EDABU: An online application for self-managed data A case of the Social Security Administering Body for the Health Sector

Transcription

1 Good Practices in Social Security Good practice in operation since: 2015 EDABU: An online application for self-managed data A case of the Social Security Administering Body for the Health Sector Special mention, ISSA Good Practice Award - Asia and Pacific competition 2015 Social Security Administering Body for the Health Sector Indonesia Published

2 1 Summary BPJS Kesehatan (Badan Penyelenggara Jaminan Sosial Kesehatan) is a public agency established to implement the social security programme. The ultimate vision of BPJS Kesehatan is "Universal Health Coverage"; to provide all participants with health care benefits and protection to meet the basic needs of health care. As Indonesia is fourth most populous country in the world there are a large number of participants, so BPJS Kesehatan is facing constraints in the participants' registration process. One of the biggest challenges is to manage the registration process of participants from the formal sector; either it is complicated or wastes a lot of time. Knowing this problem, BPJS Kesehatan hired a special technology in the form of a web based application to counter this barrier. EDABU is an online application for self-managed data for formal sector participants. It is being formed to make sure the formal sector participants can update and change their employees' data in real-time. By implementing EDABU, BPJS Kesehatan has minimized potential losses and mitigated any kind of risks in this field. CRITERIA 1 What was the issue/problem/challenge addressed by your good practice? Since all residents of Indonesia should become participants of the national health insurance managed by BPJS Kesehatan, BPJS Kesehatan is creating a Road Map in order to achieve its vision "Universal Health Coverage" for all the people in Indonesia. By 1 st January 2014, BPJS Kesehatan had started its operations. The existing insurance progammes automatically became part of the insurance of BPJS Kesehatan (civil servants, police army, formal sector of the Jamsostek programme, subsidized members). Small, medium, and large companies and state-owned enterprises had to register their employees, including the family members, by the deadline of 1 st January Micro-enterprises should register their employees and the family members, by the deadline of 1st January And by the end of December 2018 or latest 1 st January 2019, all Indonesian citizens should be members of BPJS Kesehatan. Participants in the formal sector, especially from enterprises all of whose employees need to be registered as a member of BPJS Kesehatan, have identified that the procedure and registration process are either frustrating or really time-consuming. On the other hand, considering the large number of participants that need to be registered, officers of BPJS Kesehatan could not work alone on this matter. Participation from the enterprises themselves to help their own employees get the service and update the changes to the employee data would be in realtime and is what is really needed. While the understanding of participants is lower than ever, there are so many mandatory fields to be filled in on the registration form that it is complicated for them, so BPJS Kesehatan is providing the application based on ICT to reduce the problems being faced in this

3 2 operational activity. This ICT based application is called as EDABU (Elektronik Data Badan Usaha - Electronic Enterpises Data). CRITERIA 2 What were the main objectives and the expected outcomes? Realtime in registering and updating participants' data: The main objective of this breakthrough step is to achieve a comprehensive operational system of information access for formal sector participants to register and update their employees' data more in realtime. Educating participants about the programme: Moreover, through EDABU, BPJS Kesehatan is trying to educate people about the procedure and their understanding of this programme itself. As one of the biggest participants in contributing premium payments, enterprises are expected to be well-informed about the programme so that it stimulates them to know their rights as well as their obligations in paying premiums. To reduce participants' visits to branch offices: Simultaneously with the second point, by making sure all the participants know about the programme, it may help reduce participants' visits to BPJS Kesehatan branch offices and could help them save money and time. Optimizing human resources abilities: The number of participants of BPJS Kesehatan is immense. Up to August 2015, the number of BPJS Kesehatan participants is not less than 130 million people. This number is still counting and growing from day to day. So that with EDABU, one of the problems can be solved. Escalating participants' participation in the formal sector: EDABU has been created to catalyze participants in the formal sector. Increasing the number of participants from the formal sector is very important as their total premiums are required to sustain the entire programme. Stimulating a good relationship between BPJS Kesehatan and public: By providing a user-friendly application, the relationship between BPJS Kesehatan, as an executant, and the public as participants, is anticipated to be more intimately constructive and productive. Furthermore, a good relationship between the two parties could create a mutualunderstanding to achieve what is expected from this programme.

4 3 CRITERIA 3 What is the innovative approach/strategy followed to achieve the objectives? BPJS Kesehatan is really concerned about the easiest way to serve participants in getting the best health benefit. It therefore created EDABU (an online application) to accommodate participants' (formal sector) needs in updating their employees' data in a quick and simple way with less human intervention. EDABU is the most excellent way to solve the problem in membership matters. Enterprises will get the username and password of EDABU once they have registered themselves with BPJS Kesehatan. CRITERIA 4 Have the resources and inputs been used in an optimal way to achieve the set objectives and the expected outcomes? Please specify what internal or external evaluations of the practice have taken place and what impact/results have been identified/achieved so far. To see how effective EDABU is, the comparison table below differentiates between participants managing data manually (without EDABU) and by the EDABU system. No Point of Interest Manual EDABU 1 Requirements All the paper based documents The documents needed can (i.e: identity card, tax card, etc.) be completed via the site (paperless). 2 Period of time Consuming hours of time or even days. 3 Data privacy Paper based - minimum data secrecy. 4 Validation of data Risk of human error cannot be mitigated. 5 The need for resources Needs a lot of human resources and big efforts. 6 Cost efficiency Costly because it should be solved in office directly. Compatible, can be accessed anytime, quick, simple, and realtime. Data in the system can only be managed by an interested party - data secrecy is high. Automatic warning system identifies inappropriate data. Accuracy is optimized. Minimizes human interventions and data effortlessly wellmanaged by utilizing the system. Less money being spent because participants can do the process via internet - free of charge

5 4 and compatible to be accessed anywhere. Table 1 Comparison Manual vs EDABU Up to 17 th August 2015, about 163,972 enterprises had recorded their employees' data by utilizing EDABU; or equal to 21,768,879 peoples' data being recorded in the EDABU system. It is a great improvement, both in increasing level of participants' participations, as well as, in implementing ICT advancement. In only less than 2 years, EDABU could help a large number of participants to join the BPJS Kesehatan programme. CRITERIA 5 What lessons have been learned? To what extent would your good practice be appropriate for replication by other social security institutions? The use of ICT in social security administration is a key development in terms of time and money saved and service quality. ICT nowadays becomes more important in social life. By implementing EDABU, BPJS Kesehatan tries to use ICT advancement in giving participants, especially in the formal sector, the best services. Implementing this practice has minimized potential losses and increased the number of participants over time. EDABU has proved that a huge number of participants can be handled very well by its system. With this easy way, it is predicted that another large number of participants can be stimulated to come and join the programme run by BPJS Kesehatan. EDABU helps enterprises to manage their employees' data, and at the same time helps BPJS Kesehatan to achieve its "Universal Health Coverage" vision. Furthermore, by using EDABU, enterprises as participants in the process have been involved in directly managing their data. In addition, the involvement of participants themselves could help them to understand more about the programme.