By: I Gede Putu Rahman Desyanta, CEO of Baliola

(The following article was published on the Bekraf website)

In the waiting room of the Emergency Department at a regional hospital, a mother waits anxiously for news of her child who has been referred from a community health center. The doctor is forced to repeat the examination because the information systems between facilities are not yet fully integrated. Meanwhile, an elderly patient is transferred from a private hospital to a public hospital, but the medical records are incomplete due to the absence of an integrated system across hospitals. At the same time, BPJS insurance claims are delayed due to data mismatches, and administrative staff face challenges in synchronizing manual and digital data simultaneously.

This is not fiction. In many hospitals across Indonesia, patient medical records are still scattered or not integrated between facilities, doctor credential verification is slow and vulnerable to manipulation, vaccine or medication distribution is inaccurate and hard to trace, and insurance claim systems are slow and prone to fraud.

These issues are not merely technical problems but directly impact the quality of service and even patient safety. This is where blockchain technology offers a real solution.

Blockchain is a distributed digital ledger system that stores data securely, transparently, and immutably (unchangeable). Every transaction or data change is recorded in connected blocks verified by the network.

In the hospital context, this means: patient medical records can be stored encrypted and cannot be tampered with, data access can be controlled by the patient with records of who accessed what, validation processes like doctor credentials or insurance claims can be automated through smart contracts, and information between hospitals can be synchronized in real-time without intermediaries.

Global Case Studies

During the COVID-19 pandemic, the UK’s National Health Service (NHS) collaborated with Everyware and Hedera Hashgraph to monitor vaccine distribution. This system recorded vaccine storage temperature in real-time and was immutable. The result: no vaccines spoiled due to temperature errors, distribution was faster and more transparent, and public trust increased.

In the United States, a consortium including Aetna, Humana, MultiPlan, and Quest Diagnostics uses blockchain for automatic verification of medical staff credentials, cross-hospital data synchronization, reducing administrative burdens, and lowering costs.

In Estonia, nearly all health data has been digitized and secured by blockchain technology since 2008. Patients can access their medical records and grant access independently to doctors.

In South Korea, hospitals such as Myongji and Gil Medical Center have implemented blockchain for medical data management and research development.

Besides these countries, the UAE, Canada, Switzerland, India, and South Africa are also developing similar solutions to enhance efficiency and security in their healthcare systems.

What About Indonesia?

Our country needs to implement blockchain technology in hospitals for several fundamental reasons. First, there is data and system fragmentation where every hospital has its own information system. Not all are connected yet, and many processes remain manual.

Second, data security and patient privacy are very fragile. Medical data leaks often occur. In this context, blockchain provides stronger encryption and access control.

Third, efficiency and administrative burden reduction are increasingly urgent. With blockchain, doctor credential verification, insurance claims, and medical logistics distribution can be drastically accelerated.

Fourth, national and regional interoperability to synchronize data across facilities, provinces, and even between insurance systems (BPJS and private).

All this aligns with the Indonesian Ministry of Health’s efforts to launch the SATUSEHAT data integration platform and respond to the Personal Data Protection Law (PDP), which provides a legal framework for sensitive data management.

AI, Medical Records, and Blockchain’s Role in Maintaining Trust

Medical records hold various important information that is not only technical but also personal and confidential. In practice, many challenges exist: doctors’ limited time, age, or digital skills result in incomplete record entries. In some cases, record-keeping is done by nurses, which is actually against regulations.

According to the Indonesian Ministry of Health Regulation No. 24 of 2022 on Electronic Medical Records, medical records must be recorded and signed by doctors or healthcare workers providing direct patient care.

AI technology can now assist this process without burdening doctors. Using voice recognition and use-case mapping based on diagnosis or medical action, AI can capture conversations and activities during examinations. AI then proposes an automatic summary of medical records to doctors, who then only need to verify before storing in the system.

But a question arises: Can AI be trusted to process sensitive medical data?

Here blockchain is the key to trust. Every medical record data generated by AI will be encrypted and recorded in the blockchain. Before AI can access or use the data for training or analysis, patient consent is requested via a notification system. Thus, every AI access to medical records is recorded, transparent, and only occurs with patient permission.

Baliola has developed Medisa, a blockchain-based medical record protocol ensuring that full control of medical records remains with the patient. Medisa is not just a storage system but also a data protection and consent management mechanism based on smart contracts, providing patients security and flexibility for healthcare workers. Medisa combines a DID protocol built on the IDCHAIN network, a collaboration between Baliola and PANDI (Indonesia’s internet domain manager), with smart contract medical records, guaranteeing security and returning rights over medical records to the patients.

junaidi-ai.id: The Future of Doctors and Everlasting Intellectuality

One notable initiative in Indonesia’s healthcare digital transformation is junaidi-ai.id. This platform was created by a group of doctors who recognize that the future of medicine will be shaped by the collaboration of human intelligence and artificial intelligence (AI). They do not see AI as a replacement for doctors but as a personal digital assistant that enhances doctors’ capacity in clinical decision-making.

Junaidi focuses on building a community of doctors ready for a new era where AI acts as a collaborative partner. Through the platform, doctors have AI assistants that help manage medical knowledge structurally, discuss cases similar to mentoring by seniors, and develop diagnostic and treatment plans based on the doctor’s own insights.

Uniquely, each AI Doctor created in junaidi is not generic but highly personal. This AI is trained from the knowledge, experience, and thinking style of a specific doctor. Thus, every AI Doctor is a digital representation of that doctor’s intellect and will never be the same as another’s. Given diverse and complex patients and high workloads, such assistants help doctors stay focused, organized, and calm in decision-making. However, final decisions remain with human doctors, as medical considerations involve not only logic but empathy, intuition, and human values.

From rights and protection perspectives, blockchain is crucial here. Since AI Doctors are forms of intellectual property, the system is built on smart contracts that record ownership and rights over the AI model. Each AI Doctor also has a Decentralized Identifier (DID), a digital identity storing metadata about its creator, usage license, and its roles and limitations in the health system.

Smart contracts also act as governance systems ensuring AI Doctors do not exceed their assistant role. They cannot make decisions without doctor approval, and every access to the AI Doctor can be tracked and verified.

Furthermore, AI Doctors open new possibilities for sustaining medical knowledge. When a doctor retires or passes away, their knowledge lives on through their AI Doctor. Juniors and medical students can keep learning from that doctor’s experience and thinking via the AI created. With blockchain-based recording, these contributions can be recognized and rewarded economically and socially, even becoming a form of “digital charity” whose benefits can be inherited by the doctor’s descendants.

This is a real form of personalized digital twin—a digital human representation built with real values, knowledge, and experience, reinforced by blockchain technology as a protector of integrity and rights. A concrete step towards a more humane, sustainable, and fair future healthcare system for medical professionals.

Implementation Challenges

There are challenges if this system is to be implemented in Indonesia, but these should not be reasons to avoid it, rather to understand the issues and take precise steps.

Some challenges include: digital literacy of medical staff and hospital management; readiness of human resources and digital infrastructure; initial costs of infrastructure and training; technical regulations and national standards; and the need for adaptive communication and training approaches to support the transition.

Implementation Recommendations for Indonesia

To improve healthcare services, new technologies like Blockchain and AI must be carefully mapped. This requires limited pilot projects starting at large regional or national referral hospitals.

Initial implementation could focus on one function, such as medical staff credentialing or vaccine distribution. It could also integrate with SATUSEHAT where blockchain protects and strengthens the integrity of SATUSEHAT’s collected data, and AI builds knowledge from those cases.

For success, multi-stakeholder collaboration is essential. The government should engage local startups, universities, regional governments, and state pharmaceutical companies. Socialization and training are critical to build awareness and technical understanding for health workers and hospital managers.

Equally important is ecosystem preparation, involving the Ministry of Health, BPJS Health, Financial Services Authority (OJK), Ministry of Communication and Informatics (Kominfo), research institutions, and professional associations.

Conclusion

Blockchain and AI technologies will not replace doctors or nurses, but they can become trust infrastructure that supports them to save more lives. When data is accurate, secure, and easily accessible; when administrative processes no longer consume medical workers’ time; when vaccine and medication distribution can be monitored in real-time — that’s when we are building the hospital of the future.

Indonesia does not have to wait for perfection to start. What is needed is vision, courage, and strategy. If countries like Estonia, the UK, and even Bangladesh have started, Indonesia can too. It’s time for blockchain and AI to become the backbone of a strong, fair, and transparent health information system.