Abstract

Background: Cancer and its management can incur high costs, high risks and high demand. In Indonesia, there remains gap in the availability of national cancer data despite the establishment of a National Committee for Cancer Control. Multiple pilot projects have been developed by the Ministry of Health to improve the delivery of care, including interventions utilising digital health approaches and integrated referral information systems. However, it is not yet clear to what extent these approaches influence patient management or the experience of cancer patients themselves. This research aims to explore the current role of health information technology (HIT) in the provision of services and treatments for patients with cancer from primary to tertiary healthcare centres in Yogyakarta, Indonesia. Methods: The study will adopt an observational mixed-methods single case study design of health facilities involved in the delivery of cancer services in a sub-national health system. We will collect data through face-to-face interviews with a range of health professionals involved in the delivery of cancer care. Patients will be interviewed to share their views and experiences of the existing cancer referral system and communication with health facilities. Alongside interviews, we will undertake an analysis of routine data from participating health facilities to assess gaps in existing information systems. Data analysis will include framework analysis for qualitative data alongside descriptive analyses of quantitative data. Findings will be used to inform conceptual maps to be presented as part of Theory of Change workshops focused on understanding how the existing cancer referral system works, why and for whom, with a focus on future refinement and intervention development. Conclusion: Our findings will inform critical thinking around the design, implementation, adaptation, and evaluation of existing systems. Through early engagement and participation of key stakeholders and project partners, we intend that findings will have immediate utility.

Highlights

  • In 2018, there was an estimated 348,809 cases and 207,210 deaths from cancer in Indonesia, projected to increase to 575,814 cases and 366,567 deaths annually by 20401

  • The limited provision of cancer care in Indonesia was reflected in the Cancer Preparedness Index, an initiative in 20194 to highlight differences in cancer policy and systems between countries and how they relate to outcomes

  • As a first step to explore the role of health information technology (HIT) in cancer care, this study focuses on the Special Region of Yogyakarta, a region of Indonesia located on the island of Java

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Summary

Introduction

In 2018, there was an estimated 348,809 cases and 207,210 deaths from cancer in Indonesia, projected to increase to 575,814 cases and 366,567 deaths annually by 20401. Indonesia was rated 25th of 28 countries evaluated[5], largely influenced by limitations in its service availability, workforce, infrastructure, alongside a lack of cancer research. Multiple pilot projects have been developed by the Ministry of Health to improve the delivery of care, including interventions utilising digital health approaches and integrated referral information systems. This research aims to explore the current role of health information technology (HIT) in the provision of services and treatments for patients with cancer from primary to tertiary healthcare centres in Yogyakarta, Indonesia. Patients will be interviewed to share their views and experiences of the existing cancer referral system and communication with health facilities. We will undertake an analysis of routine data from participating health facilities to assess gaps in existing information systems.

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