The Role of Digital Technology in Improving the Efficiency and Quality of BPJS Health Services: Concept Overview

Health services in Indonesia, particularly within the BPJS Health system, face numerous challenges lacking optimal solutions. This research provides recommendations for a more efficient BPJS Health outpatient service business model by integrating Internet of Things (IoT), Internet of Medical Things (IoMT), Artificial Intelligence (AI), and Blockchain technologies. Using a systematic literature review (SLR), the study analyzes relevant literature on technology applications in BPJS health services. The findings indicate that these technologies can enhance service efficiency and quality. IoT and IoMT reduce queues and administrative workloads, providing real-time access to medical records and efficient drug stock management. AI assists in pre-screening, scheduling, drug recommendations, and digital claims verification. Blockchain ensures claim validity and integrity through smart contracts and secure, transparent data storage. By optimizing these technologies, BPJS Health can address various health service challenges, improving service efficiency, accuracy, and quality. The proposed business model includes online/offline registration, patient verification via IoMT and Blockchain, AI-based pre-screening, and digital claims management supported by Blockchain and AI.