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Saiful hidayat 09112012 rancangan ina integrated e-health persixii 1.1


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Saiful hidayat 09112012 rancangan ina integrated e-health persixii 1.1

  1. 1. The world in your hand SAIFUL HIDAYAT EHealth Project Director PT. Telekomunikasi Indonesia . Tbk Kongres XII PERSIPlenary Hall, Jakarta Convention Center Jakarta , 7 November 2012
  2. 2. Curriculum Vitae : SAIFUL HIDAYAT Education : - MT in Information System and Technology, ITB - S1 in Telecomunication, Unibraw Working Experiences : - 2004-2006 : PT. Telekomunikasi Indonesia, Tbk : Manager e-Solution Divisi Multimedia - 2006 – 2007 : PT. Finnet (Telkom Group) : General Manager of Operation - 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. 3. The world in your hand Indonesia eHealth Ecosystem Overview National eHealth Implementation Benchmark Information System for Healthcare TELKOM Initiatives for eHealthcareIndonesia Integrated eHealth Challengges & Key SuccesFactors
  5. 5. The world in your hand Healthcare Ecosystem in Indonesia Healthcare ecosystem is complex and often fragmented, eHealth benefits both public and private stakeholders by improving communications and information-sharing Healthcare Ecosystem Legend: Diagnostic : Private Services (Lab, Clinic/ Rad) : Public GP Hospitals Specialist (Inpatient, : Public & private Outpatient, ED) Pharmacy • Wide EMR penetration Employer Benefit • Automated referrals • CPOE and EMR Managers • Automated coding and • Referral claim submission • Remote health Pharmaceuticals monitoring Health • Automated coding & CRO Private Insurers claims submission Information• Members Exchange database maintenance State Owned Suppliers Pharmacies• Automated Insurer (e.g. eligibility/ claims processing ASKES, JAMSOSTEK) Patient/• Claims rating Consumers• Effective case/ Mobile Clinic/ disease Home Care management MOH• Medical records • Portable PHR storage • Personalized Portals Other • Patient Education Healthcare (e.g. • Remote health Regulatory Dental) monitoring Agencies Province/ Nursing Care • Population health database District Health • Disease detection & analysis Offices • Pharmaceutical supply chain optimization
  6. 6. Healthcare Trend & PlatformImproving Stakeholders Interactions & Benefits MOH Ensure Quality of Care and Patient Safety Corporate Strategic Planning
  7. 7. Solusi eHealth di Indonesia Saat Ini Solusi eHealth Parsial Profil solusi e-Health di Indonesia masih parsial: • Implementasi silo-silo • Tidak terstandarisasi:Hospital (2.066) Asuransi Jiwa (54) • 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. Membutuhkan Integrated Shared Service Industri Farmasi (260) PlatformPraktek Dokter(115.155) Corporate Strategic Planning
  8. 8. eHealth Readiness di IndonesiaDeveloping Stage World Health Organization Global Key Observations Observatory for e-health in Indonesia – Year 20091 • Average score is around 52% Section 1 - e-health • The lowest eHealth readiness Foundation Actions dimension is Section 3 - Telemedicine. Which requires Section 7 - 69% Organization and Section 2 - mHealth infrastructure, connectivity and support for e-health advanced application of 50% 55% eHealth • The highest eHealth readinessSection 6 - Legal and 31%ethical frameworks 53% Section 3 - dimension is Section 1 – Telemedicine for e-health 63% eHealth Foundations. This is 46% indicative of the guidelines Section 5 - being put in to facilitate better Section 4 - eLearning Management of communication and in health sciences patient information collaboration and also form the eHealth foundation Note: (1) The WHO Global Survey for eHealth provides a secondary analysis of Indonesia e-readiness based on WHO e-health framework Source: WHO, SME Input, Deloitte Consulting Analysis Corporate Strategic Planning
  9. 9. Trend eHealthcare di IndonesiaHealthcare ecosystem is complex and often fragmented, eHealth benefitsboth public and private stakeholders by improving communications andinformation-sharing Corporate Strategic Planning
  10. 10. National eHealth Implementation Benchmark
  11. 11. Singapore Corporate Strategic Planning
  12. 12. Canada Corporate Strategic Planning
  13. 13. Corporate Strategic Planning
  14. 14. INFORMATION SYSTEM FOR HEALTHCARECorporate Strategic Planning
  15. 15. Information System Support for Healthcare Services Business Process Healthcare services business process required Information Insurance/Payors Suppliers System Support : • E-PMS (Patient Management System) • EMR (Electronic Medical Record)/EHR (Electronic Health Record) Laboratoium • E-Claim (Insurance Application) Pasien Loket/UGD/Admin • E-Referral System • E-Prescription • E-Pharmacy/e-Apotek • E-Laboratory • CRM (Customer Relationship Diagnosa Poli Rawat Inap Warehouse Management)Rawat Jalan • Telemedicine • E-SCM (Supply Chain Management) • HRIS (Human Resource Information System) RS Rujukan Apotek • Accounting/Financial System • EIS and CDSS Corporate Strategic Planning • etc
  16. 16. Basic Management Expectation of eHealthcare System Need Of Healthcare Organization 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 PlanningSource : SKT
  17. 17. Kompleksitas Sistem Aplikasi Saat iniContoh : Proses Bisnis Rumah Sakit Marketing Kesusteran Ruang Operasi Administrasi Paper MySQL MySQL MySQL In House Development Pendaftaran Apotik 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
  18. 18. Integration : Simplify The System E-Health Cloud Services Corporate Strategic Planning
  19. 19. Cloud Computing : Definition & Key Characteristics Corporate Strategic Planning References : Gartner Research
  20. 20. Why Cloud Now ? --Demand SideEfficient Effective  Innovation • Cost Pressure, CAPEX to OPEX: Metered by New Economics Used, Accelerate Speed to Value Reduce • no patching /maintenance, faster development, robust multi layer Management security, reliability & fault tolerance Redifining • latest software, internet collaboration, anywhere access, instant self Productivity provisioning… by 2012 80% of Fortune 1000 will use some of cloud computing services, 20% ofbusiness will own no IT asset (Gartner)The bottomline : Early Adopters are finding serious benefits, meaning that cloudcomputing is real and warrant your scrutiny as a new set of platform for businessapplication (Forrester) Corporate Strategic Planning References : Microsoft, Gartner Research, Forrester
  21. 21. Cloud Security ImplementationSecurity In The Cloud1. Secure Access into the Cloud2. Secure Access to Web Apps3. Server Virtualization • Mitigate risk towards the hypervisor • Secure the OS VM VM VM • Inter-VM traffic visibility and security • Secure (shared) file systems4. Secure Standard Operation & Procedures5. Secure System Development Life Cycle Procedures Security implemented everywhere … not just on a firewall somewhere. Corporate Strategic Planning
  22. 22. Cloud Based Healthcare System Trend … “Healthcares Future Is “By 2012, 20% of Partly Cloudy: External businesses will ownService Provider Options for no IT assets.” Healthcare Delivery Organizations”“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” adoption of the cloud” total BPO market by 2012” Corporate Strategic Planning
  23. 23. 76% of hospitals have failed in theimplementation of HIS (TELKOM-Probis eHealth riset, 2011) Corporate Strategic Planning
  24. 24. Implementation CredentialKey Lesson Learn• Strong Commitment from C’s Level / • Standardization of Hospital High Level Management Business Process• Acceptance & Technology Adoption • Compliance with International• Change Agent and Continuous Standard/ Accreditation Mentoring (ICD9CM, ICD!), CCD/KARS, ISO• Continuous HR Training and Process 9001, JCI) Development • Good IT Governance (RACI on every Process) Successful E-Hospital Technology People Implementation • Integrated and Interoperable Solution (eg : support MOH e-Reporting, e-Referral, e-Claim and e-Bill to Insurance, etc) • Easy to implement, simple, modularity, multiplatform • Security (CIA) • Reliable, Auditable, Manageable • DRC,DRP,BCP Corporate Strategic Planning • Readiness and Sustainability of Solution Partner
  26. 26. TELKOM HIE-EHR TELKOM eHealth Development Activities 1 1. Pengembangan platform HIE (Health Information Exchange) 2. Pengembangan Sistem Mini eHR : 2 4 2  Pilot Project 6 RS Vertikal Jakarta 3  Dashboard Dirjen BUK  Dashboard PPJK (JAMKESMAS) Dashboard eReferral Analityc 3. Modernisasi Sistem elektronik klaim eClaim SPGDT 3 Nasional, termasuk administrasi eHR rujukanDKB  Pilot Medical eReferral Sragen (Puskesmas – RSUD – Dinkes)  JAMKESDA (RSUD – Dinkes Kab/Kota – Dinkes Prov) 1  Pengembangan Sistem Penanganan HIE 4 Gawat Darurat Terpadu, termasuk 5 pengembangan sistem jejaring Rumah Sakit, sistem rujukan elektronik dan Praktek Dokter Rumah Sakit sistem contact center (SPGDT S/B) Puskesmas Asuransi KEMKES DINKES 1. Pengembangan aplikasi vertikal untuk Klinik BPJS 5 kesehatan (eGP, eClinic, ePuskesmas, HIS, eClai m) DKB: Data Kepesertaan Bersama EHR: Electronic Health Record Corporate Strategic Planning HIE: Health Information Exchange BPJS: Badan Pelaksana Jaminan Sosial
  27. 27. TELKOM Group eHealth Solution Solusi eHealth Terintegrasi Menggunakan TELKOM HIE IT Security Infrastructure Internet & Mobile GOV & TPA & Personal Health Institutions Private Insurance Web Portal Provider Certificate SEHR Email & SMS Directory Authority Gateway Universal PKI Server Patient IdentifierHospitals will provided the Payor’s (GOV’t) will benefit by Routing & an interoperability andinteroperability with Payers Transformation Telkom HIE (Health Information Exchange) Workflow Services and Medical Supplier integrated EHR and online Services (e-Health Hub) reporting of Health Claim to reduce fraud Web Service Adapter Pharmacies Will Provide Government Insurance Healthcare Providers Pharmacies Suppliers Finance eReferrals from primary to Interoperabilities with & SOE’s Doctors / Specialist Clinics & Hospitals Laboratories EMR secondary to tertiary Healthcare Provider thru Expansion to eBilling healthcare (e.g. ePrescribe and eSCM to and eSettlement ePuskemsas to District Pharceutical Company perpetuates end-to-end and Vertical Hospitals) paperless & efficient Hisys e-Hospital Hisys e-Apotik HIMBARA Link & claims processing ASGARA & 141 SOE’s 52 other Banks TELKOM eHospital (HIS), eclinic, epuskesmas, eGP, eApotek , eSCM, eClaim
  28. 28. The world in your handExample of EHR (Electronic Health Record)
  29. 29. Processing and Reporting of National Health Data:JAMKESMAS Integrated Reporting Jamkesmas (INACBG Based) Laporan Kasus Penyakit – Jawa BaratIntegration of Existing Applications INADRG / CBG VERIFIKATOR Web Service Administrasi Koder Rekam medis Cek Claim Proses Verifikasi Kepesertaan Distribusi Pasien Berdasarkan Kelompok Usia Verifikator Mendapatkan Pelayanan Online Batch report & Report analytic Processing Reporting & Analytic Kemenkes Server TOP 10 Diagnosa Utama – Berdasarkan Jumlah Pasien dan Jumlah Kasus Corporate Strategic Planning
  30. 30. TELKOM SPGDTSistem Penanggulangan Gawat Darurat Terpadu • SPGDT sistem yang menekankan pada time saving untuk menyelamantkan nyawa dan mencegah cacat. • SPGDT terdiri atas pre hospital, intra hospital dan inter hospital HIE (future0) CorporateIntegrasi Layanan Strategic Planning Pre Hospital + Jejaring Rumah Sakit = SPGDT
  31. 31. TELKOM EHOSPITALSolusi Sisitem Informasi Rumah Sakit Terintegrasi TELKOM eHospital merupakan solusi terpadu untuk sistem informasi rumah sakit, yaitu sistem terkomputerisasi yang mengintegrasikan seluruh alur proses bisnis layanan kesehatan di dalam rumah sakit dalam bentuk koordinasi, pelaporan, dan prosedur administrasi mulai dari fungsi front office dan back office. Disamping itu, TELKOM eHospital juga terintegrasi dengan entitas kesehatan lain di luar rumah sakit secara elektronik melalui Health Information Exchange (HIE). RSUD Pemkab/Dinkes Dokumentasi auditable & accountable  Monitoring performansi RSUD (mendukung audit & proses akreditasi) secara realtime Percepatan proses klaim Jamkesmas  Monitoring kondisi penyakit & Meningkatkan citra RS maping pasien RSUD (mutu, kepastian biaya, kecepatan)  Percepatan pengambilan Meningkatkan profesionalisme Benefit keputusan secara akurat manajemen RS Meningkatkan akses & pelayanan RSUD ke pihak ketiga : mitra /PBF, Askes, dll Proses reporting cepat, akurat Optimalisasi pendapatan RS melalui : minimalisasi fraud & loss opportunity Tenaga Medis RSUD INA-CBG  Transparasi & akurasi IRNA ASKES IGD penghitungan jasa Pasien medis Pendaftaran Back Office Pelayanan regristrasi cepat & mudah  Standar praktek IRJ Penunjang FARMASI Kepastian biaya pelayanan RS kedokteran yang baik Lab, Rad Jaminan Keamanan Pasien dan benar Corporate Strategic Planning
  32. 32. TELKOM EGP INITIATIVESSolusi Ekosistem Kesehatan bagi Dokter Praktek Ekosistem Interaksi KKI Kolegium  Uji kompetensi Dokter [UKDI] KKI  Surat Tanda Regeristasi [STR] IDI  Keanggotaan IDI/profesi  Kompulasi SKP Dinkes  Surat Ijin Praktek baru [SIP]  Perpanjangan SIP Farmasi  Peresepan obat [Pabrikan]  Data penggunaan obat Apotek  Peresepan obat [penebusan obat] Asuransi  Pelayanan medis Pasien Apotek Asuransi  Proses administrasi penghitungan jasa dokter Rumah Sakit  Proses rujukan Laboratorium  Proses rujukan Pasien  Pelayanan medis Pasien Corporate Strategic Planning
  33. 33. Indonesia Integrated eHealth Challenges & Key Succes Factors
  34. 34. The challengesthat must be addressed Corporate Strategic Planning
  35. 35. KEY SUCCESS FACTOR Agreement from Hospital Executive to provide data People Determineownership, governance, and residency of data & information Consensus on coding Successful Standard (ICD, SNOMED, etc.) Informa HIE-EHR Process and Exnchange Protocols tion (HL7, CDA, CCD, etc.) Implementation Right Adaptor for complex Techno and heterogenous apps. in logy the hospitals Corporate Strategic Planning
  36. 36. Key Lesson Learnt• Self Sustainable systems  Right sustainable business models• Economically viable for All Stake Holder• Cost effective  We don’t have tons of cash to wasted• Used proven technology  We don’t have time for R&D and take a risk  We use what has been work  Only Innovate when necessary Example: ICD9CM, ICD10, CCD works – used it• Involve regulators, doctors, pharmacies, health & IT consultants in the team Business Heavy VS Engineering Heavy Its should be business case driven Corporate Strategic Planning