Saiful Hidayat : HIMSS ASPAC SI07_IndonesiaOpportunitiesChallengesAndExperiences

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Saiful Hidayat : HIMSS ASPAC SI07_IndonesiaOpportunitiesChallengesAndExperiences

  1. 1. HIMSS ASIAPAC12 CONFERENCE 17-19 SEPTEMBER 2012 MARINA BAY SANDS, SINGAPORE
  2. 2. S&I-7 SAIFUL HIDAYAT INDONESIA MOH EHR OPPORTUNITIES CHALLENGES AND EXPERIENCES9/25/2012 ©2012 Healthcare Information and Management Systems Society 2
  3. 3. Agenda• Telkom Group Business Portfolio• Indonesia Healthcare Current Landscape & Implication• Telkom HIE-EHR Implementation and Plan• The challenges that must be addressed• Key lessons learnt9/25/2012 ©2012 Healthcare Information and Management Systems Society 3
  4. 4. TELKOM’s HighlightTelkom is the largest telecommunication company and TELKOM is listed atnetwork provider in Indonesia, majority owned by the Indonesia Stock Exchange (IDX),Government of Indonesia New York Stock Exchange (NYSE),(Total shares = 20,159,999,280, including 1 Dwiwarna share series A) London Stock Exchange (LSE) and also Publicly Offering Without Listing (POWL) at Tokyo Stock as of January 2nd , 2012 Exchange (TSE) Government 53.24% 10,320,470,712 shares Public 46.76% 9,065,868,068 shares Treasury Stock 773,659,960 shares Market cap USD 16.09 Billion or + 4.2% of total market cap. at IDX Indonesia 9/25/2012 ©2012 Healthcare Information and Management Systems Society 4
  5. 5. Telkom Business Portfolio - TIMES PERSONAL CONSUMER/HOME SME LARGE ENTERPRISEservices Wholesale InternationalTelecommunication Information Media & EdutainmentPOTS Premise Integration Services MediaFWA VA, Managed App & Performance/ITO Online BusinessMobile / Cellular E-PaymentInternational Services ITeS (BPO, KPO, e-health)Fixed BroadbandNetwork ServicesTower 9/25/2012 ©2012 Healthcare Information and Management Systems Society 5
  6. 6. Agenda• Telkom Group Business Portfolio• Indonesia Healthcare Current Landscape & Implication• Telkom HIE-EHR Implementation and Plan• The challenges that must be addressed• Key lessons learnt9/25/2012 ©2012 Healthcare Information and Management Systems Society 6
  7. 7. An Illustrative Healthcare EcosystemIt is complex & often fragmented; eHealth provides benefits to all stakeholders in Indonesia through improved communication and information sharing Diagnostic Services Clinic/ Hospitals (Lab, Rad) GP (Inpatient, Specialist Outpatient, ED) Pharmacy • Wide EMR penetration • CPOE and EMR Employer Benefit • Automated ref errals • Ref erral Pharmaceuticals Managers • Automated coding and • Remote health claim submission monitoring • Automated coding & Private Health claims submission CRO Insurers Information • Members Exchange database maintenance Suppliers State Owned Pharmacies • Automated eligibility/ claims Insurer (e.g. processing ASKES) Patient/ • Claims rating Consumers • Ef f ective case/ Mobile Clinic/ disease Home Care management MOH • Medical records • Portable PHR storage • Personalized Portals Other • Patient Education Healthcare • Remote healthLegend: Regulatory monitoring (e.g. Dental) Staking share in key : Private Agencies components of the : Public Province/ eHealth ecosystem is Nursing Care • Population health database District important to ensure : Public & private • Disease detection & analysis Health growth & viability • Pharmaceutical supply chain optimization Offices 9/25/2012 ©2012 Healthcare Information and Management Systems Society 7
  8. 8. eHealthcare Trend Improving Stakeholders Interactions and Benefits Ensure Quality of MOH and Patient Safety CareSource : Deloitte Analysis
  9. 9. Indonesia eHealthcare TrendSource: Telkom & SKT 2010
  10. 10. Indonesia Macroeconomic Outlook Increase Healthcare Spend in Indonesia • The Indonesian government is encouraging foreign investment in the provider sector to offset health care funding shortages • Government is planning to increase health care spending from 2.8% to 5% of the gov. budget • ASEAN Free Trade Area (AFTA). • Analysis project 11 percent growth in personal disposable income through 2014 will drive higher individual health care spending in the country Health Care Expenditure Indonesian GDP and health care expenditure(a)(b) (GDP, healthcare spending, USD, %, Indonesia, 2000 - 2015) 1,400 1,297 3.0 Portion of GDP (%) 1,200 2.5 USD (B) 1,000 2.0 800 707 1.5 600 1.0 400 286 165 0.5 200 36.3 3.3 8.0 19.8 0 0.0 2000 2005 2010 2015Source: Deloitte Analysis Healthcare expenditure Total GDP % of GDP 9/25/2012 ©2012 Healthcare Information and Management Systems Society 10
  11. 11. Indonesia Healthcare Outlook Demand Exceeds the Supply Demand Supply • Factors such as improving macro economic • Limited players in the market that target the conditions, incl PPI affluent and middle-up segment • Currently, the ratio of hospital beds per • Compelling epidemiology, Indonesian life 100,000 population in Indonesia is 60 beds expectancy: 74 / 69 years (m/f) with CAGR Unmet per 100,000 population — eighth lowest in the of 0.5%; 70% chronic diseases are life style Need world related; 30-50% of everyone over 40 will • Shortage of healthcare professionals and have at least 1 chronic disease; represents quality care facilities in Indonesia; Doctor to 80% of health care cost patient ratio 1:7700 vs.1:390 in USA vs. 1:1700 average in developing countries e.g. India, Malaysia, etc. ‘Universal Coverage’ by 2014 will change dynamics With provision of insurance coverage for the general public under the ‘Universal Coverage’ 2014 Public Care Providers Scheme, the population segment that currently does not have access to cardiac care or is not aware of the disease condition (lack of diagnosis), will flood public healthcare facilities Increased pressure on public Medical Tourism care facilities will further increase demand for private care Indonesia’s demand for cardiac care Post-2014 Affluent to mid-up segment 150 million people added to the patient pool Mid- to lower- strataSource: Deloitte Analysis of the population 9/25/2012 ©2012 Healthcare Information and Management Systems Society 11
  12. 12. The EHR implementation versus invest in core healthcare infrastructure and provisioning to basic care Perhaps unique to Indonesia, the EHR implementation costs is anticipated to be significant public sector investment that competes with raising needs to invest in core healthcare infrastructure and provisioning to basic care to more than 200 million Indonesians.9/25/2012 ©2012 Healthcare Information and Management Systems Society 12
  13. 13. Indonesia eHealthLanscape & Implication• Partial used of eHealth Solutions: • Silos Implementation 2001 plus hospitals 46 private insurers • Non Standard/ Multi Format Data: (DG BUK Sep 2012) (Bapepam) • Lack of Interoperability • Lack of data consolidation • Lack of communication and data sharing • Lack of public information access• Government plan to have Universal 9,005 Puskesmas 21,852 pharmacies Health Coverage on Jan 2014 (Bankdata Pusdatin) (IAI) • Law 24/ 2011 – Executing Agency of Social Security (BPJS) • To provide basic healthcare for all Indonesian Integrated eHealth Shared Service 115,155 eGPs 260 pharmaceutical Platform is a Must industries 9/25/2012 ©2012 Healthcare Information and Management Systems Society 13
  14. 14. Telkom Group eHealth Solution Using Telkom’s HIE (Health Information Exchange) IT Security Internet & TPA & Personal GOV & Infrastructure Mobile Private Health Institutions Insurance Web PortalProvider Certificate SEHR Email &Directory Authority SMS Gateway Universal PKI Server Patient Identifier Routing & Transformation Telkom HIE (Health Information Exchange) Workflow Services Services (e-Health Hub) Web Service Adapter Government Healthcare Providers Pharmacies Suppliers Finance Insurance & SOE’sDoctors / Clinics & Laboratories EMRSpecialist Hospitals HIMBARA Link & ASGARA & 141 SOE’s Hisys e-Hospital Hisys e- 52 other Banks Apotik TELKOM eHospital (HIS), eclinic, epuskesmas, eGP, eApotek , eSCM, eClaim 9/25/2012 ©2012 Healthcare Information and Management Systems Society 14
  15. 15. Agenda• Telkom Group Business Portfolio• Indonesia Healthcare Current Landscape & Implication• Telkom HIE-EHR Implementation and Plan• The challenges that must be addressed• Key lessons learnt9/25/2012 ©2012 Healthcare Information and Management Systems Society 15
  16. 16. HIE-EHR Implementation plan & RoadmapVALUE-ADD Illustrative Purposes mHealth Enterprise- Analytics Driven Health Portal Tele-med EHR eOrder eRefer eProcure eClaims eRe- minder eBilling ePro- Consumer- motion driven eShop eGP CIS/HIS ePhar m TIME Infrastructure Wide Scale Innovation
  17. 17. Agenda• Telkom Group Business Portfolio• Indonesia Healthcare Current Landscape & Implication• Telkom eHealth Initiatives and Activities with MOH• Telkom HIE-EHR Implementation and Plan• The challenges that must be addressed• Key lessons learnt9/25/2012 ©2012 Healthcare Information and Management Systems Society 17
  18. 18. The challenges that must be addressed9/25/2012 ©2012 Healthcare Information and Management Systems Society 18
  19. 19. Agenda• Telkom Group Business Portfolio• Indonesia Healthcare Current Landscape & Implication• Telkom eHealth Initiatives and Activities with MOH• Telkom HIE-EHR Implementation and Plan• The challenges that must be addressed• Key lessons learnt9/25/2012 ©2012 Healthcare Information and Management Systems Society 19
  20. 20. Key Success Factors Agreement from People Hospital Executive to Determine ownership, provide datagovernance, and residency of data & information Consensus on coding Standard (ICD, SNOMED, etc.) and Exnchange Successful Protocols (HL7, CDA, CCD, Informa HIE-EHR Process etc.) tion Implementation Right Adaptor for complex and Techno heterogenous apps. in logy the hospitals9/25/2012 ©2012 Healthcare Information and Management Systems Society 20
  21. 21. Key Lesson Learnt• Self Sustainable systems  Right sustainable business models• Economically viable for Telkom and Government• Cost effective  We don’t have tons of cash to waste• Used proven technology  R&D vs. time to market  We don’t take unnecessary risk  Proven Technology & Processes • Example: CCD works – used it, MIMS works – used it• Involve doctors, pharmacies, health consultants in the team Business Heavy VS Engineering Heavy Its should be business case driven9/25/2012 ©2012 Healthcare Information and Management Systems Society 21
  22. 22. THANK YOU9/25/2012 ©2012 Healthcare Information and Management Systems Society 22

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