Analysis of Indonesia’s digital health industry.

The Microsoft founder, Bill Gates invested in Indonesia’s healthcare startup, Halodoc through his foundation Bill & Melinda Gates Foundation. Funds from Bill Gates went to Halodoc in an extended Series B funding round. We can see that the health tech sector has a big chance to develop considering the government continues to support the country’s startup, especially by inviting more investors to put money into edutech and health tech startups.

With the COVID-19 spreading in Indonesia, services on digital platform demand rose intensely. The improvement on digital health can help address challenges in Indonesia’s healthcare system, especially during the pandemic. It is also as solutions improve the delivery of precision healthcare and end-to-end care and provide greater opportunity for foreign investors. 

Bill Gates Investment 

Through Bill & Melinda Gates Foundation the World’s billionaire, Bill Gates invested in an Indonesia-based online healthcare startup, Halodoc. The foundation supports the startup’s ongoing series B funding round. Series B is the second round of funding for a business through investment, including private equity investors that have met certain milestones of the initial startup stage. In this series, Bill & Melinda Gates Foundation invested in the start-up company alongside Allianz X and Prudential.

The Bill & Melinda Gates Foundation inspired the CEO of Halodoc, Jonathan Sudharta to improve the delivery methods of health care solutions and increase life’s quality for people all over the world. The start-up company will further its commitment to simplify health care in Indonesia through technology using the new funds. Without revealing the amount, Halodoc reportedly has raised funds to USD100 million and will be used to expand its services across Indonesia. 

Currently, the start-up company has already partnered with 1,300 pharmacies to distribute medicines through 50 cities in Indonesia. Halodoc has over 20,000 registered doctors and 2 million users that serve approximately 7 million patients around Indonesia every month.

Indonesia’s Health Startups 

Halodoc and Alodokter are the key players of the health startups in Indonesia. Apparently, not only those two startups exist in Indonesia’s health sector. There are also KlikDokter, Pasienia, TanyaDok, Good Doctor, ProSehat, Dokter.id, DokterSehat, MoCehat, and HalloSehat.com. With the country’s large and growing market, healthcare is becoming a competitive and fast-growing sector in the startup ecosystem. 

Indonesia has been experiencing rapid growth in terms of GDP over the past two decades at 5% every year. The digital and innovation startups contributed to Indonesia’s economic growth with the internet economy expected to rise to USD 100 billion by 2025. This also includes the health startups that are becoming one of the developed sectors in Indonesia. Indonesia has healthcare problems that are quite complex, and there needs to be a collaboration between the government, the community, and other private parties to find a solution.

The key challenge in improving lives in Indonesia is access and affordability. We can solve the healthcare problems in Indonesia through health tech startups. They can provide accessible healthcare and financial benefits. The country’s local telemedicine services can help cut the overlooked medicinal cost and also help to cut rates of transmission of COVID-19. Especially for minor patients complaints by providing facilities such as online consultation spaces. 

The Digital Health Industry in Indonesia 

The health technology industry in Indonesia is rapidly growing as Indonesia’s sizable youth population increasingly looks to digital solutions to access goods and services. The industry is expected to facilitate Indonesians to gain health access easily that will benefit more than 260 million population that live in 17.504 islands. 

COVID-19 has accelerated the growth of digital businesses, specifically digital health businesses as movements are restricted. Moreover, Indonesia is the fastest-growing internet economy in Southeast Asia that is expected to reach USD 174 billion by 2025 and experience a compounded annual growth rate (CAGR) of 40% and home to 170 million internet users, with 10 million of the youth population in which 90% use the internet (Tamasek, 2020). 

According to the World Health Organization’s (WHO) digital health includes improving information sharing and communication, increasing availability, fostering better alignment with local norms and individual beliefs, and increasing availability, utilization, efficiency, and accountability to reduce cost. Thus, digital health is emerging in Indonesia to address the challenges of the country’s healthcare system that still lacks physical infrastructure and lack of healthcare professionals. 

COVID-19 Impact 

The spread of the COVID-19 pandemic has accelerated the growth of digital health care. In this regard, telemedicine and web or mobile-enabled platforms could help expand access and lower the unit cost of healthcare across the vast Indonesian archipelago. The outbreak of COVID-19 has prompted surge demand for telehealth worldwide. Indonesian government stands out by leaning on health tech firms. 

Indonesia has around 300,000 hospital beds, mostly concentrated in the densely populated island of Java. Indonesia also faces a doctor shortage with about four doctors per 100,000 residents. With these challenges, Indonesia used the apps as building blocks of the health-care system. Most notable Indonesian tech leaders such as Halodoc, Alodokter, and GrabHealth run health applications providing private doctor consultations through chat or video calls. This includes the purchase and delivery of prescription medicine through a partnership with ride-hailing apps such as Grab or Gojek and pharmacies. 

The pandemic also gives digital health tech a boost with increased app downloads and website traffic 25% rise based on Organisation for the Review of Care and Health Applications (ORCHA) reports. The health tech companies have become the first stage of COVID-19 first stage screening for million users in Indonesia. The government also included links to 20 telemedicine services on its website and collaborated with health tech forms to share aggregated data on patients and initiatives to flatten the curve. 

Industry Opportunities: Digitized Indonesia 

Technology Engaged Population

With the rising youth population, Indonesia has a large customer base for digital health businesses. Indonesia’s young population that accounts for 64.8% of the country’s total population is more likely to be internet users with internet penetration of 91% of 15 to 19 years olds and 99.5% of 20 to 24 years olds (MTPConnect, 2020). For instance, in terms of Indonesia’s internet usage in the health care sector, the internet is utilized for browsing health information at 51.06% and to consult with health care professionals at 14.05% (Deloitte,2019).

Growing Digital Market

The rise of successful tech unicorns in Indonesia encourages other digital companies looking for opportunities in Indonesia including in digital health businesses. It is estimated that by going digital, Indonesia will experience economic growth of USD 150 billion in annual economic impact by 2025 (McKinsey, 2020). For instance, digital penetration to healthcare follows the rise of digital healthcare startups such as AloDokter, Halodoc, Homemedika, and Periksa.id. 

Android Base Application

With cheaper smartphones becoming available in the market it will positively affect the digital health industry in Indonesia with a mobile penetration rate of over 100% (MTPConnect, 2020). Most Indonesian smartphone users use the Android operating system with only 7.39% using Apple’s iOS (Statcounter, 2021). Thus, the availability of smartphones and the predominant use of Android operating systems offer investment opportunities for companies that wish to develop digital health phone applications that support Android operating systems for Indonesian users. 

Government Support

The Indonesian government is motivated to support its digital market growth by finding the next tech unicorn to drive investor interest in digital health as Indonesia’s potential sector. Following this arrangement, Indonesia’s Ministry of Communication and Information hosts an annual summit Nexticom (Next Indonesian Unicorns) to widen opportunities for investors to meet start-up founders (Nexticom, 2019). Moreover, to boost the country’s internet penetration, the government is implementing measures such as the Palapa Ring Project of over 36,000km fiber-optic cable and Multifunction Satellite Project to increase internet access to remote areas (Kominfo, 2019).

Challenges to Entry 

Lack of Stakeholders Support

According to dr. Hans Wijaya, CEO National Hospital Group and CEO Lifepartners Healthcare, one of the challenges of digital health in Indonesia is how stakeholders react to change as in Indonesia, stakeholders in private hospitals are often the doctors who work there. The problem is, older doctors are more resistant to change their habits and the way they traditionally conduct the health system (MTPConnect, 2020). 

Lack of Expertise  

Digital health services in Indonesia are still relatively new and there is a shortage of skilled professionals with adequate information technology expertise in data analytics, cybersecurity, and cloud management. Moreover, cloud security remains a concern for many e-commerce companies in Indonesia which include data leaks and unauthorized access to applications, particularly in a shared cloud environment.

Security Concern

Another challenge in Indonesia’s digital health market is the absence of current regulations of upcoming digital economy issues such as cross-border e-commerce transactions and personal data protection. The bill of personal data protection is still an ongoing discussion between Indonesia’s Ministry of Communication and Informatics and Legislative. On the other hand, the regulation for cross-border e-commerce transactions is still managed by the Central Bank and Indonesia’s Ministry of Finance to be monitored. 

Prominent Players and Projects

In Indonesia, private sectors have been the prominent players in the development of the country’s digital health. Practicality and convenience are the primary causes for customers to prefer digital health care applications. There are many health applications available in Indonesia, however a survey done by Deloitte stated that the majority of Indonesians use AloDokter and  HaloDoc as from 33 respondents, 21 are using AloDOkter and 12 are using Halodoc. 

AloDokter is a mobile application that provides medication and teleconsultation solutions, which is one of Indonesia’s biggest players in the health digital market.  It is estimated in March 2020 the application recorded 61 million web visits with more than 33 million users and has been downloaded by 5.5 million users (The Jakarta Post, 2020). On the other hand, Halodoc is a mobile application healthcare platform that includes doctors, insurance, pharmacies, and patients into one simple application. According to CNBC Indonesia, due to COVID-19 Halodoc sales revenue grew 600% in just two months and it is estimated that since March 2020 7.2 million users have accessed Halodoc’s COVID-19 special feature while downloads increased by 300% (Channel News Asia, 2020).

Moreover, Indonesia’s government has also pushed initiatives in the digitalization of healthcare systems with projects such as JKN Mobile, P-Care BPJS, and BPJS Digital Claim Verification. For instance, Badan Penyelenggara Jaminan Sosial (BPJS) Kesehatan or Indonesia’s Social Social Insurance Administration Organization is utilizing technology to create a Mobile JKN application. The digital transformation business model allows the user to access it with no limited time. The services include BPJS general information, invoicing, and selective health screening. 

A Bright Future for Digital Health Industry in Indonesia

As the fourth largest country in the world with over 270 population, Indonesia is currently facing many challenges in its healthcare system. The population is spread across an archipelago that makes it harder to equally distribute proper health care services. Indonesian people, especially those in rural areas, are still facing healthcare delivery and access challenges. 

Digital health has a huge opportunity in the future as it is said to be one of the solutions to these challenges. The current healthcare system is lacking medical professionals and is facing geographic challenges. As of 2018, Indonesia only possesses 118 hospital beds per 100,000 population, 62 registered medical practitioners per 100,000 population and 135 nurses per 10,000 population (MTPConnect, 2020). We have covered the opportunities in Indonesia’s healthcare industry in our last article that you can read .  The utilization of digital health in Indonesia could potentially increase access to healthcare, the quality, and the cost of healthcare. It could even increase the efficiency of the healthcare system in the country and simultaneously increase the patient experience. 

Currently, the utilization of digital health and information technology in Indonesia is considered to be in its early stages of development. The industry itself is expected to keep on growing rapidly, with a 60% annual growth rate, it is projected to increase from USD 63.5 million in 2017 to USD 973 million by 2023 (MTPConnect, 2020). 

The country is rapidly going digital, numerous digital companies were born encouraged by the rise of four tech unicorns in the country. There has also been a rising interest in investment in the digital health sector. It is projected that the digital health company would be the next big tech success (MTPConnect, 2020). Numerous major Indonesian hospitals, such as Siloam Hospital, Pondok Indah Hospital Group and Mitra Keluarga Group, have tapped into the growing digital health market by launching their online outpatient and teleconsultation services (The Jakarta Post, 2020).   

Despite the low penetration rate, Indonesia’s population is highly engaged in technology and the internet. This provides a strong foundation for the industry to grow in the country. It is reported that Indonesians are among the fastest adopters of digital health, proven by the number of health application downloads and a 600% increase in telemedicine users during COVID-19. Therefore, Indonesia possesses a great opportunity for the industry to grow in the future. 

How to Enter Indonesian Health Tech Market?

Regulation

Currently, the industry is regulated by the Regulation of Indonesia’s Ministry of Health No. 20 of 2019 regarding the Implementation of Telemedicine Healthcare Services. However, the rising number of digital health applications prompts the Government to establish an improved regulation that surrounds the industry.   

As stated on the Indonesian Investment Coordinating Board (BKPM) regulation, Indonesia’s healthcare sector is mostly open for foreign investment. In 2014, The Government of Indonesia revised and adjusted the regulations to encourage foreign direct investment  (FDI) in the healthcare sector, especially for ASEAN countries. Still, just like any other country, the healthcare industry is highly regulated in Indonesia. Investing in the industry could be challenging as there are numerous complex and overlapping regulations. Investors would be required to obtain certain permits that usually take a long process.   

A Smooth Expansion to Indonesia with BRIGHT Indonesia

The complex bureaucracy in Indonesia could lead to a long and inconvenient investment process. With BRIGHT Indonesia, you could skip the hurdles and let us do the hard work. BRIGHT Indonesia offers a wide range of services that could help ease your way into the Indonesian market. Ranging from providing a thorough market insight report to supporting the process of registration and permit including expatriates utilization plan (RPTKA), expatriates utilization permit (IMTA), and limited stay permit (KITAS),  BRIGHT Indonesia will help you and your company into the Indonesian market.    

For more information, email to info@brightindonesia.net. 

This article is Co-Written with Gianina Amira Zahra and Ristya Sangaji