Chief DTO Reveals Update on Digital Health Transformation

Two years ago, the Ministry of Health (Kemenkes) published digital transformation roadmap to fix the chaos in the health industry. One of them aims to improve public health services.

The execution was carried out by the Digital Transformation Officer (DTO), a new division within the Ministry of Health and led by Setiaji who has strong experience in the technology and bureaucratic sectors. This road map contains three main focuses which are targeted for completion in 2024; integration and development of data systems, service application systems, and ecosystems in health technology.

What is the progress of implementing the health digital transformation roadmap in 2023? The following is a summary of the interview DailySocial.id with Chief DTO Setiaji.

Progress: medical records to AI systems

At the start of the interview, Setiaji talked about data standardization as the backbone of the entire health ecosystem. Why is that? For a long time, health facilities (faskes) have operated with a format and system that was built individually. Because the formats and systems are different, it is difficult to combine and process health information data.

Throughout 2022, DTO will implement a number of initiatives to smooth data integration and connectivity, starting from the launch of the Satu Sehat platform, health coding (e.g. drug codes, medical devices), to rules for administering Electronic Medical Records (RME).

"Last year, we focused on completing data standardization and integration, starting from Java and Bali. Because we were creating a platform, not building a system in health facilities, we met with related parties to introduce this standardization," he said.

He also revealed the progress of integration into medical records. With PeduliLindungi's transition to the Satu Sehat platform, people can now access their health data. Setiaji said, only around 500 health facilities have sent data online real-time from the initial target of 10.000 health facilities ready to be integrated.

This year, DTO is implementing an AI and biotechnology-based health analysis system, as well as developer licensing healthtech. Setiaji revealed a number of strengths data scientist have joined forces to develop modeling to aid the diagnosis process or screening tests certain diseases.

Then, his party is also reviewing the results regulatory sandbox for platforms telemedicine. Some of the points observed are health worker licensing, scope of practice, and data security. Of the 60 platforms that registered, 15 were selected so that their policies could represent each category.

They are also currently asking for input from venture capital (VC) which is now heavily involved in developing health technology related to service/product clustering.

"From regulatory sandbox We will also look at the licensing of telemedicine service providers, for example whether as a platform or virtual clinic. Another example, health workers have a regional practice permit (SIP), they must have a national SIP to be able to do so cover nationally too."

Setiaji added that technical regulations regarding health technology will be regulated through Minister of Health Regulations (PMK) or Directorate General Regulations (Dirjen). Meanwhile, Government Regulation (PP) will regulate it in large spades. This will facilitate the development of health innovations in the future, without the need to change the PP again.

Please note, the Government is currently finalizing the Draft Government Regulation (RPP) from Law no. 17 of 2023 concerning Health. Article 344 states that health technology will be regulated in the PP.

Furthermore, DTO is also preparing a Health Tech Space which will become a hub to bring together the health ecosystem. Health Tech Space will also function as an advocacy space for regulatory sandbox, accelerators and incubators. For startup players, this space can be used to develop ideas and health innovations.

Challenges: internet access to human resources

In its implementation, Setiaji admitted that there were a number of challenges that made the health data integration process difficult. First, unequal internet access. Of the total 10.000 community health centers in Indonesia, 745 do not have adequate internet access. "To handle this, the government is facilitating it with satellite internet."

Second, many health facilities still do not have a system to implement electronic medical records (RME). The government is trying to encourage the involvement of startups or related solution provider platforms so that health facilities do not need to build infrastructure from scratch.

"These startups offer solutions with a subscription model, there is also a free package for one year. We once conducted research where one hospital spent IDR 2 billion for paper-based medical records. So, we are trying to direct them to switch to electronics," he said.

Lastly is the challenge of human resources (HR). Since last year, DTO and related stakeholders have been actively intensifying educational activities for 10.000 health workers (nakes) regarding digital literacy. This education is needed to understand the digital transformation of the health sector.

With the remaining one year remaining, DTO is trying to accelerate this transformation agenda. At the very least, this year integration can be realized in 30.000 health facilities by the end of 2023. If this is not achieved, there will be sanctions imposed as regulated in PMK No. 24 of 2022. This sanction can be in the form of a written sanction or an administrative sanction (for example, accreditation lowered).

"We are trying speed up by improving the registration model. Health facility data already exists, we verify it automatically. We also separate teams for to market and operational teams for integration. Well, this integration is actually not necessary full reach level 6, so gradually. Digital transformation must be movement-based, it cannot be done by DTO alone."

BGSi: enablers biogenomic innovation

Last August, the Ministry of Health just launched the first initiative program Biomedical & Genome Science Initiative (BGSi) to develop appropriate treatment methods for the community. The output can produce diagnostic products for prevention and vaccines for disease treatment.

The method is to use technology to collect genetic information (genome) from humans and pathogens, such as viruses and bacteria, or called Whole Genome Sequencing (WGS). "The target is to collect 100 thousand samples by 2025 to map genome data," said Setiaji.

Setiaji revealed that currently the BGSi implementation plan is being prepared, especially the related details biobank, bioregistry, and ethical clearance. The target, BGSi can be enablers for related ecosystems to accelerate biogenomic innovation in Indonesia.

Apart from tools sequencing, BGSi is also preparing equipment to analyze samples. It requires high computing equipment because samples require very large data, up to 300 GB per sample. We once tried using a regular computer and it took three days. By device high computing, only 30 minutes," he explained.

Later it will be prepared too hub portal which can facilitate the system effectively end-to-end, starting from the data sequencing, transferring data for analysis, to matching data according to medical records to find out genomic results.

"Startups [in the field of genomics or biotechnology] will also be able to send our samples. This will allow them to reduce R&D costs. We are also preparing revenue models with related ecosystems, starting from researcher, vendors, to startups."

Please note, the BGSi program is supported by a number of domestic and foreign investors and collaborators, including The Global Fund, Panin Bank, Biofarma, and East Ventures; and involving Illumina, BGI, Oxford Nanopore Technologies, and the Satria Budi Dharma Setia Foundation.