Implementing Google Health in Indonesia

This article in Bahasa Indonesia/Lihat artikel ini dalam Bahasa Indonesia

Released in 2006, the idea of Google Health (can be accessed in https://www.google.com/health) was to store and manage health information in more practical format. This Google application is free. And we only need to have a Google account to utilize this application. This application is actually another form of personal online health records.

Apart from the privacy and security issue, how is the possibility to implement Google Health application in Indonesia? The first question is ARE WE READY?

Google is a corporation which headquarter is located in US, a country with a "well-organized" health system. One of Google Health application feature was health records importing facilities (from Google Health partners, of which none is located in Indonesia). That's one of the issue.

If the user entry their health information regularly and correctly, this application would help the user (and the doctor, if needed, or other people the user wants to share the information with, for example spouse, parents, etc.) to monitor user's medical history easily.

The application also enables user to know if there's a possibility of drug interaction between the drugs they are taking, going to take, or have already taken. Some complain about the interaction notification. Still about the same topic -medication-, there are two ways to fill the medication form, entering manually and using medication registered in Google Health database (those are drugs sold in US). Drug interaction analysis can not be performed if we enter drug's brand name manually. Otherwise we can enter the drug's compositions.

One thing I really want to emphasize (as I've mentioned above) is that Google Health does not function as clinical guidance or reference. Google Health is more to store and manage our health information so it will be easier for user to access their health information at any place and any time.

Google Health application features can be optimally utilized if the health system in the country is well established and the inhabitants of the country are already aware and well educated about their health, medical records and their rights as a resident related to health and medical records. The health system comprises of family physician system, health insurance system, and health information system.

Health information system includes drugs dispensed by patients records in pharmacy, medical records in clinic, hospital, Puskesmas (primary health care) etc. Google Health affiliates non commercially with some health care facilities like clinics, pharmacies and e-Health providers in US (such as Cleveland Clinic, CVS Caremark, Wallgreen, etc) in order to facilitate the user to import their health data. Recently, this feature can not be user optimally for Indonesian patients yet, since health information system in Indonesia is still in development stage.

Medical Records Regulation in Indonesia Peraturan Menteri Kesehatan (Health Minister Regulation) no. 269 tahun 2008 states that medical records is patient's property and is confidential. Medical records might be useful for its owner legally, medically, and can be used for other purposes. The confidentiality of medical record is not absolute which means that it can be revealed for legal purposes, science or educational purposes, or other purposes by request or permission of the owner. The patient as the owner also has the right to have the copy, but apparently this right is rarely known and used by Indonesian residents.

I've added few links related to online health records and Google Health :

1. Akhirnya Datang Juga: Google Health
http://anisfuad.wordpress.com/2008/05/21/akhirnya-datang-juga-google-health/

2. Google Health About
http://www.google.com/intl/en-US/health/about/index.html

3. Google Health - How to implement it in Singapore (or other countries) http://bleongcw.typepad.com/simple_is_the_reason_of_m/2008/05/google-health.html

4. Mencoba Google Health, Rekam Medis Elektronik
http://daniiswara.net/2008/05/21/mencoba-google-health-rekam-medis-elektronik/

5. Feature Baru Google Health
http://www.chip.co.id/internet-networking/feature-baru-google-health.html

6. Online Health Records: What's the Big Deal?
http://www.accessmyhealth.org/documents/How%20safe%20are%20my%20records.pdf

7. Americans Overwhelmingly Believe Electronic Personal Health Records Improve their Health
http://www.connectingforhealth.org/resources/ResearchBrief-200806.pdf

Overview of HealthMapper

HealthMapper is a mapping application developed by WHO. And I was quite lucky for having the opportuniy to learn HealthMapper directly from WHO SEARO trainer, couple weeks ago in the Ministry of Health, Jakarta. I underwent training for trainer sessions and then together with three other facilitators from UI, WHO and Binkesmas practised facilitating almost 50 participants from WHO, Ministry of Health and Province Health Office staffs from 12 provinces.

What is so special about this mapping application?
This application is a freeware (means : you may download this application freely, but may not modify the application). Unlike ArcView, though in some cases using ArcView gives more advantages, and in other cases HealthMapper does give the advantages.

Another advantage of HealthMapper is that it is "user-friendly". (Why I gave quotation marks on user-friendly phrase? You'll see in the next section of this post). This application is easy to use. The user can simply create a map, overlay indicators and import points, lines, or polygons.

HealthMapper also contains in-built data. Unfortunately the data used for the previous training were still from year 2000 data in WHO Head Quarter.

Something ain't cool about HealthMapper?
I think there are some...despite its advantages. It takes extra efforts to update data from a computer to another since HealthMapper is a stand-alone application. This is crucial since GIS for health and decision making lean heavily on data.

Based on my opinion, HealthMapper is developed for data representation, data analysis more than for the data preparation, data building etc. Because the steps it takes to build and prepare data (either in map or tabular form) are quite time consuming and not very user friendly.

The steps are okay for those who are familiar with computers (eg. the facilitators) but not for many of the participants (who fall into 3 subgroups : mapping application literate, computer literate and computer semi illiterate). And these subgroups are definitely represent the pattern of GIS application users (and future users) in Indonesia. So I consider... the user-friendliness of this application is relative.

Want a bite of HealthMapper?
Either download here or download the tutorials here.