Dr. Kuntjoro Adi Purjanto, Chairman of PERSI (National Association of Hospitals in Indonesia), explains the role that public and private hospitals are playing to successfully realize the national healthcare goals and the active collaboration of PERSI with the government to enhance the Indonesian hospital eco-system.
Could you please introduce yourself to our international audience as well as the main activities and responsibilities of the National Association of Hospitals in Indonesia (PERSI)?
The vision of PERSI is to become an umbrella organization that gathers the voice and interests as well as looks after the prosperity of all hospitals in Indonesia, regardless of their segment. We operate in many fields but are always aligned with our values: transparency, accountability, responsibility, independency, and fairness.
It is important to consider that Indonesia is a big archipelago country composed of more than 17,000 islands and, therefore, bringing care to the Indonesian citizens is certainly a challenge. Thus, we are also highly concerned with enhancing the patients’ access to quality, affordable, and nearby healthcare services.
From the political standpoint, PERSI is continuously working in collaboration with the government to define the best regulation and quality control practices that are related to hospitals. In this sense, we are highly involved in aligning the hospital industry’s interests with the national health goals such as the implementation of Universal Healthcare Coverage (JKN).
What are the main priorities on your agenda as chairman of PERSI?
As aforesaid, the alignment of the industry interests and the national health objectives is one of my main priorities and concerns. Such alignment is certainly a tough nut to crack since it is a fact that hospitals in Indonesia need more resources, both in terms of infrastructure and human capital, to successfully support the government health goals and cover all patients across Indonesia.
The Ministry of Health appointed PERSI as the national association that gathers both public and private hospitals to act as a bridge between hospitals and government ensuring the perfect symbiosis between them. I would like to highlight that private hospitals represent more than 50 percent of the hospitals in the country and, consequently, their inclusion in the governmental healthcare policies is crucial to ensure the accomplishment of the national health goals.
What is the added value that PERSI is bringing to its members through its different activities?
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We are working closely with the Indonesian government and hospital accreditation committees to define the best standards of quality as well as to promote the development of human capital; PERSI is absolutely adding value to the entire industry through the aforementioned lines. Furthermore, we obviously do lobbying and networking for our members to showcase the interests of our industry members to the government; the success of the national healthcare programs highly depends on public and private partnerships within the hospital arena, we are strongly supporting this kind of collaborations.
The association also has a data and information center called PD PERSI; could you expand on the rationale behind having a separated line within your operations and what exactly it covers?
We are creating different e-platforms to define clearer strategies for each line of action. In this sense, PD PERSI aims to offer accurate data with the objective of ensuring that both public and private industry stakeholders undertake proper decisions according to reliable information. In addition, we have just developed “Canal PERSI” that aims to foster the activity in the industry through training, education courses, round tables discussions, and seminars.
What is the main challenge that is impacting your members?
Shortage of medication has been always one of the main challenges for hospitals but such a threat is now even bigger with the implementation of the Universal Healthcare Coverage (JKN) because of the increasing demand for healthcare services in hospitals. In addition, we are fully aware of the increasing impact that such a shortage will represent once JKN is fully implemented; therefore, PERSI is already working together with the Public Procurement Agency of Indonesia (LKPP) to enhance the medicine procurement planning for hospitals in Indonesia.
It is well known that counterfeit drugs are a challenge in Indonesia. Indeed, the Indonesian Food and Drugs Supervisory Agency (BPOM) is making strong efforts to strengthen the supervision of unregistered drugs and such drugs represents around 10 percent of the total Indonesian pharmaceutical value. How is such a national challenge affecting hospitals, considering that some of them are buying counterfeit drugs to treat patients?
Indonesia already has great and solid regulation to properly fight against counterfeit drugs; nonetheless, the implementation of such regulation is not an easy journey. The reasons why hospitals are eventually buying counterfeit drugs are the low costs of such medicines and the existing shortage of drugs in healthcare centers. Therefore, the solution to be placed has to be supported by two underpinnings: increasing compliance of the industry with the existing regulation, and better medicines procurement planning
As aforementioned, PERSI is already working with the government to define the quality and operational standards that should be followed by hospitals to get a quality certification; such certification will strongly diminish the footprint of counterfeit drugs in hospitals. This is still a work in progress but the results will come up in the mid-term.
As chairman of the national association of hospitals in Indonesia, could you expand on the role played by hospitals to ensure the success of JKN?
Hospitals play a key role on JKN, especially in the implementation, because they are the infrastructure needed to bring care to patients; there is not possibility to deliver healthcare services without a proper network of hospitals.
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The main challenge in this discussion is that the premium paid by the government for JKN through BPJS (Health Social Security Institution) is very low in comparison to the cost that hospitals actually incur when delivering care to patients. PERSI is influencing the Indonesian government to develop a more accurate price premiums policy according to the real cost of such health services. In addition, and aligned with the commented challenge, we are developing clinical procedures to enhance the efficiency in hospital operations and, consequently, make their operations more profitable within the JKN scheme.
We have perceived within the global hospital equipment industry that technology is breaking health boundaries through digitalization and other disruptive innovations. How is such innovation being embraced by Indonesian hospitals to enlarge patients’ market access to high quality care and gain efficiency in their operations?
The introduction of such technologies is mostly limited by financial constraints from either public or private hospitals. We believe that collaboration between hospitals is the best way to introduce high-end technologies such as telemedicine and digital capabilities in Indonesia. Obviously, private hospitals are embracing more advanced technologies in their operations in order to gain efficiency; nonetheless, the government is also trying to introduce such technology giving budget to each public hospital specifically to invest in cutting-edge equipment. Furthermore, in Indonesia, there is a classification of public and private hospitals according to several criteria and one of them is technology, thus if a hospital wants to raise its classification it has to invest in technological capabilities. To conclude my answer, there are a lot of technological developments to be introduced in the country but, fortunately, the entire hospital eco-system is advancing in this regard.
PERSI collaborates with several institutions to enlarge the reach of its operations in Indonesia and within the region. Could you explain to our international audience what your partnership strategy is?
We are looking to any local, regional and global partnership that may enhance the Indonesian hospital landscape in areas such as technology, human resources, and best operational practices. Indeed, last month, March 2017, PERSI and the Korean Hospital Association (KHA) signed an agreement to collaborate in the medical field in terms of hardware, software, and knowledge.
What are the main objectives that you would like to accomplish in the upcoming years?
The main priority on my agenda is to successfully implement the accreditation standards for hospitals in Indonesia. Secondly, one of my objectives is to foster the compliance of all the hospitals in Indonesia with the regulation standards of JKN. Finally, continue helping the government in overcome several healthcare challenges such as antimicrobial resistance and healthcare human capital.
