by Telkom Indonesia

Ir. Saiful Hidayat MTDirektur Pengembangan Bisnis

PT. Administrasi Medika (Telkom Group)

Seminar Pengembangan Rumahsakit Pendidikan di Daerah TerpencilYogyakarta, 5 Maret 2011

Model Manajemen RS Pendidikan di daerah sulit dengan model Sister Hospital : Kebutuhan sarana pendukung; Fasilitas Fisik, Telekomunikasi, Telemedicine

TELKOM’s e-health Initiative and Readiness

by Telkom Indonesia

E-Health Concept

Agenda

Telkom Group Readiness

Telemedicine Overview

by Telkom Indonesia

e-Health Value Chain Connecting The KeyStakeholders of Healthcare

3

SUPPLIERS CONSUMERSHEALTHCARE ORGANIZATION

Doctors/ Specialist

Hospitals

Pharmacy

Vendors/ Supplier

Insurance Providers Healthcare

Providers

Patients & their families

B 2 BSupport Value

Processes

B 2 CPrimary Value

Processes

Operating Efficiency :– Online Claims

Submission and Reimbursements with Insurance Carriers

– Connects Multiple Suppliers and Buyers

– One Stop Shopping –MedPool, Reverse Auctions, Auctions

Electronic Prescriptions– Reduces Errors, Saves

Lives, Increases Efficiency

– Online Pharmacy – Targeted Marketing

Connecting Patients and Physicians– Online posting of

surgical procedures including costs, and sorting results

Remote Patient Monitoring– Cardiac and Diabetic

Monitoring of Patients

Online Second Opinion

Source : Georgia State University

Telemedicine

by Telkom Indonesia

Model dan definisi e-Health

Patients & their families

Doctors/ Specialist Hospitals

Healthcare Providers

Pharmacy

Insurance Providers

Vendors/ Supplier

1. Hospital/Clinic Information System2. On Line Medical Report (dapat diakses oleh

pasien, docter / specialist dan lab) 3. Telemedicine: Penggunaan perangkat audio,

video dan telekomunikasi untuk memprosesinformasi terkait jasa pelayanan kesehatan ataumembantu paramedis yang jauh dari lokasipasien.

4. Personal Health Care System: Sistempencegahan pendukung untuk mengawasi danperawatan pasien secara individu (contoh: HotHealth)

5. Third Party Administrator: Penyedia jasa yang memberikan layanan kepada perusahaanasuransi dan TPA seperti Yakes dalammelakukan pengecekan dan validasi klaim daripasien (contoh: AdMedika)

6. Supply Chain Management/On line distribution support system untuk obatdan/atau farmasi (contoh: Kimia Farma, Century, Guardian)

7. National Healthcare Management Sytemuntuk menyediakan infrastruktur dan aplikasipelaporan data kesehatan nasional berupaDatawarehouse dan Decision Support System (SIKDA/SIKNAS)

Network/Connection

Laboratories

Key e-health Modules

Source: Georgia State University & Internal Analysis

Stakeholder e-Health Indonesia

5

Stakeholder dari e-Health di Indonesia dapat dikelompokkan sebagai berikut:

1. E-Health sebagai Service Support > Rumah Sakit dan Klinik> Praktek Dokter> Apotik dan Toko Obat

2. E-Health sebagai Decision support system and Research reference > Pemerintahan (Kementrian Kesehatan)> Perguruan Tinggi

3. E-Health sebagai Business Support> Asuransi dan Perbankan> Industri Farmasi dan Alat Kesehatan

4. E-Health sebagai Information of Healthcare services> Pasien dan Keluarga-nya> Publik

: Impementasi Telemedicine

by Telkom Indonesia 6

ICT

B

E

C

D

ASecurity• CIA (Confidentiality, Integrity, Availability)• Audited by certified

security auditor• Comply to

international Best Practices/standards

Infrastructure• National Coverage, Reliability, Manageability, Scalable

• Auditable• Disaster Management:(DRC, DRP, BCP)

Business/Operation• Convenience• Shared services• Outsourcing

Devices• Smart

• Integrated•Mobility

Application•Flexibility•Modularity•Multiplatform•Interoperability

ICT Requirement for E-Health

by Telkom Indonesia

E-Health Concept

Agenda

Telkom Group Readiness

Telemedicine Overview

by Telkom Indonesia

Penggunaan perangkat audio, video dantelekomunikasi untuk memproses informasi terkaitjasa pelayanan kesehatan atau membantuparamedis yang jauh dari lokasi pasien.

Telemedicine

Telemedicine umumnya diimplementasikanuntuk :

TelekonsultasiTele-edukasiTelemonitoringTelesurgery

Telekonferensi

“Top Three” penggunan Telemedicine padadisiplin ilmu kedokteran :

TeledermatologiTelepsikiatriTeleradiologi

by Telkom Indonesia

Tipe Telemedicine Telemedicine diimplementasikan berdasarkan duakonsep:

Real time (synchronous)Sesederhana panggilan telepon atau serumit operasi menggunakan remote robotic. Membutuhkan kehadiran kedua belah pihak pada saat bersamaan dan link komunikasi yang memungkinkan interaksi real-time.Video-conferencing adalah salah satu bentuk teknologi yangpaling umum digunakan dalam telemedicine sinkron.Contoh peralatan :Tele-otoscope memungkinkan dokter terpencil untuk 'melihat' telinga pasien Tele-stetoskop memungkinkan konsultasi dokter jarak jauh untuk mendengar detak jantung pasien

Store-and-Forward (asynchronous)Pengiriman data medis (seperti gambar medis, biosignals dll) kepada dokter /spesialisPenilaian pada waktu yang tepat sehingga tidak memerlukankehadiran kedua belah pihak pada saat bersamaan.Specialis Dermatologi, Radiologi, dan Patologi adalah pengunaumum dari telemedicine asinkron.

by Telkom Indonesia

Data Telemedicine Jenis Sumber Ukuran

fileTeks dannumerik

Laporan, rekam medik, korespondensi

< 10 KB

Audio Pembicaraan konsultasi, Stetoskop elektronik

100 KB

Gambar Hasil CT Scan, Foto rontgen, citra dermatologi

1MB

Video Ultrasound fetus (30 sec) 10 MB

Sumber: Johan Harlan, Pusat Studi Informatika Kedokteran, Universitas Gunardama

by Telkom Indonesia

Kebutuhan Bandwith aplikasi Telemedicine

Sumber: Johan Harlan, Pusat Studi Informatika Kedokteran, Universitas Gunardama

by Telkom Indonesia

Must Optimize Lower Priority

Telemedicine Video Accuracy:- Full, Constant 30 frames/sec- Minimize Jitter- Minimize transmission loss- Loss Indicators

Latency not critical: Audio primarily unidirectional

Video Conferencing

Low Latency Can Interpolate Video

The Public Internet was NOT DESIGNED for VIDEO• Best Effort, NO PRIORITIES for Telemedicine: Packet Loss• Requires special video transport technology

“Telemedicine” Vs Public Internet Video Conferencing

http://www.bf-technologies.com

PACS : Picture archiving and communication system http://www.bf-technologies.com

DICOM Capable : • Digital Imaging and Communications in Medicine (DICOM) is a standard for handling, storing, printing, and transmitting

information in medical imaging. It includes a file format definition and a network communications protocol..• DICOM files can be exchanged between two entities that are capable of receiving image and patient data in DICOM format. • The National Electrical Manufacturers Association (NEMA) holds the copyright to this standard.[1] It was developed by the

DICOM Standards Committee,• DICOM enables the integration of scanners, servers, workstations, printers, and network hardware from multiple

manufacturers into a picture archiving and communication system (PACS).http://en.wikipedia.org/wiki/Digital_Imaging_and_Communications_in_Medicine

by Telkom Indonesia

http://jtt.rsmjournals.com/cgi/content/abstract/14/7/377

Kisah sukses Tele-consultation (Telemedicine)

Kebutuhan terdefinisidengan jelasPenggunaan teknologiyang relevanKesiapan infrastrukturICTIncorporation into medical practice ; (Kesiapan tenagamedis, kesiapankomunitas, aspeklegal dan etika)Dukungan Pemerintahuntuk regulasi danpembiayaan

by Telkom Indonesia

E-Health Concept

Agenda

Telkom Group Readiness

Telemedicine Overview

by Telkom Indonesia

Telkom Company Profile

Telecom

Information

Media

Fixed Wireline

Fixed Wireless

Mobile/Cellular

Broadband Access

Satellite

Tower

Premises Integration

IT Services & BPO/ KPO

E-Money

Multi Channel TV

Edutainment

Portal

E-Commerce

Content

Customers Portfolio

Consumer Enterprise Wholesale

Product Portfolio

SME

*) Geography coverage for international investment is basically all over the world, however for the initial investment, Asia and Middle-East will be the priority. Geography*DomesticDomestic InternationalInternational

BPO: Business Process Outsourcing

KPO: Knowledge ProcessOutsourching

Our business portfolio (T.I.M.E)

16

by Telkom Indonesia

TELKOM Group Integrated e-Health SolutionUsing Telkom e-Health Hub as a Shared Service Platform

Telkom e-Health shared service platform (e-Health Hub)

Transformation service

Finance : Himbara Link

& Other 52 Banks

Web service adapter

Doctors/Specialist Hospitals

Healthcare Providers

Clinics

ClaimProcessing System

TELKOM e-Hospital (HIS)

Laboratories

Pharmacies

TELKOM e-ApotekASGARA

& Other 32Insurance/

SIC

Ailed health(Suppliers)

Personal HealthWeb portal

Gov institutions

Note : SIC (Self Insure company)

IT Security Infrastructure

Workflow Services

Routing & Transformation

Services

by Telkom Indonesia

Main roles1.Member Eligibility2.Automated Outpatient Claims Processing3.Inpatient Admission & Cashless Discharge4.24 X 7 Call Center Assistance

Dial-up/GPRS/VPN-Instant/VPN-IP/Speedy

Insurance,TPA &Corporate

(34)

Hospitals&polyclinics

(+725)Insurance Members

(1.5m by Nov’10)

EDC/PC

= TPA (Third Party Administrator)

Claims & treatment Services : Online Provider Network Personal Customer Service Medical Evacuation / Personal Assistant

Services Membership / Policy Administration

Inpatient Case Monitoring Online Claim Administration Periodic or Adhoc online Reporting Real time data access through

web Online Utilization Review (alert system) 24 hours Call Centre manned

by medical professional

32 Partnering Hospital(Malaysia & Singapore)

3,000 insurance policies (with 500 unique benefits)

Admedika Solution : Third Party Administrator – Claim Processing System (TPA-CPS)

by Telkom Indonesia

AdMedika National Network : Hospital/Clinic & Insurance

No Region Hospital Clinic Sub Total

Nasional1 Bali 11 10 21

2 Banten 9 24 33

3 Jabodetabek 222 144 366

4 Jawa Barat 45 27 72

5 Jawa Tengah 48 3 51

6 Jawa Timur 63 14 77

7 Kalimantan 18 2 20

8 Maluku 3 - 3

9 Aceh (NAD) 3 - 3

10 NTB 2 - 2

11 NTT - 1 1

12 Riau 16 4 20

13 Sulawesi 12 1 13

14 Sumatra 30 3 33

15 Papua 3 1 4

Total 487 234 721

International Partner1 Malaysia 28 - 28

2 Singapura 4 - 4

Total 32 32

AdMedika Insurance Partners

by Telkom Indonesia10/06/10

e-Hospitals (Cloud Computing – SaaS Model- Pay per Use)

Module and Cloud Computing Configuration

Benefit Hisys SaaS Business Model : • No Investment• Capex to Opex• Pay as Used• No Operational and Maintenance Cost• High level SLA

by Telkom Indonesia

BANDA ACEH

PALEMBANG

DENPASAR

KUPANG

DLI

BDR LAMPUNG

MANADO

FAKFAK JAYAPURA

PALUPADANG

PBR

PONTIANAK

BANDUNG

AMBON

SORONGBALIKPAPAN

JAKARTA

BATAM

MATARAM

PAREPARE

SAMARNDA

SINGAPORE

PENANG

SATUN

SEMARANG

BANJARMASIN

MAKASAR

SURABAYAENDE

MEDAN

Songkhla

TIS (Thailand)

SANGATA

BATURAJA

DMCS,

BENGKULU

WAINGAPU

KETAPANGPKL.BUN

AAG (Hongkong, USA)

JAMBI

TERNATE

Telkom Super Highway TopologyNational Backbone Capacity

Main IP Core Link :Total 5,3 TBps

IP Core Eastern Link :170 GBps

Metro Ethernet

Jawa Timur

METRO - E

Metro Ethernet

Denpasar

METRO - E

Metro Ethernet

Makassar

METRO - E

Metro Ethernet

Palembang

METRO - E

Metro Ethernet

Pakanbaru

METRO - E

Metro EthernetMedan

METRO - E

Metro Ethernet

Jawa Barat

METRO - E

Metro Ethernet

JawaTengah

METRO - E

International Link :40 GBps

Metro EthernetBanjarmasin

METRO - E

Metro EthernetJakarta

METRO - E

Softswitch

MSAN/DSLAM

TIMIKA

MERAUKE

AAG Consortium : Development of Asia-Amerika Internet Gateway 1.92 Tbp/s Capacity

by Telkom Indonesia

Peta Connectivity BALI – NUSA TENGGARAPembangunan jaringan Backbone Optic untuk menghubungkan Seluruh Kota Kabupaten di Bali dan Nusa Tenggara,termasuk Hub Denpasar dan Mataram .Pada tahun 2011 akan dibangun Fiber Optik Pulau Timor Region sampai dengan titik border dengan Timor Leste

FO Coverage & Connectivity Per Kabupaten KotaSelesai Maret‘11:• Labuhanbajo• Ruteng• Bajawa• Ende• Maumere• Waingapu• Kupang

Selesai Desember‘11:• Waikabubak• Soe• Kefamenanu• Atambua

Telkom Group Fixed and Wireless Broadband

Jabodetabek DSL Ports (~ 900K) Astinet Metro Ethernet Telkomsel 3G / HSDPA 3.3 GHz WiMax

Jabodetabek DSL Ports (~ 900K) Astinet Metro Ethernet Telkomsel 3G / HSDPA 3.3 GHz WiMax

Bali & Nusa Tenggara DSL Ports (~ 100K) Astinet Metro Ethernet Telkomsel 3G / HSDPA

Bali & Nusa Tenggara DSL Ports (~ 100K) Astinet Metro Ethernet Telkomsel 3G / HSDPA

Sumatra Utara DSL Ports (~ 100K) Astinet Metro Ethernet Telkomsel 3G / HSDPA 3.3 GHz WiMax

Sumatra Utara DSL Ports (~ 100K) Astinet Metro Ethernet Telkomsel 3G / HSDPA 3.3 GHz WiMax

Kalimantan Timur DSL Ports (~ 70K) Astinet Telkomsel 3G / HSDPA 3.3 GHz WiMax

Kalimantan Timur DSL Ports (~ 70K) Astinet Telkomsel 3G / HSDPA 3.3 GHz WiMax

Sulawesi Selatan DSL Ports (~ 30K) Astinet Metro Ethernet Telkomsel 3G / HSDPA

Sulawesi Selatan DSL Ports (~ 30K) Astinet Metro Ethernet Telkomsel 3G / HSDPA

Papua & Maluku• DSL Ports (~ 7K)• Astinet• 2.3 GHz WiMax

Papua & Maluku• DSL Ports (~ 7K)• Astinet• 2.3 GHz WiMax

Maluku & Papua DSL Ports (~ 7K) Astinet 2.3 GHz WiMax Wide Availability

through pan-Indonesian coverage

• 3 million DSL ports

• 5 million HSDPA capacity

Ability to differentiate offering using broadband portfolio : Speedy, Flash, Metro-E, WiMax

Source: PT. Telkom, A.T. Kearney analysis

by Telkom Indonesia

Speedy ViCon adalahlayanan sewaberbayar yang menyediakanfasilitas komunikasivideo conference melalui jaringaninternet Telkom Speedy Tentukan

TerminasiSusunPerencanaan

AktifkanLayanan

PanggilanVideo Conference

1 2 3 44 Langkah mudah penggunaan layanan

Berlangganan layanan Speedy ViCon sepertiberlangganan telepon seluler: Peralatan diusahakansecara terpisah oleh pelanggan dan Telkom menyediakanakses jaringan serta sistem komunikasinya.

Speedy ViConPowered by TELKOM

by Telkom Indonesia

Speedy ViConPowered by TELKOM

FiturUtamaSpeedy ViCon

Fitur Aplikatif: Point to Point Call (unlimitted) Multipoint Cal ( 3 sites - unlimitted) Dual Video (desktop sharing, video playback, ext camera, etc) Device Colaboration (ext display, sound system, electronic whiteboard) Recording & Streaming URL Domain Name

Fitur Perfomansif: HD (High Definition) Video Quality up to 1080p@30fps Stereo Audio Quality (20 KHz) Firewall/NAT Traversal Audio Conference Call Zone User Policy User Bandwidth Limitation

Operational & Support : Web Portal Services (information, registration, booking,

billing system) Device Management Monitoring Reporting Help desk (24x7x365) Operational Technical Support

by Telkom Indonesia

Jenis Layanan TELKOM Speedy ViCon

Standard Premium

ID Pengguna (User Account) Global Direktori Max call speed: 1.5 Mbps Panggilan Point to Point Panggilan Multipoint (On Demand) Fasilitas gratis endpoint Vicon software

MoVi

ID Pengguna Global Direktori Max call speed: 4.0 Mbps Mendukung panggilan Point to Point Panggilan Multipoint (Dedicated & On

Demand) Fasilitas gratis endpoint ViCon software

MoVi Fasilitas VAS (Value Added Services)

Akses LayananSpeedy ViCon1

E20

EX60/EX90

C20Quick set

Profile 42C20 plus

C40Codec

PenyediaanEndpoint

ViCon(penyewaan)

2

+

MoVi

Layanan termasuk: Instalasi & training Operasional (optional)

by Telkom Indonesia

Arsitektur Dasar Sistem Speedy ViCon

Cloud Service

SpeedyNetwork

Call Control,

SBC,MCU,

Mgmnt

TELKOMHot SpotTELKOMSEL

FLASH

Customer Customer

Provisioning

Directory

Billing

ViCon Infrastruktur

ServicesCentre

ISDN & PSTN

TELKOMVPN

TELKOM TelePresencePerangkat video-conferenceyang mampu“menghadirkan” lawanbicara kita dalam ruang danwaktu yang sama secara realtime dengan kualitas highdefinition

Dengan Telepresence kitadapat mengadakanpertemuan dengan lawanbicara kita yang berbedalokasi seolah-olah beradadalam satu ruang pertemuanmelalui video conference

Definisi “High Definition”

StandartTelevisi

HD

Full HD

• High definition - ukuran pixel yang makin tinggi:• Gambar makin tajam• Dapat dipasang pada display yang makin besar.

• Video conference tradisional menggunakan standart dengan ukuran maksimum 480 x 720 pixel dengan BW Video dengan kisaran 256 kbps sampai dengan 2Mbps

Manfaat penggunaan TELKOM TelePresence1. Pelaksanaan pertemuan “real” dapat dilakukan secara efektif dan efisien

2. Percepatan dalam pengambilan keputusan dalam kondisi kritis (crisis management)

3. Solusi dari keterbatasan ruang dan waktu dalam melaksanakan pertemuan

4. Interaksi dan diskusi dua arah dengan melibatkan data, suara dan gambar dalam waktu yang

bersamaan

5. Sebagai salah satu media efektif dalam pengendalian pelaksanaan program strategis antara

kantor pusat dan daerah

CTS 500 series

•Display 37 inci•Ideal untuk 1 – 2 orang

CTS 1000 series

•Display 67 inci•Ideal untuk 1 – 4 orang

CTS 3000 series

• Display 3 unit @ 67 inci• Ideal untuk 6 orang (ditambah 12

orang untuk tipe 2 lajur)

Model Penawaran Telkom TelepresenceCAPEX Model

Biaya Pembelian“TP End Point +

Setup Fee”

Biaya Bulanan/ Pemakaian“Managed TP

Connectivity Services”

Leasing ModelBiaya 1 kali“Setup Fee”

Biaya Bulanan/ Pemakaian“Managed TP

Connectivity Services”

Equipment Cost

Maintenance & Warranty

Central Component (alokasi)

Bandwidth Charges

Implementation Cost*

Biaya Bulanan Sewa Perangkat

“Managed End PointServices”

Opsi 1: Model Biaya Tetap

Model 2: Model Biaya per Pemakaian

by Telkom Indonesia 32

Our Value

TELKOM Group

ICTSolution

Price CompetitivenessManageable costConvenience, flexible business model

One Stop Managed Solution

Managed voice, application, data & converged network

services including high performance Data Center &

DRC

Improving Business Performance:Improved network utilization, availability, reliability & performance enable the customers to focus on their business

Secured & Trusted Corporation:

Stated Owned Company

public listed Auditable

Compliance

Coverage & Full Services:Integrated infocom services

Nationwide

Consulting & Integrating services:Experienced team in plan & manage the design, build & deployment of Innovative solutions

by Telkom Indonesia

thank you

Source : Orange Healthcare for Telco 2.0 Exec Brainstorm

by Telkom Indonesia

Curriculum Vitae

Pendidikan:• MT in Information System and Technology, ITB • S1 in Telecomunication, Unibraw

Saiful Hidajat• Lahir : Surabaya, 10 Februari 1970

Jabatan :• 2004-2006 : Manager e-Solution Divisi

Multimedia PT TELKOM• 2006-2007 : GM Operation PT. FINNET

(Telkom Group)• 2007 – Sep 2010 : Head of IT Service Strategy

PT. TELKOM• Sep 2010 – Now : Director of Business

Development PT. Admedika (Telkom Group)

saifulh@telkom.co.idSaiful.hidayat@admedika.co.id

http://namakuiful.com