MoH Speaks: Tech and regulations in local healthcare
Tech has impacted all areas of healthcare.
During an interview with the Senior Deputy Director of Planning Division Ministry of Health, Dr. Fazilah Shaik Allaudin, she explained exactly where we can find technology at work in the healthcare domain.
But first things first, to ensure our readers understand the scope of healthcare, she wanted to explain about the spectrum of healthcare, a continuum that ranges from individuals to home to community to hospitals/primary care settings and back to community again.
The part which most of us are familiar with when it comes to receiving medical attention, are physical healthcare facilities like hospitals and clinics. But healthcare proponents like Dr Fazilah, believes that the focus of future healthcare should be to move people out of these hospitals. There should also be focus on wellness.
For all these to happen, an enabling environment has to be put in place. This is where Dr Fazilah and her team at the Ministry of Health, has a huge role to play.
In the public sector, there are about 145 hospitals under the purview of the MOH, as well as over 3000 clinics big and small. Then there are the nine university hospitals which are under the Ministry of Education (MOE), while the Ministry of Defense (MINDEF) oversees about four army hospitals and all its satellite clinics.
On top of all these are the over 200 private hospitals and over 7000 General Practitioner (GP) clinics, which make up the private healthcare sector. But, there are many more players/stakeholders in healthcare.
From all of this, Dr. Fazilah asked the hypothetical questions: How do we integrate public and private healthcare? Can technology enable this?
How do we enable interoperability on a platform?
Dr. Fazilah explained, “All healthcare facilities have to be ICT-enabled and using EMR or electronic medical records. Recently the Minister announced a target of 3 years. Right now, about less than 30-percent of MOH hospitals have some form of an ICT system, but many are still manual and paper-based especially when it comes to patient records.”
This paper-based system to an extent, fudges up industry efforts for patients’ medical records to follow the patient; when they move from one hospital to another during the lifecycle of their illness or condition, their medical data should be accessible by the current doctors for continuity of care.
This sharing of patient medical records pertinently addresses treatment of non-communicable diseases (NCD) like hypertension and diabetes, Dr. Fazilah had pointed out. These NCDs are lifelong conditions and sufferers need continuous treatment throughout the lifecycle, which one hospital or clinic may not be able to provide.
To enable all of this to happen, there has to be standardisation of data, pertinently to facilitate a health information exchange (HIE). Dr. Fazilah shared that buy-in from all parties involved is an important element in the whole initiative and there is active effort to get everyone onboard.
DIGITAL SERVICES AND REGULATIONS
Healthcare services can be digitalised as well.
In the case of the local healthcare sector, there are already digital platforms out there that offer healthcare services, for example DoctorOnCall, Door2Door Doctor, DoctorHouse and more. It’s beyond the traditional business model and enters the realm that’s becoming known as “Uberisation of healthcare.”
Technology platforms are used as connectors between patients and healthcare services, and currently these entities are not regulated with the Ministry of Health (MOH).
That said, Dr. Fazilah and her team are facilitating a regulatory framework with guiding principles of patient safety, privacy, traceability, accountability and security.
This also ties into Dr. Fazilah’s belief that future healthcare should focus on moving people out of hospitals and back into their homes to receive care.
“People today are very empowered (about their health) with all the information out there, and wellness gadgets,” she pointed out.
These online health services can help achieve this future healthcare goals, but she admits that the right policies have to be in place.
With an eye to co-design legislation with other regulators, she feels the right policies in place can encourage innovation in the healthcare industry.
The key is risk-based approach for mitigation and regulation that is anticipatory with regular scanning of the technology and industry horizons.
In recent years, there has been a slew of technologies that has brought about rapid change and disruption to almost every industry and sector. It is no different for healthcare with technologies such as like cloud, artificial intelligence, Internet of Things (IoT), and so on.
“But for all these to happen we need to ensure connectivity and broadband and other enablers, so we collaborate with Malaysian Communication and Multimedia Commission (MCMC) and telcos.
“Whatever we do, it has to be mobile-first,” she emphasised, referring to the need for service initiatives, having to be supported by mobile devices first and foremost.
Another technology that Dr. Fazilah encourages is cloud, which she believes is driving the slew of online health services in the market now.
“It lowers barrier to entry (into healthcare industry), and it drives innovation. This is something that we together with relevant agencies, are looking into, to ensure security and confidentiality of data, is maintained.”
Besides this, Dr. Fazilah admitted that stakeholder engagements, both internal and external the last three years, have been more than for all years previous to that.
That’s how fast technology is changing the landscape and it’s indicative of the level of responsiveness regulators need to have to address these changes.
Hence, regulations need to be anticipatory in nature.
Dr. Fazilah hopes to create guidelines by end of within the 2019-2020 time frame, with a view for effective legislation to be made in the longer run.