Indonesia, the fourth most populous country in the world, uses digital technologies to improve its health system. During the webinar “Building a Successive Digital Transformation Roadmap in Indonesia” on June 10th, three hospital managers in the country shared their strategies and blueprints for implementing digital initiatives.
PT Siloam Hospitals CIO Ryanto Marino Tedjomulja, Mandaya Hospital Group President Director Dr. Ben Widaja and Dr. Fathema Djan Rachmat, President Director of Pertamina Bina Medika (Pertamedika) spoke about the challenges and lessons they learned from their hospitals’ digital health journey.
Dr. Joanna Pang, Chief Manager for Information Technology and Health Informatics at Hong Kong’s Hospital Authority (HA), contributed to the discussion with her experience in developing Hong Kong’s digital health ecosystem.
Dedicated teams for digital transformation
The first step in the digital transformation of Siloam Hospitals was the consolidation of the data. Tedjomulja said they had created a single department to oversee this process, which resulted in the connection of all 40 hospitals through a single system.
During this phase, all available data, such as patient, medication and service costs, were merged into a single database to encourage clinicians and staff to use data in decision-making. “We’re using this data to drive culture transformation in Siloam; to be more data driven, ”he said.
According to Dr. Rachmat had a dedicated IT team behind Pertamedika’s latest integrated hospital service system called One Solution System.
She recalled that all 73 state hospitals belonging to Indonesia Healthcare Corporation (IHC), the network operated by Pertamedika, ran their own separate apps. Now they are working with a solution that is easy to use for doctors and includes an end-to-end module from the dashboard to EMRs.
Dr. Rachmat said she wouldn’t mind having an audience with her IT team to discuss, for example, the latest software they are developing. She said the hospital management will provide the space they need.
On her digital health journey, she emphasized the importance of getting everyone on board. “We make sure that everyone understands the term digitization and IT as well as the business processes of our hospital services.”
Recently, the IHC has also tried drone technology in providing remote coverage and assessing its capacity for remote deployments. It didn’t take many people to try out such an innovative practice, said Dr. Rachmat. “We just need a strong team that ensures that everyone can implement this in their hospital. We also ensure that a digital mindset grows in the hospital. “
The problem with system integration
The Mandaya Hospital Group will open its newest digital hospital in West Jakarta this year. Construction of the Mandaya Royal Hospital Puri (MRHP) began in 2018. It will be a 16-story general hospital with centers of excellence in cardiovascular services, neurology and oncology.
According to Dr. Widaja is one of the challenges in opening a greenfield hospital the lack of a basic record. “We have a brand new team with no data migration. That means [we] do not have an initial record. We have to build a lot of new things [like] Building a new database “.
In addition to starting from scratch, it requires multiple pieces of software that a single vendor cannot provide all, he claimed. MRHP requires 13 software systems – seven for medical purposes and six for non-medical operations. These, including an EMR, had to be obtained from various suppliers abroad, for example in Europe, Malaysia and Indonesia.
However, what is important across the board is system integration. “How do we combine and work all 13 software systems together into a single patient and family experience system to ensure that their experience is seamless and they don’t know that we have 13 software systems in our system,” Dr Widaja said. The unified system must also be predictive, proactive, personalized, robust and useful, he added.
In the case of the Hong Kong public hospitals, Dr. Pang the integration of a closed loop system into the clinical workflow for “really a challenge”. This is one of the areas that HA is focusing on to support the clinical operations of the network. HA manages approximately 43 hospitals and a hundred other clinics that care for 90% of all inpatients in the region.
“We and our IT colleagues have invested a lot of time and resources to develop the mobile capability, the cloud service, [and resolving] Data problems because they are all interconnected so we can support our clinical operations and administration. “
In choosing the right systems, Dr. Widaja, you need to weigh your options especially with vendors whose solutions require their standard operating procedures to be adopted. “Do these procedures meet our needs? Can they be tailored to our needs, the patients and the needs of our clinicians?”
There are communication problems with multiple systems. MRHP has set up a dedicated team to control communications.
Based on Dr. Rachmat also said, “We need a strong in-house IT team to manage these implementation and integration phases.”
“Innovation Thinking”
Tedjomulja said they had to go “back to the drawing board” in the second phase of Siloam’s digital transformation – the digitization phase. When entering this phase, they first had to consider the patient’s expectations.
Digital initiatives in this phase include the introduction of a mobile application for patients; a new clinical system to streamline administrative tasks; and using robotic process automation technology to automate routine work, especially in their finance department, as well as analytics to gain insights.
The digital transformation of Siloam does not quite end in the final phase. “We know that technology is constantly changing, it is constantly being updated,” said Tedjomulja. Therein lies the challenge of encouraging people to adapt to change.
In order to advance digitization, a “Mindset of Innovation” is needed, he emphasized. “We have to keep innovating. We have to make sure that we are not left behind.” Current innovations from Siloam hospitals include the use of remote patient monitoring to support diabetics.
Dr. Pang agreed to Tedjomulja’s call. In the end, HA set up its own AI laboratory in which projects are carried out according to an AI innovation process. Despite these efforts, as the hospital network adopts the latest AI-powered solutions, it must address clinician considerations such as medico-legal concerns, safety issues, and patient outcomes. “We [found] that it is not easy to implement AI solutions in clinical settings because clinicians will have their own considerations “.
But dr. Pang is certain of one thing: “AI will be one of the areas we should be investigating due to increasing patient demand, limited resources and human resource issues. We need to think about how to properly use AI to address the challenges ahead. “Healthcare Challenges”.
For Dr. Rachmat doesn’t just “create an app”.
“That means we’re changing everything in healthcare. We transform our organization through innovation, [changing] culture and people through the use of technology, “she said.
One of the missions of the IHC network of Pertamedika is the digital transformation, which for Dr. Rachmat also means human transformation. “We’re not just changing the media from paper to digital, we’re changing the way people think and culture and how they work,” she said.
In 2019-2020, the IHC made efforts to consolidate its network and ensure digital, business and cultural change. For this year, they are looking for or adapting existing EMR models across the hospital network so that they can have a single EMR by 2022.
Dr. Rachmat noted that the digital adoption rate in the Indonesian healthcare system is 10%, which is a “great opportunity” for expanding digital transformation in domestic hospitals. COVID-19, she said, is one of those factors driving digital adoption.
Last year, the IHC implemented data integration and interoperability to collect logistics data from all hospitals as the network worked to meet the needs of COVID-19 patients. This year IHC plans to build a data infrastructure before introducing business analytics and optimizations in 2022. In 2023, IHC will add state-owned pharmaceutical companies to its digital ecosystem via API sharing and focus on robotics development in the following year.
At his end, Dr. Widaja that the concept and the leadership are crucial when building a digitally supported hospital: “Make sure that we have the right concept, how we plan it, we set the deadline and the goal and how do we carry it out. And we have to make sure that the leadership is able to drive the implementation forward. “
source https://dailyhealthynews.ca/strong-it-teams-behind-indonesias-digital-transformation/
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