RSUP Sanglah is a state-owned 765-bed teaching hospital in Denpasar, Bali. Hospital Insider speaks to Chief Executive Dr I Wayan Sudana on the challenges arising from the rollout of universal healthcare coverage, and how he is emphasising skills and training programmes.

What is your vision for providing quality care at your hospital?

Since 2015, we have a vision to focus on the integration between services, education, and research, and become a world-class national referral hospital.

To achieve our vision, we are taking a four-part approach. First, we hope to provide a complete, high quality inter-profession health service for all Indonesians. Second, we hope to provide education to improve professionalism and competitiveness of our healthcare professionals. Third, we hope to establish partnerships with stakeholders in health care services, and finally we hope to provide a safe and comfortable working environment.

Our philosophy is to greatly uphold the self-esteem and dignity of human beings in providing healthcare services, education, and research. We always have to uphold the dignity of our patients, and never treat them as an object. We need to avoid the stigma that teaching hospital only treat patients as the object for their research.

What are some of the challenges that you are facing, and how are you overcoming them?

At this moment we have limited human resources for the IT department, both from quantity and quality. To cover the lack of quantity, we recruited more IT experts. And to improve the quality of our IT people we train them to increase their technical skills and keep them up to date.

And besides the IT experts, also have a lack of healthcare professionals like nurses, who are the key players in giving the best service to the community. Therefore we prioritise their skills development by conducting trainings to improve their technical skills, and encouraging them to pursue further education like bachelor, master, and doctoral degrees. That is not only for doctors and nurses, but for all the employees, even the non-medical ones.

What we are developing right now is what we call SISRUTE, the integrated referral system, which connects provincial health departments with regional hospitals. Using the integrated referral system, provincial hospitals can see, “Oh there is a vacant bed in Sanglah Hospital for our female patient in the obstetrics-gynaecology ward.”

This is the real challenge, to develop this integrated referral system so that our patients will be happy with the service.

How are you adapting to the implementation of universal health coverage in Indonesia?

By having Universal Health Coverage (UHC), all Indonesians, regardless of their socioeconomic status, can have access to health care services. Before we have UHC, most patients who are financially challenged could not get complete treatments. Even those with adequate income might struggle to pay for their treatment.

This is why the government launched National Health Insurance – but even so, in provincial, regent, and city levels there are some health insurance programmes to back up this insurance scheme because sometimes there are still some people who are not covered.

After we provide the accessibility to health care services and financial support to help cover the cost, we also have to address the quality of the service – with regards to both quality and patient safety assurance.

We also need to educate the people to maintain their health and not neglect it by thinking “I don’t need to be concerned with my health because it is easy to get healthcare treatment.” We have to promote that preventive is better than curative. This is not only for personal health, but also for the environment. For example, in Bali, we are now reducing the use of plastic bags; it is not easy to implement this, but we are doing it for the sake of our local people and tourists visiting our island.

There are various strategies to educate our community through germas (gerakan masyarakat hidup sehat or Healthy Community Movements) carried out by hospital, puskesmas (community health centres), and regional health departments. Meanwhile, hospitals are more concerned with curative and rehabilitative measures – but I think we are still responsible for preventive measures as well.

How are you leading digital transformation in your hospital?

Sanglah Hospital has started developing information technology to provide services based on digital platforms, not only to improve the flow of information, the use of information technology has also reduced the use of paper, so it improves efficiency as well. As for quality and patient safety, in using digital platforms we reduce human error.

For example, with e-prescribing, a pharmacist will be able to provide the correct medication as prescribed by the doctor. Because as we know, doctors are famous for their unique penmanship.

Currently we are developing our e-medical records, as well as e-budgeting and e-procurement. And to support the digitalisation of the hospital, we have a special department dedicated to IT.