Abstract
A socio-technical review of Indonesia's NHS e-health strategy aims to navigate the digital frontier by identifying key challenges and proposing a novel socio-technical model to guide future endeavors. The study analyzed the NHS's e-health strategy within existing frameworks and global best practices, examining technical interoperability challenges and socio-organizational barriers. The results revealed significant challenges, including clinician resistance, financial constraints, and cybersecurity threats. A new socio-technical model was proposed, incorporating dimensions of “lifecycle” and “purpose,” advocating a shift in focus from EHRs to inter-organizational clinical and social care workflow improvement. Emphasizing interoperability and cybersecurity, the model recommended promoting national standards and infrastructure, coupled with national funding support. This strategic redirection provides a roadmap for future e-health initiatives in Indonesia, ensuring a holistic and sustainable transformation of the healthcare landscape.
TopIntroduction
The National Health Service (NHS) e-health initiative launched in 2020 is causing a sea change in Indonesia's healthcare system (Bhaskar et al., 2020). The plan highlights interoperability as the electronic glue that binds the transmission of patient data across organizations, with an ambitious aim of being paperless at the point of treatment by 2023 (Khandelwal et al., 2023). This formative socio-technical study addresses critical gaps in academic research, shedding light on the complex dynamics influencing the strategy's progress. As e-health initiatives are ubiquitous but fraught with potential pitfalls, this study navigates the uncharted territory of socio-technical dimensions, revealing cultural barriers, funding challenges, and unforeseen shifts in program structures (Stoumpos et al., 2023). The findings underscore the significance of a “middle-out” approach yet reveal the impracticality of the set timeline. Noteworthy cultural obstacles, including resistance from clinicians and operational challenges, such as delayed funding and disruptive government reorganizations, are identified. A novel socio-technical model is proposed, introducing “Lifecycle” and “Purpose” dimensions to enhance strategy viability. With an emphasis on cybersecurity and interoperability, the proposal pushes for a deliberate transition towards bettering social and clinical care workflow across organizations. Priorities should shift away from electronic health records and toward national infrastructure, standards, and systems. The report marked a significant change in the direction of the NHS e-health policy in Indonesia, which calls for national budgetary support for health economy-wide projects. This chapter unfolds the intricacies of the socio-technical evaluation, paving the way for a nuanced understanding of the challenges and a strategic roadmap for future success.
The results of this research may provide useful information for many people involved in e-health project design, implementation, and assessment; it is especially pertinent to the Indonesian National Health Service (NHS)... The following individuals or groups can benefit from the findings: Policymakers can use the insights to refine and adjust existing e-health strategies, ensuring they align with the identified socio-technical considerations and address barriers. Government officials responsible for healthcare funding and regulations can leverage the research to make informed decisions about resource allocation, budgeting, and regulatory frameworks. Healthcare administrators can gain strategic insights into overcoming cultural, financial, and technical challenges in implementing e-health strategies. Organizational leaders within the NHS and other healthcare institutions can use the information to make informed decisions about technology adoption, workforce training, and overall digital transformation. IT professionals and consultants specializing in healthcare can benefit from understanding the nuances of the “middle-out” strategy, including the emphasis on interoperability, cybersecurity, and the challenges faced in selecting IT suppliers. Clinicians and healthcare practitioners can gain insights into the cultural barriers and concerns surrounding e-health adoption. Understanding these perspectives is crucial for successful engagement and collaboration between technology and healthcare professionals. Based on the study's results, healthcare technology solution providers might adjust their offerings to meet the specific requirements of the Indonesian market. Researchers and academics can build upon the findings to investigate socio-technical aspects of e-health strategies. This contributes to the academic discourse on effective healthcare technology implementation. Patients and advocacy groups can benefit indirectly as successful e-health strategies contribute to improved healthcare delivery. Understanding the challenges and proposed solutions empowers patients to engage with and support digital healthcare initiatives. International health organizations can use the research to draw comparisons and lessons for other countries or regions undertaking similar e-health initiatives. This promotes cross-border learning and collaboration. The potential for informed decision-making, strategic planning, and successful implementation of e-health strategies in Indonesia is enhanced by disseminating the knowledge generated from this research to these stakeholders.
Key Terms in this Chapter
Strategy Implementation: Strategy implementation involves executing planned activities and initiatives outlined in a strategic plan to achieve specific objectives and goals. In the context of e-health strategy, implementation encompasses the practical application of digital solutions, organizational changes, and stakeholder engagement to realize the envisioned improvements in healthcare delivery.
E-Health Strategy: An e-health strategy refers to a comprehensive plan or framework developed by healthcare organizations or governments to leverage information and communication technologies (ICT) to improve the delivery of healthcare services. Goals of the adoption of EHRs, interoperability, telemedicine, and other technological solutions to improve healthcare's accessibility, efficiency, and quality are common components of such a plan.
Socio-Technical Dimensions: Socio-technical dimensions refer to the interrelated and reciprocal aspects of social and technical factors within a system or organization. The socio-technical aspects of an e-health approach include technical factors and human, organizational, cultural, and societal factors.
IT Consultants: IT consultants are professionals specializing in information technology (IT) who provide expert advice, guidance, and solutions to organizations seeking to optimize their IT infrastructure, systems, and strategies. In e-health, IT consultants play a crucial role in advising healthcare entities on adopting and integrating digital technologies.
Indonesia: Indonesia is a Southeast Asian archipelago comprising thousands of islands, known for its diverse culture, extensive biodiversity, and rapidly growing economy. As the fourth most populous country globally, Indonesia faces unique challenges and opportunities in developing and implementing healthcare strategies.