Beyond Data — Partnership is Key for Improving Health Services
In our recent blog, titled health data analytics for managing pandemics, we discussed how UN Global Pulse through Pulse Lab Jakarta has been collaborating with the Indonesian Ministry of Health to uncover COVID-19 data insights. Beyond data, this follow-up blog takes a different look — it focuses on the importance of partnerships, as a necessary ingredient for accelerating digital transformation, especially in the health sector.
Across the Indonesian Government, there are varied data assets that can be harnessed for policy planning, not least related to promoting inclusive healthcare. However, as the blueprint of the digital health transformation strategy highlights, the datasets and applications are scattered across units within the Ministry of Health, healthcare institutions, healthcare providers, amongst others. This makes it challenging for policymakers, researchers and others working in the health space to discover, access and make use of the relevant data.
As part of the collaboration two main activities were organised: i) a capacity building research dive involving an interdisciplinary group of participants from the Ministry of Health and Pulse Lab Jakarta; and ii) an international development partners roundtable that was attended by 60 representatives from 16 development organizations. Adopting insights garnered from these engagements, the Ministry of Health has taken steps to improve the capturing, validation and integration of data across its system, whilst reinforcing the ethical and responsible use of health data. These aspects are discussed further below.
Improving Data Capture, Validation and Integration
As a systematic process, the research dive we conducted revealed that some of the data related to COVID-19 could not be further processed to extract actionable insights, as the data was either invalid, contained a null value, inconsistent or was not interoperable. As is, the Ministry of Health’s ecosystem is complex, layered with various units working within the Ministry of Health to collect and produce different data — albeit the data flows are not integrated. One way to minimize these issues around data quality is to improve data capture, validation and integration through standardized protocols, both within the Ministry of Health and other national data ecosystems. This of course requires greater cross-collaboration, cooperation and meaningful partnerships.
Recognizing the importance of having integrated information systems for improved data analytics, the Digital Transformation Office (DTO) is currently developing the Indonesia Health Services (IHS), which will serve as a digital health ecosystem platform that provides data connectivity, analysis and services to support and integrate various health applications in Indonesia. To achieve this, Dewi Nur Aisyah (Senior Data Scientist and Health Informatics Expert of the DTO in the Ministry of Health) pointed out that DTO has been building partnerships with different stakeholders to integrate and connect various health data into the platform. Some of which include health data producers such as the Indonesian Health and Social Security Agency (BPJS) and medical laboratories. In addition, a partnership with the Population and Civil Registration Agency (Disdukcapil) was established to ensure data is accurately matched with each individual’s identity.
Improving Data Capture Related to Vulnerable Groups
The COVID-19 crisis has disproportionately impacted the elderly, women and other vulnerable groups. As discussed in our previous blog, the current datasets do not fully capture information on these vulnerable groups, especially people with disabilities. Whilst recognizing and prioritizing certain groups such as health workers, pregnant mothers, the elderly, and those with comorbidity as part of the government’s strategic COVID-19 response, the manner in which some of these data are currently captured limits their utility in providing policy-relevant and actionable insights
This issue calls for a new approach, considering that at least 20 million people in Indonesia have some form of disability, representing around 10 percent of the country’s population (Tempo, 2021). During the international development partners meeting that was convened, participants from various development agencies discussed the importance of designing more inclusive methods to capture relevant data. For instance, this can be done through a service design approach, which would ensure that the vulnerable cohorts are at the heart of the products and services produced by DTO. With this in mind, DTO has started to explore different guidelines, such as the Washington Group Questions, to ensure more data on and for people with disability is collected, with a view to reducing barriers they often face.
Reinforcing Responsible and Ethical Use of Health Data
This analytic partnership also highlighted that whilst more data is expected to be collected and better integrated, ethics must also be built-in. In particular, careful data management practices should govern both data collection and data processing. As DTO is currently undergoing a significant digital transformation (that includes the increased use of electronic health data records), this process needs to be carried out whilst considering responsible and ethical use. This is particularly relevant as health data contains sensitive personal information, and overriding consent and privacy rights may fuel distrust from the public with negative consequences.
To enforce the ethical and responsible use of health data, DTO has been working closely with The National Cyber and Encryption Agency (BSSN) to ensure all the data collected, integrated and used within the Ministry of Health is in compliance with the Agency’s principles on personal data protection, as well as security procedures and standards.
Moving Forward in Partnership
As the development of the Indonesia Health Services platform is already underway, collaboration with all stakeholders is critical for overcoming challenges related to pervasive data fragmentation across the health sector. Partnerships with data producers such as medical laboratories and health offices will be needed to provide better data connectivity for integrated electronic health records. In the work that it does, DTO is well-placed as an effective accelerator that can bring together different stakeholders from the health sector. To this end, DTO plans to conduct regular roundtable discussions with development partners working in the health space to ensure its efforts contribute to system-wide impact.
Authors: Agus Rachmanto (Deputy Chief Digital Transformation Office/ DTO, Indonesian Ministry of Health), Desi Vicianna (Government Partners Coordinator, UN Global Pulse), and Angga Gumilar (Programme Assistant, UN Global Pulse)
With editorial support from Dwayne Carruthers (Public Advocacy Manager, UN Global Pulse).
Pulse Lab Jakarta is grateful for the generous support from the Government of Australia