Aisyah Dewi Nur, Setiawan Agus Heri, Lokopessy Alfiano Fawwaz, Faradiba Nadia, Setiaji Setiaji, Manikam Logan, Kozlakidis Zisis
Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom.
Digital Transformation Office, Ministry of Health Republic of Indonesia, Jakarta, Indonesia.
JMIR Med Inform. 2024 Jul 18;12:e55959. doi: 10.2196/55959.
BACKGROUND: Indonesia has rapidly embraced digital health, particularly during the COVID-19 pandemic, with over 15 million daily health application users. To advance its digital health vision, the government is prioritizing the development of health data and application systems into an integrated health care technology ecosystem. This initiative involves all levels of health care, from primary to tertiary, across all provinces. In particular, it aims to enhance primary health care services (as the main interface with the general population) and contribute to Indonesia's digital health transformation. OBJECTIVE: This study assesses the information and communication technology (ICT) maturity in Indonesian health care services to advance digital health initiatives. ICT maturity assessment tools, specifically designed for middle-income countries, were used to evaluate digital health capabilities in 9 provinces across 5 Indonesian islands. METHODS: A cross-sectional survey was conducted from February to March 2022, in 9 provinces across Indonesia, representing the country's diverse conditions on its major islands. Respondents included staff from public health centers (Puskesmas), primary care clinics (Klinik Pratama), and district health offices (Dinas Kesehatan Kabupaten/Kota). The survey used adapted ICT maturity assessment questionnaires, covering human resources, software and system, hardware, and infrastructure. It was administered electronically and involved 121 public health centers, 49 primary care clinics, and 67 IT staff from district health offices. Focus group discussions were held to delve deeper into the assessment results and gain more descriptive insights. RESULTS: In this study, 237 participants represented 3 distinct categories: 121 public health centers, 67 district health offices, and 49 primary clinics. These instances were selected from a sample of 9 of the 34 provinces in Indonesia. Collected data from interviews and focus group discussions were transformed into scores on a scale of 1 to 5, with 1 indicating low ICT readiness and 5 indicating high ICT readiness. On average, the breakdown of ICT maturity scores was as follows: 2.71 for human resources' capability in ICT use and system management, 2.83 for software and information systems, 2.59 for hardware, and 2.84 for infrastructure, resulting in an overall average score of 2.74. According to the ICT maturity level pyramid, the ICT maturity of health care providers in Indonesia fell between the basic and good levels. The need to pursue best practices also emerged strongly. Further analysis of the ICT maturity scores, when examined by province, revealed regional variations. CONCLUSIONS: The maturity of ICT use is influenced by several critical components. Enhancing human resources, ensuring infrastructure, the availability of supportive hardware, and optimizing information systems are imperative to attain ICT maturity in health care services. In the context of ICT maturity assessment, significant score variations were observed across health care levels in the 9 provinces, underscoring the diversity in ICT readiness and the need for regionally customized follow-up actions.
背景:印度尼西亚迅速接纳了数字健康,尤其是在新冠疫情期间,每日有超过1500万健康应用用户。为推进其数字健康愿景,政府将健康数据和应用系统的开发列为优先事项,旨在构建一个综合医疗技术生态系统。该倡议涵盖了从初级到三级医疗保健的各个层面,涉及所有省份。特别是,其旨在加强初级卫生保健服务(作为与普通民众的主要接口),并推动印度尼西亚的数字健康转型。 目的:本研究评估印度尼西亚医疗保健服务中的信息通信技术(ICT)成熟度,以推进数字健康倡议。专门为中等收入国家设计的ICT成熟度评估工具,被用于评估印度尼西亚5个岛屿上9个省份的数字健康能力。 方法:于2022年2月至3月在印度尼西亚9个省份进行了横断面调查,这些省份代表了该国主要岛屿的不同情况。受访者包括公共卫生中心(Puskesmas)、初级保健诊所(Klinik Pratama)和地区卫生办公室(Dinas Kesehatan Kabupaten/Kota)的工作人员。该调查使用了经过改编的ICT成熟度评估问卷,涵盖人力资源、软件和系统、硬件以及基础设施。调查以电子方式进行,涉及121个公共卫生中心、49个初级保健诊所和67名地区卫生办公室的信息技术人员。举行了焦点小组讨论,以更深入地探讨评估结果并获得更具描述性的见解。 结果:在本研究中,237名参与者代表3个不同类别:121个公共卫生中心、67个地区卫生办公室和49个初级诊所。这些实例是从印度尼西亚34个省份中的9个省份的样本中选取的。从访谈和焦点小组讨论中收集的数据被转换为1至5分的分数,1分表示ICT准备程度低,5分表示ICT准备程度高。平均而言,ICT成熟度得分细分为:人力资源在ICT使用和系统管理方面的能力为2.71分,软件和信息系统为2.83分,硬件为2.59分,基础设施为2.84分,总体平均得分为2.74分。根据ICT成熟度水平金字塔,印度尼西亚医疗保健提供者的ICT成熟度处于基础水平和良好水平之间。追求最佳实践的需求也强烈显现。按省份对ICT成熟度得分进行进一步分析时,发现了地区差异。 结论:ICT使用的成熟度受到几个关键因素的影响。加强人力资源、确保基础设施、提供支持性硬件以及优化信息系统对于实现医疗保健服务中的ICT成熟度至关重要。在ICT成熟度评估的背景下,9个省份的不同医疗保健层面观察到了显著的得分差异,凸显了ICT准备程度的多样性以及采取区域定制后续行动的必要性。
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