Post-2020 plans for Malaysia’s digital health initiatives

During one HIMSS’ Digital Health Summit panel discussion, the moderator Tim Kelsey who is also HIMSS’ SVP of Analytics International had said, “I love the challenges and opportunities for digital in healthcare.”

He had observed that governments have prioritised digital health for quite some time even before COVID-19, and they do so because they recognise the evidence that supports the value of an empowered patient in improving their health-seeking behaviour.

“The drivers have been there and the pandemic has generally accelerated (digital health),” he said.

COVID-19 experiences

Ayala Health’s Chief Digital Officer Christian Besler in Philippines, shared about how as part of their corporate health strategy, the company had brought primary health care clinics into the work premises of large corporations.

Patients could schedule appointments with the on-site doctor via a digital app, and a typical daily ritual of a corporate employee under this service’s care would be a quick check-in with the doctor before work, and even their blood pressure taken and recorded into an EMR system (electronic medical records).

The upward or downward trend of a patient’s health would be easier spotted and these trends could also inform doctors whether to adjust medications or carry out an intervention, and so on.

Christian said, “By moving the doctor literally next to the entrance at work, there is no excuse not to check in.”

When Manila went into lockdown due to the coronavirus, all corporate clinics were closed. But the beauty of having technology installed earlier on, was that it enabled a seamless continuance of this healthcare service via one-on-one video conference sessions with patients.

‘We had to retool our workforce overnight to enable this. Luckily, doctors were open-minded and forward-thinking enough in how to still fulfill healthcare needs, medication needs, prescription needs, and all that,” Christian said.

Malaysia’s digital initiatives

This acceleration in equipping the healthcare system with digital tools and platforms is something Malaysia underwent as a country as well.

Dr. Fazillah Shaik Allaudin

The panel discussion also saw Malaysian Ministry of Health’s Dr. Fazilah Shaik Allaudin share perspectives at the national level. The overall public health preparedness and response is wide-ranging from activation of the national CPRC (Crisis Preparedness and Response Centre) to strengthening (immigration) point of entry screening, expanding hospital capacity, activation of rapid response teams, international collaborations, and many more.

Digital response

Of these, there is also the digital response and within that there are six focus areas  identified for upgrade and/or enhanced activities includes strategic and risk communications with the use of many media channels like social media, mass media and so on to keep the public informed.

“Community engagement is also very important,” Dr. Fazilah said adding that they either leveraged an existing platform/system, or they created a new initiative/tool.

Contact tracing solutions like MySejahtera and MyTrace are examples of new tools created as a national-level response to contain and fight the virus.

Virtual clinics and e-appointment activities also increased convenience of access to healthcare.

When it came to operational efficiencies for hospitals and clinics and the crisis centre, the realisation dawned that proper data collection tools or platforms are very important. “We had to have very rapid data collection tools to be able to understand what’s happening on the ground, and at same time have dashboards and analytical tools to help us make strategic decisions,” Dr. Fazilah said.

There was also a massive infrastructure for connectivity and bandwidth, research in terms of usage of artificial intelligence (AI) on x-rays and CT scans, and ongoing clinical trials, drug trials, genomic studies, and health system response dashboards.

“This all was done in a very short span of time, with speed, coordination and collaboration that was never seen before. I have worked in healthcare for almost 20 years and what has happened in the last 6 months is just extraordinary.”

Citing implementation challenges around process, technology, people and policy, Dr. Fazilah also expressed hope that this speed and urgency can be maintained as Malaysia moves forward with digital health.

“I’m sure as we move forward and look at new emerging technology like AI, data analytics and more there may be other challenges to consider like safety, ethics, legal challenges,” she added.

Post-2020 plans for Malaysia’s digital health drive

Dr. Fazilah who is also Senior Deputy Director for MOH’s Planning Division, brought up the very pertinent question of the the future workforce – What is it going to look like? Does the healthcare system need to reskill and what are the new knowledge and new expertise that education needs to consider?

“Moving forward for the next 5 years, we are focusing a lot on community empowerment,” she said explaining that part of this includes introducing technology and encouraging tech adoption when it comes to self-managing wellness.

Also being explored is technologies for monitoring health at home, and getting communities accustomed to virtual consultations. Taking note of the need to bridge the digital divide and increase digital equity, connectivity and access to technology  for rural communities is another important consideration.

“Non-communicable disease (NCD) is one of our major disease burdens, and whatever we do with digital tech should also address NCD especially continuity of care between primary, secondary, tertiary levels, back to home and so on.”

She also expressed hope to initiate the Lifetime Heatlh Records (LHR) project and to build out a robust platform for health information exchange, in the next 5 years.

“Many of our facilities are still manual, and we need to address that and make it our priority. Whatever we do, we must not forget the 3 principles of Availability, Accessibility and Affordability. Affordability is very important,” Dr. Fazilah concluded.