Indonesia makes health data available at one’s fingertips
By Mochamad Azhar
Finally, Indonesia has an integrated health information system. Patients no longer need to go back and forth to health facilities to retrieve their medical records – they can simply register on the SATUSEHAT application and all their data will be available.
The SATUSEHAT platform will become a data repository for individual health history, starting from immunisations, medical history, to medical actions taken on patients. Source: Ministry of Health
Until now, medical record data in Indonesia was only held by health facilities. Patients would only be able to get a copy of the documents, but were not able to access this data online.
"Now, if there are patients who have blood tests in one laboratory, the results can be accessed directly from the SATUSEHAT application which can be accessed by the public," said Minister Budi.
Minister of Health Budi Gunadi Sadikin explained in an online press conference that the SATUSEHAT platform was designed to make it easier for people who want to access health services and obtain their complete medical record data.
Data integration across health facilities
Beyond blood tests, all medical records of patients who undergo health checks from MRI to CT scans will be entered into the application. Patient drug consumption data will also be entered into the system to make it easier to track.
"People no longer need to carry physical medical record files if they have to move hospitals. All patient medical record resumes are recorded digitally in the application," he added.
SATUSEHAT was officially launched by the Minister of Health Budi Gunadi Sadikin in July 2022, as an integration platform for all health information technology in Indonesia.
This platform adopts a platform-as-a-service model that connects the entire ecosystem of health industry players to create one reliable national health data repository.
According to Minister Budi, SATUSEHAT will be integrated with the PeduliLindungi application, a Covid-19 app that is already familiar to Indonesians and has been accessed by more than 60 million users.
For the initial phase, 2,893 (77.04 per cent) health centers and 370 hospitals (31 per cent) on the islands of Java and Bali are ready to be integrated into SATUSEHAT. "It is hoped that this year, 9,422 other health service facilities throughout Indonesia will be integrated," said the Minister of Health.
Apart from being integrated with healthcare facilities, laboratories and pharmacies, the Ministry of Health plans to integrate SATUSEHAT with BPJS Kesehatan, Indonesia’s healthcare social security agency. The integration will include a tuberculosis recording system, mortality data, maternal and perinatal data, immunisation data, and a national referral system.
The process of integrating data into the SATUSEHAT platform will be carried out through several phases. The first phase will encompass patient registration data and diagnoses. The second phase will consist of data on patients’ medical procedures, vital signs and diet.
The third phase will integrate drug data along with the drug dictionary. The fourth phase will integrate laboratory observation data and radiology observation data, and the fifth phase will integrate allergy data and physical condition data.
Easing the work of healthcare professionals
Additionally, the SATUSEHAT platform makes the work of health workers easier. Now, health workers do not need to input data repeatedly in different applications. They can simply fill in one application which will automatically sync up with all the other applications.
SATUSEHAT will make it easier for hospitals to serve patients, and better support the development of the national health system, said Anis Fuad, Head of the Data and Information Centre at the Indonesian Hospital Association (PERSI).
"This will make it easier when a patient is referred from one health facility to another or to a more specialised hospital, as their medical history will already be recorded in one system," said Anis.
In addition, an integrated medical record system can help doctors to carry out health analysis and make decisions. Doctors do not need to bother searching through a pile of someone's medical record files even if the patient is moving between health facilities, either from hospital to hospital or from health centre to hospital.
Weak data, poor digital infrastructure pose challenges
Based on the regulation of the MOH Regulation No. 24 of 2022 on Medical Records, all health facilities are required to integrate their electronic medical record system into the SATUSEHAT platform no later than the end of 2023.
The regulation also requires all health service facilities such as vertical hospitals, government hospitals, private hospitals, health centres, posyandu (Indonesian integrated care centres), laboratories, clinics, and pharmacies to follow the standards set by the Ministry of Health.
In principle, hospitals have no difficulty integrating their existing electronic medical record system into the SATUSEHAT platform. "However, problems arise when not all healthcare facilities have the same infrastructure and resources to process data," Anis added.
According to a PERSI survey of around 3,000 hospitals in Indonesia, only 16 per cent of them have implemented an electronic medical record system with strong criteria, with 32 per cent possessing sufficient criteria. The majority of hospitals, or 52 per cent, have weak criteria.
This does not include digital infrastructure constraints experienced by health centres and posyandu in remote areas or certain types of hospitals. In a number of facilities, medical workers still record their patient's medical history manually on a computer because there is no internet.
According to Anis, the collaboration of all parties is needed to overcome these challenges. "The government needs to provide support, such as in the form of an internet network in remote areas and providing training for qualified IT extension workers."
In addition, it is necessary for the Ministry to provide convincing incentives for health facilities that have submitted access to medical record data according to established standards.
Another issue that is also important is formulating security standards for the patient's medical record data so that data leakage does not occur. "Raising awareness regarding the protection of medical record data must be intensified, both within the Ministry of Health, health facilities, and the public as application users," concluded Anis.
This article was originally written in Bahasa Indonesia, and has been translated by Yogesh Hirdaramani.
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