Inside a smart hospital in Indonesia

Exclusive interview with Adj Prof Hananiel Widjaya, CEO of National Hospital Surabaya.

In stark contrast to Indonesia’s massive economic growth is the country’s track record of poor health outcomes. The government faces several significant challenges in providing adequate healthcare, resulting in a “lack of trust” in the local system and infrastructure, according to a 2018 report by management consulting company Oliver Wyman.

This has resulted in lost revenue of about $48 billion a year from outbound medical tourism, as Indonesian patients seek the services they need elsewhere, the report said. But one bright spot is in Surabaya, where National Hospital Surabaya is shaping the definition of a smart hospital in Indonesia.

“Our hospital is the benchmark for digitisation in Indonesia,” CEO Dr Hananiel Widjaja tells Hospital Insights Asia. He shares how telemedicine, EMR systems and various automations are helping to make a difference.

Smart health

The hospital’s big thing is its teleconsultation capability, which it began piloting two months ago. Patients can have video consults with doctors via an app, and pay for healthcare services online. This reduces the need for patients to physically visit the hospital, Dr Widjaja says. In light of the recent COVID-19 pandemic, the hospital has seen an increase of teleconsultations by 60 percent, according to him.

Meanwhile, the hospital has an established electronic medical records system that has been in use for six years, says Dr Widjaja. “We do not use paper anymore, and we try to integrate all the devices and vital sign measurements directly to communicate with our EMR system,” he explains.

Doctors have an app to ease their workload. The hospital worked with Singapore-based Bot MD to build a chatbot that acts as “a Google for doctors”. It can directly access tens of thousands of journals, along with the hospital’s internal guidance on standards, KPIs and therapies, according to Dr Widjaja.

At the same time, the hospital has introduced a speech-to-text option for doctors to convert their scripts to EMRs. “Doctors don’t have to write or type, they just talk out loud,” he explains. This helps reduce burnout, and in fact adds to a better patient experience, he adds, as the clinician can have more eye contact with their patients.

Moving towards preventive healthcare

Dr Widjaja notes how Indonesia’s healthcare system faces two major challenges. First and foremost, it does not place enough emphasis on preventive healthcare or health education to empower citizens to take charge of their personal health. “The government is only focusing on the curative level,” Dr Widjaja notes. “We need to go forward to prevention.”

“The government is only focusing on the curative level. We need to go forward to prevention.”

His hospital’s target demographic consists of the more affluent members of society, who are generally more health-conscious, he says. “It is possible for us,” he continues.

What’s more, many Indonesians lack adequate access to healthcare. This is a “uniquely Indonesian” challenge: the country is dispersed across over 17,000 islands; there is a lack of transport infrastructure; and income distribution varies widely, according to the Oliver Wyman report. The life expectancy of people in the urban areas outpaces those in the rural ones by 15 years, the report noted.

Teleradiology is helping to fill the gap, at least for hospitals in east Indonesia. National Hospital’s radiologists lend their expertise to these hospitals, and interpret test and scan results remotely, says Dr Widjaja. “They have the devices but they don’t have the experts,” he notes. These radiologists also conduct video consultations with patients remotely, he adds.

His vision for the next few years will focus on “networking and developing an ‘invisible hospital’ in the home”. Dr Widjaja hopes to connect homes with the hospital in a more effective way, so that devices can take over the job of monitoring a patient’s health and vitals. “We are trying to connect home care with IoT.”

This way, patients’ doctors can remotely keep track of blood pressure measurements or blood glucose levels, for instance. “The issue here is the assurance – patients want to be assured that there are health monitoring systems,” he goes on to say.

Another key focus will be on helping patients to manage their health through wearables. Each patient’s health will be tracked, and will feed into the hospital’s existing EMR system, he adds. “Whenever there is an abnormal measurement, it will be automatically connected and we will be notified that you have problems with your vital signs.”

Technology is plugging the gaps in Indonesian healthcare, but access remains spotty – not to mention affordability. There is a tremendous opportunity for hospitals to introduce tools and solutions to provide high-quality healthcare services and a better patient experience all around.