A doctor gives remote consultation to her patient using an app provided by national health insurance provider BPJS Kesehatan from her office at Mutiara Medika Clinic in Lebak, Banten, last month. (Antara Photo/Muhammad Bagus Khoirunas)
Reimagining Indonesia’s Healthcare With Telemedicine
BY :FREDERIC HO
NOVEMBER 09, 2020
Since the Covid-19 pandemic began, routine doctor visits have become an unnerving task for many patients. This has led to a surge in patients leveraging telemedicine services in Indonesia, with platforms such as Halodoc seeing 7.2 million users accessing its Covid-19 special feature since March, while the app’s mobile downloads increased 300 percent.
Telemedicine’s meteoric rise can be partly attributed to Indonesia's government — which, in an attempt to lessen the strain on its healthcare facilities — has encouraged citizens to get consultations and treatment online through existing medical apps in Indonesia.
Driven by a shortage of professionals and the lack of medical care in rural areas, telemedicine providers have popped up in Indonesia’s healthcare landscape, implementing remote services for low-risk, high-volume clinical tasks such as general practitioner consultations for minor ailments and prescription refills.
Telemedicine can not only help manage the sector’s talent shortage by freeing up resources, but it also can make healthcare more accessible to patients with mobility issues or those residing in inaccessible areas. Increased accessibility is also important in driving early intervention and diagnosis, contributing to better long-term patient outcomes and lower public health costs.
While telemedicine has the potential to be a game-changer for patient care, there is a long way to go before it becomes mainstream in the archipelago. But what can be done to speed up the adoption of telemedicine?
From the patient’s perspective, there are plenty of practical and emotional considerations before turning to online medical services. First and foremost, patients must be aware of the services offered and feel confident that the quality of care they get will not be compromised.
Providers must also educate patients about the services and treatments that are ideally suited for telemedicine vs. those where an in-person clinical assessment is crucial.
Second, telemedicine services must be easy for patients to use. Once again, the onus is on healthcare providers to offer services that cater to a wide base of users with differing digital abilities. This particularly applies to older patients, who have the most to gain from access to remote healthcare services and tend to have the lowest digital literacy levels.
Finally, to ensure greater trust in telemedicine, patients must also be assured that their medical data is being stored and used securely and in compliance with local privacy legislation. Healthcare institutions must look into best practices for safeguarding patient information and communicate this data security commitment to patients.
Knowing Your Patients
To get patients on board with telemedicine and successfully get the sector off the ground, providers will have to reimagine how they manage basic tasks. One such task is patient registration.
During an in-person appointment, the registration process enables the healthcare provider to pull patient records, medical history, drug allergies, and more, and is essential to providing high-quality care. A similar process needs to be set up for e-consultations so that doctors can be sure of who they are treating, even though the doctor and patient are not in the same room.
This is where Know Your Patient (KYP) processes come in. Similar to the banking industry’s Know Your Customer (KYC) process, which enables banks to verify a customer’s identity, assess risk and determine appropriate product offers, KYP is essential for the safe and accurate delivery of digital healthcare services.
Traditionally, the approach to verifying patients’ identities has been to require them to show their IDs over a video call. This approach is less than ideal. It may be difficult for a healthcare administrator to discern between a legitimate government-issued ID and a fake one over a video call. Most practitioners are not trained to identify fake documentation.
Assuming that the ID is authentic, doctors may not be able to assess whether the person pictured on the ID matches the person on the call — especially if the photo on the ID is dated.
This is why sophisticated technologies, such as facial biometrics and AI, need to be leveraged for identity verification. This will allow KYP to be the first line of defense against fraudsters who use stolen or fake identities to see a doctor, get access to controlled substances, or file unlawful insurance claims.
This approach will also enable telemedicine providers to streamline telemedicine's online process — from registration to scheduling appointments and filling prescriptions — while complying with existing regulatory guidelines. KYP can also now be conducted securely, allowing doctors to treat patients confidently and confidentially — secure in knowing that they have access to the right records.
Beyond verifying patients for routine consults and prescription deliveries, KYP can also effectively verify third parties, for example, when young children must have a parent or guardian present during consultations or medication purchases.
As with any new industry, governments and market innovators need to work together to understand telemedicine's benefits and limitations better. This includes establishing best practices and standards of care that prioritize patient welfare and security but also encourage innovation and ease-of-use.
Indonesia is making significant progress in this regard. Its health ministry is taking steps in 2019 to regulate the telemedicine industry and provide companies with guidance and
supervision on implementing these services. Additionally, with the onset of Covid-19, the government further bolstered the industry by working with healthcare professionals to
provide telehealth services.
In the private sector, many healthcare and telemedicine start-ups and entrepreneurs have emerged in Indonesia over the past few years alone — including Halodoc, Alodokter, and GrabHealth. More focus and investment should be placed on supporting early innovators to develop the industry further and tackle Indonesia’s healthcare challenges.
However, it is also important for the public and private sectors to continue collaborating to reimagine every step within the consultation and treatment process. This will help identify any risks and establish best practices early on, ensuring that telemedicine can flourish and positively impact those who need it most.
Frederic Ho is the vice president of Asia Pacific at Jumio Corporation, a multinational company specialized in AI-powered identity verification and authentication.