Telemedicine

Now or Never
Aspek Teknologi, Protokol dan Ecosystem
Pengembangan Telemedicine
Oleh : HMTI94
 Today the greatest risk of global catastrophe doesn't look like this (atomic
bomb). Instead, it looks like this (virus). If anything kills over 10 million people in
What current problem the next few decades, it's most likely to be a highly infectious virus rather than a
war. Not missiles, but microbes. Now, part of the reason for this is that we've
we are facing now? invested a huge amount in nuclear deterrents. But we've actually invested very
little in a system to stop an epidemic. We're not ready for the next epidemic.
 Covid19 has
accelerated the
development and
adoption of Health
Application

Covid19 drive Digital

Transformation in all
sectors specifically in
Telemedicine
3 Focus Area

Information & Telecommunication 4G / 5G

Technology and Consumer Devoice IoT / Wearable

Patient Data
Health Digital Identity and Data in Medical Record
Telemedicine
Data Access

Predictive
Big Data Analysis Ecosystem
Technology
4G/5G Technology accelerate
Telemedicine
• Provide Highspeed Bandwidth with very low latency
• HD Teleconference for Consultative
• Transmission High Definition Image (X-Ray) , MRI, etc
Digitally
• Support any format of Telemedicine:
• Live-Video Conference
• Store-forward or asynchronous video
• Remote Patient Monitoring
• Mobile Health or M-health
• Telemedicine growth beyond Teleconsultation, i.e
Teleradiology, Tele-ECG, Tele-USG in
• Remote Robotic Care / Rescue for Emergency
5G Telemedicine in
Covid19 is proven
Technology Adoption
• 5G-powered telemedicine, remote
CT scanning, and remote
ultrasound testing were utilized to
tackle the shortage of medical
personnel in the worst-hit areas
and avoid person to person
transmission of infection.
• It is reported that during the
coronavirus outbreak, more than
100 hospitals used 5G systems for
telemedicine consultation.

How about 5G di
Indonesia?...Commercially
predicted launched in
2025…However 4G is available
now…
From: China-Japan Friendship Hospital
From: China-Japan Friendship Hospital
IoT, Sensor, and Wearable
(Data, Data, Data)

Real-time • Patient Surveillance

health • Equipment Status
monitoring • Prompt Action

• Vital Tracker
Wearable • Enrich the Data for
Analysis

IoT, Sensor, Wearable Device no Need High Bandwidth, but

require constant and secure connection
Vital Data can safe life
• Human surrounding by sensor nowadays, tracking
vital human (Temp, HeartBeat, Weight, Height,
Calorie, etc) from Smartphone, Activity Tracker
• Connect to Central Database of application on
through Mobile Application (Google Fit, Samsung
Health, Suunto, Garmin, etc)
• Those are very valuable data for Patient Analysis

These Vital Data can provide valuable insight if patient share

digitally
Health Digital
Identity & Data
Digital Identity and Data
Telemedicine

Acquired
Inherent Preference
Attributes
• Date of Birth • Address • Favourite
• Gender • Medical Food
• Nationality Record • Hobby
• more • Purchase • more
History
• Hospital
Tracking
• Clinic
location
• Sport Activity
• more
360⁰ Patient Data
Health Digital Identity & Data to
establish Telemedicine
Ecosystem

• Tailoring Application for Patient Care

• Aggregate Patient Information
• Build Foundation of Data Source
• Promote Healthy Living with Alert
Capabilities
• Making Healthcare Connected and IoT Device
Ready, Realtime
• Manage Relationship
• Good Visualization
• Continuously & Secure
• Authorization, Authentication, but
frictionless
Health Digital Identity & Data to
establish Telemedicine
Ecosystem

• Keeping Sensitive Data Private

• how do patients consent to share data with
your organization? What services, devices, and
third-party partners do they use? How easy is it
to scale this permission management as the
user base grows? How do you audit the sharing
of patient data
• Create a fast, flexible, and collaborative ecosystem
• Accommodate many different platform
requirement and connectivity
• Consolidate Identities
Data Protection: General Data Protection Regulation
(GDPR) / Perlindungan Data Pribadi (PDP)
GDPR
GDPR contains three additional, important definitions that
pertain to health data:
• “Data concerning health” is defined by the GDPR as
“personal data related to the physical or mental health of
a natural person, including the provision of health care
services, which reveal information about his or her
health status.”
• “Genetic data” is defined by the GDPR as “personal data
relating to inherited or acquired genetic characteristics of
a natural person which give unique information about
the physiology or the health of that natural person and
which result, in particular, from an analysis of a biological
sample from the natural person in question.”
• “Biometric data” is “personal data resulting from specific
technical processing relating to the physical, physiological
or behavioral characteristics of a natural person, which
allow or confirm the unique identification of that natural
person, such as facial images or dactyloscopic data.”
PDP
• Yang dimaksud dengan data pribadi yang bersifat spesifik
meliputi: a. data dan informasi kesehatan yaitu catatan
atau keterangan individu yang berkaitan dengan: 1)
Kesehatan fisik; 2) Kesehatan mental; dan/atau 3)
Pelayanan kesehatan
• data biometrik yaitu data yang berkaitan dengan fisik,
fisiologis atau karakteristik perilaku individu yang
memungkinkan identifikasi unik terhadap individu,
seperti gambar wajah, atau data daktiloskopi. Data
biometrik juga menjelaskan pada sifat keunikan dan/atau
karakteristik seseorang yang harus dijaga dan dirawat,
termasuk namun tidak terbatas pada: 1) rekam sidik jari;
2) retina mata; dan 3) sampel DNA
BIG DATA
ECOSYSTEM
Indonesia’s National Healthcare System
FASKES Tingkat Pertama Pharmacy
(FKTP)

FASKES Rujukan Tingkat Lanjut Organizer

Member (FKRTL) (BPJS)
Membership Healthcare Infrastructure

As of May 31st, 2019 (in Mio)

222.002.996

208,1
187,9
persons

171,9
156,8

83,7%
133,4

Of Indonesia citizen

Jumlah Penduduk data Ditjen

Dukcapil s.d TW II Tahun 2018
265.185.520 jiwa 2014 2015 2016 2017 2018
Ecosystems and Collaborations Expectations

#Competency
#Clarity
Areas of Regulatory #Transparency
• Healthcare infrastructure data (location, facility, occupancy)
• Medical personnel distribution (doctor, nurse, laboratory) #Compassionate
• Citizens data (demographic, geographical, educational #Affordable
economy)

Areas of Enablers
• Financial enablers for healthcare transaction
system (payment, verification, settlement)
BIG DATA as a SERVICES
• Record all transactional (by disease, by locations,
by time)

Areas of Healthcare Services #Simplicity

• Healthcare services (medical doctor competency, facility) #Comfort
• Inventory (room availability, medicine stock)
• Diagnostic and prescription records #Referral
• Boost medicine research efficiency by data
• Patient medical record (examination note, lab result, etc)
The Untold
Value Discovery – Putting the Patient at the Center

Smart City Patient Profiling Te l e m e d i c i n e Quality Assurance

Citizens health status is recorded Central repository of patient info Online platform that connect Scoring and open-feedback
by the government. Medical and medical records (diagnose, patient into healthcare system (gamification). It enables
facility and supporting functions recipes, treatment). It can be ecosystem (doctor, pharmacist, the referral systems and give
availability are managed enriched with external data such hospital, insurance, and patient the best options of
centralized. as demography of patient’s bank/fintech) healthcare services they are
domicile and epidemiology study needed.

Potential Benefits: Potential Benefits: Potential Benefits: Potential Benefits:

• Policy and budgetary can be
made by DATA
• Reduce risk on spread of
infectious disease among the
citizens
• Accuracy in diagnose
• Reduce risk on side-effects of
medical treatment
• Reduce risk of patient and
medical doctor on
transferring a disease
• Simple and comfort for
patient
• Transparent and efficient for
medical services provider
• Patients able to choose the
medical facility based on
their needs and preferences
• Conducive competition for
healthcare provider
If Healthcare Data is the New Oil (It is), how do we extract them?

PEOPLE PROCESS SYSTEM

Endorse data-driven culture in • Policies are made to • Open platform that are
ecosystems to gain real impact empower ecosystem extensible for community
of data insight (visibility, collaboration (patient and medical
authority, consistency, quality, • Secured data transfer provider)
unity) protocol aligned with • Seamless data integrations
National’s citizen data among ecosystem
protection regulation
E-Health Digital Ecosystem
Key Takeaway

Current Infrastructure in
Information & Technology can
Telemedicine is taking off, and
support. The challenge the
become reality now
digital/bandwidth divide in
Indonesia

The move forward to make

maximize of use the data by
We need to deep dive analysis on
collaboration and sharing but align
Digital Identity Data Protection
with data policy and governance to
build Good E-Health Ecosystem
Thank you