TELEFARMASI Menjangkau Negeri.

Pemanfaatan Telefarmasi di Masa Pandemi

Seminar Nasional Online

PC IAI kab Kapuas
26.09.2021

Apt. Stefanus Nofa, S.Si

Founder GWS Care & Pharmamed Bot
Founder Perhimpunan Informatika
Farmasi Indonesia

Hak Cipta @ Stefanus Nofa

Hak cipta dilindungi Undang-Undang. Dilarang menerjemahkan, mencetak ulang, memperbanyak, ataumenggunakan sebagian atau seluruh isi buku ini dalam
bentuk apapun, baik secara elektronik, mekanik atau cara lainnya, yang saat ini diketahui atau nanti ditemukan, termasuk menggandakan dan mencatat, atau
menyimpan dalam sistem penyimpanan dan penyediaan informasi, tanpa izin tertulis dari penulis
Sanksi Pelanggaran Pasal 113: Undang-Undang Nomor 28 Tahun 2014 tentang Hak Cipta
 OUTLINE
1. Background
2. Definition
3. Telepharmacy Services & Pharmaceutical Care
Regulations
4. Telepharmacy
5. Telemedicine & Telepharmacy Implementation in
Indonesia Challenges and Opportunities
6. Take Home Massage
Background
Background
Background
Background
Telemedicine (WHO)
Distance is an important factor in telemedicine
services. There are four main elements related to
telemedicine, namely:
1. Telemedicine aims to provide clinical support
2. Telemedicine aims to overcome geographic
barriers, by connecting users who are not in the
same physical location
3. Telemedicine involves the use of various types of
Information and Communication Technology
(ICT)
4. Telemedicine aims to improve health outcomes
 Definition of Telemedicine
(Permenkes No. 20 Tahun 2019)

Telemedisin is the
provision of health services remotely by
health professionals using information
and communication technology,
including the exchange of diagnosis,
treatment, information on disease and
injury prevention, research and evaluation,
and continuing education of health
service providers for the benefit of
improving individual and community
health. (Article 1 no 1)

Telemedicine services are carried out by health workers who have a Practice
License at the provider's Health Service Facility (Fasyankes). (Article 2)
TELEHEALTH - TELEMEDICINE - TELEPHARMACY
WORK

Penggunaan teknologi yang lebih luas

pada pelayanan kesehatan (misal:
kesehatan masyarakat, pendidikan medis,
layanan non- klinis)

Pelayanan medis jarak jauh (misal: konsultasi

dokter online, kunjungan virtual)

Pelayanan kefarmasian jarak jauh

(misal: MTM/medication therapy
management, konsultasi online)
Telemedicine Level Adoption – HIMSS 2015
eHealth in Indonesia
 PEMANFAATAN TEKNOLOGI INFORMASI
Sebagai Upaya Peningkatan Akses Pelayanan Kesehatan

PENINGKATAN
AKSES
Terwujudnya Akses
• SARANA PENINGKATAN
Pelayanan
• PRASARANA MUTU
• ALAT KESEHATAN • AKREDITASI
SUMBER DAYA Kesehatan Dasar
FARMASI PKM
KESEHATAN dan Rujukan yang
• SISTEM • AKREDITASI RS berkualitas Bagi
RUJUKAN Masyarakat
• PEMANFAATAN
TEKNOLOGI
INFORMASI
Optimalisasi penggunaan Teknologi Informasi
untuk memperluas dan mempermudah akses
masyarakat terhadap pelayanan Kesehatan

PENGUATAN PELAYANAN KESEHATAN

 Telepharmacy Services
&
Pharmaceutical Care Regulations
 Telepharmacy Services

Telepharmacy
is a form of pharmaceutical service where the pharmacist and patient
are not in the same location but can interact using information and
communication technology facilities.

At first telepharmacy developed in the 1940s in Australia.

Telepharmaceuticals were then used again in 2006 in the North Dakota
region, United States.

Telepharmacy is also applied to provide pharmaceutical services to

patients in the form of consultation and drug information, patient
counseling, monitoring drug therapy, and monitoring drug side
effects by utilizing telecommunications technology.
 4 Types of Telepharmacy

Telepharmaceutical services can be divided into 4 types, namely:

1. Traditional-full service which is direct pharmaceutical service by

pharmacists,
2. Remote consultation services are pharmaceutical services carried
out to reach remote areas
3. Hospital telepharmacy is a telepharmaceutical service that is carried
out in hospitals in monitoring and evaluating treatment with video calls
(video calls), and
4. Automated dispensing machine, which is a pharmaceutical service
in the form of an electronic prescription examination, then dispensing
drugs (dispensing) by a machine, and ending with patient counseling via
voice or video calls.
 Telepharmacy Opportunities & Threats

Opportunity Theats
Time and cost efficiency Legal Aspect
Expanding the range of Cyber crime (e.g. data misuse)
services
Flexibility in service Operational error (network,
device)
The scope of the pharmacy Error, Misuse, and Abuse of
area becomes wider Medication
 Benefits of Information Technology in
Pharmaceutical Care

Menyediakan informasi
yang cepat dan akurat
Memperbaiki
automatisasi
alur kerja

Meningkatkan
kolaborasi antar tenaga
kesehatan

Menjamin pemberian Mengurangi human error

obat “5R” (tepat: pada titik-titik pelayanan
pasien, obat, dosis, melalui Clinical Decision
rute, waktu) Support (alerts, guidelines)
 Examples of Information Technology
Implementation in Pharmaceutical Care

Electronic prescribing
CDDS (Clinical Decision
/CPOE
Support System) : Alert
(Computerized Physician Pelayanan berbasis
system, guidelines
Order Entry) barcode

Pharmacy Automated Dispensing

Information Cabinet (terintegrasi
System (PIS) dengan PIS)
 Telepharmacy Type –
Automated Dispensing Machine (ADM)
HOW ARE THE REGULATIONS?
Digital Health Regulations in Indonesia
Digital Health Regulations in Indonesia

The concept of Telemedicine Services (MoH, 2020)

Digital Health Regulations in Indonesia

Doctor’s authority in Telemedicine Services (MoH, 2020)

Digital Ecosystem of Health Services

Digital Ecosystem of Health Services (MoH, 2020)

Pharmaceutical Services
(Government Regulation No. 51 of 2009
concerning Pharmaceutical Work)

Pharmaceutical service is a direct and

responsible service to patients related to
pharmaceutical preparations with the aim of
achieving definite results to improve the
quality of life of patients
(article 1 paragraph 4).
 Pharmaceutical Community Care Regulation
1. Pharmaceutical Service Standards in Pharmacies (Permenkes No. 73 of 2016)
2. Pharmaceutical Service Standards in Hospitals (Permenkes No. 72 Year 2016)
3. Pharmaceutical Service Standards in Puskesmas (Permenkes No. 74 of 2016)

Minister of Health Regulation 72, 73, 74 /2016 concerning Pharmaceutical Service

Standards in Hospitals, Pharmacies and Health Centers, include the following standards:
1. Management of Pharmaceutical Preparations, Medical Devices, and Consumable
Medical Materials; and

2. Clinical pharmacy services.

• Prescription review;
• dispensing;
• Drug Information Service (PIO);
• counseling;
• Pharmacy services at home (home pharmacy care);
• Drug Therapy Monitoring (PTO); and
• Drug Side Effect Monitoring (MESO);

By a pharmacist
 Peraturan BPOM No. 8 Tahun 2020
Permenkes No. 14 Tahun 2021
tentang Pengawasan Obat dan
tentang Standar PSEF
Makanan yang Diedarkan secara
Daring

Penyelenggara Sistem
Elektronik Farmasi yang Pasal 6
selanjutnya disingkat Penyerahan Obat secara
PSEF adalah badan daring yang dilakukan oleh
hukum yang Apotek dapat menggunakan
sistem elektronik yang
menyediakan, mengelola, dimiliki oleh Apotek dan/Atau
dan/atau yang disediakan oleh PSEF
mengoperasikan sistem
elektronik farmasi untuk
keperluan fasilitas
pelayanan kefarmasian.
 BPOM Regulation No. 8 of 2020 concerning
Control of Drugs and Foods Circulated Online

Pasal 27
Apotek dan/atau PSEF dilarang mengedarkan
secara daring untuk Obat yang termasuk dalam:

a. Obat keras yang termasuk dalam obat-obat

tertentu sesuai dengan ketentuan peraturan
perundang-undangan;
b. Obat yang mengandung prekursor farmasi;
c. Obat untuk disfungsi ereksi;
d. Sediaan injeksi selain insulin untuk
penggunaan sendiri;
e. Sediaan implan yang penggunaannya
memerlukan bantuan tenaga kesehatan; dan
f. Obat yang termasuk dalam golongan
Narkotika dan Psikotropika.
 Overview of Existing Regulations from a
Pharmaceutical Perspective

Permenkes No. 20 Tahun This PMK only regulates services

2019 tentang Pelayanan between health care facilities, not
Telemedicine antar Fasilitas
Pelayanan Kesehatan with patients

This regulation has regulated online

Peraturan BPOM No. 8
circulation, not only for drugs but also
Tahun 2020 tentang
for traditional medicines, health
Pengawasan Obat dan
supplements, and cosmetics.
Makanan yang Diedarkan
but does not cover the overall
secara Daring
pharmaceutical service standards
Rancangan Permenkes
tentang Pelayanan Expectations: Harmonization with
Kefarmasian Secara previous regulations ??
Elektronik
Telepharmacy Amid Pandemic Times
CONDITIONS OF ELECTRONIC AND/OR MEDICAL PRESCRIPTIONS
SE MENKES HK.02.01/MENKES/303/2020
KMK No. HK.01.07-MENKES-4829-2021 ttg Pedoman
Pelayanan Kesehatan Melalui Telemedicine Masa Pandemi
COVID-19
The Guidelines for Telemedicine Services During
the COVID-19 Pandemic as referred to in the FIRST
Dictum are used as a reference for the central
government, regional governments, doctors and
other health workers, health service facilities,
persons in charge of telemedicine applications,
and relevant stakeholders in the delivery of health
services through telemedicine in the time of the
COVID-19 pandemic.

Health services through telemedicine during the

COVID-19 pandemic as referred to in the SECOND
Dictum are remote health services using
information and communication technology for the
provision of health information, diagnosis,
treatment, prevention of deterioration, evaluation
of the patient's health condition, and/or
pharmaceutical services, including for monitoring
of COVID-19 patients who are self-isolating, which
is carried out by doctors and other health workers
at health service facilities in accordance with their
competence and authority while still paying
attention to the quality of service and patient safety.
 Telemedicine/Telepharmacy Implementation
in Indonesia
• Telemedicine has developed quite widely. In hospitals, for
example, the use of telemedicine has been implemented
such as e-prescription and e-dispensing.
• In the community, people who have limited access to health
consultations and treatment have been facilitated by the
presence of various platforms (Apps, Whatsapp Business or
Bot, Social Media)
 LEGAL ASPECT : PHARMACEUTICAL SERVICE
STANDARDS

The implementation of e-prescribing has been carried out by several

health facilities, but facilities or media for pharmacists, both in
conducting counseling, Drug Information Services (PIO), Monitoring
Drug Side Effects (MESO), monitoring drug compliance and patient
therapy developments have not yet been implemented adequately
and carried out individually, partially and not standardized through
telephone, whatsapp and video calls.
 Telepharmacy Implementation in Indonesia
Challenges and Opportunities
Pada masa Pandemi Covid -19 ini, layanan apotek di tanah air menghadapi
berbagai tantangan.
• Diantaranya, tantangan yang harus dihadapi apotek untuk menjalankan
layanan telefarmasi. Tantangan apotek untuk berinovasi menyediakan layanan
telefarmasi masih minim dilakukan. Layanan seperti konseling obat, pengkajian
resep, pelayanan informasi obat, pemantauan terapi obat, serta homecare
farmasi, sebagian besar masih dilakukan secara offline/manual.

• Peningkatan penjualan obat bebas seperti vitamin, suplemen dan bahan medis
habis pakai (masker, hand sanitizer, thermometer, thermo gun, disinfektan)
tidak didukung kelancaran pasokan obat dan alkes tersebut dari distributor
resmi.

• Banyaknya sales-sales tidak resmi (black market) menjual produk obat dan
alkes tersebut secara online, berpengaruh terhadap turunnya omset apotek
yang merupakan salah satu mata rantai jalur resmi penjualan obat dan alkes.
Hal ini tentunya menimbulkan risiko keamanan terhadap konsumen dan harus
dapat diawasi dan dicegah.
 Telepharmacy Implementation in Indonesia
Challenges and Opportunities
Pada masa Pandemi Covid -19 ini, layanan apotek di tanah air menghadapi
berbagai tantangan.

• Badan POM dalam operasi penindakannya selama Maret – September

2020 di 29 provinsi, menemukan barang bukti senilai 46.7 miliar rupiah.
Bahkan, selama masa pandemi, melalui tim cyber patrol yang baru
dibentuk, BPOM menyarankan kepada Kominfo untuk men”takedown”
sebanyak hampir 25 ribu akun tautan penjualan obat yang di klaim
sebagai obat Covid-19.

• Belum adanya regulasi mengatur terkait pelayanan Kefarmasian

oleh Apoteker dan TTK untuk Telefarmasi atau e farmasi.

• Tantangan apotek untuk “memodernkan” diri memang penting untuk

dilakukan. Era pandemi Covid-19 menjadi momentum penting untuk
memulai upaya tersebut
 Opportunities

There is rising effort to implements health solution using

telemedicine / telepharmacy, based on situations in Indonesia.
These efforts can be classified into three categories:

Electronic Health
Record, Electronic
Medical image Physician/Pharmacists
Medical Record,
Personal Medication archiving collaboration solution
Record e Prescribing
 Opportunities

Telemedicine services by the Ministry of Health (MoH, 2020)

 TELEPHARMACY ECOSYSTEM IN INDONESIA

GWS Care + Pharmamed Bot Telepharmacy Application Development Scheme

•Portofolio Perusahaan / Startup Kesehatan /Asosiasi
& organisasi Kesehatan

CYBER PATROL
BPOM
 WhatsApp TeleMedicine – usage patterns and
physicians views on the platform
Edward Barayev, Omri Shental, Dotan Yaari, Elchanan Zloczower, Itai Shemesh, Michael
Shapiro, Elon Glassberg & Racheli Magnezi 
Israel Journal of Health Policy Research  volume 10, Article number: 34 (2021) 


Background
Telemedicine has become an integral part of health care delivery in recent years. One of the leading
applications for this use is WhatsApp — a free smartphone application that allows instant
messaging with pictures and videos. This study analyzed the emerging role of WhatsApp on
reducing the need for referrals to medical specialists and to compare the views of physicians
regarding WhatsApp consultations.

Methods
A cross-sectional study based on an anonymous web-survey was conducted among PCPs and
medical specialists working in the Israel Defense Forces Medical-Corps during September and
October, 2019.

Results
Of 201 participants, 153 were PCPs and 48 were medical specialists. 86.9 % of PCPs and 86.5 % of
specialists used WhatsApp every day in professional settings. Added workload, potential breaching
of patient confidentiality and lack of full documentation of consultations were the main concerns
among physicians using the application. 60.7 % of PCPs and 95.7 % of specialists stated that these
consultations have reduced the need for in-person appointments at least once a week.

Conclusions
In times of COVID-19 that require social distancing, WhatsApp provides a simple, readily available platform
for consultations between healthcare providers, even to the extent of rendering some in-person
appointments unnecessary. Healthcare organizations should address the matters troubling healthcare
providers, mainly patient confidentiality and lack of documentation in patients’ medical records, while
providing adequate compensation for those providing the service during and after work hours.
https://pharmamed.online
 https://pharmamed.online

Asisten Virtual Farmasi & Kesehatan

 Pharmamed ChatBot

PelayanAN Daring Apoteker

melalui WhatsApp (PANDAWA)
PharmaMed Bot dalah SaaS framework chatbot
whatsapp untuk membantu Apotek menjual obat
melalui media whatsapp

• Belanja mudah via Whatsapp tanpa harus tatap muka

• Chat dengan Apoteker untuk tanya obat dan kasus ringan
✔ Live chat apoteker
• Buat janji dengan apoteker untuk konsultasi , informasi
✔ Sambungkan saya
dan edukasi
ke
• Tetap terhubung dengan Apotek dan TTK dimanapun
apoteker/Users/nofa/
dan kapanpun (sesuai jam layanan)
File Papa
Nofa/Pharmamed/Pha
rmamed Demo.mp4✔ Demo / Uji Coba Pharmamed Bot ?
Saya mau bicara
dengan apoteker Klik https://wa.me/+6288290703107
✔ Konsultasi dengan
apoteker Info lanjut / Daftar :
https://pharmamed.online/dashboard/reg.php
 Mobile pharmacy platform
Connecting patients, pharmacist and health care teams
,
Email : [email protected]
https://gws.care

www.gws.care
Example of Telepharmacy Implementation

Features Prototype :
• Personalized health news
• Personal Health Organizer
• Pharmbot - PharmaMed
• Easy Price Checking
• Ask Pharmacists / Doctors
• Powerfull Search : Providers,
Medicines, disease conditions
GWSCare Farita
Connecting & Empowering Patients with Pharmacists
Inovasi Pelayanan Kefarmasian dengan Apotek Online, Pembelajaran
Jarak Jauh & Smart Vending Machine untuk Adaptasi Kebiasaan Baru
paska Covid-19

Apoteker AR / VR Leaflet AR / VR Smart Vending machine

Konsep dan Inovasi Farmasi di Adaptasi Kebiasaan Baru

 The Use of Telemedicine / telepharmacy

• Population Health Management: Cloud and Big

Data analytics can be used to track diseases, map
them geographically, and identify key risk areas.
• Patient Connectivity: Services ensuring patient
connectivity to healthcare providers
• Data Distribution Services: Enabling the exchange
of health- related data between organizations, such
as electronic health records, patient images etc.
• Diagnostic Support: Development of new SaaS
products and services to focus on the expertise
r e q u i r e d , wi t h a l o we r c o s t o f o p e r a t i o n s f o r
healthcare providers.
 Future Directives

• Standardized Format: Information to patients and consent form Option to

opt out in future

• Telemedicine courses: Mandatory for all new medical students Refresher

courses for medical practitioners

• Responsibility of privacy, confidentiality and security of patient

information, treatment: By both the referring and consulting physicians

• Qualifications and skills: Expertise & eligibility of the doctor

• Accreditation: To the practicing telemedicine practicing doctors

• Building confidence: Of both the patient and distant doctor create bonding
of mutual trust

• Provision for remuneration: For each player should be decided clearly

 Future directives

• Medical insurance: Clear outlines for tele-consulting insurance

• Cross-border issues: Should be governed by an international body

• Standards, Interoperability: Standards of the equipment and tele-

services periodic checks and submission to regulatory authority

• Instrument and services: Liability, maintenance, safety

• Licensing: The authorization and capability of the service provider

• Telemedicine / Telepharmacy laws: IT laws for information storage

and access

• E-heath portal for regulations and grievances: For social media

such as apps, SMS, telephonic consultations
 FIP : Gain some “AI”
Pharmaceutical Care in Digital
Revolution 1st Edition
Insights Towards Circular
Innovation

the Trailer of the book

"Pharmaceutical Care in Digital
Revolution" by Claudia Rijcken, Paul
Iske, Rob Peters, Barry Meesters, Paul
Rulkens, Wilma Gottgens & the
foreword by Gerd Leonhard.
• Gain some AI – “apothecary intelligence” “Not every pharmacist needs to be a
data scientist, but there needs to be some data interest and expertise in every
pharmacist in order to excel in AI: ‘Apothecary Intelligence’,” says Claudia
Rijcken, founder and owner of pharmacare.ai, a company that develops strategy for
the digital pharmaceutical care ecosystem.

• Buying online has become easier than ever, with functions such as “frequent
purchased” and “automated delivery”. Could the same models be applied to
medicines? Will pharmacies survive or could they even add value to e-
commerce?
 Take Home Massage

1. Pharmacists in the implementation of telepharmacy must comply with

community pharmacy service standards and have a special
competency certificate in telepharmacy
2. The Ministry of Health and the Food and Drug Administration support
telepharmacy services with a focus on patient safety and patient
empowerment.
3. Telemedicine and telepharmacy are expected to strengthen health
services, NOT REPLACE standard services.
4. The development of digital health knowledge in pharmacy school must
be implemented immediately in order to obtain a digitally enabled
workforce
5. Competency improvement for already working professions must be
made to ensure that workers understand the advancement of
telepharmacy and telemedicine technology
6. GWS care + Pharmamed bot is ready to provide telepharmacy services
that ensure compliance with government regulations, management of
confidentiality and security of consumer health data.
 Terima Kasih

Pharmamed - Asisten Virtual Apotek & Kesehatan

Situs : https://pharmamed.online
Telegram channel : http://t.me/pharmameds

Media Sosial :
Linkedin : https://www.linkedin.com/in/pharmamed/
IG : @pharmamedbot https://www.instagram.com/pharmamedbot/
FB : @pharmamedbots https://www.facebook.com/pharmamedbots
Youtube : https://www.youtube.com/channel/UCvj1pm9GVrIfUDKEItI446w/videos
Twitter : @pharmamedbot https://twitter.com/Pharmamedbot
Tentang
Saya adalah Apt. Stefanus Nofa, S.Si
Konsultan Digital Health / Pharmacy
Founder Pharmamed Bot & GWS Care

Follow Media Sosial :

Fanspage : https://www.facebook.com/StefanusNofa
Dunia Farmasi & Tanya Apoteker

IG : https://www.instagram.com/stefanusnofa/

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Hak Cipta @ Stefanus Nofa
Hak cipta dilindungi Undang-Undang. Dilarang menerjemahkan, mencetak ulang, memperbanyak, ataumenggunakan sebagian atau seluruh isi buku ini dalam bentuk apapun,
baik secara elektronik, mekanik atau cara lainnya, yang saat ini diketahui atau nanti ditemukan, termasuk menggandakan dan mencatat, atau menyimpan dalam sistem
penyimpanan dan penyediaan informasi, tanpa izin tertulis dari penulis
Sanksi Pelanggaran Pasal 113: Undang-Undang Nomor 28 Tahun 2014 tentang Hak Cipta