JMIR Publications

ABSTRACT

Background:

Telemedicine has emerged as a valuable tool for improving healthcare delivery, especially in low-resource and geographically isolated regions. In Indonesia, the COVID-19 pandemic highlighted the need for digital health solutions to manage chronic diseases and improve access to specialists.

Objective:

This study examines the rapid adoption of telemedicine in Indonesia, focusing on its role in managing chronic and rare diseases and highlighting both its benefits and challenges to long-term viability during and post-pandemic.

Methods:

A qualitative study was utilized, following the COREQ-32 checklist and guided by established theories and frameworks. Data were collected through semi-structured interviews conducted between October and December 2024. The interviews were divided into two phases: first with physicians from various medical specialties and six out of seven regions within Indonesia, and then with patients diagnosed with autoimmune diseases.

Results:

Before the COVID-19 pandemic, telemedicine adoption in Indonesia was limited, with many physicians recalling its non-existence before 2015. The pandemic accelerated the adoption of virtual platforms, which became essential for patient consultation, follow-ups, and medication management. Though its use decreased after the pandemic, telemedicine remains valuable, particularly for chronic and rare disease management in remote areas with limited access to specialists. Telemedicine also reduced financial burdens for patients, with six out of nine participants reporting cost savings after switching from monthly in-person visits to a hybrid model with one in-person visit and five virtual consultations over six months. Despite these advantages, challenges such as the inability to perform physical exams, physician burnout, and concerns over data privacy persist. Telemedicine complements in-person care, but future improvements should focus on enhancing infrastructure, addressing gaps, and ensuring secure platforms to support both patients and healthcare providers.

Conclusions:

The findings reveal that telemedicine has become a valuable tool in Indonesia for managing chronic and rare diseases, particularly for follow-up care and medical specialist access across diverse geographical areas. While telemedicine has improved healthcare accessibility and demonstrated significant cost benefits by reducing transportation and consultation costs, challenges such as limited infrastructure and physician burnout remain. Long-term success will depend on the development of sustainable regulatory frameworks, continued investment in digital infrastructure, and a focus on optimizing cost-effectiveness in healthcare delivery.