Adalah materi presentasi saya pada Seminar Pengembangan Rumahsakit Pendidikan di Daerah Terpencil Yogyakarta, 5 Maret 2011 yang diselenggarakan oleh Fakultas Kedokteran Universitas Gajah Mada Yogyakarta

1. 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 2011
by Telkom Indonesia

2. E-Health Concept
Telemedicine Overview
Agenda
Telkom Group Readiness
by Telkom Indonesia

3. 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
3
by Telkom Indonesia Source : Georgia State University

4. 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

5. 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

6. 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
•Interoperability
by Telkom Indonesia 6

7. E-Health Concept
Agenda Telemedicine Overview
Telkom Group Readiness
by Telkom Indonesia

8. 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
Telesurgery
by Telkom Indonesia

9. 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

10. 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 Gunardama
by Telkom Indonesia

11. Kebutuhan Bandwith aplikasi Telemedicine
Sumber: Johan Harlan, Pusat Studi Informatika Kedokteran, Universitas Gunardama
by Telkom Indonesia

12. “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 technology
by Telkom Indonesia http://www.bf-technologies.com

13. http://www.bf-technologies.com
PACS : Picture archiving and communication system
DICOM 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

14. 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/14/7/377
by Telkom Indonesia

15. E-Health Concept
Agenda Telemedicine Overview
Telkom Group Readiness
by Telkom Indonesia

16. 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* International
by Telkom Indonesia 16

17. 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)

18. 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 Assistance
by Telkom Indonesia

19. 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 32
by Telkom Indonesia

20. 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 SLA
by Telkom Indonesia
10/06/10

21. 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/DSLAM
by Telkom Indonesia Internet Gateway 1.92 Tbp/s Capacity
Asia-Amerika

22. 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 Leste
FO Coverage & Connectivity Per Kabupaten Kota
Selesai Maret‘11:
• Labuhanbajo
• Ruteng
• Bajawa
• Ende
• Maumere
• Waingapu
• Kupang
Selesai Desember‘11:
• Waikabubak
• Soe
• Kefamenanu
• Atambua
by Telkom Indonesia

23. 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 WiMax
Source: PT. Telkom, A.T. Kearney analysis

24. 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

25.  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 TELKOM
by Telkom Indonesia

26. 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
Codec
2 Penyediaan Profile 42
Endpoint E20 C20 C20 plus
ViCon Quick set
(penyewaan)
Layanan termasuk:
 Instalasi & training
 Operasional (optional)
by Telkom Indonesia

27. 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
Customer
by Telkom Indonesia

28. 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

29. 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

30. 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 daerah
CTS 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)

31. 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

32. 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 business
by Telkom Indonesia 32

33. thank you
by Telkom Indonesia
Source : Orange Healthcare for Telco 2.0 Exec Brainstorm

34. 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