TECHNOLOGY MEETS HEALTHCARE The demand for technology has challenged the Government, through the Minister of Health ("MoH") to keep healthcare services more accessible during the pandemic by utilizing technology to bridge communication between health professionals and the public without compromising the public's safety. Telemedicine was first mentioned in MoH Regulation No. 90 of 2015...
TECHNOLOGY MEETS HEALTHCARE
The demand for technology has challenged the Government, through the Minister of Health ("MoH") to keep healthcare services more accessible during the pandemic by utilizing technology to bridge communication between health professionals and the public without compromising the public's safety. Telemedicine was first mentioned in MoH Regulation No. 90 of 2015 concerning the Organization of Health Service Facilities in Remote Areas and Very Remote Areas ("MoH Reg 90/2015") to support health services in remote areas in Indonesia, especially where qualified health expertise is scarce.
The MoH took swift action by allowing doctors and dentists to provide certain treatment through telemedicine. MoH Regulation No. 20 of 2019 concerning the Organization of Telemedicine Services between Health Service Facilities ("MoH Reg 20/2019") covered more aspects of telemedicine between Health Service Facilities ("Health Service Facilities ") than the previous regulation to accommodate demand and utilize the new era of technology. The purpose was to support Health Service Facilities located in remote areas to help confirm diagnoses, therapy, and/or prevention of diseases.
On 6 July 2021, the MoH provided the latest update with Decree of the Minister of Health Number HK.01.07/MENKES/4829/2021 of 2021 concerning Guidelines for Health Services through Telemedicine during the Corona Virus 2019 (COVID-19) Pandemic ("MoH Decree 01/2021") where the new regulation covers health services through telemedicine during the COVID-19 pandemic as long-distance health services with the use of informatics and communication technology in providing information on health, diagnosis, treatment, prevention of deterioration, evaluation of the patient's health condition, and/or pharmaceutical services, including monitoring self-isolating COVID-19 patients, carried out by doctors and other health professionals at health care facilities based on their respective competences and authority with quality of care and the patient's safety taken into consideration. The Health Service Facilities providing telemedicine are narrowed down to:
(a) hospitals;
(b) community health centers (puskesmas);
(c) clinics;
(d) private practices of doctors/dentists and specialists/dental specialists;
(e) medical laboratories; and
(f) pharmacies.
Health services through telemedicine can be carried out by the above Health Services Facilities using applications developed by the Health Services Facility itself or in cooperation with a government or private-sector application provider.
Scope of telemedicine services under MoH Decree 01/2021 are:
Health Communication, Information and Education | a form of health promotion for those seeking information about a healthy lifestyle, diet, information on sports and body fitness, information related to COVID-19, and other health information. The guidelines also emphasize that these consultation services can be provided not only by doctors, but also by other health workers in accordance with their respective competencies. |
| Clinical Consultation | Health services provided by doctors, consisting of: (a) Online history taking, which covers presenting complaints, accompanying complaints, history of the current illness, ther disease or risk factors, family information and other relevant information that doctors ask patients/families to provide; (b) Physical examination by audio visual means; (c) Providing recommendations or advise needed based on the result of the supporting examination and/or certain physical examinations. Supporting examinations may be carried out by the patient using the patient's own resources or based on a recommendation from the previous supporting examination on the doctor's instructions. Recommendations or advise may be in the form of further medical examinations at Health Service Facilities; (d) Diagnosis, made based on the results of examinations, which are mostly obtained from the history taking, certain physical examinations or any additional examinations; (e) Management and treatment of patients, carried out based on the diagnosis, which includes non-pharmacological and pharmacological management and medical action for the patient or the family according to the medical needs of the patient. In the event that action requires medical action or further management, it is advisable for the patient to have a follow up checkup at health services facilities; (f) Prescribing medication and/or medical equipment for the patient in accordance with the diagnosis. The doctor or dentist may issue the prescription electronically in accordance with the prevailing regulations except in the case of any type of narcotics and psychotropics, drug injections (except insulin for personal use) and birth control implants; and (g) Issuing a reference letter for further examination or action at a laboratory and/or Health Services Facility depending on the treatment of the patient. |
Supporting Examination | Laboratory examination through telemedicine, either at the request of the doctor at the health services facility or at the request of the patient himself by means of patient visits to a medical laboratory or other health services facility that has medical laboratory services, or by visits of medical laboratory personnel to the patient (home visit) for taking samples. In the event that the medical laboratory services or medical laboratory personnel performs a COVID-19 examination, it must be designated as a COVID-19 laboratory according to the prevailing laws and regulations. |
Telepharmacy Service | (a) Electronic prescription services are carried out by pharmacists with reference to pharmaceutical service standards in accordance with the provisions of laws and regulations. (b) Pharmacists communicate with prescribing doctors to confirm or provide recommendations that may lead to changes to electronic prescriptions. (c) Pharmaceutical preparations, medical devices, medical consumables, and/or health supplements prepared based on electronic prescriptions may be delivered to patients/patient families at pharmaceutical service facilities, or through delivery of pharmaceutical preparations, medical devices, medical consumables, and/or health supplements. |
With the preparation of the guidelines for health services through telemedicine during this pandemic and support from the Indonesian Medical Council (Konsil Kedokteran Indonesia), the government hopes to reduce the risk of transmission between doctors and patients in health care services while all patients still receive the best health care services possible with due attention to the quality of services and patients' safety.