General Overview On Legal Aspects Of Telemedicine Service Business In Indonesia During COVID-19 Pandemic
Telemedicine business service has been rapidly growing in Indonesia, especially during COVID-19 pandemic. Despite the growth of this industry, many have debated on the ethicality and accuracy of rendering complete medical diagnosis through remote consultation without direct physical examination.
In that concern, the Indonesian Medical Council/ Konsil Kedokteran Indonesia ("KKI") and the Minister of Health ("MoH") have issued a set of guidelines on the implementation of telemedicine during COVID-19 pandemic. Such initiative is a positive move considering the high demand for telemedicine/ remote health services, especially during the second wave of COVID-19 in mid-2021, in which many patients with mild symptoms were encouraged to do self-isolation and utilize telemedicine services.
Legal Framework: In writing this article, we refer to the following prevailing laws and regulations:
- MoH Regulation No. 20 of 2019 on the Implementation of Telemedicine Services by Health Service Facilities ("MoH Regulation 20/2019");
- MoH Decree No. HK.01.07/MENKES/4829/2021 on Guideline on Telemedicine Healthcare Services During COVID-19 Pandemic ("MoH Decree 4829/2021"); and
- KKI Regulation No. 74 of 2020 on Authorized Clinical and Medical Treatments Through Telemedicine during COVID-19 Pandemic ("KKI Regulation 74/2020").
Note: MoH Decree 4829/2021 revokes MoH Circular Letter No. HK.02.01/MENKES/303/2020 on Implementation of Healthcare Services Through Utilization of Information and Communication Technology to Prevent the Spread of COVID-19.
Telemedicine Services by Healthcare Facilities: Chapter II (A) of MoH Decree 4829/2021 stipulates that the following healthcare facilities may provide telemedicine services during the pandemic: (i) Hospitals; (ii) Public Healthcare Centers (Puskesmas); (iii) Clinics; (iv) the independent practice facilities of general practitioners, and dentists, also medical and/or dental specialists; (v) Medical Laboratories; and (vi) Pharmacies (together referred to as "Healthcare Facilities")
Scope of Telemedicine Services: Healthcare Facilities may provide telemedicine services through online platforms or electronic systems to establish effective communication between the medical professionals (i.e., doctors) and the patients. Such telemedicine services can be done online through text, voice, and/or video conference to ensure accurate diagnoses and treatments to the patients.
Healthcare Facilities can provide telemedicine services through their own online platforms, or, in cooperation with privately-owned electronic system providers (e.g., Alodokter, Halodoc, etc.), or using the platforms provided by the government (e.g., Temenin as provided by MoH)
Requirements for Telemedicine Service Providers: Below are the requirements to be fulfilled by healthcare facilities as the legal providers of telemedicine services:
- They are competent operators (i.e., the general practitioners and/or dentists, specialists and sub-specialists, and other related medical workers have sufficient expertise in operating the Information and Technology (IT) systems);
- They have sufficient facilities and infrastructure to provide telemedicine services; and
- They utilize legal telemedicine platforms provided by MoH, or, if developed independently, registered to MoH.
Requirements for Medical Personnel of Telemedicine Services: It is important to note that all medical doctors and dentists of telemedicine services have to previously obtain: (a) Registration Letter/ Surat Tanda Registrasi; and (b) Practice Permit/ Surat Izin Praktik issued by the relevant healthcare authorities. (Art. 2 of MoH Regulation 20/2019 jo. Art. 3 (4) of KKI Regulation 74/2020).
Telemedicine for Self-isolating COVID-19 Patients: Pursuant to MoH Decree 4829/2021, telemedicine services for self-isolating patients include, among others;
- Daily monitoring of the patient's (i) vital indicators (i.e., temperature, blood pressure, oxygen saturation); and (ii) pre-existing condition treatment (if he/she has been diagnosed with any pre-existing conditions/ comorbidities), at least, twice a day through texts and video calls;
- Providing COVID-19 education to patients, communities, and families;
- Providing the electronic prescriptions of drugs, if necessary; and
- Providing the referral letters and coordination in cases of worsening conditions.
In addition, telemedicine services can be provided to COVID-19 patients in centralized public isolation facilities organized by the central government, regional governments, or private institutions if the public facilities have no sufficient healthcare resources.
The article above was prepared by Marshall S. Situmorang (Partner), Audria Putri (Senior Associate), and Aniendita Rahmawati (Associate).