Indonesia's National Artificial Intelligence strategy: One year on from a health perspective

By Jum’atil Fajar*

(Source: Unsplash | Irwan Iwe)

In August 2020, the Indonesian Agency for Technology Research and Development launched the National Strategy for Artificial Intelligence 2020-2045. The strategy sets out five priority areas, one of which is health services.

The roadmap for the artificial intelligence (AI) programme for the health sector includes three programmes, namely the preparation of health data, the assessment of the 4Ps of Health (Predictive, Preventive, Personalised and Participatory) with the support of AI, and the application of the 4P paradigm in health workers and in health facilities.

One data preparation programme that must be completed in 2020/2021 includes the implementation of an electronic medical record system in government health facilities and regulation of electronic medical records, interoperability of health data, and the use of data for research. The institutions responsible for implementing the programme include the Ministry of Health, the Ministry of Communication and Information, the Technology Research and Development Agency, Hospital Associations, Healthtech Associations, industry associations and other related stakeholders.

Currently, government-owned health facilities that have implemented an electronic medical record system are Type A (registered and licensed by the Ministry of Health) and Type B hospitals (registered and licensed by provincial local government), which are generally located in big cities. An example of a Type A hospital that has implemented electronic medical records is the National Central General Hospital dr. Sardjito in Yogyakarta. According to medical professionals at the hospital, medical records are in electronic form, which means that all patient examination results can be retrieved from the hospital management information system (HMIS).

An example of a Type B hospital that has implemented an electronic medical record system is the Damanhuri Barabai Regional General Hospital. According to their IT team, their electronic medical record system for outpatients and inpatients greatly helps the hospital accreditation process.

Despite this progress, however, the application of the electronic medical records is not evenly distributed in all regions. In the Central Kalimantan province, not one Type C hospital (registered and licensed by the district/municipality local governments) has fully implemented the system. A more limited implementation at Type C District General Hospital dr. H. Soemarno Sosroatmodjo Kuala Kapuas,is a new electronic medical record system to enter COVID-19 patient data into the HMIS, especially for the results of x-ray photos and analyses carried out by radiology specialists.

The existence of electronic medical records is a prerequisite for interoperability of health data. Through the provision of a centralised platform, the government can ensure that all health information is accessible through various locations. The information cannot only be used by doctors to access the clinical history of the patients, but also for research. Furthermore, the platform also allows patients to access their own data, helping them better understand their own clinical records.

Regarding the assessment of the 4Ps of health, a programme using AI was started in 2020 to map genomes of healthy and sick Indonesians in a complete life cycle. Since 2009, research on the Indonesian human genome has been carried out by the Eijkman Institute, which has mapped the genetic diversity of various regions and ethnicities in the archipelago. The results of this human genetic research have been uploaded to a data centre that can be accessed by researchers.

Other initiatives under the assessment of the 4Ps of health include the mapping of medical algorithms for symptoms and signs to support diagnosis by artificial intelligence (predictive, preventive, participatory). However, to date, the mapping has not been yet completed. (See the author's previous article entitled Overview of AI in healthcare in Indonesia.)

Regarding the application of the 4P paradigm to health workers and in health facilities, basic trainings of the 4P paradigm for medical personnel have been conducted, covering big data, AI, Internet of Things (IoT) and genetics. In the past year, there have been many webinars discussing these topics. These trainings were organised by the Indonesian Hospital Association (PERSI) in collaboration with companies that utilise AI and IoT. However, only a few of the training activities have been carried out.

Dr Gregorius Bimantoro, the only doctor on the national strategy drafting team, explained that as a follow-up to the National Strategy, an Artificial Intelligence Innovation Center (PIKA) was formed, which will be transformed into Industrial Collaboration and Artificial Intelligence Innovation (Korika). Korika is expected to have pillars of its work: (1) digital talent; (2) research and innovation; (3) physical and digital infrastructure; and (4) supporting regulations and policies. He also explained that there are many programmes from this national strategy that are still being implemented. For example, the Ministry of Health has established a Digital Transformation Office with a roadmap to achieve health data interoperability.

Dr Bimantoro added that data mapping – of human genomes, medical algorithms, and physical sensor interpretation data – is expected to be carried out by universities with a Centre of Excellence in Biomedical Research.

It has been a year since the launch of the National Strategy for Artificial Intelligence. While there is still a lot to be done, it is important to highlight that despite a very challenging year, its implementation is underway, and the process is still ongoing. Hopefully the efforts of various parties to realise this strategy will continue and be strengthened over time at a national level.

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*Jum’atil Fajar is an AI enthusiast. He holds a Masters degree in Health Sciences. He helped develop the hospital management information system. He currently manages the Hospital Accreditation Data Management Information System.


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