By Rose Onilongo and Nurfilzah Rohaidi – University of Pembangunan Nasional Veteran in Jakarta is a private university built in 1958 by independence war veterans. Dr A Heri Iswanto, Deputy Dean of Student Affairs and Cooperation at the Faculty of Health Science, discusses how hospitals can tackle the administrative challenges surrounding universal health coverage; why he thinks lean management is valuable for hospitals anywhere in the world; and the potential of RFID to transform hospital management.
What are the major challenges that hospitals are facing in Asia Pacific?
A major challenge faced by hospitals in Asia Pacific nowadays is implementing Universal Health Coverage (UHC) programmes. Various countries in Asia Pacific have begun to implement UHC but are facing enormous administrative challenges, both for hospitals and for government.
In places such as China and Vietnam, hospitals are experiencing communication problems with the government. Whereas in Indonesia and Philippines, there is a large number of informal markets, which makes it difficult to collect data and withdraw fees. This also in turn will affect hospitals since they must try to finance patients while waiting for payments from the government.
What can be done to address these challenges, and improve patient outcomes?
Countries in Asia Pacific need to strengthen capacity, both administrative capacity and capacity in providing services to patients with various complaints. This will require cooperation among stakeholders, including between the government, hospitals and supply chain components.
It is also very important to improve the quality of human resources. Many hospitals are not ready to provide excellent services because of the low quality of human resources. This means not only improving on health technical skills, but also on customer service aspects.
With the high interest of the community in UHC, people from various social demographics can emerge and create communication challenges for healthcare workers. Here, the community needs to be trained in basic knowledge and skills support in dealing with diseases.
This measure will prevent a large administrative burden on the hospital side, which in turn will allow hospitals to handle fewer patients and can focus on patients with urgent needs.
Is there a tool or technique that particularly interests you?
I am very interested in Radio Frequency Identification (RFID) for effective and efficient medical records and patient tracking solutions. The use of RFID and its support system will significantly reduce the administrative burden on hospitals.
I am sure RFID technology will become the next big thing in health services in the future. Its use has proven successful in manufacturing, corporate, and retail settings. This system requires a fairly large scale if applied in a hospital.
In line with this, costs will be a big problem. As the technology develops, we hope that this will also mean reduction in cost. RFID, combined with lean-based quality improvement methods, will be able to create a smart hospital that is truly efficient and hence provide optimal outcomes for patients.
I have also been quite successful in implementing lean in hospital management, and hope that many hospitals follow suit by becoming lean hospitals. Lean techniques can improve hospital efficiency since it focuses on reducing unnecessary waste.
This is especially important in hospitals in Indonesia, where the number of patients continues to grow due to high health awareness, while the capacity of existing hospitals is still very limited.
Which hospital are you most interested to learn from?
With regards to quality improvement, I am very interested in the experiences of the Hospital District of Helsinki and Uusimaa (HUS). HUS is a large hospital complex consisting of 22 hospitals, and sees 500,000 patients per year.
Despite its large size, HUS is able to implement lean well and deliver extraordinary results. This dismisses the previous assumption that lean cannot be applied in a large hospital environment, let alone a hospital complex.
RFID technology is still in its infancy; however, it has great potential to improve hospital efficiency.
I also look to hospitals that are successful in implementing RFID in providing excellent patient services. RFID technology is still in its infancy; however, it has great potential to improve hospital efficiency, especially now as we undergo the 4.0 industrial revolution.
What is one thing that you hope to achieve this year?
This year, I am trying to implement lean techniques more broadly than before. So far, I have succeeded in implementing lean in quality management in several parts of the hospital. I also hope to apply it to the management of the hospital’s medical inventory. Other parts of the hospital that have not implemented lean will slowly be transformed. At its peak, I will implement lean at the hospital level.