For people suffering from diabetes and other chronic illnesses, it can be a pain to keep going into the hospital to fill out prescriptions. To reduce patients’ waiting time and increase access to care, one hospital group in Jakarta is exploring teleconsultations and home delivery systems for medication.

“That’s the idea – to have a teleconsultation system with one of these application platforms,” says Dr Num Tanthuwanit, the Group COO and Deputy CEO of OMNI Hospital Group. “The medication delivery doesn’t need to be dispensed from the point of care, but can be done from any of our satellite hospitals and pharmacies.”

This way, “patients don’t need to come in regularly for chronic medication,” he says on the sidelines of the recent Clinical Effectiveness CEO Summit in Jakarta, hosted by Hospital Insider and Wolters Kluwer.

The programme fills several gaps: Indonesia’s capital suffers from crippling traffic congestion, and patients may live quite far away from the nearest hospital. What’s more, the hospital group is seeing more and more patients, who are demanding higher quality services. “It just allows patients who prefer not to wait, or who are not acutely ill, to get to go home and go back to work,” Dr Tanthuwanit says.

And when the medication is delivered, the loop ‘closes’ with a call from a pharmacist: “Once the medication reaches the patient, there is an SMS back to our pharmacist who then dials up the patient either by video call on the phone to make sure, did you receive the right medications? Are you the right person? Do you understand what the medication does?” About a quarter of patients in the group’s four hospitals are already benefiting from this programme, Dr Tanthuwanit adds.

Focus on preventive health

A challenge he is experiencing right now is the “lack of awareness, urgency about preventive care”. There is little public awareness or legislation around screening programmes, for instance, says the group COO, who used to hold a leadership role at Bumrungrad International Hospital, one of Thailand’s biggest private hospitals.

As a solution, the hospital has started “promoting the concept of having a virtual colonoscopy,” he explains, using modified software on CT machines. This gets rid of the uncomfortable experience of having a colonoscopy altogether. “It’s almost the same as having a real colonoscopy.”

What’s more, Indonesia has the highest rates of tobacco use in the world, with over 61 million users. Cardiovascular disease caused by the use of tobacco claims over 147,000 lives every year. Here is where preventive screening can really make a difference: “a chest X-ray every year is proven to reduce mortality by up to 60%,” Dr Tanthuwanit notes.

The hospital has developed a pioneering initiative to combined low-dose CT scans with cardiac calcium scores. This means that clinicians can detect growths or signs that indicate lung cancer, and at the same time, provide an estimate of a patient’s risk of heart disease based on plaque buildup in the arteries. “Just by adding an extra software programme, you’re also getting cardiac calcium scores,” Dr Tanthuwanit continues.

“We can showcase that fourth hospital to the other three hospitals to say, look how well it’s running, how efficient it is.”
The hospital group’s fourth and newest hospital, OMNI Hospitals Pekayon, opened a year ago – creating a unique opportunity for innovation, according to Dr Tanthuwanit. “We thought we would have a perfect sandbox” for a fully realised and “paperless” electronic medical record (EMR) system, the group COO says. “We can showcase that fourth hospital to the other three hospitals to say, look how well it’s running, how efficient it is,” he continues, adding that it will also be easier to cut medication errors.

Here, Dr Tanthuwanit notes how EMR systems cannot be standalone, but need to be paired with clinical decision support (CDS), echoing the sentiments of Dr Denise Basow, chief of clinical effectiveness at Wolters Kluwer. Clinical decision support systems help doctors to make decisions based on evidence and analysis from journals and clinical trials. “Having an EMR where everyone is using the same platform and CDS is built in – Lexicomp or UpToDate are great examples – I think that will have the most impact and utilisation in a hospital,” he remarks.

In May, the hospital group was recognised for their efforts at the Healthcare Asia Awards 2019, clinching Diagnostics Provider of the Year, Clinical Service Initiative of the Year, Service Innovation of the Year, and Health Promotion Initiative of the Year.

On the back of these new and exciting initiatives, Dr Tanthuwanit summarises the hospital’s approach to innovation in a few words: “Innovation doesn’t have to be technological invention or changes, it’s just how you can do your job more safely and efficiently.”