Perkembangan Teknologi Informasi dan Pem (1)

Perkembangan Teknologi Informasi dan
Pemanfaatannya di Bidang Kesehatan

Prof. Richardus Eko Indrajit
indrajit@post.harvard.edu

Indonesian Healthcare Vision and ICT Core Vision

“Masyarakat sehat yang mandiri dan berkeadilan”

“Terwujudnya Sistem Informasi Kesehatan terintegrasi padatahun 2014 yang
mampu mendukung proses pembangunan kesehatan dalam menuju
masyarakat sehat yang mandiri dan berkeadilan.”

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(c) Richardus Eko Indrajit, 2009

ICT Healthcare Missions in Indonesia
Memperkuat pengelolaan SIK yang meliputi landasan hukum, kebijakan dan program, advokasi dan
koordinasi.

Menstandarisasi indikator kesehatan agar dapat menggambarkan derajat kesehatan masyarakat.

Memperkuat sumber data dan membangun jejaringnya dengan semua pemangku kepentingan
termasuk swasta dan masyarakat madani.

Meningkatkan pengumpulan,pengolahan, penyimpanan, penyajian dan analisis data serta informasi
kesehatan.

Memperkuat sumber daya Sistem Informasi Kesehatan yang meliputi pemanfaatkan teknologi
informasi dan komunikasi, sumber daya manusia, pembiayaan, sarana dan prasarana.
Memperkuat kualitas data kesehatan dengan menerapkan jaminan kualitas dan sistem
pengendaliannya.

Meningkatkan budaya penggunaan data dan informasi untuk penyelenggaraan upaya kesehatan yang
efektif dan efisien serta untuk mendukung tata kelola kepemerintahan yang baik dan bagi masyarakat luas.
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(c) Richardus Eko Indrajit, 2009

The Core ICT Roles and Functions in Healthcare
Mengoptimalkan Proses Pelayanan Kesehatan pada Masyarakat
(melalui penerapan beragam aplikasi teknologi informasi)
Mengelola Data, Informasi, dan Pengetahuan yang Berkualitas
(melalui pengembangan sistem basis data terpadu)
Mengintegrasikan Pusat-Pusat Penyelenggaraan Proses Kesehatan
(melalui pembangunan jejaring infrastruktur telekomunikasi)
Jika MANUSIA = BADAN + ROH + JIWA maka
ICT = APPLICATION + DATABASE + NETWORK
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(c) Richardus Eko Indrajit, 2009

Human Body versus ICT Architecture

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(c) Richardus Eko Indrajit, 2009

ICT Systemic and Holistic Architecture

Proses
Bisnis

Aplikasi
Data dan
Informasi

SDM
Finansial

Jaringan

Budaya
Mitra

Kebijakan

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Strategi
dan
Peta Pandu

POS
Insentif

(c) Richardus Eko Indrajit, 2009

National ICT Flagships and Program in Indonesia

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(c) Richardus Eko Indrajit, 2009

Indonesia ICT Roles in Globalisation Agenda

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(c) Richardus Eko Indrajit, 2009

Indonesia WSIS Target on 2015
1. 
2. 
3. 
4. 
5. 
6. 
7. 
8. 
9. 

Connect all villages with ICTs and establish community access points
Connect all secondary schools and primary schools with ICTs
Connect all scientific and research centres with ICTs
Connect all public libraries, museums, post offices and national archives with ICTs
Connect all health centres and hospitals with ICTs
Connect all central government departments and establish websites
Adapt all primary and secondary school curricula to meet the challenges of the
information society, taking into account national circumstances

Ensure that all of the world’s population has access to television and radio services
Encourage the development of content and put in place technical conditions in order to
facilitate the presence and use of all world languages on the Internet

10.  Ensure that more than half the world’s inhabitants have access to ICTs within their
reach and make use of them

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(c) Richardus Eko Indrajit, 2009

Changing Paradigm in Healthcare Industry
OLD and TRADITIONAL View
  ILLNESS paradigm

NEW and EMERGING View
  HEALTHY paradigm

  REACTIVE and PREVENTIVE
behavior

  QoLIFE IMPROVEMENT QUALITY
behavior

  AD-HOC/SITUATIONAL activities

  ROUTINE/PERIODIC activities

  REFERENCE-based task

  NEED-based task

  PUSH into healthcare facilities

  LIABILITY oriented process

  PULL into communities kiosk
  ASSET maintenance process

By nature, it is a revolutionary change in culture & people set of mind !

Unfortunately, that is the key to a sustainable business in the long run…
The choice: let the future change you or you invent the future …
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(c) Richardus Eko Indrajit, 2009

Paradigm Change from Then to Now …

20

th

Century

Provider-centered
Price-driven
Knowledge-fragmented
Slow diffusion of innovation
Paper-based
Episodic care

Fragmented care
Limited choice
Little quality measurement
Management by process
Adversarial government regulation
Persistent escalating cost

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21

st

Century

Patient-centered
Value-driven
Knowledge-organized
Rapid diffusion
Electronically-based

Continuous care
Coordinated care
More choice
Ubiquitous measurement
Management for outcomes
Collaborative regulation
Overall cost decline

(c) Richardus Eko Indrajit, 2009

“Shift Left”” in Healthcare through Technology
HOME CARE

100%

Healthy,
Independent Living

Community
Clinic

Chronic
Disease Management

Doctor’’s
Office

RESIDENTIAL CARE
ACUTE CARE

Assisted Living

QUALITY
of LIFE

Skilled
Nursing Facility

Specialty
Clinic
Community
Hospital
ICU

0%
$1

$10

$100

$1,000

$10,000

COST of CARE/DAY
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(c) Richardus Eko Indrajit, 2009

Technology can Help You in Re-Invent the Future
MATURITY

 Level 1

 Level 2

 Level 3

 Level 4

ICT STRATEGIC ROLE

VALUE

: Support the Healthcare

efficiency

: Enable the Healthcare

effectiveness

: Drive the Healthcare

rapid growth

: Transform the Healthcare

sustainability

Learning from the past experience of successful ICT implementation, it
is better to start with SIMPLE applications, followed by FAST replication,
and continued with GROWING MODULES that create quick wins …
ICT in Healthcare: to meet the UNMET stakeholder and customer needs
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(c) Richardus Eko Indrajit, 2009

Healthcare Institution is Assigned a Spectrum of Roles

The Multi Dimensional Roles of Healthcare Institution

Clinical
Aspects

 Hospitality

 Personal Care

 Responsiveness

 Prompt Treatment

 Community Support

 Medical Practitioners

Business
Aspects

 Cost Efficiency

 Cost Effectiveness

 Competitive Advantage

 Strategic Alliances

 Networking

Management
Aspects

 Decision Support

 Resource Management

 Policy Formulation

 Monitoring System

 Financial Portfolio

 Office Automation

Research
Aspects

 Medical Records

 Information Quality

 Data Accessability

 Statistics Development

Legal
Aspects

HR/Personnel
Aspects


 Confidentiality

 Document Management

 Legal Protection

 Audit Processing


 Experts Pool

 Personnel Management

 Analysis Tools

 Training & Development

 Personal Assistance

Managing today’
’s healthcare without IT is somewhat impossible …
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(c) Richardus Eko Indrajit, 2009

Example of Healthcare Value Chain in Hospital

CURE

Patient
Release

Mortuary
Services

ICU & ICCU
Services
Operation
and Surgery

Day Care
Services

Diagnostic

Medical Advise
and Treatment

OUT-PATIENT I/S

Admission

EMERGENCY I/S

Patient
Evacuation

IN-PATIENT I/S

Stay In
Services

VISION and MISSION
1. Education 2. Prevention 3. Treatment
4. Early Diagnosis 5. Rehabilitation

SUPPORT I/S
Administration and Operation
Procurement and Materials Management

Financial and Accounting System
Human Resource Development

CARE

Supplier and Liaison Management

Corporate Services and Public Relations
Decision Support System and Executive Information System
Firm Infrastructure and Technology
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(c) Richardus Eko Indrajit, 2009

Example of Management and Governance Framework

CARE

CURE

Patients

Clinical
Services

Administrative
Services

REGULATORY &
GOVERNMENT SERVICES

KNOWLEDGE COMPLEX
(pharmaceuticals, biotechnology, information
technology, instruments, etc.

FDA; CDC&P; state & local agencies; NIH,
NIMH, NCI, joint commission; CMS, etc.

INFRASTRUCTURE
financial services; third party payers; education; legal services; patents

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The Technology are Attached to Key Players

The Customers

The Practitioners

The Center

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The Technology for the Healthcare Customers

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The Technology for the Healthcare Practitioners

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(c) Richardus Eko Indrajit, 2009

Case #1: Electronic Medical Record

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(c) Richardus Eko Indrajit, 2009

Case #2: Laboratory and Pharmacy on Hand

–  Most widely used PDA
program by medical
practitioners
–  Rx, (Drugs & Complementary
meds)
–  Sx/Dx (Symptom & Disease
Reference)
–  Labs & other tools.
–  iPhone version has been
released

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(c) Richardus Eko Indrajit, 2009

Case #3: Clinical Learning Center

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Case #4: Patient Handling Simulation Center

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Case #5: Multimedia Healthcare Library

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Case #6: Personal Healthcare Assistance

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Case #7: E-Learning for Professional Certifications

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Case #8: Medical Calendar Software

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Case #9: Appointment Scheduling System

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Case #10: Medical Clinical System

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Case #11: 3D Medical Processing System

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Case #12: Pharmacy Information System

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Case #13: Hospital Management System

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Case #14: Outpatient-Inpatient System

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Case #15: Patient Dashboard Management System

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Case #16: Mobile Medical System

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Case #17: Mobile Medical Unit

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Case #18: Monitoring Resources

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Case #19: Healthcare MIS Dashboard

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Case #20: Healthcare GIS and Alert System

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“Towards Affordable Quality Healthcare Services”

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(c) Richardus Eko Indrajit, 2009

Projected IT Priorities
Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions

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(c) Richardus Eko Indrajit, 2009

Top Business Issues Facing HealthCare
Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions

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(c) Richardus Eko Indrajit, 2009

Most Significant Barriers to Implementing IT
Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions

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(c) Richardus Eko Indrajit, 2009

Most Important Applications
Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions

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(c) Richardus Eko Indrajit, 2009

Status of Electronic Medical Record Implementation
Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions

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(c) Richardus Eko Indrajit, 2009

Top Security Concerns
Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions

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(c) Richardus Eko Indrajit, 2009

Security Tools
Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions

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(c) Richardus Eko Indrajit, 2009

Technology Adoption
Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions

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(c) Richardus Eko Indrajit, 2009

2008 Health IT Staffing Needs
Source: 19th Annual HIMSS Leadership Survey Sponsored by ACS HealthCare Solutions

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(c) Richardus Eko Indrajit, 2009

How and Where to Start ?

Care Delivery

Identifiers &
Coding

The Patient
Record Info
System

Information
Interchange

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Security &
Privacy

(c) Richardus Eko Indrajit, 2009

It is a Simply Individual Database Repository

Hospitals
Health centers
Specialists
Apoteks
Director of health
Social security
institute

Healthcare
net

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Firewall/security

Other health
institutions

Hospitals
Departments:
Admission restrictions
Doctor records
Nursing records
Waiting list
Recommendations
Personal data
Letters
Requests and replies
Test records
Other data

x-ray
Hospital
apotek
Tests
Surgery
Accident
records
Bookkeeping

(c) Richardus Eko Indrajit, 2009

Let’’s Invent the National Healthcare Future …..
Current system fragments patient information
and creates redundant, inefficient efforts

Future system will consolidate information
and provide a foundation for unifying efforts

Payers
Hospital
Hospital
s

Public
health

Health
Information
Exchange

Primary care
physician

Laboratory

Labs

CLOUD
COMPUTING

Pharmacy

Data
repository

Specialty
physician

Network
applications

Outpatient RX

Payers

Ambulatory
center (e.g.
imaging
centers)

Physician office
Ambulatory centers
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Public health

(c) Richardus Eko Indrajit, 2009

Who is Inside the “Cloud Computing”
” Ecosystem?

Ministry of Health and
National Education
General Directoarate
of Health

The Universities and
Medical Learning Center
Icelandic Medicinces
Control Agency

Hospitals

Healthcare Centers

Healthnet
Cloud
Computing

Pharmacies
The Research and
Development Centers

Specialists
IT companies
General Practitioners
Public

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Other partners

(c) Richardus Eko Indrajit, 2009

You are Living in a National Healthcare Ecosystem…

Collaboration
is a MUST !!!

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(c) Richardus Eko Indrajit, 2009

Terima Kasih

Prof. Richardus Eko Indrajit
indrajit@post.harvard.edu