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now Can 8|g Data Support Learn|ng rocess?
A Case Study |n Crgan|zanon Interna|
nea|thcare rov|der
usp|ta kencana Sar|, School of Lconomy and 8uslness, 1elkom unlverslLy, pusplLakencana[LelkomunlverslLy.ac.ld
L|v|ra Az|s, School of Lconomy and 8uslness, 1elkom unlverslLy, vlra.azls[gmall.com
usp|ta kencana Sar|, L|v|ra Az|s
Abstract
Nowdays Big Data analytics is used in many aspects of organisations. This paper
discuss about how big data is used to improve learning process and support learning
organization. This paper take case of Yakes Telkom as PT. Telkom internal healthcare
provider that has 403 of staff separately in 950 clinics all-over Indonesia. Yakes Telkom
has to service more less 150.000 people, including employees, pensions and their
dependents. Yakes has online medical record system that integrate all medical data from
all clinics. Having huge medical records from its patients, could be used to improve
quality of care that they provide. By sharing and analyzing healthcare information,
physicians can identify the best treatments for their patients and do service excellent.
Comprehensive analytics can also give more correlated view of cost and quality of both
in healthcare delivery and administrative process. Furthermore, it could be reduce
healthcare expenditure of the organization itself.
Keywords: 8ig Da|a, nca||ncarc prctidcr, |carning crganiza|icn
Introducnon
Data is one of important asset had by organization. Data is commonly used to
help decision making process in any level of management. Data is also basic for creating
knowledge. It then used by organization to improve and innovate process or product.
Digitalization almost all data in organization make explotion number of data. Beside
increasing the volume, technology development also enable organization to process and
analyze variation of data, not only structured data but also unstructured data. Organization
should also consider about its velocity and veracity to optimize that large amount of data,
either from outside or inside organizitation. Now days, its called as Big Data.
Data and information that have pattern can form knowledge. According to Delphi
Cioup ieseaich in 2OOO, 42 knovIedge ieposiloiy in enpIoyees liain(Uiiaile }i, 2OO8).
But now in the Big Data era and information technology development, organizations can
have knowledge not only from their employees but also from their consumers, partners,
and other sources outside them.
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Big Data could improve the way organizations do businesses even generate a
new business. According to research by McAfee and Brynjolfsson from MIT, companies
that inject big data and analytics into their operation show productivity rates and
piohlaliIly lhal aie 5 lo 6 highei lhan lhose of lheii peeis (McAfee, 2O12)

. Big Data
anaIylics couId le used in nany heId of lusiness, incIuding in heaIlhcaie seivices. ig
Dala anaIylics can le used lo suppoil hve nain acliviles of Ieaining oiganizalion dehned
by Garvin (1993) in Jashpara (2004); systematic problem solving, experimentation with
new approaches, learning from their own experience and past history, learning from
the experiences and best practices of others, and transferring knowledge quickly and
efhcienlIy lhioughoul lhe oiganizalion.
This paper propose a concept of Big Data analytics to support learning process
in organization especially healthcare service provider. In Indonesia, a big corporate, like
PT. Telkom Indonesia.Tbk, commonly has internal healthcare provider which organize
healthcare services for all employees, pensions, and their families. With better learning
process, it is expected can improve the services and claim-cost. This paper take a case
study from Yakes Telkom as internal healthcare provider of Telkom.
1heor|nca| Iramework
koowleJqe Moooqemeot
Relation between pieces of data can form information. Information that processed
further can become knowledge when one realize and understand the pattern relation
among data and information and their implication
[4]
. Knowledge is one of important
asset in an organization. Therefore, organization should optimize knowledge to support
the development of product, process, or services.
Information technology has been used for supporting knowledge management
foi decades. Hayes (2O11) dehned lvo ioIes of IT in knovIedge nanagenenl, inleiaclive
and integrative application. Integrative applications take the form of structured
databases that allow employees to store and retrieve information on past projects, expert
hndeis, eIeclionic luIIelin loaids lhiough lo lesl piaclice iepoils and voiking papeis.
Interactive applications take the form of email, desktop conferencing, and discussion
forums allowing for interactions with other staff and the garnering of their views and
experiences regardless of physical location.
Knowledge management and learning organization are two terms that related
each olhei. Snilh and LyIes (2O11) dehned lhe dislinclion lelveen Ieaining and
knowledge: knowledge being the stuff (or content) that the organization possesses,
and learning being the process whereby it acquires this stuff. Therefore, information
technology used in knowledge management can also be usefull for supporting learning
organization.
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leotoloq Otqoolzouoo
Ielei Senge (199O) dehned Ieaining oiganizalions as organizations where people
continually expand their capacity to create the results they truly desire, where new and expansive
pa||crns cf |nin|ing arc nur|urcd, uncrc cc||cc|itc aspira|icn is sc| frcc, uncrc pccp|c ccn|inua||q
learning to see the whole together (Jashpara, 2004). Almost same with Senge, Pedler,
uigoyne, and oydeII (1991) dehne lhe Ieaining oiganizalion as an organization that
faci|i|a|cs |nc |carning cf a|| cf i|s ncnocrs and ccn|inucus|q |ransfcrns i|sc|f in crdcr |c ncc|
its strategic goals (Yang, 2004). While Garvin (1993) said, a learning organization is an
crganiza|icn s|i||cd a| crca|ing, acquiring and |ransfcrring |ncu|cdgc, and a| ncdifqing i|s
ocnaticr |c rccc| ncu |ncu|cdgc and insign| (VassaIou, 2OO1). Iion lhose dehnilions, ve
conclude that in a learning orgnization, employees are encouraged and facilitated to
upgrade their knowledges and skills by improve their learning capacity in order to meet
organization strategic goals.
Theie aie hve dicipIines lo inpIenenl Ieaining oiganizalion accoiding lo Ielei
Senge (Senge, 2004):
1. System thinking. A framework for seeing interrelationships rather than things,
for seeing patterns of change rather than static snapshots. System thinking is a
discipline for seing wholes.
2. Personal mastery. It is the of personal growth and learning. People with high levels
of personal mastery are continually expanding their ability to create the results in
life they truly seek. Organizations learn only through individuals who learn.
3. Mental model. Assumptions, generalizations, or even pictures or images that
inuence hov peopIe undeisland lhe voiId and hov lhey lake aclion. Managing
mental models promises to be a major breakthrough for building learning
organizations.
4. Building shared vision. A vision that many people are truly commited to, because it
ieecls lheii ovn peisonaI vision. Shaied vision is vilaI foi lhe Ieaining oiganizalion
because it provides the focus and energy for learning.
5. Team learning. When teams are truly learning, not only are they producing
extraordinary results but the individual members are growing more rapidly than
could have occured otherwise.
esides hve dicipIines fion Senge, VassaIou (2OO1) aIso dehned hve piincipIes of
learning organization in order the process to succeed:
1. Mission and vision. A widely shared and understood mission enables staff at all
levels to develop their skills and capabilities, take reponsibilities and contribute to
organizational performance
2. Leadership. Empowers employees, encourages an experimenting culture, rewards
learning, supports innovative suggestions and frequently generates learning
opportunities on-the-job
3. Transfer of Knowledge. Learning form past failures makes knowledge explicit and
enables its transfer from individual to organizational level
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4. Teamwork and co-operation. Diversity of team members knowledge and
backgrounds stimulates dialogue, brainstorming and team problem solving
5. Experimenting culture. Sets aside resources for employees to enagage in creative
pet projects, develops rewarding mechanisms for those that excel in this area and
tolerates errors.
Caivin (1993) in }ashpaia (2OO4) said lhal Ieaining oiganizalion nodeI has hve
main activities:
- systematic problem solving,
- experimentation with new approaches,
- learning from their own experience and past history,
- learning from the experiences and best practices of others, and
- liansfeiiing knovIedge quickIy and efhcienlIy lhioughoul lhe oiganizalion
8lq uoto Aoolyucs
a. ig Dala dehnilion
Big data refers to datasets whose size is beyond the ability of typical database
software tools to capture, store, manage, and analyze (McKinsey, 2011). Every
oiganizalion nov use digilaI dala. Theie aie hve appIicalIe vays lo Ieveiage lig
data that offer transformational potential to create value an have implications for
how organizations will have to be designed, organized, and managed.
1. Creating tansparency. Making big data more easily accessible to relevant
stakeholders in a timely manner.
2. Enabling experimentation to discover needs, expose variability, and improve
performace. Organizations can collect more accurate and detailed performance
data (in real or near real time) on everything as they create and store more
transactional data in digital form.
3. Segmenting populations to customize actions. Big data allows organizations to
cieale highIy specihc segnenlalions and lo laiIoi pioducls and seivices pieciseIy
to meet those needs.
4. Replacing/supporting human decision making with automated algorithms.
In some cases, decisions will not necessarily be automated but augmanted by
analyzing huge, entire datasets using big data techniques and technologies.
5. Innovating new business models, products, and services. Big data enables
companies to create new products and services, enhance existing ones, and
invent entirely new business models.
Big Data analytics is developed from data analytics dicipline which has been used
for a long time ago for helping decision making in organization. Data analytics was
used structured data with ETL (Extract, Transform, and Load) process. Some its
popular applications are business intelligence, data mining, and other OLAP (Online
Analytical Process) systems.
There are four Vs that characterize Big Data (Sathi, 2012):
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1. Volume. With automation and digitalize data, organizations now have a
huge amount of data that come from within the corporation and outside the
organization.
2. Velocity. There two aspects of velocity, throuhgput of data (data moving in the
pipes) and latency (using data in motion)
3. Variety. The source data includes unstructured text, sound, and video in addition
to structured data.
4. Veracity. Veracity represents both the credibility of the data source as well as the
suitability of the data for the target audience.

b. Big Data Application in Healthcare
In heaIlhcaie indusliies, incieasing use of nuIlinedia has conliiluled signihcanlIy
to the growth of big data. Image data in the form of X-rays, CT and other scans
dominate data storage volumes in healthcare. While a singe page of records can
total a kilobyte, a single image can require 20 tp 200 megabutes or more to store
(McKinsey, 2011).
Healthcare organization usually has multiple stakeholders, including pharmaceutical
and medical products industries, providers, insurance agencies and patients. Each
generates pools of data, but they have typically remained unconnected from each
olhei. McKinsey CIolaI inslilule dehne foui dislincl lig dala pooIs exisl in lhe US
health care domain; pharmaceutical R&D data, clinical data, activity (claims) and
cost data, and patient behavior and sentiment data. Using big data analysis from
lhal dala pooIs couId inciease efhciencies, inpioved liealnenl effeclivenss, and
productivity enhancement (McKinsey, 2011).
According to McKinsey Global Institute (2011) in healthcare industry, Big Data
could be used to:
1. Comparative effectiveness research
2. Clinical decision support systems
3. Transparency about medical data
4. Remote patient monitoring
5. Advanced anaIylics appIied lo palienl piohIes
6. Automated payment systems
7. Health economics and outcomes research and performance-based pricing plans
8. Creating new business models: Online platforms and communities
9. And supporting public health program.
Methodo|ogy
This research uses qualitative method and exploratory approach. Its a case study
of an internal organization of a healthcare provider. Primary data is from interview with
head of service division of Yakes-Telkom. Secondary data consists of internal documents
and internet references. The data was analyze by comparing study with another cases in
US healthcase services to formulate a conceptual strategies of learning process using Big
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Data in the case study object.
Case Study
PT. Telekomunikasi Indonesia, Tbk (Telkom) is one of the biggest state-owned
enterprise in telecommunication industry. Since 1965, healthcare services had given for
aII enpIoyees and lheii faniIies as civiI ofhceis in Indonesia. If lhey veie sick, lhey couId
get restitution for they health care fee from the government through their institution.
UnliI 1998, heaIlh caie nanagenenl foi enpIoyees and pensions and lheii faniIies vas
nanaged ly heaIlh unil in IT. TeIkon. Since ApiiI 1sl, 1998 Yayasan Kesehalan Iegavai
Telkom (Yakes-Telkom) was founded as separated entity from Telkom, following the
policy to become go public company. Since 2000, all health care management, in regional
devision, support devision, and some subsidiaries of Telkom have been managed
byYakes-Telkom.
Yakes-Telkom has mission to becoming the best healthcare service provider in
Indonesia. To support its mission, Yakes-Telkom has establishes some strategies and
policies. Some of them, that related to this paper, are increasing healthcare services and
controlling expenditures. Until mid-year 2013, Yakes-Telkom has 403 employees, consits
of medical and non-medical staff, spread in 950 clinics operated in 7 regions in Indonesia.
Healthcare services provided inlcuding medical laboratorium, pharmacy, optic, general
check-up, and some specialist. Yakes also has six internal laboratoriums under Rasapala
(Yakes subsidiaries) management. Yakes-Telkom has around 120.000 members from
Telkom Group (including employees, pensions and their families) and around 30.000
members from Telkom subsidiaries.
Yakes-Telkom has online medical record system that integrate all medical data
of Yakes members. The system record patients personal data, treatment duration,
healthcare expenditures, hospitality history, and drugs records. With this system,
patients can get treatment from any clinic with any doctor without worry about their
medical data. All data from internal clinic (organized by Yakes) will be uploaded to
medical record system by each doctors. If they take medical treatment from partner
hospital, data will be input by staff when employees or pensions ask for restitutions.
They should give proof of payment and medical resume from the partner hospital. From
all clinics, it could reach 2560 transactions a day.
To reach it goals, Yakes-Telkom has a lot of programs devided in preventive,
currative, and rehabilitative programs. Preventive programs consist of health club,
healthiest family award, health-life paradigm, annual medical check-up, monthly
monitoring (for employees and pensions grouped as unhealthy condition). Currative
programs including medical treatment in clinic and hospital. Another program is
establishing Telkoms dugs list or Daftar Obat Telkom (DOT) for employees and pensions
of Telkom. DOT is list of drugs and pharmacy materials that have selected by medical
proof, save and efective. This program has objectives for drug use standardization,
quaIily conlioI, efhciency of cIain-cosl, and diug use noniloiing.
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Beside programs for healthcare services, Yakes also has programs to increase
cosl efhciency. Sone piogians aie nedicaI liealnenl slandaidizalion, ieducing cIain
cost by maximizing factory discount, reward and punishment, decreasing margin of
pharmacy and hospital, drugs formulation, and regulation of healthcare facility.
D|scuss|on]Interpertanon of Data
Yakes-Telkom has a large number of data that can be optimized to improve its
piocesses oi seivices. CeneiaIIy, lhe dala can le cIassihed in lhiee najoi pooIs. They aie
clinical data, patients behavior data, and activity and cost data. Each data pools consists
of some data sets that come from different elements. These are the detail of data pools
that can be formed by Yakes.
1. Clinical data.
Example datasets: electronic medical record, medical image, drugs list standard
Sources: Yakes clinics, partner hospitals
2. Patients behavior data
Example datasets: exercise data, patients behavior and preferences
Source: Patients
3. Activity and cost data
Example datasets: utilization of care, cost estimation
Sources: Yakes clinics, partner hospitals
Figure 1. Rcccncnda|icn cf 8ig Da|a Pcc|s fcr Ya|cs Tc||cn
With those data pools, Yakes can implement some Big Data solution are to do
improvement for services and processes. These are some potential improvement from
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big data analytics implementation, adopted from Mc Kinsey Global Institute analysis
(McKinsey, 2011).
1. Comparative effectiveness research.
Deleinining vhich liealnenls viII voik lesl foi specihc palienls ly anaIyzing
comprehensive patient and outcome data to compare the effectiveness of various
interventions. This solution can be supported by clinical data and patients behavior
data
2. Clinical decision support systems.
DepIoying cIinicaI decision suppoil syslens foi enhancing lhe efhciency and quaIily
of operations. This solution can be supported by clinical data and activity and cost
data.
3. Transparency about medical data.
The goal is to identify and analyze sources of variability and waste in clinical
processes and then optimize processes. This can be supported by clinical data and
activity and cost data.
4. Remote patient monitoring.
Collecting data from remote patient monitoring for chronically ill patients and
analyzing the resulting data to monitor adherence (determining if patients are
actually doing what was prescribed) and to improve future drug and treatment
options. This can be supported by patients behavior data.
5. Advanced anaIylics appIied lo palienl piohIes.
AppIying advanced anaIylics lo palienl piohIes (e.g., segnenlalion and piediclive
nodeIing) lo idenlify individuaIs vho vouId lenehl fion pioaclive caie oi IifeslyIe
changes. This can be supported by clinical data and patients behavior data.
6. Automated pricing systems.
Implementing automated systems for fraud detection and checking the accuracy
and consistency of patients claims. This can be supported by activity and cost data.
7. Online platforms and communities.
Forum for individuals can share their experience as patients in the system, or a forum
for physicians to share their medical insights. This can be supported by patients
behavior data
This table below shows how those big data solution could be used in each
learning process.
Learn|ng rocesss
8|g Data So|ut|on
1 ComparaLlve effecLlveness research v v v
2 Cllnlcal declslon supporL sysLem v v
3 1ransparency abouL medlcal daLa v v v
4 8emoLe paLlenL monlLorlng v
5 Advanced analyLlcs applled Lo paLlenLs proflles v
6 AuLomaLed prlclng sysLem v
7 Cnllne plaLform and communlLles v v
No
Systemat|c
prob|em
so|v|ng
exper|ment
at|on
|earn|ng
from own
exper|ences
|earn|ng
from
others
transferr|ng
know|edge
eff|c|ent|y
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Table 1. Mapping of Big Data Solution and Learning Process
Next step, we mapped Big Data Solutions above (from Tabel 1) to Yakes Progams.
Nunleis in ig Dala SoIulions heId shov lhal lhose soIulions suppoil oi le suppoiled
by related programs.
Increasing
healthcare services
Controlling
expenditures
health club V 4, 7
health family awards V 4, 7
health-life paradigm V 4, 7
annual medical check-up V 1, 5
monthly monitoring V 4, 5
currative treatment V 1, 2, 3
drug lists (DOT) V V 1, 2, 6
medical treatment standardization V V 2, 3
reducing claimcost V 6
reward and punishment V V 2
decreasing margin of pharmacy & hospital V 6
drugs formulation standard V 2, 6
regulation of healthcare facility V 2
Strateg|es
Big Data
Solution(s)
Yakes' Programs
Tabel 2. Mapping cf 8ig Da|a Sc|u|icn and Ya|cs Prcgrans
Conc|us|on and kecommendanon
ig dala anaIylics can le used lo inpiove hve nain acliviles in Ieaining piocesses.
In case of Yakes Telkom, those solution can also help Yakes programs to increase
healthcare services and control expenditures. This research still has many weakneasses.
For further research, we recommend to add more data and more detail discussion about
big data solutions that could be implemented in organization.
keferences
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