Acceleration of Telemedicine Use for Chronic Neurological Disease Patients during COVID-19 Pandemic in Yogyakarta, Indonesia: A Case Series Study

Vincent Ongko Wijaya, Dessy Paramitha, Rizaldy Pinzon


COVID-19 preventions have cut access to routine medical care, especially for many chronic neurological disease patients. This condition has especially promoted telemedicine use in providing healthcare. This study aims to review telemedicine use catalyzed by several regulations of the Indonesian Government and review 20 cases from Bethesda Hospital in Yogyakarta providing online consultation services. Perceptions of experience on telemedicine were collected from neurological patients at the hospital who were asked about their impressions of consultations and pharmacy medication services, and their suggestions about the new system in outpatient consultations. The regulations for telemedicine use are relevant because of these patients’ risks related to comorbidities and treatments. Of 20 respondents involved in this study, 15 (75%) were satisfied with the service, 3 (15%) very satisfied, and 2 (10%) others neutral. Most respondents suggest improvement of reimbursement (80%) and others suggest improvement on medications (10%) and services (10%). System and hospital requirements for telemedicine services for neurological cases have been accelerated due to the pandemic. Telemedicine is a way to provide healthcare needed by patients at high risks for COVID-19 fatality related to comorbidities and treatments. Payment regulations, regulatory structures, state licensing, and credentialing across hospitals for better telemedicine experience need to be enhanced.


COVID-19, Indonesia, neurologic disorder, telemedicine

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 1. Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterization and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565–74. doi:10.1016/S0140-6736(20)30251-8

 2. WHO. Coronavirus disease (COVID-2019) situation reports. 2020.

 3. Indonesian Task Force for COVID-19, current situation reports of COVID-19 in Indonesia, 2020 (

 4. Liu Y, Gayle AA, Wilder-Smith A, Rocklov J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J Travel Med. 2020. doi:10.1093/jtm/taaa021

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et, al, Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020 Mar 11. pii: S0140-6736(20)30566-3. doi:10.1016/S0140-6736(20)30566-3

 5. Indonesian Government Regulation, Peraturan Pemerintah Nomor 46 Tahun 2014 tentang Sistem Informasi Kesehatan (Lembaran negara Republik Indonesia Tahun 2014 Nomor 126, Tambahan Lembaran Negara Republik Indonesia Nomor 5542); URL:

 6. Indonesian Ministry of Health regulation, 303/2020, Indonesian Health Ministry regulation of the use of Information Technology and Communication for Preventing the COVID-19, Indonesian Ministry of Health. URL:

 7. Indonesian Medical Council Regulation, 74/2020, The Use of Telemedicine and clinical appointment in the Era of COVID-19 Pandemic. Indonesian Medical Council. URL:

 8. Indonesia FDA regulation, 8/2020. Indonesia FDA regulation for medicine and food online transaction, Indonesia FDA 2020. URL:

 9. Al-Abri R, Al-Balushi A. Patient satisfaction survey as a tool towards quality improvement. Oman Med J. 2014;29(1):3‐7. doi:10.5001/omj.2014.02

 10. Indonesian Neurological Association, Technical Information for the use of Telemedicine for Neurological Patients, Indonesian Neurological Association, 2020

 11. Helmich RC, Bloem BR. The Impact of the COVID-19 Pandemic on Parkinson's Disease: Hidden Sorrows and Emerging Opportunities. J Parkinsons Dis. 2020;10(2):351-354.

 12. Dafer RM, Osteraas ND, Biller J, Acute Stroke Care in the Coronavirus Disease 2019 Pandemic, Journal of Stroke and Cerebrovascular Diseases, 2020,

 13. Bloem BR, Dorsey ER, Okun MS. The Coronavirus Disease 2019 Crisis as Catalyst for Telemedicine for Chronic Neurological Disorders. JAMA Neurol. Published online April 24, 2020. doi:10.1001/jamaneurol.2020.1452

 14. Lurie N, Carr BG. The role of telehealth in the medical response to disasters. JAMA Intern Med 2018;178:745-746 . doi:10.1001/jamainternmed.2018.1314

 15. Mulyanto J, Kringos DS, Kunst AE. The evolution of income-related inequalities in healthcare utilisation in Indonesia, 1993–2014. 2019. PLoS ONE 14(6): e0218519.

 16. Lin JC, Kavousi Y, Sullivan B, Stevens C. Analysis of Outpatient Telemedicine Reimbursement in an Integrated Healthcare System. Ann Vasc Surg. 2020;65:100‐106. doi:10.1016/j.avsg.2019.10.069

 17. Evans DA, Benameur K, Busis N. Telemedicine and COVID-19. American Academy of Neurology. 2020. Accessed May 27, 2020. URL:



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