Depok, June 27, 2026 – The Faculty of Public Health, Universitas Indonesia (FPH UI), has once again produced a research-based innovation that supports the transformation of Indonesia’s national health system. At an open doctoral promotion examination held on the FPH UI campus, Unting Patri Wicaksono Pribadi successfully defended his dissertation on the development of an electronic contract (e-contract) model for managing cooperation agreements between BPJS Kesehatan and healthcare facilities. The research, entitled “An Analysis of the Effectiveness, Efficiency, and Security of Manual and Electronic Contracts in the National Health Insurance Program,” demonstrates that contract digitalization can improve the effectiveness, efficiency, and security of partnership governance in the implementation of the National Health Insurance (JKN) Program.
The study was motivated by the lengthy administrative process involved in manually managing cooperation agreements with thousands of healthcare facilities partnering with BPJS Kesehatan across Indonesia. The process requires document printing, physical delivery, in-person signing, and manual archiving, all of which can cause delays, increase operational costs, and create the risk of document loss. These challenges have become increasingly significant amid the government’s ongoing efforts to accelerate digital transformation in the healthcare sector.
Using a mixed-methods approach through a non-experimental comparative study, the research examined 2,649 hospitals partnering with BPJS Kesehatan throughout Indonesia. Quantitative analysis was combined with in-depth interviews and field observations to compare the implementation of electronic and manual contracts in terms of effectiveness, efficiency, and security.
The findings demonstrated that electronic contracts performed substantially better than conventional methods. In terms of effectiveness, electronic contracts accelerated the completion of cooperation agreements, improved timeliness, reduced administrative errors, and facilitated real-time process monitoring through a digital dashboard. Average contract completion delays were also lower than those associated with manual contracts, as all administrative stages were conducted electronically without relying on the physical distribution of documents.
In terms of efficiency, the study found that contract digitalization significantly reduced administrative costs. The average cost of managing an electronic contract was IDR 321,148, compared with IDR 565,241 for a manual contract, representing savings of approximately 43.2%, or IDR 244,093 per contract. If implemented across approximately 27,000 healthcare facilities partnering with BPJS Kesehatan, the system could potentially generate national cost savings of up to IDR 3.375 billion. Digitalization also reduces the need for human resources to perform repetitive administrative tasks, thereby improving organizational productivity.
Another important finding concerned the security of digital documents. Electronic contracts utilize electronic signatures, digital certificates, electronic duty stamps (e-meterai), encryption mechanisms, audit trails, and automatic backup systems, providing better protection than physical documents. All user activities can be traced, strengthening accountability while minimizing the risks of document loss and misuse. Nevertheless, the study also identified the need to improve cybersecurity literacy and strengthen user access governance to optimize the implementation of the digital system.
The study further found that organizational characteristics influence the successful adoption of electronic contracts. Private hospitals tend to adopt digital systems more quickly because they have greater flexibility in decision-making and information technology development. Meanwhile, government hospitals and healthcare facilities with limited infrastructure still require support in strengthening human resource capacity, internet connectivity, and comprehensive digital transformation governance.
The novelty of this research lies in the development of an evaluation model for electronic contract implementation that comprehensively integrates measurements of effectiveness, efficiency, and security within the framework of partnerships between BPJS Kesehatan and healthcare facilities. The model goes beyond measuring the acceleration of administrative processes by also identifying organizational factors that influence the success of digital transformation. It can therefore serve as a foundation for formulating national policies on e-contract implementation.
The findings provide strategic recommendations for BPJS Kesehatan to develop an integrated digital contract ecosystem encompassing contract preparation, signing, monitoring, and implementation evaluation. The study also recommends strengthening information security through regular security audits, multi-factor authentication, access control mechanisms, and enhanced human resource competencies to support successful digital transformation in the healthcare sector.
Through this research, FPH UI reaffirms its role as a higher education institution that produces innovative research to address challenges in Indonesia’s health system governance. The development of this electronic contract model is expected to improve the quality of JKN administrative services, strengthen partnership governance between BPJS Kesehatan and healthcare facilities, and contribute to a more effective, efficient, and sustainable digital healthcare transformation.
Unting Patri Wicaksono Pribadi’s open doctoral promotion examination was chaired by Prof. dr. Amal Chalik Sjaaf, S.K.M., Dr.PH, as Chief Examiner. Prof. Dr. Ascobat Gani, M.P.H., Dr.PH, served as the dissertation promoter, assisted by co-promoter Dr. rer. nat. I Made Wiryana, S.Si., S.Kom., M.AppSc. The examination committee comprised Prof. Dr. drg. Mardiati Nadjib, M.Sc.; Prof. Dr. drg. Anne Agustina S., M.K.M.; Dr. dr. Mahlil Ruby, M.Kes.; and Dr. dr. Enrico Adhitya Rinaldi, M.A.R.S., M.H., M.M., CPM (Asia), FISQua. (wrk)