BPJS Kesehatan wins big at the Asian Technology Excellence Awards

It was recognised for its use of AI and Big Data that enabled the country’s healthcare sector to attend to vital concerns immediately and efficiently.

BPJS Kesehatan (The Social Security Administrative Body for Health) is a public legal entity directly responsible to the President of The Republic of Indonesia, mandated by law to manage social health insurance.

BPJS Kesehatan has won the Indonesia Technology Excellence Award for AI - Healthcare and Indonesia Technology Excellence Award for Big Data - Healthcare at the Asian Technology Excellence Awards. The award was given to the Director of Information Technology of BPJS Kesehatan, Edwin Aristiawan. Through the awards received, BPJS Kesehatan is recognised as having been successful in using artificial intelligence to reduce the member churn and improve the contribution collection from the informal sector for Indonesia’s, universal healthcare programme, as well as the use of big data to empower local governments to craft evidence-based health-related policies.

BPJS Kesehatan, the body that oversees the implementation of Indonesia’s universal healthcare programme Jaminan Kesatahan Nasional (JKN Programme), which enrols around 263 million people, leveraged the power of artificial intelligence to ensure the effective collection of contributions from the informal sector and reduce their member churn.

The AI solution was launched to develop predictive analytics based on participant data and the history of the use of health services. This solution predicts who amongst the participants may fall into arrears shortly, reduces member churn, improves the contribution collectability and reduces billing costs. The prediction results can also be used for premium payment reminders, blast notifications or tele-collecting to remind them of their timely dues.

In leveraging AI predictive analytics to give out timely payment reminders, BPJS Kesehatan uses the results to send personalised payment reminders to individuals and help inform them of their payment obligations, thus increasing their likelihood of making their payments on time.

BPJS Kesehatan also relies on this to send blast notifications to all participants where they emphasise the importance of regular premium payments as well as the consequences of non-payment. These targeted communications underpin the value of timely contributions which also leads to improved collectibility and lower member churn.

Predictive analysis is also beneficial to tele-collection. Tele-collection is done in various ways which include both online and offline methods. Online collections are done by phone, whilst offline methods are collected by the Kader JKN. Participants with arrears of two to 23 months are targeted by tele-collection by phone, whilst the offline method is employed for participants with arrears of 12 to 24 months.

Through the predictive analysis of AI, it identifies the participants who are likely to experience difficulty in paying their dues on time. With this, BPJS Kesehatan contacts these participants directly, enabling personalised assistance, flexible payment options and resolving their other concerns, resulting in improved communication and the provision of support to the targeted participants.

Overall, the predictive analytics tool allows BPJS Kesehatan to strengthen its contribution collection efforts and ensure the affordability and accessibility of healthcare for the informal sector. Not only does this tool reduce member churn and improve collection efforts but the tool leads to personalised communication, enhanced financial sustainability, improved participant engagement, and data-driven decision-making. BPJS Kesehatan should prioritise data accuracy, and develop effective communication strategies, whilst maintaining privacy and security standards.

JKN Program data and information is like a gold mine. Every day, there are 112 million data transactions taking place within the JKN Program ecosystem, or 1,296 data transactions per second. There are 397.8 billion rows of data, which includes data on membership, health services and contributions. Therefore, BPJS Kesehatan also ensures that the security of BPJS Kesehatan participant data is protected as well as possible.

Local governments are facing various challenges when making informed decisions and developing effective policies. Barriers to the decision-making process include an inconsistent prevalence of diagnoses, incomplete data collection, reliance on paper-based systems, and limited data accessibility. This calls for the implementation of a comprehensive healthcare dashboard that will serve as a necessary tool to improve strategic policymaking.

The Healthcare Analytical Dashboard aims to integrate comprehensive data which includes the prevalence of diagnoses in each area to provide decision-makers with a deeper understanding of healthcare challenges, allowing them to properly allocate resources and ensuring that their initiatives are aligned with the needs of the community.

The Dashboard also helps encourage local governments to minimise the morbidity rate and reduce health utilisation through proactive campaigns and disease prevention personality-based health promotion. This will also help them identify areas that require targeted interventions as they have access to up-to-date information, allowing them to craft evidence-based strategies to improve community health and lower healthcare costs in the long run.

This dashboard, which has been accessed by 98% of the local governments, eliminates the reliance on paper-based systems and streamlines data collection, whilst also improving data accuracy. Through this solution, policymakers not only have access to real-time information but are also enabled to respond promptly to issues that need to be addressed and monitor ongoing efforts. This also simplifies complex information, allowing policymakers to better comprehend and communicate data amongst stakeholders.

Patient health service history data plays a very important role for doctors in providing optimal care. Therefore, BPJS Kesehatan is taking concrete steps in advancing health services in Indonesia by releasing a revolutionary application called i-Care JKN. This application provides easy access to health facilities to view the health service history of National Health Insurance (JKN) participants over the past year. Through i-Care JKN, doctors can plan appropriate treatment based on more real time, current and factual data. This will increase efficiency in health services.

Apart from benefits for medical staff, i-Care JKN also facilitates communication and collaboration between doctors, especially when patients are directed to other doctors or specialists. This application will interact with the P-Care and SIM RS applications through a bridging scheme, enabling a smoother exchange of information between various health service providers.

Apart from doctors, JKN participants can also directly access i-Care JKN via the JKN Mobile Application. With this, JKN participants can easily view the history of services provided at First Level Health Facilities (FKTP) and Advanced Level Referral Health Facilities (FKRTL). This information includes details of the diagnosis, medical treatment, health facility providing the service, and date of service.

One of the main problems that BPJS Kesehatan has successfully overcome is reducing the waiting time for JKN participants to receive health services. By implementing an online queuing system on the JKN Mobile Application, the average time for outpatient services has succeeded in reducing the waiting time to just 2.5 hours from the previous 6 to 8 hours.

The Asian Technology Excellence Awards is presented by Asian Business Review. To view the full list of winners, click here. If you want to join the 2024 awards programme and be acclaimed for your company's outstanding retail initiatives, please contact Jane Patiag at [email protected].