Indonesia Telemedicine Evaluation Initiative: Strengthening Digital Health for Universal Access to Care 

Overview 

The Indonesia Telemedicine Evaluation Initiative is a collaborative effort led by the Johns Hopkins Bloomberg School of Public Health’s Center for Global Digital Health Innovation, in partnership collaboration with the BPJS Kesehatan (Indonesia’s Social Security Agency), SMERU Research Institute, Gates Foundation. This initiative seeks to assess, optimize, and expand telemedicine services under the Jaminan Kesehatan Nasional (JKN) universal health coverage program. Through rigorous research and implementation science, this initiative aims to identify challenges, test solutions, and inform recommendations to enhance digital health service delivery. 

Objectives 

  1. To describe supply and demand side challenges to the uptake and utilization of JKN Mobile telemedicine services:
  2. To support the BPJS in the design and initial deployment of a new facilitated telemedicine model through continuous quality improvement mechanisms and support for institutionalization of the new model.
  3. To assess the impact of the facilitated (providers in puskesmas to providers in posyandu/pustu) telemedicine intervention on the utilization of JKN Mobile; on health outcomes (e.g., timeliness of services, access to primary and referral services, costs to patients, quality of services etc.) and health systems outcomes (e.g., availability of primary care provider, shorter wait times) 

Study Phases

Phase 1 (Objectives 1 & 2)

Focused on identifying supply- and demand-side barriers to inform the design and implementation of the new facilitated telemedicine model

Phase 2 (Objective 3)

Focused on testing the efficacy of the facilitated telemedicine model for the use case of RMNCH and NCDs

Key Focus Areas 

1. Assessing Current Telemedicine Use & Challenges 

  • Understanding supply- and demand-side barriers affecting telemedicine uptake.
  • Evaluating health provider incentives, patient experiences, and system inefficiencies.
  • Analyzing telemedicine utilization data from BPJS Kesehatan and JKN Mobile users. 

2. Implementing & Evaluating a Facilitated Telemedicine Model 

  • Piloting a provider-facilitated telemedicine model that connects midwives/nurses at lower-level health posts (Pustu/Posyandu) to general practitioners (GPs) at higher-level facilities (Puskesmas).
  • Testing whether this model improves accessibility, care quality, and health outcomes for MNCH and NCD patients.
  • Applying implementation science approaches to optimize service delivery and policy alignment. 

3. Measuring the Impact on Health & System Outcomes 

  • Assessing timeliness of services, access to primary and referral care, cost savings, and quality of consultations.
  • Evaluating the economic and operational feasibility of the facilitated telemedicine model for national scale-up.
  • Informing policy and financing strategies to sustain telemedicine integration into Indonesia’s national health insurance system. 

Collaborating Institutions 

This initiative is a collaborative effort involving: 

  • Center for Global Digital Health Innovation at the Johns Hopkins Bloomberg School of Public Health (JHSPH) Center for Global Digital Health Innovation – Research leadership and impact evaluation.
  • BPJS Kesehatan – Indonesia’s national health insurance agency overseeing digital health integration.
  • SMERU Research Institute – Implementation research and local expertise.
  • Gates Foundation- Funder 

JHU Research Team 

Smisha Agarwal, PHD, MPH ’09, MBA, Associate Professor (Principal Investigator) 

Dustin Gibson, PhD ’14, MSAssociate Research Professor (Principal Investigator) 

Ligia Paina, PhD ’14, MHS ’08, Assistant Professor  

Marlene Joannie Bewa, PhD, MD, Assistant Scientist and Project Lead 

Lena Kan, MSPH ’21, Research Associate II