Exclusive interview with Malaysia Ministry of Health’s Director General of Health, Datuk Dr Noor Hisham Abdullah

Paper-based patient data is a thing of the past. Hospitals are driving the digitalisation of patient records, in a bid to streamline both patient care and business. The global electronic medical record (EMR) market is expected to hit US$20.7B in the next 5 years

In Malaysia, when the Ministry of Health announced it’s to roll out EMR systems across all hospitals and clinics nationwide last year, the message was clear: the country would not be left behind in the global digitalisation wave. The nation is on the brink of the next step of their digital trajectory, the 12th Malaysia Plan (2021-2025), which will focus on priorities, such as “quality and safety of care” and “inclusive innovations and smart solutions”. 

As the nation makes its quantum leap towards Malaysia 5.0, the Ministry’s Director General of Health, Datuk Dr Noor Hisham Abdullah, tells Hospital Insights Asia about how the COVID-19 pandemic has increased the pace of innovation, why partnerships are key for interoperability success, and what the “next normal” will look like for patient care.  

Malaysia’s digitalisation journey

Malaysia’s healthcare is at a critical junction. With an ageing population expected to jump by 40% in the next 30 years, growing demand for treatment is putting increasing pressure on the system. And governments and hospitals are turning to technology for support and innovative solutions to streamline operations without spending excessively. 

The pandemic has accelerated this demand for digital evolution, and the Ministry is stepping up to embrace the new challenges of a socially distanced era. “COVID-19 has altered attitudes and accelerated adoption of policies that enable the business of work”, says the Director General. “This crisis offered a unique opportunity to accelerate digital transformation”.

Where “virtual engagements have become a norm”, the Ministry has rapidly improved connectivity and bandwidth across the nation to meet the need for virtual clinics and highly tele-networked operations, with “system implementation and solutions for COVID-19 going live in a short period of time”. 

An integrated future, and past 

Telemedicine may be the future, but when it comes to Malaysia, it is also a key part of its past. Since its Telemedicine Blueprint 1997, the Ministry’s key focus has been a “people and services focused… wellness through an integrated healthcare”. Today, that mission has received fresh impetus from the coronavirus pandemic.

In February this year, the MoH partnered with DoctorOnCall, a medical video consultation start-up to create a customised virtual health consultancy platform that would address public concerns about Covid-19, a “first-of-its-kind solution initiated by a government in the region”.

Today, Datuk Dr Noor Hisham speaks of the Ministry’s vision of “nationwide system implementation”, and missions such as the “Lifetime Health Record for individuals”: an e-health initiative set to provide a “one record, one person, accessibility to data and patient engagement”.

“The MOH has been strengthening its digital health strategy and technology adoption…with a goal towards achieving Universal Health Coverage”, Datuk Dr Noor Hisham shares. 

Centrally accessible data: at the heart of the new normal?

For hospitals which have already embarked on their EMR journey, interoperability might seem like a natural next step: linking hospitals across the nation’s healthcare system by carrying information through an interconnected network, like veins connecting vital organs. 

Interoperability can improve the patient experience, co-ordinating administration, and providing greater visibility of possible treatments and prescriptions. It allows for hospitals to track, trace, and protect their sensitive data. And it is good for business: a white paper from American research organisation West Health, estimated that interoperability could save the health sector $35 billion annually through streamlined production and reduced costs.

The Director General is quick to confirm that “a robust interoperability platform” is critical. While there is no announced timeframe, the Malaysia Health Information Exchange, a patient record interoperability platform launched in 2009 as a precursor for public-private integration in health, remains a “significant digital health initiative” the MoH is “actively pursuing” to shape the future of Malaysia’s health system. 

But making a health system interoperable, especially on a national level, is not always a smooth journey. EHR systems from different hospitals using different vendors, don’t always mesh together, meaning communication can be lost. And without established industry-wide standards and policies to send, receive and manage data, hospitals meet challenges in identifying patients and their healthcare needs. Pricing of integration can also be a barrier to entry for smaller hospitals. 

When man and machine interact, the human factor can sometimes be the weakest link. Describing her EMR journey at the first hospital to embark on a fully automated early warning scoring system in the APAC region, Dr Tan Hui Ling, Managing Director, Bagan Specialist Centre and Oriental Melaka Straits Medical Centre admitted earlier this year that “the biggest challenge is in the mindset, expectations and the ability to visualize how to… use technology to improve our work process or quality of care” across medical professionals and hospital managers. 

“Many health sectors across the globe have embarked on interoperability with many challenges” Datuk Dr Noor Hisham ventures. For him, success lies in involvement from both public and private sector, and taking lessons from other countries’ interoperability journeys. In the USA, a pioneer in healthcare operability, one issue has been a disconnect between government and industry. “Federal reporting and administrative requirements” were cited earlier this year as a roadblock to operators in implementing efficient electronic exchange. 

“An interoperability layer is crucial”, confirms Datuk Dr Noor Hisham, “(but only) with agreed standards and policies”. 

Partnerships for the next normal 

“4IR with telecommunication advances, and the dawn of 5G technology, are presenting multiple strategies and challenges ahead”, says Datuk Dr Noor Hisham. To plan for this connected future, the Ministry is reviewing and developing regulatory strategies and policies to foster digital health technologies, spur innovations and boost the digital economy. 

But the success of digital health also requires partnerships and strategic collaborations at regional and global levels. And to build the required competencies, policies and frameworks for a Smart future, the right partnership with the right solutions provider is critical. 

The overall increase in global demand for information exchange and connection enabling solutions has resulted in a “market explosion of vendor offerings” and a search amongst hospitals and governments for an elusive “golden standard” of interoperability solutions. 

For Malaysia and its Ministry of Health, these “collaborative partnerships” and “public-private integration” are key components to the country.

“Sharing of medical information is important to ensure continuity of care, improved outcome and population health”, asserts Datuk Dr Noor Hisham. Connectivity is more than just electronic information. It is the network of relationships that help build, not just data, but also expertise for the future. 

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