Indonesia to improve telehealth services as patients struggle during home isolation


File picture of Health Minister Budi Gunadi Sadikin inspects the vaccination programme hosted by the Alumni Menteng 64 (AM64), a group of Kolese Kanisius Catholic high school alumni, in Jakarta on March 9, 2021. - Courtesy of Alumni Menteng 64

JAKARTA (The Jakarta Post/Asia News Network): While the government works to improve online treatment services for self-isolating Covid-19 patients amid the ongoing third wave of the pandemic, reports continue to surface about complications in the use of telehealth apps.

Ria, a 27-year-old private company employee, went into self-isolation in a kost (rooming house) in South Jakarta early this month after she tested positive for Covid-19. She believes she had a mild case, experiencing a fever, headaches, muscle aches and chills.

“I chose to self-quarantine because I thought the symptoms were light and I did not want to put people at risk by having them drive me to a hospital,” Ria said.

The next day, she received a WhatsApp message from the Health Ministry saying that she was eligible for free virtual consultations and medication. She immediately consulted with a doctor on a telehealth app, who confirmed her mild case and prescribed the antiviral medicine Favipiravir, as well as paracetamol and multivitamins.

“The medication arrived only a day after I uploaded the prescription, but not all of them matched with what the doctor had prescribed," she said.

"So, I was worried about whether it was safe to take them or not." She said she still had to buy up to Rp 900,000 (US$62) worth of drugs out of pocket that included additional multivitamins, nasal spray to reduce flu-like symptoms and medication for indigestion.

Still, she found the service helpful enough for a patient with mild symptoms like her.

“I didn't have to go to a hospital, [...] so the service was still quite practical,” Ria said.

Under the programme, people aged 18 and above who have tested positive for Covid-19 and are showing mild or no symptoms are eligible for free virtual consultations and medication during home isolation.

However, they must have taken either a polymerase chain reaction (PCR) or antigen test at a registered health facility in certain cities in Java and Bali. They will then receive a WhatsApp notification or can check their eligibility on the Health Ministry’s at-home treatment website isoman.kemenkes.go.id before scheduling an appointment via 17 popular telehealth apps.

Patients must upload a copy of their prescription onto the website to have their medication sent to them via courier.

Asymptomatic patients will get multivitamins, while mild cases will receive paracetamol, multivitamins and either Favipiravir or antiviral medicine Molnupiravir.

The ministry is now also expanding the programme to other cities outside of Java and Bali: Medan in North Sumatra, Palembang in South Sumatra, Balikpapan in North Kalimantan, Banjarmasin in South Kalimantan, Manado in North Sulawesi and Makassar in South Sulawesi.

In South Tangerang, Banten, on the outskirts of Jakarta, 30-year-old Anry Susetya had recovered from Covid-19 earlier this month before his free medication even arrived.

Anry tested positive in late January and went into home isolation at his parents' house. The parents and his two siblings at the time temporarily moved to his grandmother's house to avoid catching the virus.

He received a notification the next day telling him that he was eligible for the programme. He consulted with a doctor via a telemedicine app for multivitamins for asymptomatic patients, a prescription for which he uploaded to the ministry's website.

The medication arrived eight days later and two days after that, he was fully recovered.

Anry fought the infection with multivitamins and decongestants he had bought himself. A package tracker showed that his delivery was rescheduled several times by the courier.

“Maybe there was a lot of demand for free telemedicine [services] at the time. I didn't expect [to rely on free medication], but I still had to wait that long," he said.

In Bali, 25-year-old Mayang Devi Kamaswari wondered why her sick husband in home isolation was not eligible for the programme, even though he had taken a PCR test at a registered hospital on Feb 9.

She entered his citizenship identity number (NIK) on the website to check his eligibility, only to find that he was not even registered in the system.

“I contacted a customer service representative who promised to follow up on the matter. But I haven’t heard back from them,” Mayang said.

Setiaji, the ministry’s digital transformation office head, said that the ministry would enlist more pharmacies to cut courier delivery times.

According to the ministry, from Jan 17 to Feb 14, some 364,000 people out of nearly 392,000 who had tested positive for Covid-19 in Java and Bali were eligible for the programme.

About 129,100 people used the service and received free medication, most for treating mild symptoms.

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Indonesia , covid-19 , telehealth , isolation

   

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