Health Service Data (ID0099)

January 2019 - December 2020
Commitment Description
Lead implementing
agency/actor
Ministry of Health
The availability data of health facilities (wards,
medical personnel, drugs, and other health facilities)
in government health facilities such as hospitals and
Community Health Centers is still needed to be
renewed and periodically published.
Most of the health facilities data are not updated
regularly by hospitals. This information is also difficult
to be accessed and not available in all health facilities.
Such data is very important to notify people about the
availability of health facilities due to many cases on
the rejection of patients asking for treatment
happened, especially for disadvantaged people.
On the other hand, the Ministry of Health has
published health services data portal called Inpatient
Information System (IIS) and Hospital Management
Information System (HMIS). It contains the
information about hospital management process,
including diagnostic services, medical treatment for
patients, medical records, pharmacies, billing, a
personnel database, and management controls.
These two portals have been integrated into 366
hospitals and Puskesmas. Moreover, people often
use it optimally. Therefore the Ministry of Health
should encourage hospitals to publish and update the
data regularly.
What is the public problem that
the commitment will address?
In response to the matter above, this commitment aims
to encourage hospitals to publish health facilities data
in IIS and HMIS regularly. This data will consist of
drugs availability, medical personnel, wards, and other
health services in 366 government health facilities.
What is the commitment?
This commitment will encourage the Ministry of Health
to strengthen the use of Siranap and SIMRS by
requiring hospitals and Puskesmas to update health
service data twice a day. Furthermore, this
commitment also encourages the Ministry of Health to
update the facility data up to 2020. By doing so, this
commitment is expected to increase the prevention of
patient rejection.
How will the commitment
contribute to solve the public
problem?
The commitment is relevant with transparency as one
of Open Government Partnership (OGP) values.
Transparency is related to the quality of public
information and people access the information. It is implemented by publishing information on the
availability of government health facilities which can be
accessed by people extensively.
The commitment is related to Sustainable
Development Goals (SDGs) specifically Number 3:
“Ensure healthy lives and promote well-being for all at
all ages”, especially on Number 3.8: “Achieve universal
health coverage, including financial risk protection,
access to quality essential health-care services and
access to safe, effective, quality and affordable
essential medicines and vaccines for all”, that
indirectly intersects with SDG Number 1: “End poverty
in all its forms everywhere”, especially on target 1.4:
“By 2030, ensure that all men and women, in particular,
the poor and the vulnerable, have equal rights to
economic resources, as well as access to basic
services, ownership, and control over land and other
forms of property, inheritance, natural resources,
appropriate new technology, and financial services,
including microfinance.”
Additional information
Milestone Activity with a verifiable
deliverable
Start Date: End Date:
1.The availability of updated
identity, wards, and personnel
information in Puskesmas through
health services data portal (the
year 2018) on iHeff Application
January 2019 December 2019
2. The availability of hospital
application that can be accessed
online in the Regional Health
Department.
January 2019 December 2019
3. The availability of updated
identity, wards, and personal
information in Public Hospital
through health services data portal.
January 2020 December 2020
Contact information
Other Actors
Involved
State actors
involved
Ministry of Home Affairs
CSOs, private
sector, multilaterals,
working groups
Indonesian Corruption Watch (ICW)

8. Publication of Health Services Data in Government Health Facilities

Language of the commitment as it appears in the action plan:

In response to the matter above, this commitment aims to encourage hospitals to publish health facilities data in IIS and HMIS regularly. This data will consist of drugs availability, medical personnel, wards, and other health services in 366 government health facilities.

Milestones:

1. The availability of updated identity, wards, and personnel information in Puskesmas through health services data portal (the year 2018) on iHeff Application.
2. The availability of hospital application that can be accessed online in the Regional Health Department.
3. The availability of updated identity, wards, and personal information in Public Hospital through health services data portal.

Start Date: January 2019                                                               End Date: December 2020

Context and Objectives

The quality of healthcare frequently depends on the quality of healthcare facilities. In Indonesia, the Ministry of Health is responsible for providing basic healthcare services through government-funded healthcare facilities. To ensure that every citizen has basic healthcare, the government provides assistance through the Social Security Agency for Health (BPJS Kesehatan).

During the action plan development, the Ministry of Health expressed concerns over difficulties faced by citizens accessing healthcare using the BPJS Kesehatan program. Since its inception, the program has been the subject of national debate, facing claims that it’s inefficient in providing healthcare.

An investigation conducted by Tirto in 2018 ^[95] chronicled the problems related to the health insurance program. The report emphasized criticism over the program’s two-step reference system where patients need a referral by a first-level healthcare facility such as a community health center (Puskesmas) in order to receive treatment from an advanced level healthcare facility. The system was intended to ensure efficiency by only allocating patients with certain conditions to advanced level healthcare facilities. ^[96]

To ensure availability of care in healthcare facilities, the Ministry of Health developed the Inpatient Information System (Siranap) and the Hospital Management Information System (SIMRS). Through these systems, the Ministry could monitor the availability of services provided by all public healthcare facilities, such as patient diagnostics, medical records, medical bills, and personnel management. Additionally, the Ministry developed the Indonesia Health Facility Finder (iHeff), a mobile-based application to help citizens easily find the closest healthcare facility within a three-kilometre radius. ^[97]

However, these applications have not eliminated challenges for healthcare access. According to the government, healthcare facilities reject patients over the unavailability of beds, medical professionals, drugs, and other services. ^[98] The Ministry, meanwhile, does not have accurate data to hold healthcare facilities accountable should they reject patients on unjustified grounds. Through this commitment, the government aims to open information on available facility services. Citizens can then verify claims made by healthcare facilities regarding service unavailability. This problem has also gotten the attention of the Ombudsman ^[99] who has gone on the record to acknowledge disputes between healthcare facilities and the government’s healthcare insurance program.

The commitment does not provide any mechanism to hold healthcare facilities accountable for improperly refusing services. As such, it remains unclear how this commitment will improve healthcare for recipients of the government’s health insurance program.

Next Steps

Access to healthcare is a basic need that must be available to all citizens. While this commitment takes concrete steps toward providing reliable information to public, it falls short of addressing the multi-dimensional complexities with the healthcare system in Indonesia. Nonetheless, the government could take the following steps to ensure meaningful impact in implementing this commitment:

• Develop a transparent, clear coordination mechanism between the Ministry of Health, the BPJS Kesehatan, and healthcare facilities to ensure an accurate and reliable data portal of health service availability; and
• Incorporate a feature on the iHeff application that would enable citizens to submit feedback, including complaints when healthcare facilities refuse to provide services despite having the resources.

[95] Aditya Widya Putri, “Masalah Akut Sistem Rujukan dan Pembayaran BPJS Kesehatan” (Tirto, 28 Sept. 2018), https://tirto.id/masalah-akut-sistem-rujukan-dan-pembayaran-bpjs-kesehatan-c26x.

[96] Social Security Agency for Health, “BPJS Kesehatan Pentingkan Kualitas Faskes Tingkat Pertama” (2015), http://bpjs-kesehatan.go.id/BPJS/index.php/post/read/2015/314/BPJS-Kesehatan-Pentingkan-Kualitas-Faskes-Tingkat-Pertama.

[97] Ministry of Health, “Kemenkes Luncurkan 4 Aplikasi Bidang Kesehatan” (2018), http://www.depkes.go.id/article/view/18110900004/kemenkes-luncurkan-4-aplikasi-bidang-kesehatan.html.

[98] Tities Eka Agustine (OGI National Secretariat), interview by IRM researcher, 18 Mar. 2019.

[99] Yunita Amalia & Henny Rachma Sari, “Dalih Rumah Sakit Sering Tolak Pasien Peserta BPJS” (Merdeka, 2017), https://www.merdeka.com/peristiwa/dalih-rumah-sakit-sering-tolak-pasien-peserta-bpjs.html.

8. Publication of Health Services Data in Government Health Facilities

Complete:

Information on bed and service availability at users’ nearest health facilities was added to the online Hospital Information System (SIRS), the online Inpatient Care Information System (Siranap), [62] and the Indonesia Health Facility Finder (IHeFF) mobile app. [63] These portals and apps are gradually integrating existing information from hospitals and primary health centers, and do not provide access to updated health data. Information availability varies by region, depending on updates from health facilities. [64] IHeFF received a 4.5/5 rating from users, but only has approximately 1,000 downloads, reflecting limited uptake. [65] Siranap has had 26,192 total visits, also reflecting somewhat limited uptake. [66] In 2021, Siranap was updated to offer information on emergency room beds. [67]