Provision of healthcare services rising in Indonesia
Indonesia’s healthcare landscape is shifting to better suit its more vulnerable citizens, as insurance policies and infrastructure create stability, according to findings made by healthcare intelligence provider GlobalData in a new report.
The overall healthcare system in Indonesia is still under development, with healthcare spending increasing gradually from only 1.7 percent of gross domestic product (GDP) in 2002 to 2.4 percent in 2010.
And while services and medicines provided by public hospitals are either subsidised or available free of charge, Indonesia’s healthcare market currently lacks universal healthcare insurance and has poor access to facilities.
This is something the government is desperate to improve on.
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A significant change in Indonesia’s rate of urbanisation means that more than half of the population is expected to live in urban areas by 2020.
To better cater to these demographic shifts, the government is therefore focusing on human capital development and education programmes.
In 2001, the government announced a policy of decentralisation, increasing the responsibility of provincial governments for the provision of healthcare facilities.
Following this, in 2011, a prenatal and post natal insurance policy was also introduced to help meet set targets for maternal and infant mortality rates.
Changes such as these show a steady improvement of the Indonesian healthcare landscape.
Indonesia’s large population and poor healthcare infrastructure have caused healthcare expenditure to increase, which in turn is leading insurance coverage to expand.
Currently, the provincial government is responsible for filling the gap between the real cost of health insurance and the budget allocated to it by the central government.
In 2005, the Ministry of Health for the Republic of Indonesia (MoHRI) launched an insurance scheme known as Askeskin, which offers coverage to the poor population, while in 2008 MoHRI converted Askeskin into the Jamkesmas insurance program in order to expand the level of insurance coverage for the entire population.
This is entirely funded by the central government, and covered approximately 76.4 million people as of 2010.
However, only 46 percent of the population was insured during this year, meaning that the majority of the Indonesian population remained unsupported.
Nevertheless, coverage is increasing over time due to the increase in purchasing power and government initiatives.
The main drivers of the Indonesian pharmaceutical market in the future will be an increasing level of access to medicines, increasing affordability and a higher compliance rate due to growing public awareness concerning common diseases.
However, much remains to be done to realise the vision and potential of Indonesia’s healthcare sector.
A large percentage of the population is already vulnerable to poverty, and the periodical impact of natural calamities such as floods, earthquakes, wildfires, and tsunami remains the biggest challenge for Indonesia’s population.
As past events have shown, the country’s medical industry may not yet be ready to support them fully.
The pharmaceutical market in Indonesia valued an approximate US$3.8 billion in 2010 and it is projected to reach approximately $9.6 billion by 2020, following growth at a compound annual growth rate (CAGR) of 9.7%.
In 2010, the Indonesian pharmaceutical market was the largest in the region of Southeast Asia.
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How healthcare can safeguard itself against cyberthreats
One of the most fundamental lessons from the COVID crisis is that health should always be a priority. In a similar fashion to the human body that frequently fights off viruses and foreign invaders that intend to cause it harm, the sector itself is now a prime target for another type of external threat: cyberattacks.
The figures speak for themselves: between December and January this year, hospitals in the UK were at 89% capacity, with 7,000 fewer available beds than there usually are. As the pandemic increased pressure on hospitals, clinics, and research facilities to create a treatment for patients globally, it has left the sector exposed to hackers who, like a virus, have been targeting it relentlessly and evolving their tactics.
From patient records being held ransom, to fake emails claiming to originate from the UN WHO, the NHS, or vaccine centres, through to attacks on the cold supply chain to find out the secret formula of the COVID vaccine, the healthcare industry is facing constant cyberattacks and struggling to cope. This threat is unlikely to go away anytime soon – and as such, the industry needs to take a proactive, preventative stance to stay safe in a dynamic digital world.
The responsive nature of healthcare – particularly of hospitals – means that efficiency is crucial to the industry’s standard operations. To support this, the sector has been embracing technological advancements that can improve the quality of work, enabling staff to meet pressing deadlines, and enhancing patient care. For example, the industry has been digitising records and improving its ways of working through digital means over the past few years.
This shift is critical to offer high quality patient care; yet, it also means the sector has become more dependent on IT, which can come with a risk if cybersecurity processes employed are deemed as inadequate.
Without the correct security measures in place, the desired efficiency gains realised, can be easily lost in a heartbeat. Simply put, an elementary glitch in the system can have a tremendous ripple effect on many areas, from accessing patient records and conducting scans, to maintaining physical security and protecting the intellectual property of experimental treatment development.
To prevent this, healthcare organisations need to ensure they’re considering cybersecurity as part of their overall digital transformation strategy – and setting the right foundations to create a culture where safety goes hand in hand with patient care.
Before implementing cybersecurity process, healthcare organisations need to assess the potential risks they face. Depending on how much confidential data the trust has, where it is stored, who has access to it and via which means, the cybersecurity strategy and associated solutions will change.
It’s fair to say that a medical device start-up where all employees have a corporate-sanctioned laptop and access data via a VPN will have radically different needs to a large hospital with hundreds of frontline workers connecting to the hospital’s Wi-Fi using their personal device.
These requirements will pale by comparison to a global pharmaceutical giant with offices in multiple locations, a large R&D department researching new treatments for complex diseases and a fully integrated supply chain. Considering the existing setup and what the organisations is looking to achieve with its digital transformation strategy will therefore have an immediate impact on the cybersecurity strategy.
Despite this, there are fundamentals that any organisation should implement:
Review and test your back-up policy to ensure it is thorough and sufficient – By checking that the organisation’s back-up is running smoothly, IT teams can limit any risks of disruption in the midst of an incident and of losing data permanently.
In our recent State of Email Security report, we found that six out of ten organisations have been victims of ransomware in 2020. As a result, afflicted organisations have lost an average of six days to downtime. One third of organisations even admitted that they failed to get their data back, despite paying the ransom. In the healthcare industry, this could mean losing valuable patient records or data related to new treatments – two areas the sector cannot afford to be cavalier about.
Conduct due diligence across the organisation’s supply chain – Healthcare organisations should review their ways of working with partners, providers and regulatory institutions they work with in order to prevent any weak link in their cybersecurity chain. Without this due diligence, organisations leave themselves exposed to the risks of third party-led incidents.
Roll out mandatory cybersecurity awareness training - Healthcare organisations shouldn’t neglect the training and awareness of their entire staff – including frontline workers who may not access the corporate network on a regular basis. According to our State of Email Security report, only one fifth of organisations carry out ongoing cyber awareness training.
This suggests it is not widely considered as a fundamental part of most organisations cyber-resilience strategy, despite the fact many employees rely on their organisation’s corporate network to work. By providing systematic training, healthcare organisations can help workers at all levels better understand the current cyberthreats they face, how they could impact their organisation, the role they play in defending the networks, and develop consistent, good cybersecurity hygiene habits to limit the risks of incidents.
Consider a degree of separation – Information and Operational Technology (IT and OT) networks should be separated.
Although mutually supported and reliance on each other, employees shouldn’t be accessing one via the other. This should be complemented by a considered tried and tested contingency and resiliency plan that allows crucial services to function unabated should there be a compromise. Similarly, admin terminals should not have internet access to afford a degree of hardening and protection for these critical accounts.
As the sector becomes a common target for fraudulent and malicious activity, putting cybersecurity at the core of the organisation’s operations is critical. It will help limit the risks of disruption due to cyberattacks, reduce time spent by the cybersecurity team to resolve easily avoidable errors, and ensure that institutions can deliver patient care, safe in the knowledge that their networks are safe.
Fighting future threats
With technology continuing to change the face of healthcare, the surface area and vectors available for attacks by malicious actors is constantly increasing. With the introduction of apps, networked monitoring devices, and a need for communication, the attack vector is ever expanding, a trend that needs to be monitored and secured against.
To prevent any damage to patients, staff, or the organisation they are responsible for, healthcare leaders must put security front and centre of their digital transformation strategy. Only then can the sector harness the full benefits of technology. Doing this should include implementing cybersecurity awareness training to challenge misconceptions around security, encourage conversation, and to ensure employee knowledge of the security basics and threats faced.
This ultimately allows healthcare organisations to do what they do best: provide the highest standard of patient care, safe in the knowledge that their operations, patients, and data are safe.