Sehat IndonesiaKu (ASIK) – Digitisation of Individual Health Data Record in Primary Care

Launched in May 2022, Sehat IndonesiaKu (ASIK) is the first app for healthcare workers to record outdoor service at Public Health Centers (Puskesmas). It was initially developed to support National Child Immunisation Month (BIAN) and has expanded to record routine immunization, early detection of non-communicable diseases (NCDs) and Posyandu data. In 2023, over 10,000 Puskesmas (98.5%) used the app, successfully integrating the recording system from regional to national levels.

Innovation Summary

Innovation Overview

Before ASIK, healthcare workers record individual health data manually. There was no detailed information by name by the address of children who received the immunization, making it difficult for them to monitor the success of the program and to follow up on children who have not been immunized. Another risk is related to records lost/damaged.

After ASIK was launched, health workers easily and quickly recorded individual health data (by name by address). Makes it easier for them to monitor individual health history and carry out necessary follow-up. Because the data is recorded and stored digitally, people do not need to worry about health records being lost/damaged anymore.

Currently, ASIK is available for Android and iOS users, and is equipped with features for recording routine immunization programs and Posyandu for babies and toddlers to accelerate stunting prevention programs, apart from the immunization and early detection of non-communicable diseases (NCDs) which were previously released.

ASIK has also been integrated with the WhatsApp chatbot feature for recording Posyandu data, which displays measurement results and education directly to each parent’s cell phone regarding the child's growth and development status.

More than 10,000 Puskesmas (98.5%) have used ASIK to record data of immunization, early detection of NCDs, and Posyandu. This is a result of various efforts from MoH Indonesia that continuously encourages health workers to use ASIK, including through socialization, training, and mentoring.

MoH Indonesia also did participatory action research in South Central Timor (NTT) and Lubuklinggau (South Sumatera). This was done to gain a deeper understanding of any obstacles as well as identify factors that can be implemented as best practices in stunting prevention. Including ASIK utilization by health workers and cadres to record and monitor children’s growth and development in each respective area.

As of December 2023, more than 31 million immunization data, 75 million data on early detection of NCDs, and 25 million data on Posyandu have been recorded in ASIK. Further, citizens can also access and download their routine immunization history certificates via SATUSEHAT Mobile.

In the future, ASIK will continue to be developed until its records can cover all services outside the Puskesmas building.

Innovation Description

What Makes Your Project Innovative?

ASIK transformed the data recording process from paper to digital by:
1) Digitising individual health data records from manual to digital
2) The simplified recording process for healthcare workers, increasing efficiency.
3) Standardized health data for integration with ASIK and SATUSEHAT Platform.
4) Facilitated monitoring of individual health data, enabling timely interventions.
5) Supported data-based policymaking by aggregating and displaying data on the SATUSEHAT Dashboard for stakeholders.

What is the current status of your innovation?

ASIK is a solution for recording individual health data which was previously paper-based and done manually, has now changed to digital, where input is done via a website/application by recording individual health data by name by address. ASIK is integrated with the SATUSEHAT Platform and the input data can be accessed almost in real-time by stakeholders via dashboards to support data-based policy making.

ASIK also has a WhatsApp chatbot feature which was developed based on the concept of community-based surveillance by encouraging community participation (health cadres), to participate in improving community health efforts through digital recording of posyandu activities and visits to residents' homes.

ASIK has recorded more than 133 million individual service recipients and succeeded in recording 399 million immunization data, PTM screening, and weighing data for babies and toddlers.

Innovation Development

Collaborations & Partnerships

The development of Sehat IndonesiaKu is a result of collaboration of Pusdatin-DTO with the General Directorate of Immunisation, Directorate of Nutrition and Maternal and Child Health, and Directorate of Prevention and Control of Non-Communicable Diseases, also with support from UNICEF.

Users, Stakeholders & Beneficiaries

ASIK enhances health service record-keeping efficiency, reducing errors and minimising tasks. It monitors real-time health programs, providing data on immunisation, NCD screening, and child growth. The app facilitates in-depth analysis, aiding early disease detection and growth tracking. ASIK informs government decision-making for effective health policies. Stakeholders access program achievements at the village level through the ASIK dashboard.

Innovation Reflections

Results, Outcomes & Impacts

ASIK has achieved significant engagement, involving over 10,000 (98.5%) Puskesmas across Indonesia within a span of 7 months since its launch. This indicates that Puskesmas has been informed about the data input process and user guide updates that come with it, although adherence to input data remains a challenge. The high number of ASIK utilisation might be supported by several aspects, such as the compatibility of the Android application in Indonesia, the friendliness of the system interface, and the ease of use.

Challenges and Failures

Implementing ASIK in Indonesia faces challenges such as underdeveloped digital infrastructure in remote areas, with 745 out of 10,378 Puskesmas lacking internet access. The transition from manual to digital processes requires time and ongoing socialisation and training for healthcare workers. Limited resources hinder near-real-time data recording in ASIK at Puskesmas, and the app's dependence on detailed data poses challenges when individuals lack ID numbers during implementation.

Conditions for Success

To optimise ASIK's functionality, a robust infrastructure, including high-speed internet, is crucial for seamless data connectivity. Human resources, especially health workers, require training and capacity building to effectively utilise ASIK, enhancing healthcare services. Visionary leadership, exemplified by the Minister of Health, recognizes the pivotal role of data and technology, emphasising the need for digital leadership in guiding ASIK's integration and evolution in the healthcare ecosystem.

Replication

ASIK has not been replicated, but has great potential for adoption by other Ministries/Agencies in Indonesia and abroad because it prioritises digital recording per individual. Countries that have challenges with complete data for health across the life cycle can adopt the implementation of ASIK.

Lessons Learned

Despite the initial challenges faced during the launch of ASIK, the electronic immunization registry for Indonesia, subsequent phases of the BIAN 2022 campaign have shown improvements in data quality and performance. Addressing these challenges and ensuring adequate support for healthcare workers are essential steps in enhancing the effectiveness of electronic immunization registries in improving public health outcomes. Ease of use or user-friendly applications that simplify data input processes are essential to reinforce user acceptability.

Anything Else?

In the future, ASIK can be developed for a wider immunization program, provided that improvement features are carried out, including the preparation of the relevant human resources, supporting digital infrastructure, and strong regulatory support.