Sparking Digital Transformation in Indonesia

In the early days of the COVID-19 pandemic, health data collector and manager Elia Nofian drove his motorbike up to four hours a day to visit health facilities in Makassar, Indonesia and areas surrounding the city.?

His goal was to record—on paper—whether those facilities had suspected COVID-19 cases. This labor-intensive process was necessary as more than 80% of health facilities across the country did not utilize digital technology at the start of the pandemic.

“With the data being manually collected using paper and Excel, the potential of double entries was relatively high,”? said Elia.?

Similarly, when Indonesia began to roll out COVID-19 vaccinations, health workers and vaccinators struggled to keep records on recipients and track their vaccination status. This was the case for Reskiani Aspar, a vaccinator at a primary health care facility (known as puskesmas) in Sudiang, Makassar, South Sulawesi.

“At the beginning of the vaccination implementation, we had to take notes manually on paper and then input the data into an Excel form for each recipient, which was very time-consuming and prone to data collection and data entry mistakes,” she said.

Data entry mistakes result in an incomplete or inaccurate picture of COVID-19 vaccination coverage in the country, impacting vaccine planning and implementation efforts.?

Reducing health workers’ workload

To help health workers accurately and efficiently collect and access data to support the pandemic response, Indonesia’s Ministry of Health (MOH) and partners developed a number of COVID-19-related health information systems.?

One platform that was used to consolidate patient data was the New All Record (NAR) system, which the MOH had begun developing in 2020 for COVID-19 lab results. When COVID-19 infections spiked in 2021, Indonesia’s government needed real-time data on patients.?

“NAR really helped us in keeping records. It saved us time and effort because we didn’t have to visit the sites every day just to identify whether there were COVID-19 patients in the area,” said Elia.?

While NAR helped health workers like Elia capture COVID-19 information, it also added another health information system that increased his data entry burden.??

The ministry quickly recognized how disjointed health data was across the various information systems—making data management time-consuming and the data more complicated to access. Indonesia still needed to connect all the information systems at each level of the health system—including primary health care—to reduce the burden of data entry on health workers while simultaneously improving their ability to manage and access health data for timely decision making.

Transitioning from the pandemic to support primary care

USAID leveraged the principles of its Digital Health Vision to support Indonesia’s Digital Health Transformation Agenda.

USAID developed a roadmap and technical guidelines on COVID-19 vaccination and confirmed cases for SATUSEHAT (or “OneHealth”), the country’s national health information exchange platform. These guidelines provided information on how to support the exchange of data between the various information systems and electronic medical records with SATUSEHAT.?

Today, this platform is providing health workers in Indonesia with the information that they need—and ultimately helping them manage patients in a more effective and efficient way.

And, as COVID-19 shifted out of its pandemic phase, Indonesia decided to integrate influenza and other respiratory infection monitoring into NAR.

To expand the use of NAR, the Ministry of Health applied internationally recognized terminology standards. USAID then developed an interoperability layer to facilitate the exchange of data in NAR with the puskesmas systems in Makassar through the SATUSEHAT platform—which resulted in health workers spending less time on data entry and having faster access to lab results.?

“Since Indonesia’s digital transformation, lots of things have changed,” Elia said. “Reporting is now improved and much easier as we can access real-time data in the system.”

For many health workers, Indonesia’s improved data information systems enable them to spend less time manually collecting and entering data—and more time focusing on providing the best possible care for their patients.?

“I had more time to provide health services and administer vaccines to targeted recipients,” she added.

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Dwi Prafitria is a Communications and Knowledge Management Specialist for USAID’s Country Health Information Systems and Data Use (CHISU) program’s Indonesia team, and Maggie Barnes is the USAID Office of Health Systems’ Program and Communications Coordinator.?