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For much of 2009, the country was gripped by the case of the Tangerang housewife who was sued by a hospital for complaining in a private e-mail to friends about its service.

Although the saga ended well for Prita Mulyasari, who won her appeal against the Rp 204 million ($24,000) fine issued against her for defamation, the root cause of the issue remains.

The case stemmed from Prita’s suspicions that something was amiss in her treatment and the hospital’s subsequent refusal to allow her to see her own medical records.

That issue, says Kartono Muhammad, a public health expert and former chairman of the Indonesian Doctors Association (IDI), underscores the importance of hospitals using electronic databases to keep patients’ records and not insisting on using paper.

“Electronic medical records could save a lot of time, space, money and save more lives because of the faster treatment they afford the patients,” he says.

He also says they are more secure than handwritten records that can be viewed by anyone and are open to manipulation.

The country’s biggest hospital, Cipto Mangunkusumo General Hospital (RSCM), began migrating its patients’ records to an electronic database last year and expects to complete the move in two years as part of efforts to obtain international accreditation.

The hospital’s director, Akmal Taher, says the system implemented so far affects the release of prescription medication.

“It makes it easier for us to audit the prescriptions and control the release of generic medicine,” he says. “It also helps minimize mistakes arising from illegible prescriptions from doctors.”

Kartono says most hospitals around the country still keep paper records. “There’s a bulky file on every patient, which makes it bothersome to go through the record each time the patient visits the hospital,” he says.

“With conventional record-keeping methods, we use a lot of paper and have to cut down so many trees. We also need a lot of storage space and it takes a long time to retrieve the documents when needed.”

Kartono says electronic databases would also make it possible to link up all the hospitals in the country so patients’ records could be accessed at whichever hospital they visited.

“If a patient from a hospital in Papua is referred to a hospital in Makassar, for instance, the doctor can immediately look up their medical record in the system and prescribe prompt treatment,” he says.

Implementing such a system, however, is hampered in part by the lack of government support, Kartono says.

“It requires a big capital investment and all hospitals must have computers,” he says. “We’d also need reliable servers that wouldn’t crash.”

Another challenge, he says, is the reluctance of older doctors to switch to a computerized system. “Convincing the younger doctors is easy, but the older ones are usually stubborn,” he says.

Akmal concedes it has been difficult to convince some doctors at RSCM to switch to electronic record-keeping, but says the hospital is confident it can teach everyone how to use the new system.

“We’re going to set up a learning center to persuade our doctors to keep learning,” he says.

He adds full implementation of an electronic database will help RSCM and other government hospitals work more efficiently and cut costs.

Only a handful of private hospitals have implemented paperless databases, but government hospitals are beginning to make the change. The Indonesian Red Cross Hospital in Bogor has begun storing its patients’ data electronically, but the system is a very basic one.

Akmal says RSCM expects full support from the government to develop a system that is not easily disrupted by technical errors.