Digital Health Innovations at BPJS-K: Beacon of Lessons for JLN countries

Authors: Vrishali Shekhar, Dr. Anthony Adofo Ofosu, Mouhamed Mahi SY

In response to popular country demands, Joint Learning Network (JLN) launched a new collaborative on Digital Health, between November 8-10, 2023, in Jakarta, Indonesia. The Digital Health Collaborative convened key decision makers from 15 countries including Bahrain, Bangladesh, Cambodia, Ethiopia, Ghana, India, Indonesia, Kenya, Malaysia, Nigeria, Pakistan, Philippines, Tajikistan, Senegal, and Ukraine to brainstorm on the scoping activities of the collaborative and initiate associated knowledge products. Technical facilitation support for the collaborative is provided by the World Bank along with the Digital Health Exemplars initiative, including the Center for Global Digital Health Innovation at the Johns Hopkins Bloomberg School of Public Health, eHealth Lab Ethiopia, the McKinsey Health Institute, Gates Ventures, and Exemplars in Global Health.

One of the highlights of the in-person Collaborative launch meeting in Jakarta was the field visit to the BPJS Health or the Health Social Security Organizing Agency’s office premises. The field visit included warm welcoming remarks by Dr. Ali Ghufron Mukti, President Director of BPJS-Health followed by a technical presentation by Dr. Donni Hendrawan, Deputy Director of Data and Information Management.

President Ghufron Mukti, fondly called Pak Ghufron, gave the audience an insight into Indonesia’s health reform process with the implementation of the national health insurance program- Jaminan Kesehetan Nasional or JKN. Indonesia’s journey with JKN which successfully covers over 95% of the country’s population, or over 250 million people, is not only remarkable but also aspirational to other low-middle income countries that are looking to achieve universal health coverage in their countries.

In its ten years of existence, Pak Ghufron underscored the importance of digital health transformation as a crucial factor in the success of a relatively young JKN program. He acknowledged the significance of digital health innovations to secure equitable and universal access to high-quality affordable health services; improve health system efficiencies; promote health-seeking behavior; disease prevention and diagnosis management; amongst others very early on in its health reform process.

He also highlighted the criticality of building a sustainable e-health ecosystem in alignment of the national vision promoting evidence-based decision-making in the health system. One such initiative supporting the transformation of health service quality is the launch of the i-Care JKN. I-Care JKN, an innovative application is focused on improving the accessibility of the medical history of JLN participants over the past year to the health facilities, hence allowing them to provide faster and more precise care to its beneficiaries. By facilitating communication and collaboration between doctors and health facilities, i-Care JKN allows doctors to plan appropriate treatment based on more real-time, actual, and factual data.

By adhering to the rules in Law Number 27 of 2022 concerning Personal Data Protection (PDP Law) and ISO/IEC 27001 standards as well as cooperating with the National Cyber and Encryption Agency (BSSN) and the Ministry of Communication and Information Technology, BPJS-K has maintained security and protection of the BPJS Health participants’ data. Edwin Aristiawan, Director of Information Technology BPJS Kesehatan, proudly noted that endeavors to ensure the strengthening of data security and protection were high priority and that the encryption process and passwords minimize data leakages.

President Director of BPJS Kesehatan Ghufron Mukti explained the operational system of BPJS Kesehatan to delegates from   15 countries participating in the Joint Learning Network (JLN) at BPJS Kesehatan Head Office, Jakarta, Wednesday (8/11/2023).

President Director of BPJS Kesehatan Ghufron Mukti explained the operational system of BPJS Kesehatan to delegates from 15 countries participating in the Joint Learning Network (JLN) at BPJS Kesehatan Head Office, Jakarta, Wednesday (8/11/2023).

The field visit included a real-time demonstration of the command center that displayed the magnitude and relevance of the data that is visualized by the BPJS analytics teams. This gold mine of data, which comprises 112 million data transactions per day in the JKN Program or 1,296 data transactions per second, plays a pivotal role in the data-driven implementation and optimization process of the JKN program. The 397.8 billion raw data are visualized as live dashboards on a range of areas such as problematic equipment at facilities; contributions; claims; population coverage; access to health services and region-level service profile; and facility and region-level ICD-10 diagnosis rates etc. The BPJS IT team also substantiated creating a standalone sample of their data, representative of the BPJS Kesehatan system, that allows for analytical work by researchers, academics, practitioners, and other related parties.

The digital health strategy of BPJS-K recognizes its influential role in changing health outcomes in Indonesia. As a result, BPJS-K has been making concerted investments in governance and capacity building of its workforce to allow for maximum utilization of the modernized benefits in the health sector. However, it is equally important to acknowledge that the implementation of appropriate digital health interventions may not be an easy task for low and middle-income countries that face financial and infrastructural constraints. In this context, Indonesia’s e-health journey offers potential lessons and solutions to JLN member countries that are looking to incorporate the vision for the digitalization of the health sector aimed at improving health system efficiencies in their respective country contexts.

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