Enhancing Security, Privacy, and Traceability in Indonesia’s National Health Insurance Claims Process using Blockchain Technology

BPJS Kesehatan, Indonesia’s national healthcare insurance company for almost a decade, has succeeded in providing affordable health insurance to around 89% of the citizens with assets worth IDR 98.76 Trillion. This growth raises new concerns regarding their policyholder’s data security and privacy. Using blockchain technology, we proposed a model to protect the stakeholder’s data security by giving the data owner access to control the authorized user. Blockchain anonymity also provides pseudonymity to solve the privacy vulnerability of the process. This research also enables data traceability by giving them access to data status and activity tracker. We combine a hybrid database system with an InterPlanetary File System (IPFS) and a local central database to address the blockchain scalability issue and minimize the impact on the existing database, thereby avoiding integration issues. The research proposes three different architectures using the existing healthcare treatment and insurance claim process. The functional architecture illustrates the actor’s behavior, the logical architecture represents parallel processing activity and data movement, and the physical data architecture explains a detailed data relationship between actors during the healthcare treatment and insurance claim. The proposed system allows the actors to create or write data to or from the determined database through the blockchain network.