Materia Medica Malaysiana

Revisiting healthcare

IT has been eight years since the Government adopted a national-level strategy to leapfrog the country’s healthcare system to a new e-Health paradigm. With the Multimedia Super Corridor Telehealth Project and MSC Telehealth Blueprint (1997) in place, the Government hopes to transform the healthcare system to a nation of healthy individuals, families and communities via the adoption of information technology (IT).
To support the developments in e-healthcare, the country also went on to define the legal framework with new cyberlaws such Telemedicine Act 1997, Digital Signature Act 1997 and Personal Data Protection Bill.
Even a Telehealth Unit under the Health Ministry was established to oversee the project implementation and play a strategic role in aligning future IT projects undertaken by the Ministry. The unit is also responsible for the development of code sets, policies, health informatics standards and functional specifications of e-Health applications.
Several significant developments have taken place since the launch of the MSC Telehealth project. Among them are the establishment of two hi-tech hospitals with total hospital information systems (Selayang Hospital and Putrajaya Hospital), 37 health centres and two hospitals (Hospital Kajang and Hospital Seremban) with clinical information systems, and 42 health centres with teleconsultation facilities. Another 14 hi-tech hospitals will be rolled out by next year, and another 20 are in the planning process.

Lacking human capacity
Though the e-Health endeavour has come a long way, the country is currently facing a shortage of domain experts or health informaticians in the design, development and deployment of the e-Health projects, says Dr H.M. Goh, secretary for both Malaysian Health Informatics Association and Asia-Pacific Association for Medical Informatics.
He attributes this shortage to the lack of awareness by the stakeholders and healthcare community about health informatics.
The field of health informatics provides the training and research opportunities to develop and implement new technologies that will enhance decision support to healthcare professionals and biomedical scientists.
“While our doctors need to be more IT savvy, so must IT professionals be more medical savvy,” Dr Goh says. “We need a good mix of both type of professionals to exchange ideas and collaborate in research and development.”
“We cannot provide quality, safe and efficient healthcare without IT, so there will be a direct impact to the cost of healthcare. As Malaysia is getting more developed, demographics have changed too and people are living longer. We will be dependent on strategic information to manage our national health and policy-making. We can’t get timely information for planning if we don’t computerise,” he explains.
In addition, he believes that if the country is serious about health tourism to attract international patients, she must be better equipped and IT-ready, otherwise patients will choose to seek healthcare elsewhere.

People development
Dr Goh calls for a more structured national training programme to be established and given high priority. This, he says, is to ensure that Malaysia has sufficient human resource expertise to meet the demand for the e-Health projects.
He suggests that academic institutions look into developing a more structured curriculum to churn out more health informaticians, and that the country emulate some of the successful initiatives undertaken by countries such as Taiwan, South Korea and Japan in human capital development.
Taiwan has started many postgraduate programmes in health informatics while Korea and Japan have recognised professorship in health informatics. These, Dr Goh says, have created a strong research foundation for health informatics development.

Standards development
Apart from people development, standards development in healthcare is equally important, points out Dr Goh.
To meet national objectives, standards must be in place so disparate and fragmented systems can work together, interface and collaborate, he says. This way, health information can be standardised among different healthcare facilities, and a more continuous and seamless care can be achieved.
These standards need not necessarily be created, according to Dr Goh. “Some of the standards have already been developed elsewhere and we can actually evaluate them for possible adoption and integration. Additionally, we can localise some of the international standards for our own use,” he says.