Adjustment of Regulations is a Fresh Wind for the Indonesian Telemedicine Industry

Since the end of March, Indonesia has responded to the outbreak of the Covid-19 pandemic with a number of regulations, including Large-Scale Social Restrictions and a ban on going home for those in affected areas. One of the important regulations issued by the government is the easing of rules for telemedicine services as stated in Circular Number HK.02.01/MENKES/303/2020. A rule that makes a surge in users of telemedicine services and accelerates technology adoption in digital services.

The Circular gives some powers to doctors, through telemedicine services, to perform history, which includes the main complaint, accompanying complaints, current medical history, other diseases or risk factors, family information and other related information that the doctor asks the patient/family online; physical examination through audiovisual; providing necessary advice or suggestions; diagnosis; treatment based on diagnosis; prescription writing; and issue a letter of reference.

Loosening of telemedicine regulations is driving a surge in service usage in Indonesia. Halodoc and HealthReplies.com believe this matter. Doctors' demand for online consultations is growing rapidly during this pandemic.

"There are two things that have an influence on the increase in users of telemedicine services. First, consumers pay more attention to health aspects and adapt more positive behavior in maintaining health because they are worried about the impact of the pandemic on their health. Second, the COVID-19 pandemic has resulted in most people being active. at home and reducing interactions outside the home," explained the party HealthReplies.com.

The same thing was conveyed by SehatQ and ProSehat. SehatQ said, "During the pandemic, the increase in SehatQ users was quite drastic. [..] From our data, users have increased by more than 600% since the beginning of this year, and there has been a spike of more than 100% for our doctor chat. Our health shop is also recorded a 16-fold increase in transactions since the beginning of the year."

Meanwhile, Founder ProHealth Dr. G. Bimantoro (Bimo) explained that their teleconsultation services had grown 3 times compared to before. He also highlighted the growth in demand for other on-demand health services, such as requests for calls from health workers to homes or companies which increased fivefold.

The telemedicine industry and the pandemic

The telemedicine industry and other digital health services have been developing with caution due to fairly strict regulations. This is very natural considering that personal health data is very crucial. During this pandemic, emergency conditions "forced" the adoption of technology to be accelerated, one of which is in the health sector.

After regulations loosen, the next challenge is excellent service to provide the best experience for those who have never had contact with technology. This is related to the availability of doctors, quality of service, and most importantly data protection.

Currently, telemedicine services have become a solution to reduce the number of face-to-face consultations (face-to-face). The ongoing pandemic situation means that the safest conditions for initial consultations and examinations are carried out using technology.

In times like this, several innovations are born that accelerate the growth of the telemedicine industry. YesDok develops video-based consultation services and has integrated with DANA or SehatQ which focuses on developing features related to health services during the pandemic.

"The first [innovation] is Health Passport, which is integration with hospitals/clinics providing Covid-19 tests, so that patients can do booking Covid-19 test to access test results, all in one SehatQ application. The second is the hospital/clinic telemedicine channel, so that patients can continue to have online consultations with doctors at the hospitals/clinics they subscribe to. The third is features booking "Covid-19 test via SehatQ, where users can easily choose from 100 test locations for SehatQ health facility partners throughout Indonesia," said the team HealthyQ.

Meanwhile, Dr. Bimo said, ProSehat has developed TeleProSehat using chatbots, so that people can access teleconsultation services without needing to install them again.

"Just WhatsApp, city and village residents can immediately consult safely with a doctor and use it video call link to open directly in the browser. "Of course, we always maintain security and privacy for each teleconsultation," added Dr. Bimo.

Indonesian Telemedicine Association

Indonesia now has Attention or the Indonesian Telemedicine Association. In it there are dozens of telemedicine service providers with various concepts and specialties. Names like Halodoc, Alodokter, SehatQ, ProSehat, and YesDok are included.

Attention Secretary Dr. Karina Andini to DailySocial said, ATENSI was born with a vision and mission to develop alternative health services that are easier, relatively cheap, but still pay attention to the safety of patients and doctors for the Indonesian people.

The expected service is not only curative, but also holistic, starting from providing correct information, complete health consultations, providing thorough diagnostic referrals, to referring in accordance with the referral system in Indonesia.

"The telemedicine industry in Indonesia is currently only at the beginning of its growth phase. It will grow big, because Indonesia's large population with more than 50% already lives in urban areas, the natural conditions of the country which consists of thousands of islands, and the extraordinary development of the telecommunications industry rapidly in Indonesia," explained Dr. Karina.

It is also hoped that ATN's presence can help the government prepare the basis for regulations. Currently existing regulations cannot regulate the development of health technology in Indonesia as a whole.

Dr. Bimo added that the current telemedicine regulations need to be refined a lot and are still at a stage that provides relaxation during the handling of the COVID-19 pandemic. However, he is quite confident that various related regulations will be released soon after Circular Letter from the Minister of Health No. HK.02.01-MENKES-303-2020.

The presence of the Indonesian Medical Council regulations and the fatwa of the Honorary Council on Medical Ethics for medical personnel, as well as the emergence of BPOM Regulation No. 8 of 2020 concerning Drug and Food Control which is distributed online, shows how responsive the various parties involved are in supporting this telemedicine regulation.

The importance of telemedicine for Indonesia

From data from the Ministry of Health, the ratio of health workers in Indonesia is 1 doctor serving around 2500 people. Based on this data, in Southeast Asia, Indonesia is only ranked second from the bottom, or only better than Cambodia. The highest ranking is held by Singapore with a ratio of 1 doctor for 500 people.

The efficiency offered by telemedicine services is a great opportunity. This service allows doctors to treat more patients per day. Not to mention the problem of the availability of adequate health facilities in the regions. Telemedicine can be an alternative, although it does not completely replace direct consultation with a doctor.