By Matthew Brady Siloam International Hospitals is building what it calls the Hospital of the Future, an AI foundation trained on millions of real patient interactions across its 41 sites. In an exclusive interview with HealthTechAsia, President Director David Utama outlines the strategy, the thinking behind it, and why reversing Indonesia’s 170 trillion rupiah annual outflow of medical tourism sits at the centre of the plan.
The call connected somewhere on the road between meetings in Jakarta, a fitting backdrop for a conversation about navigating complexity at scale. Utama, President Director of PT Siloam International Hospitals Tbk, was in transit. Siloam, it turns out, is in a similar position: moving quickly, choosing its route carefully, and wagering that the path it has chosen will look prescient in five years’ time.
Utama joined Siloam in August 2024, bringing extensive leadership experience across the healthcare industry. Leading one of Southeast Asia’s largest private hospital networks was, he says, a compelling next step, given Siloam’s scale and growing role in expanding access to quality healthcare across Indonesia.
Today, Siloam operates 41 hospitals nationwide, serving millions of patients annually. “It’s a privilege to be part of this organisation,” Utama says. With experience as Vice Chairman for Healthcare at Kadin, the Indonesian Chamber of Commerce, he sees Siloam as well positioned to support Indonesia’s priorities of expanding access, addressing specialist shortages, and strengthening the country’s healthcare system.
A strategy for a different era
The immediate context for Utama’s appointment was a strategic inflection point. Siloam’s previous five-year strategy, Siloam 5.0, running from 2019 to 2024, had delivered strong results: revenue of IDR 12.2 trillion, underlying EBITDA of IDR 2.76 trillion, and net profit of IDR 950 billion by 2024, built on four pillars of operational excellence, network expansion, clinical programme investment, and digital health infrastructure.
The question facing Utama on arrival was whether that framework was still sufficient. Siloam’s conclusion was that it was not, and that the smarter move was to reshape the strategy before the environment forced the change. Two structural challenges drove that conclusion: a shortage of specialists relative to Indonesia’s population, and the rising cost of healthcare at a time when the government is trying to expand universal coverage.
The resulting framework, Next Gen Siloam, rests on three original pillars and a fourth added more recently. The first is a renewed commitment to talent development, framed internally as “people first” and backed by a university affiliate that now produces around 700 nurses a year trained to Siloam’s own standards. The second is a structural reorganisation of how the network’s 41 hospitals are managed.
The archetype model
For most of its history, Siloam grouped its hospitals by geography: five regions, each a mix of premium and community-focused facilities. Utama describes this as a structural mismatch, arguing that patients are not profiled by region, so hospitals should not be managed that way either.
The network is now organised into four distinct archetypes: Premium Specialist hospitals focused on advanced specialty care and Centres of Excellence; Premium Generalist hospitals offering comprehensive specialist services across multiple disciplines; Value Seeker hospitals designed for greater affordability and accessibility; and Community Generalist hospitals that expand access to care, including for patients under Indonesia’s national health insurance programme.
Rather than applying a single approach across all 41 hospitals, the model allows each archetype to develop capabilities, services, and operating structures aligned with the needs of the communities it serves.
“The needs of a patient seeking highly specialised care are different from those of a patient looking for accessible community healthcare,” Utama says. “Our responsibility is to ensure that every patient can access the right level of care, in the right setting, at the right time.”
The model is also intended to support deeper clinical expertise across the network, in areas such as oncology, neurosciences, kidney transplantation, cardiovascular care, and robotic surgery, while maintaining broad access to care nationally.
The rationale for the premium tier extends beyond revenue. Utama points to a deficit of around 170 trillion rupiah annually from Indonesians seeking treatment overseas, and positions Siloam’s premium and specialist centres as a domestic alternative, aiming to capture a share of that outbound spend by matching the outcomes and service quality of regional competitors.
The hospital of the future
The fourth pillar, and the one Utama is most animated about, emerged in the second half of 2025 under the internal name Hospital of the Future. It begins with data infrastructure.
Siloam spent the latter part of 2025 studying how hospitals and technology companies in China, India and the United States have approached AI, at the foundational level rather than the application level, a distinction Utama is careful to draw. The conclusion reached was that the right starting point is not to add AI tools onto existing workflows, but to build a centralised enterprise AI platform trained on Siloam’s own clinical data, running on a bespoke large language model tailored to its operational and medical environment.
Siloam expects to complete the AI foundation by November 2026, with the model trained on structured clinical data held locally in Indonesia rather than on external cloud infrastructure, a choice Utama says reflects both data sovereignty considerations and the specificity of the clinical vocabulary the model needs to learn.
Three applications are being built on top of that foundation. The first is a patient digital twin, a personalised interface within the MySiloam app built around an individual patient’s own records, history, appointments, and conversations with their care team, rather than generic health information. With around four million outpatient interactions annually, Utama argues that this level of personalisation would not be feasible without AI.
The second is a doctor digital twin, which Utama describes as the most difficult of the three to execute, needing to be clinician-led, commercially justifiable, and clinically meaningful, a higher bar than either of the other applications.
The third is a hospital digital twin covering operational functions: rostering, capacity balancing, and scheduling across all 41 sites.
Throughout, Utama returns to a single principle. “Physicians remain the decision-makers,” he says. “Technology should support clinical judgement, not replace it.”
What is already running
Two AI applications are already in pilot across five hospitals. The first converts recorded doctor-patient consultations into structured medical notes and clinical coding in real time, removing manual documentation work from physicians. According to Siloam, the pilot has shown promising early results, with performance improving as the model is trained on the network’s patient vocabulary, clinical terminology, and the range of Indonesian dialects spoken across its hospitals.
The second is a smart ICU system connecting patient monitoring equipment to Siloam’s cloud infrastructure, with AI analysing incoming data continuously. The aim, Utama says, is to anticipate patient deterioration roughly 30 minutes before it occurs, rather than responding after the fact, which he frames as the clearest expression of value-based care: proactive rather than reactive, with patient outcomes as the only metric that matters.
In both systems, Utama is emphatic that physicians remain the decision-makers, with the tools designed to support clinical judgement rather than substitute for it. Adoption among specialists piloting the medical scribing system has moved from scepticism to advocacy as accuracy has improved, according to Siloam, with doctors who found the early version frustrating now said to be encouraging colleagues to try the current one.
Five years out
Asked how he defines success by 2030, Utama starts with patients rather than technology: shorter waiting times, smoother care journeys, better access to healthcare services, stronger clinical outcomes, and greater public confidence in Indonesia’s healthcare system.
Utama frames Siloam’s ambition as extending beyond the company itself, arguing that Indonesia’s healthcare challenges cannot be solved by any single institution, and will instead require collaboration between healthcare providers, government, academia, technology partners, and industry.
Whether Siloam’s approach, building its own AI foundation from the ground up rather than layering tools onto existing systems, proves to be the right one will not be clear for some time. The November 2026 completion date for the foundation is itself only a starting point, with the harder test, embedding it into the daily judgement of physicians across 41 hospitals, still ahead. That is the test worth watching.
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