Grant Amount: US$ 26,992

Keywords: TELEHEALTH, PRIMARY HEALTH CARE, POLICY, INDONESIA

Geographic Coverage: Indonesia

Objectives

The objectives of this project are to develop Personal Computer (PC)-based medical stations and conduct field-testing in at least eight locations.

Research context

This project involved the development of a pilot Internet and communication technology-based telemedicine system for primary community health care in urban and rural areas of Indonesia. The project used existing Internet technology to enhance PC-based medical stations and performed field-testing. The pilot telemedicine network consists of six stations for community health centres and a station for referral hospitals, a health office and test laboratory. The project includes software development and network integration. The resulting system can be expanded to cover larger number of stations.

Target beneficiaries

• Users of telemedicine for primary community health care; 
• Under-served communities in rural and urban areas, especially mothers and children; and 
• Providers of primary community health care in Indonesia including health care providers, primary community health centres (Puskesmas), referral health offices and hospitals.

Outputs

• White Paper containing practical recommendations for information and communications technology (ICT) policy reform regarding social and community use of the Internet in Indonesia;
• A generic Internet-based telemedicine system and software modules for primary community health care in community health centres;
• Dissemination activities (seminars, meetings, mailing lists, websites) to promote the application of the ICT-based telemedicine systems; and
• Use of the system by community health centres, through the Research Group on Biomedical Engineering, Institut Teknologi Bandung (ITB).

Research results and outcomes

The project successfully completed its objectives within the proposed timeframe. In the first few months of implementation, the project faced unforeseen difficulties in initiating collaboration with various target institutions, namely, the Bandung Health Office, referral hospitals and the 70 existing community health centres in the Bandung area. Although unavoidable delays occurred on certain aspects, the project achieved its objectives and even surpassed them, as the number of community health centres joining the telemedicine system was double the project’s target.

The project integrated the fields of community health care, ICT and biomedical engineering to develop and implement a community health care telemedicine system. The system is comprised of a health office, a referral maternity hospital and a number of selected community health centres. Associated telemedicine software modules developed include: medicine data recording and reporting, patient data recording and reporting; telecoordination, community health education and teleconsultation. The project integrated ICT training for medical personnel on the use of computers for daily health care. It also undertook efforts to improve the quality of maternal health care delivery, and a developed a web-based community health care information system to provide public access to a range of health care facilities and related information.

The project worked in close cooperation with local government health institutions and personnel, especially the personnel of community health centres in Bandung, who are the primary users of the system. More than 70 percent of the medical doctors and administrative staff involved in the project are women. Local health institutions and personnel participated in the project at two key stages. The first stage involved the collection of information, definition of system requirements and the system design. The second stage involved deployment and integration of the system into daily health care delivery activities at the selected community health centres.

Significant improvements were noted in the provision of daily health care services at community health centres. The software packages that were particularly useful were Medicine Data Recording and Reporting and Patient Data Recording and Reporting. However, the project found that human resource training, in particular familiarization and socialization with computer use and telemedicine in general, required significantly more time than expected. Thus the project has shown the significant role that human resource development plays in the sustainable implementation of ICT-based telemedicine systems. This implies that the success of telemedicine and other information system implementation in health care settings is dependent on the institution’s organizational readiness. The project recommends that personnel, workflow, policy and environment should be considered throughout system development and implementation. At a macro scale the support of government and implementing institutions is vital for the success of programmes. Support should not be limited to recommendations, but should also include policy change and financial allocations for health care institutions to implement ICT-related health care solutions.

Additional research activities that evolved from this project include: Development of ICT-Based Mobile Telemedicine System with Multi-Communication Links for Urban and Rural Areas in Indonesia - also receiving a Pan-Asia ICT R&D Grant (no. 55), Development of SMS-based Telemedicine System for Communicable Disease Monitoring and Outbreak Management, and Development of an Integrated ICT-Based Telemedicine/Telecentre System for Application in Rural Areas of Indonesia.

Duration

Start Date: November 2002
End Date: June 2004
Total Duration: 20 Months

Contact information

Prof. Dr. Ir. Soegijardjo Soegijoko
Research Group on Biomedical Engineering
Biomedical Engineering Programme
School of Electrical Engineering and Informatics
Institut Teknologi Bandung
Jalan Ganesha 10, Bandung 40132, Indonesia
Telephone/Fax: +62 22 253 4117
Email: soegi@ieee.org

Website: http://biomed.ee.itb.ac.id