Aligning public, private, and policy for healthcare sustainability
When the pandemic struck over a year ago, never was there a sector more in need of digital technologies and solutions, than the healthcare industry.
Senior Deputy Director of Planning Division, at MOH, Dr. Fazilah Shaik Allaudin, observed, “Everyone was trying to solve the pandemic problem, and solve a need. We needed a mobile app, so we came up with MySejahtera, which helped to empower the community to do their own health assessments. The appp also empower themselves with COVID-19 information at their fingertips.”
But that was not all, because contact tracing needed to be done. Also, public health labs had to be further enhanced to enable lab testing and results to be sent in to relevant authorities. 
Dr. Fazilah also added another all-important need which had to be met with virtual consultations, “…because patients were unable to go to hospitals, or there were very limited follow-ups from the hospitals.
“So, we started using all the commercial (health) platforms that were out there.”
But besides this, a lot of other online activities began to mushroom. For example, virtual health advisories, webinars, even work from home – all of which served to point out that all these, and even the digital economy which we are aspiring towards as a nation, is not impossible thanks to the right infrastructure, hardware, and connectivity.
Resources could be coordinated and allocated to where they were needed most, because communications infrastructure were enhanced to be robust.
A flurry of activities begun in 2020 which made people realise that digital transformation is possible.
And digitalisation is advancing at a very, very rapid pace for this sector.
Communications infrastructure had to be enhanced and beefed up to a level of robustness so that resources could be coordinated and allocated to where they were needed most.
A plan for Malaysia
The Digital Strategic Plan is slated to be published in June of this year, by the Ministry of Health (MOH). At time of writing, this journalist understands that this 5-year strategic plan will align with the public sector transformation plan by MAMPU, the government’s ICT arm.
There will also be focus upon big data, skill and talent, as well as innovations and adaptation of emerging technologies in healthcare.
According to Dr. Fazilah this strategic plan is also aligned with other national-level blueprint initiatives; MyDigital and 4IR policy spearheaded by the Economic Planning Unit (EPU); and the STI blueprint (Science, Technology and Innovation) by the Ministry of Science, Technology and Innovation (MOSTI).
There will also be focus upon big data, skill and talent, as well as innovations and adaptation of emerging technologies in healthcare.
She observed, “These two blueprints have specific focus areas for the health sector.”
Initiatives under the health sector are related to emerging technologies like AI, precision medicine, nano technology, neuroscience, bio-science, robotics, 3D, and so on.
The MOSTI minister has blogged: We continue to support several e-government initiatives for example in healthcare, via our agency, MIMOS. TPC-OHCIS, and myHDW respectively use advanced data security technology and AI-based data analytics to improve the quality of public healthcare service delivery.
MOH was also involved in giving feedback during the development of the MyDigital blueprint. Dr. Fazilah pointed out, “Basically, there are six clusters and in three to four clusters, there are very specific health-related initiatives that will be monitored for the next five to 10 years, with their own targets to achieve.”
In this way, it can also feedback healthcare-related requirements into national-level blueprints like MyDigital and the Science, Technology and Innovation (STI) blueprint.
Today, many technologies are involved in clinical trials and research, for example robotics, 3D printing, and Artificial Intelligence (AI). Dr. Fazilah pointed out, “We have trials in imaging for COVID-19 using AI, and we have also included machine learning in our MySejahtera app.”
In summary, the healthcare sector and MOH are involved in all the roadmaps for emerging technologies mentioned above. To create a robust and future-proof strategic plan, the ministry has to keep itself abreast of all these technology developments. In this way, it can also feedback healthcare-related requirements into national-level blueprints like MyDigital and the Science, Technology and Innovation (STI) blueprint.
The way forward
It is usually when things are moving especially fast , that someone has to pause and ask the thoughtful questions.
Dr. Fazilah has asked these questions before and it seems even more urgent now than it was 12 months ago. “How do we sustain this speed and spirit of collaboration? I think (finding the answers to this question) is what is in the horizon.”
One of the pertinent questions that remains is the re-use of resources – many digital solutions were created during the pandemic, for example in hospitals, and labs and so on.
Can they be repurposed for other conditions post COVID-19?
“What about sustaining this entire model or solution like MySejahtera – can we use if for wellness, and to track other conditions, or other non-communicable diseases (NCD) – because the community is already using this app,” Dr. Fazilah asked hypothetically.
One of the pertinent questions that remains is the re-use of resources – many digital solutions were created during the pandemic, for example in hospitals, and labs and so on.
Partnerships and alignment
How is the Ministry of Health, managing with so many areas that needs to be looked into, planned, and then carried out?
Dr. Fazilah shared, “We partnered more (than before), in fact we partnered a lot!
“A lot of coordination had to be done; for example with the vaccination programme, MOSTI was our partner in this.
“Even in terms of technology, there were so many players that came in, but this will not be possible without partnerships, and industry support, along with intra-agency and inter-ministerial collaborations.”
“So in the horizon, I am thinking about horizontal integration and vertical integration between facilities across public and private sectors.”
She explained that is she is looking at public-private integration.
“Again and again I am talking about public-private integration. During this time we need information, we need data of patients – a health information exchange (HIE) and coordinated care are also important.
“So in the horizon, I am thinking about horizontal integration and vertical integration between facilities across public and private sectors.”
For example, the initiatives by the Crisis Preparedness and Response Centre (CPRC), highlighted the importance of collecting data and analysing them to manage the pandemic.
The insights which are publicly released so that Malaysians could be kept informed of the COVID-19 situation. This is possible because of data from various multiple sources, and of course relevant technology to manage them all.
Dr. Fazilah underlines the importance of data. “It looks like so much is related to data. The entire data governance, data stewardship, data collection, data analysis, is what is moving (us) forward.”
She also noticed there is a need for robotics and drones roadmaps. The pandemic has perhaps revealed an urgency to use these two technologies more pervasively and in a sustainable way.
The insights which are publicly released so that Malaysians could be kept informed of the COVID-19 situation, is possible because of data from various multiple sources, and of course relevant technology to manage them all.
A regulatory sandbox
What about a framework for online health solutions and digital platforms to participate more meaningfully and extensively in the healthcare industry?
Dr. Fazilah explained, “We did a consultancy to come up with the regulatory framework. Now, we may be moving towards a regulatory lab to see how we can co-create (with stakeholders) the regulations and policies for digital health platforms.
“There are so many (platforms) out there. So, next is to test it out in regulatory labs, and we are working with the National Regulatory Sandbox under Futurise.”
“We did a consultancy to come up with the regulatory framework. Now, we may be moving towards a regulatory lab to see how we can co-create (with stakeholders) the regulations and policies for digital health platforms.
The National Regulatory Sandbox is driven by Futurise which was mandated by the Government of Malaysia to do so. This is an initiative to explore innovation-friendly regulatory approaches, according to its website.
Another interesting development is also the potential appointment of Mr. Fabian Bigar, as CEO of the MyDigital agency tasked to deliver the digital economy blueprint.
Dr. Fazilah is optimistic he would be able to handle it well with his previous experience with the 2010 Economic Transformation Plan (ETP) and the Chief Secretary office.
You really need to understand health and the issues and the challenges to have digital transformation in health.
While the industry sees he has a monumental task getting various stakeholders of six different clusters across many different sectors, all onto the same page, Dr. Fazilah is hopeful because of his MOH background, that he will understand health.
“You really need to understand health and the issues and the challenges to have digital transformation in health,” she said.
We need answers and solutions
Before COVID-19, there were already many hurdles for more pervasive use of technologies in the healthcare sector. Now that there is acceleration of digital use, a new set of challenges have emerged, and this time with more urgent timelines than before.
“The traditional challenges, yes, we have to address (them), but what about the new challenges in the horizon? What about regulations and policies that are already outdated and hampers innovation today, or hampers digital transformation?
“That has to be looked at.”
The focus for the next few years at least, is not only digital transformation in healthcare, but real, meaningful transformation of healthcare as a whole, she said. A shared wish in 2019 to bring people out of hospitals and focus on wellness, comes to mind.
There is also healthcare financing reform to consider, and a myriad of other things that are already in the pipeline.
Dr. Fazilah said, “I think what’s next in the horizon is to get the right business model, the right partnerships and sustainability and funding. And then looking at partnerships, working together with universities and industries… because the experts are out there.
“We as MOH, cannot do this alone. We have to work together,” she said emphatically in concluding the interview.