security implemented everywhere … not just on a firewall somewhere. Corporate  Strategic  Planning  
  • 28. Cloud  Based  Healthcare  System  Trend  …   “Healthcares  Future  Is   “By  2012,  20%  of   Partly  Cloudy:  External   businesses  will  own  Service  Provider  OpEons  for   no  IT  assets.”   Healthcare  Delivery   OrganizaEons”  “Cloud  spending  will  grow   “Every  enterprise   “Cloudsourced   3X  to  $42B  by  2010.   should  be  road   delivery…will   Cloudsourcing    takes  the   mapping  their   comprise  ~25%  of  the   cloud  to  the  next  step”   adopEon  of  the  cloud”   total  BPO  market  by   2012”   Corporate  Strategic  Planning  
  • 29. TELKOM  CLOUD  FOR  EMR  SICP   Corporate  Strategic  Planning  
  • 30. Introducing  Telkom  Group  Our  business  por;olio  (T.I.M.E)       Product     Media   Telecom   Poreolio   n Fixed  Wireline     n  Mul3  Channel  TV   n Fixed  Wireless   n Mobile/Cellular   Informa3on   n Broadband  Access   n Satellite   n  IT  Services  &  BPO/  KPO   n Tower   n  E-­‐Money   Edutainment   n Premises  Integra3on   n  Portal   n  E-­‐Commerce   n  Content   *)  Geography  coverage   Customers  Poreolio   BPO:  Business  Process                        Outsourcing     for  interna3onal   KPO:  Knowledge  Process   investment  is  basically  all   n  SME   n  Enterprise   n  Wholesale   over  the  world,  however   n  Consumer                      Outsourching     for  the  ini3al  investment,   Asia  and  Middle-­‐East  will   be  the  priority.   Domes3c   Geography*   Interna3onal   Corporate  Strategic  Planning  
  • 31. Telkom’s  Healthcare  Vision   Corporate  Strategic  Planning  
  • 32. Telkom  Group  e-­‐Health  Complete  Solu3on   Telkom  HIE  as  a  Na3onal  e-­‐Health  Shared  Service  Plaeorm   HIMBARA   MOH  who  will  benefit  by  an   Hospitals  will  provided    the   interoperability  and    interoperability  with  Payers   ASGARA   integrated  EHR  and  online   reporEng  of  Jamkesmas   HIE – Health Information Exchange eReferrals  from  primary  to   Expansion  to  eBilling   secondary  to  terEary   and  eSewlement   healthcare  (e.g.   perpetuates  end-­‐to-­‐end   ePuskemsas  to  District   paperless  &  efficient   and  VerEcal  Hospitals)   claims  processing   TELKOM  e-­‐Hospital   (HIS),  e-clinic, e-puskesmas, e-GP, e-Apotek , e-SCM, e-Claim   Corporate  Strategic  Planning  
  • 33. TELKOM  Group  e-­‐Health  Services  :  e-­‐Clinic  For  General  Prac33oner  (Cloud  –  SaaS  Model  –  Pay  per  Use)   Module and Cloud Computing Configuration 1.  Registrasi 11. Laboratorium 2.  Poli umum 12. Rawat inap Kebidanan 3.  Poli Gigi & Mulut 13. IGD 4.  Poli Anak 14. Apotik 5.  Poli Internis 15. Kasir 6.  Poli Kulit & Kelamin 16. Keuangan 7.  Poli THT 17. Inventory 8.  Poli Mata 18. Rekam Medis 9.  Poli Paru & Alergi 19. EIS 10.  Poli Kebidanan 20. SMS Benefit    Hisys  SaaS  Business  Model  :     • No  Investment     •  Capex to Opex •  Pay per Used •  No Operational and Maintenance Cost •  Flexible as Business Need •   Focus  on  Hospital  Business  &  Service  not    on  IT   •  Automatic Update •   Mobility any where, any time, any device Corporate  Strategic  Planning   Telkom  Group  Services  (eq,  e-­‐Payment,  e-­‐Procurement,  SAP)   •   Integrated  with  other  
  • 34. Telkom  Group  E-­‐Health  Services  :  EMR  Standardiza3on   TELKOM EMR Standardization By applying CCD-based standard XML Schema to EMR system, indexing for effective search for electronic medical record between connected health institution is provided, and gateway foundation for document exchange is built. HL7 CCD and XML HL7 Reference Information Modelv  HL7 CCD is a XML-based high-level standard for clinical document exchange.Basically CCD is: §  Specification of record and HL7 CCD communication of patient examination <levelone> <clinical_document_header> HL7 V3 Message <document_information> §  “Human Readable” <encounter_data> <observation> <service_actors> <service_cd V="6298-8" S="LOINC" §  XML exchange format technology DN="POTASSIUM:SCNC:PT:BLD"/> <service_targets> </clinical_document_header> <result_dttm V="2000-05-22"/> <body>v  RIM of HL7 Version 3.X is a standard for <value V="4.5" U="mg/dl"/> </observation> ... </body> </levelone> XML message development process. Corporate  Strategic  Planning  
  • 35. Telkom  E-­‐Health  Development  Ac3vi3es   3 2 1 1. Pengembangan platform HIE (Health Information Exchange) 2 2. Pengembangan Sistem Mini Dashboard   eReferral   Analityc   EHR eClaim   3 3. Modernisasi Sistem elektronik eHR   DKB   klaim Nasional, termasuk administrasi rujukan 4 4. Pengembangan aplikasi vertikal untuk kesehatan 1 HIE   4 Praktek  Dokter   Rumah  Sakit   Puskesmas   Asuransi   Klinik   BPJS   DKB: Data Kepesertaan Bersama EHR: Electronic Health Record HIE: Health Information Exchange Corporate  Strategic  Planning   BPJS: Badan Pelaksana Jaminan Sosial
  • 36. Considera3on:   EMR  on  the  Cloud   -­‐  EMR  definiEon  &  rule   -­‐  EMR  data  retenEon   -­‐  EMR  data  integraEon  &   Regula3ons   exchange  -­‐  EMR  data  content  -­‐ -­‐  EMR  data  format   EMR  data  store   Cloud  -­‐  EMR  data  exchange   For   EMR   Standard   Security   -­‐  ConfidenEality   -­‐  Authority   -­‐  Integrity   -­‐  Non  RepudiaEon   Corporate  Strategic  Planning  
  • 37. Q  &  A  SICP   Corporate  Strategic  Planning  
  • 38. SICP   Corporate  Strategic  Planning