INMED Health Application

by

Gamal Albinsaid | Jun 10, 2020 | in Digital change-maker challenge | ICT applications

Define three specific objectives that you would like to achieve with your proposal.

1) Provide high quality health cares: Patients will not have anymore feel scared to be heal by unqualified health workers, which will guarantee them to obtain the most accurate cares and increase their chance of recovery

2) Provide in-home medical services: With InMed, everyone can be treated at home, which will protect them against the hassle the encountered before and make them recovered in the most comfortable surrounding environment possible, their home.

3) Make Indonesian people independent: With the InMed application sick persons can call round-the-clock a health worker directly without being backed by their family.

What problems (particularly in value chain competitiveness and global disruption) are your community’s stakeholders facing due to the Covid-19 pandemic?

Indonesia‘s healthcare system is rated as one of the poorest of any Asian country. More than 28 million    (11 percent of the population) live below the poverty line of $17 a month and about half the population have incomes below $60 a month. Accordingly, the national ambulance services are available through limited throughout the whole country. This makes the Indonesian healthcare system become more precarious and our healthcare services program even more challenging to implement. Moreover, the amount of health centers in Indonesia is still need to be improved in many aspects. There are 7,550 Units of Health Center, 22,002 Units of Sub Health Center, and 6,132 Units of The Rest Health Center. Although the basic health services they exist in all districts, but equity and affordability of health care is still a constraint. According to data obtained by Department of Health and forum built this Local Government Agency, 40 percent of people still go to traditional healers.

An important number of health workers at hospitals are not or partially qualified for the function they are occupying.  In light of these observations, we decided to react and turn things around. Because our conviction is that health is a fundamental human right. We aim to make a meaningful impact on the Indonesian society and deal with this issue at the heart of the debate. 

What minimum viable solution(s) are you proposing to address the challenge(s) in your community?

We are engaged in extending the medical assistance to home and from the urban zones to the rural ones. It provides healthcare services to everyone regardless of financial resources. The main purpose of this program is to connect health professionals to patients, via our website and mobile app, and to provide them medical assistance directly to their houses. This program aims also to improve the perception of doctor toward their patients, and incite them to work more.

Share your story (your narrative)

The Indonesian healthcare system is on alert. Recognized as one of the most populated countries in the world, Indonesia has encountered endless health system problems for more than a decade. This becomes such a big deal of homework for the government and the society to embark upon major reforms, particularly to tackle the alarming health care issues. To analyze, several factors are influencing the problems related to healthcare in Indonesia, seen from many aspects as follows:

1. The Low Income Indonesian Society

The greater part of the Indonesian population generally has very limited financial resources and therefore cannot afford health access. Recent studies indicate that more than 65 million people (approximately 35% percent of the population) live below the poverty line on less than USD 2 a day. Poverty rates increased to 18% of the population placing Indonesia 112^th among 175 countries in the UNDP Human Development Index. Below is the figure of the table providing information about the poverty and inequality matters – both relative and absolute – for the Indonesian population.

2. The Limited Health Insurance

Due to its biodiversity, tropical climate, the close interaction of humans with animals and deforestation, Indonesia is an ideal place for emerging diseases. At the same line, Indonesia‘s healthcare system is rated as one of the poorest of any Asian country with sparse and low-quality services. Private insurance programs are available for those who could afford it. Although a government program like BPJS (Indonesia National Healthcare Insurance) has been implemented for the past few years, the problems arising in this particular insurance vary from different people across the nation. The fact shows that not all hospitals in Indonesia accept the patient owing to BPJS Insurance. Accordingly, those who already use this type of insurance couldn’t be guaranteed to get sufficient and appropriate healthcare services. If we see the majority of the problems, the number of Indonesian possessing health insurance reaches up to 157,194,776. However, only 64% of them who can afford the premium routinely. The payment rate of an insurance holder is also low, only 75%.

3. The level of the household health budget

Households spend about 2.1 % of their total consumption on health, ranging from about 1.6 % for the poorest decile and 3.5 % for the richest, which is relatively low compared to other countries with similar income levels. Direct OOP (out-of-pocket) payments constitute a large share of the financing of health care in Indonesia and are potentially a significant burden on poor households ( Aran and Juwono, 2006). However, since the existence of the BPJS program from the government, the increase in OOP payments by the poor might be assisted because of this. The poor that couldn’t be able to perceive health care in the past may now be cared for since they have the health card. However, BPJS doesn’t run well in Indonesia since not all hospitals service the people owing to BPJS. As a result, the country needs a solution for these new cases to achieve universal health coverage.

4. The lack number of health workers

Besides the financial resources, another main factor contributes greatly to this healthcare access crisis: the figures of medical health workers per population. Based on the Ministry of Health data of human resource, especially for health workers in 2016, there are 108.752 medical doctors, 1.238 clinical psychologists, 214.447 nurses, 96.313 midwives, 31.904 pharmacists, 41.181 public health experts, 12.897 health environment experts, 14.881 nutritionists/dietitians, 5.165 physical therapist, 18.552 medical technician experts, and 24.092 biomedical technician experts.

5. Difficulty to get health services

Most of the Indonesian people use motorcycles as their vehicle to the hospital. Different from the Puskesmas (local clinic run by the government), most people prefer to walk. It takes 16-30 minutes to the nearest hospital, but it takes less than 15 minutes to Puskesmas. And it costs 10.000 IDR to the nearest health facility (Riskesdas, 2015).

6. The low productivity of health workers

The share of the Indonesia economy to healthcare (THE) is one of the world's lowest. With 3.1% GDP in 2012, Indonesia TEH is below other countries’, such as the UK with 9.4%, Japan 10.1%, China 5,3%, the Philippines 4.6%, Vietnam 6.6%, and Thailand 3.9%. The GGEH (general government expenditure on health) as % of GDP also shows that Indonesia with 1.2% GDP is among the lowest in the world, under the levels of the Philippines 1.7%, Vietnam 2.8%, Thailand and China 3% respectively, Japan 8.3%, and UK 7.8% (Policy Brief Indonesia National Health Account, 2014). The low investment in social health security increases the burden of healthcare costs on individuals, families, and communities with the greatest impact on those least able to pay (WHO, 2014). Accordingly, the WHO report also shows that the human resource on the health sector in Indonesia is low.

7. The limited number of health services

From the viewpoint of hospital quality in Indonesia, the fact has revealed that the number of the hospital bed is still limited, compared to the total population of Indonesia. Based on the data from Standard Chartered 2013, Indonesia ranges around 11 beds per 10,000 population. Of these, 57% of the hospitals are located in the Greater Jakarta area (42 hospitals) and there is a need for more private hospitals in areas like Makassar and Kalimantan. It is expected that Indonesia to add about 40,000 beds by 2019 and JKN would be a key driver; one of the early reports shows how the daily patient volume in some of the provinces jumped up after JKN initiation (Standard Chartered Report, 2014). The number is relatively low if it is compared to some other big countries. Indeed, the idea to enhance the quality of health services, just like seen from the number of hospital beds, should be developed since the country possesses more than 250 millions of lives.

8. The limited number of health facilities

Indonesia cannot meet the healthcare services demand in terms of figure, quality, and access, especially between urban and rural areas. Consequently, a significant number of Indonesian could not able to gain qualified and appropriate healthcare services.

The importance of health services is based on screening and early detection to prevent the severity of the disease. Hendrick L. Blum, a health professor in the University of California of the 20th century, said what determine the health status of a country or a region depends on 4 factors:  (1) heredity; (2) environment; (3) behavior; and (4) health facility.

Emergency services in Indonesia are one type of a longstanding issue. There are almost no national ambulance services available throughout the whole country, but rather individual services run by clinics and hospitals. This makes the Indonesian healthcare system even more precarious and our healthcare services program even more challenging to implement. Lack of access is the main reason which makes someone doesn‘t want to do a medical check-up. Accessibility to the health facility can be measured based on the presence of health facility, distance to the health facility, transportation, and the cost.

Because our conviction is that health is a fundamental human right, we are motivated to cope with this current issue of unequal access at the heart of the debate. We want to make a meaningful impact on Indonesian society, and to achieve this goal we have decided to set up what we called Inmed Apps. 

Please provide any additional relevant information that you would like to share.

Several services provided by Inmed Apps include (1) In-home healthcare services including medical prescriptions at home; (2) One free service for a person underprivileged per 20 health services (owner of the « Surat Keterangan Miskin » certificate provided by the Indonesian Government); (3). Access to only qualified and registered health workers (medical doctors, nurses, midwives, nutritionists, psychologists, and physiotherapists); (4) Emergency appointment at homes available 24/7; (5) Capacity for the patients to choose their medical health worker, depending on their preference of gender, age, area of intervention, religion; (6) Blood sample at home and delivery to the laboratory by the health worker; and (7) Ambulance and drugs services. Our conviction is that health is a fundamental human right. We aim to make a meaningful impact on the Indonesian society and deal with this issue at the heart of the debate. At InMed, we are engaged in extending the medical assistance to home and from the urban zones to the rural ones. It provides healthcare services to everyone regardless of financial resources. The main purpose of this program is to connect health professionals to patients, via our website and mobile app, and to provide them medical assistance directly to their houses. This program aims also to improve the perception of doctor toward their patients, and incite them to work more.