| Abstrak/Abstract |
The Social Security Agency for Health (BPJS Kesehatan) and Ministry of Health are working on telemedicine services between primary care and specialists in Indonesia using the national health insurance (JKN) payment scheme. This was also reinforced by the government's recommendation during the COVID-19 pandemic. This study aims to assess the feasibility of telemedicine services, payment scheme and health providers’ perspective.
Exploratory descriptive research was conducted to assess the implementation challenges of telemedicine services. The asynchronous telemedicine services were tested in 5 regions (involving 5 primary cares and 10 referral hospitals) using P-Care (electronic medical records) and a telemedicine application (TEMENIN) which are interoperable. In-depth interviews with 11 respondents and 3 FGD with representing stakeholders.
There were 131 tele-EKG and tele-USG services conducted from September to December 2020. Lack of personal notification of telemedicine requests and the limited number of specialists impacted the long response time. The non-capitation payment of telemedicine services that went to the primary care facility could only apply for private and some government-owned primary care facilities. Lack of resources in primary care facilities to follow up on advice from specialists. Perspective of providers who prefer conventional referral care due to the limited telemedicine services that can be provided during the pilot implementation.
The telemedicine service should expand to chronic disease including facilitating teleconsultation between patients and their primary care physicians. It is suggested that telemedicine services as part of capitation payment in primary care, while claims apply to the hospital which their specialist provides the tele-consultation service.
Keywords: Telemedicine, interoperability, payment scheme, providers perspective. |
