SICP Corporate Strategic Planning
The world in your hand
Annual Scien3fic Mee3ng 2012 Yogyakarta, 10 Maret 2012
SAIFUL HIDAYAT EHealth Project Director
PT. Telekomunikasi Indonesia . Tbk
Corporate Strategic Planning
Curriculum Vitae :
SAIFUL HIDAYAT Educa1on : -‐ MT in InformaEon System and Technology, ITB -‐ S1 in TelecomunicaEon, Unibraw Working Experiences : -‐ 2004-‐2006 : PT. Telekomunikasi Indonesia, Tbk : Manager e-‐SoluEon Divisi MulEmedia
-‐ 2006 – 2007 : PT. Finnet (Telkom Group) : General Manager of OperaEon
-‐ 2007 – 2010 : PT. Telekomunikasi Indonesia, Tbk : Head of IT Service Strategy
-‐ 2010 – 2011 : PT. Admedika (Telkom Group) : Director Of Business Development
-‐ 2011 – Now : PT. Telekomunikasi Indonesia, Tbk : Project Director Of Ehealth Business Project
SICP Corporate Strategic Planning
The world in your hand
Digital Trend & EHealth Issues
Information System For EHealth
EHealth Trend & Expectation
Telkom Cloud For EMR
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DIGITAL TREND & EHEALTH ISSUES
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TODAY THE WORLD IS GETTING NARROW AND THINGS ARE CONNECTED, CLOSER,
MOBILE AND PERSONAL
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WWW: WHOEVER AND WHEREVER WE ARE
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Now : Almost Everything is in the cloud
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All Goes Digital Teknologi digital akan banyak mengubah gaya hidup kita melalui berbagai macam
layanan digital, termasuk untuk music, video, games, books, magazine, HEALTH RECORD ….?
Source: The Future of Media, Gerd Leonhard, 2009
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HOW’S HEALTH GOES DIGITAL?
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EHEALTH IS A CARING BUSINESS
NO MATTER HOW HIGH-TECH YOU ARE
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HEALTH IS ONCE ABOUT CARING. NOW IT WILL BE MORE CARING USING TECHNOLOGY
FOR BETTER & EASIER APPLICATION
Corporate Strategic Planning
Challenges : Health Problems & Barrier
Health & Healthcare Problems • Cost • Quality of care • Consistency of care • ConEnuity of care • Disaster/Emergency response • Isolated, piecemeal, inaccessible records • Medical care separated from health, life & prevenEon
Barriers to EMR AdopEon • Co$t • Poor usability • Nerdy GUI (Graphical User Interface) • Workflow disrupEon
• Poor leadership for innovaEon and change management
Corporate Strategic Planning
Profil solusi e-Health di Indonesia masih parsial: • Implementasi silo-silo • Tidak terstandarisasi:
• Interoperabilitas, sulit dikembangkan • Konsolidasi data sulit dilakukan (multi
format dan standrat) • Kelengkapan data lemah karena
jangkauan kecamatan s.d pusat masih terbatas
• Akses Informasi Publik terbatas: atas indikator dan informasi kesehatan.
è Membutuhkan Integrated Shared Service Pla`orm
Hospital (1.722) (BUK)
Puskesmas (9.005) Bankdata Pusdatin
Apotek (21.852) IAI
Industri Farmasi (260)
Asuransi Jiwa (46) (Bapepam)
Praktek Dokter(115.155)
Solusi e-‐Health Indonesia : Saat ini masih parsial
Corporate Strategic Planning Source :
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E-‐HEALTH TREND & EXPECTATION
Corporate Strategic Planning
MOH Ensure Quality of Care and Patient Safety
Healthcare Trend : Improving Stakeholders Interac3ons and Benefits
Corporate Strategic Planning
Healthcare Trend
Corporate Strategic Planning
Basic Management Expecta3on of Healthcare System
Source : SKT
Need Of Healthcare OrganizaEon
Note : HIS (Hospital Information System) is fundamental of digitalization in medical sector, and enables hospitals to meet the needs of “Efficiency, Quality Service & Capability”
Corporate Strategic Planning
Informa3on System Support for Healthcare Services Business Process
Insurance/Payors
Loket/UGD/Admin
RS Rujukan Apotek
Diagnosa Poli Rawat Inap
Laboratoium
Warehouse
Suppliers
Pasien
Rawat Jalan
Healthcare services business process required Informa3on System Support : • E-‐PMS (Pa3ent Management System) • EMR (Electronic Medical Record)/EHR
(Electronic Health Record) • E-‐Claim (Insurance Applica3on) • E-‐Referral System • E-‐Prescrip3on • E-‐Pharmacy/e-‐Apotek • E-‐Laboratory • CRM (Customer Rela3onship
Management) • Telemedicine • E-‐SCM (Supply Chain Management) • HRIS (Human Resource Informa3on
System) • Accoun3ng/Financial System • EIS and CDSS • etc
Corporate Strategic Planning
Successful E-‐Health
ImplementaEon
Process
Technology People
• StandardizaEon of Healthcare Business Process
• C o m p l i a n c e w i t h InternaEonal Standard/ AccreditaEon (KARS, ISO 9001, JCI)
• Integrated and Interoprable SoluEon (eg : support MOH e-‐ReporEng, e-‐Referral, e-‐Claim and e-‐Bill to Insurance, etc)
• Easy to implement, simple, modularity, mulEpla`orm • Security (CIA) • Reliable, Auditable, Manageable • DRC,DRP,BCP
• Strong Commitment from C’s Level / High Level Management
• Acceptance & Technology AdopEon • ConEnuous HR Training and
Development
Key Success Factors For Successful Healthcare System Implementa3on
Corporate Strategic Planning
3 Main Considera3on : 1. Matched between e-‐health soluEon with Vision, Mission and
Business Strategy of Healthcare 2. Acceptance & Technology AdopEon (Doctors, management,
medical staff and all Stake Holder) 3. Stages and Success Criteria
5 Cri3cal Components on E-‐Health Implementa3on 1. Strong Commitment (C’s Level) 2. Internal Team Readiness 3. Readiness and Sustainability of SoluEon Partner 4. OrganizaEonal Readiness and Proper Change Management 5. Good Project Management
Implementa3on Creden3al : Lesson Learn
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INFORMATION SYSTEM FOR E-‐HEALTH
Corporate Strategic Planning
Kompleksitas Sistem Aplikasi Saat ini Contoh : Proses Bisnis Rumah Sakit
Arsip Medis
Pendakaran
Kepegawaian Keuangan
Poli B Poli A Pelaporan
IGD Billing & Claim
MarkeEng
Rawat Inap
Kesusteran
Fas. Penunjang
Fasilitas Penunjang
Ruang Operasi
ApoEk
GL SpreadSheet
Administrasi
Laboratorium
MSSQL MSAccess
DBF
MySQL
Oracle Paper
Paper
Paper
Oracle
MSSQL
MSAccess
Paper MySQL MySQL
MySQL
MySQL
MySQL
MySQL
MySQL
*.xls
In House Development
Heavy Infrastructure
Difficult to integrate
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Integra3on : Simplify The System
E-Health Cloud Services
Corporate Strategic Planning References : Gartner Research
Cloud Compu3ng : Defini3on & Key Characteris3cs
Corporate Strategic Planning
• Cost Pressure, CAPEX to OPEX: Metered by Used, Accelerate Speed to Value New Economics
• no patching /maintenance, faster development, robust mul3 layer security, reliability & fault tolerance
Reduce Management
• latest so_ware, internet collabora3on, anywhere access, instant self provisioning
Redifining Produc3vity
… by 2012 80% of Fortune 1000 will use some of cloud compu:ng services, 20% of business will own no IT asset (Gartner)
The boEomline : Early Adopters are finding serious benefits, meaning that cloud compu:ng is real and warrant your scru:ny as a new set of plaJorm for business applica:on (Forrester)
References : Microsoft, Gartner Research, Forrester
Why Cloud Now ? -‐-‐Demand Side Efficient àEffec3ve à Innova3on
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Cloud Security Implementa3on
1. Secure Access into the Cloud 2. Secure Access to Web Apps 3. Server VirtualizaEon
• MiEgate risk towards the hypervisor • Secure the OS • Inter-‐VM traffic visibility and security • Secure (shared) file systems
4. Secure Standard OperaEon & Procedures 5. Secure System Development Life Cycle Procedures
VM VM VM
Security In The Cloud
Security implemented everywhere … not just on a firewall somewhere.
Corporate Strategic Planning
“Healthcare's Future Is Partly Cloudy: External
Service Provider OpEons for Healthcare Delivery OrganizaEons”
“By 2012, 20% of businesses will own
no IT assets.”
“Cloud spending will grow 3X to $42B by 2010.
Cloudsourcing takes the cloud to the next step”
“Cloudsourced delivery…will
comprise ~25% of the total BPO market by
2012”
“Every enterprise should be road mapping their
adopEon of the cloud”
Cloud Based Healthcare System Trend …
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TELKOM CLOUD FOR EMR
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Telecom
Informa3on
Media
n Fixed Wireline
n Fixed Wireless
n Mobile/Cellular
n Broadband Access
n Satellite
n Tower
n Premises Integra3on
n IT Services & BPO/ KPO
n E-‐Money
n Mul3 Channel TV
Edutainment
n Portal
n E-‐Commerce
n Content
Customers Poreolio
n Consumer n Enterprise n Wholesale
Product Poreolio
n SME
*) Geography coverage for interna3onal investment is basically all over the world, however for the ini3al investment, Asia and Middle-‐East will be the priority. Geography* Domes3c Interna3onal
BPO: Business Process Outsourcing KPO: Knowledge Process Outsourching
Our business por;olio (T.I.M.E) Introducing Telkom Group
Corporate Strategic Planning
Telkom’s Healthcare Vision
Corporate Strategic Planning TELKOM e-‐Hospital (HIS), e-clinic, e-puskesmas, e-GP, e-Apotek , e-SCM, e-Claim
Telkom Group e-‐Health Complete Solu3on Telkom HIE as a Na3onal e-‐Health Shared Service Plaeorm
ASGARA
HIE – Health Information Exchange
HIMBARA
Hospitals will provided the interoperability with Payers
MOH who will benefit by an interoperability and
integrated EHR and online reporEng of Jamkesmas
eReferrals from primary to secondary to terEary
healthcare (e.g. ePuskemsas to District and VerEcal Hospitals)
Expansion to eBilling and eSewlement
perpetuates end-‐to-‐end paperless & efficient claims processing
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Module and Cloud Computing Configuration
Benefit Hisys SaaS Business Model : • No Investment • Capex to Opex • Pay per Used • No Operational and Maintenance Cost • Flexible as Business Need • Focus on Hospital Business & Service not on IT • Automatic Update • Mobility any where, any time, any device • Integrated with other Telkom Group Services (eq, e-‐Payment, e-‐Procurement, SAP)
TELKOM Group e-‐Health Services : e-‐Clinic For General Prac33oner (Cloud – SaaS Model – Pay per Use)
1. Registrasi 2. Poli umum 3. Poli Gigi & Mulut 4. Poli Anak 5. Poli Internis 6. Poli Kulit & Kelamin 7. Poli THT 8. Poli Mata 9. Poli Paru & Alergi 10. Poli Kebidanan
11. Laboratorium 12. Rawat inap Kebidanan 13. IGD 14. Apotik 15. Kasir 16. Keuangan 17. Inventory 18. Rekam Medis 19. EIS 20. SMS
Corporate Strategic Planning
Telkom Group E-‐Health Services : EMR Standardiza3on
v HL7 CCD is a XML-based high-level
standard for clinical document exchange.
Basically CCD is:
§ Speci f icat ion of record and
communication of patient examination
§ “Human Readable”
§ XML exchange format technology
v RIM of HL7 Version 3.X is a standard for
XML message development process.
HL7 CCD and XML
<levelone> <clinical_document_header> <document_information> <encounter_data> <service_actors> <service_targets> </clinical_document_header> <body> ... </body> </levelone>
<observation> <service_cd V="6298-8" S="LOINC" DN="POTASSIUM:SCNC:PT:BLD"/> <result_dttm V="2000-05-22"/> <value V="4.5" U="mg/dl"/> </observation>
HL7 Reference Information Model
HL7 CCD
HL7 V3 Message
By applying CCD-based standard XML Schema to EMR system, indexing for effective search for electronic medical record between connected health institution is provided, and gateway foundation for document exchange is built.
TELKOM EMR Standardization
Corporate Strategic Planning
Telkom E-‐Health Development Ac3vi3es
HIE
eHR
Asuransi
Praktek Do
kter
Klinik
Puskesmas
eClaim
eReferral
Anality
c
Rumah Sakit
DKB
BPJS
DKB: Data Kepesertaan Bersama EHR: Electronic Health Record HIE: Health Information Exchange BPJS: Badan Pelaksana Jaminan Sosial
Dashbo
ard
1
23
4
1. Pengembangan platform HIE (Health Information Exchange)
2. Pengembangan Sistem Mini EHR
3. Modernisasi Sistem elektronik klaim Nasional, termasuk administrasi rujukan
4. Pengembangan aplikasi vertikal untuk kesehatan
1
2
3
4
Corporate Strategic Planning
Considera3on: EMR on the Cloud
Cloud For EMR
Regula3ons
Security Standard
-‐ EMR definiEon & rule -‐ EMR data retenEon -‐ EMR data integraEon & exchange
-‐ ConfidenEality -‐ Authority -‐ Integrity -‐ Non RepudiaEon
-‐ EMR data content -‐ EMR data format -‐ EMR data store -‐ EMR data exchange
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Q & A
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