NATIONAL eHEALTH:

“Moving Towards Efficient

Healthcare”

By:
Dr. Fazilah Shaik Allaudin
Deputy Director
Telehealth Division
Ministry of Health MALAYSIA
 Presentation Outline

Introduction
 Health System Transformation
 MOH’s Direction
Proposed eHealth Strategy
• Challenges
• Action Plan
• RMK-11 initiatives
• New strategies
 Summary
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 Executive Summary

 eHealth in Malaysia began actively with the era of MSC. We had an era of rapid
build-up and POCs and pilots, which today, is being hampered by budget
constraints.

 Today in healthcare facilities, we have manysystems and the numbers continue

to grow due to functional needs, but we continue to have a large gap on patient
care systems despite its obvious benefits.

 Healthcare is poised for its biggest shake up ever as its transformation to a more
better, efficient and equitable healthcare requires ‘quick wins’ in ICT to be
addressed.

 Today, MOH have promising patient care system (TPC, OHCIS & SPP) that
requires scaling.

 We need to take healthcare to the next level, one that embraces the need for
changes and uses ICT as an enabler.

 The confluence of Big Data, Cloud, Managed and Shared Services combined with
uncertain budgets compels us to rethink our business model.
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 Malaysia’s Vision for Health & eight (8) Health Goals

Malaysia is to be a nation of
healthy individuals, families and
communities……..

 Wellness focus  Seamless, continuous care

 Person focus  Services tailored as much as
 Informed persons possible
 Self-help  Effective, efficient and
affordable services
 Care provided at home/close
to home
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 Current Healthcare System

Payment
Mechanism Line Item Budget
Fee for Service

NHMS2011 – 74% : 26%

only medical visit) 49% : 51% HCDA study

5
 MOH’s Health Policies

Primary health care is the thrust of National

Malaysian health care system, Referral
System

supported by

Greater
secondary care services which are equity,
accessibility
devolved & regionalized tertiary & better
care services utilization
of resources
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 Primary Health Care as thrust of the Health System
2010
Mother & child
Family planning
Outpatient
Environmental
School
Dental
Pharmacy
2000 Lab
Child with Special Need
Mother & child Reproductive Clinic
Family planning Elderly Clinic
Outpatient Diabetic Clinic
Environmental Adolescent
School Occupational Health
Dental Emergency
Pharmacy Health Informatics
1980 Lab Hypertension
Mother & child Child with Special Need Rehabilitation Services
Family planning Reproductive Clinic HPV
1960 Outpatient Elderly Clinic Needle Stick Exchange Programme
Mother & child Environmental Diabetic Clinic Methodone
Family planning School Adolescent STI/vice
Outpatient Dental Occupational Health PLKN
Environmental Pharmacy Emergency Penjara
School Lab Health Informatics K1M
77 DTS
 Growing Scope: Secondary & Tertiary Care in MOH

14 State Hospitals + HKL

(45 services)

26 Major Specialist
Hospitals (26 services)

27 Minor Specialist
Hospitals (10 services )

10 Special Institutions /
Hospitals

66 Non Specialist
Hospitals
MOH Hospitals (as of Jan 2014) (Visiting Specialists)

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 Distribution of Health Facilities in Malaysia
Source : Mapping Study of Health Facilities & Services, IKU MOH, 2013

Distribution of Government Health Clinics Distribution of Private Health Clinics

Distribution of MOH Hospitals Distribution of Private Hospitals

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 Malaysia’s health informatics multi platforms

Political National Standards &

Governance/Policy
Commitment Commitment Interoperability

1Gov*Net (MAMPU) Telemedicine MOH LHR Business

Multimedia Super Blueprint 1997 Framework
Corridor (MSC)
Flagship - 1996 1GovUC (MAMPU) HIMS Blueprint
Health Informatics
2006
Standards
PDSA (MAMPU)
Economic 8,9 & 10th MP ICT IHE Framework &
Transformation technical papers Malaysia
Programme (ETP) – 1Gov Cloud (MAMPU) Connectathon
2010
National Health
Policy 2007 Malaysian Health
1GovEA (MAMPU) Information
ICT Strategic Plans Exchange (MyHIX)
Digital Malaysia – (ISP)
Open & Big Data
2014 (absorbed into
(MAMPU)
NKEA)
SNOMED-CT
Digital Opportunities RMK-11 Plan Country License
RMK-11 (EPU/SKMM)

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 A new era of political commitment
towards digital economy

Source : MAMPU 11
 ETP as a platform for ICT in healthcare

High Income Nation by 2020: 6% growth thru 2020; Double GNI and reach per capita GDP of US$15K

NKEA projects offer …

The 12 National Key Economic Areas (NKEAs) are at the core of the ETP. A NKEA is
defined as a driver of economic activity that has the potential to directly and materially
contribute a quantifiable amount of economic growth to the Malaysian economy

Source : PEMANDU EPP Preso Pack 12

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Towards Health System
Transformation

13
 Challenges in Health

And many
more….
 National Health System Transformation Agenda

A restructured national health system that is

responsive and provides choice of quality health care,
ensuring universal coverage for health care needs of
population based on solidarity and equity.

Fully implemented transformation

Service
Delivery Hospital reform

PHC reform

Financing Organisational Public Facility autonomy

Strengthening of the current health system

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 MOH’s Policy Direction 2013-2016

• Family doctor
Strengthen PHC
• Preventive care

Public Private
• Engage GPs
Integration

Community • Working with other stakeholders

empowerment • Self-empowerment

• Domiciliary care
Care closer to home
• Step down care

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Planning for 11th Malaysia Plan (2016-2020)

Focus Area/Strategies IMPROVED

1. Strengthening
Primary Healthcare
WELL BEING
2. Health System
Delivery and Work
Process
Reengineering
3. Human Resource
and Organisational
Capacity
Development
4. Infrastructure
Planning and OUTCOME
Development
1. Quality, responsive
5. ICT Transformation
for Health and sustainable
6. Public-Private/Inter-
healthcare system;
agency Collaboration 2. Reduction on
7. Enhancing disease burden
Healthcare Financing and risk factors
Mechanism
8. Creating a Healthy
3. Healthy
Ecosystem towards environment and
healthy lifestyle and food safety
disease prevention

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Proposed eHealth Strategy

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 ICT Challenges in MOH

Policy & Infrastructure System Cost People

Procedures • Limitation of • Integration & • High CAPEX for • Clinical
• Standardisation infrastructure Interoperability implementation Leadership
• Healthcare availability e.g. • Performance of systems • Skills & Expertise
information LAN & Devices • Scalability • High OPEX for • Change and
sharing • Obsolescence • Future readiness O&M&S of these adoption
• Governance systems
• Support &
Maintenance • Ongoing CAPEX
for continuous
upgrade
Significant budget constraint; • Benefit
ICT ~5% of total MOH CAPEX realisation in
monetary terms

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 ICT Issues in RMK-10

 Inadequate and inconsistent funding

 Fragmented ICT Implementation at MOH
 Incomplete readiness of ICT infrastructure at health
facilities
 Inadequate data for strategic planning and
management
Technology
 Inadequate ICT skills and competency
Process

People
To be addressed in RMK-11
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 What is the enabler of MOH vision?

A nation of healthy individuals, families and communities….

•Achieve better
Citizen
outcomes

•Improved population
Communities
health

•Decreased cost
Nation
burden

Integrated Healthcare Delivery

Integrated Healthcare IT System / Key

Connected Health Enabler!
 Standards & Interoperability

ICT Infrastructure &

Connectivity

Applications & Systems

Health Information Exchange

(HIE)

People (Skills & Expertise;

Enterprise Architecture

Leadership & Governance

Legal Framework & Policy
National eHealth Policy & Strategy Change & Adoption)
Health System Transformation

Monitoring & Evaluation

Sustainability
GOAL
Action Plan for ICT

Pillars

Foundation
 Five initiatives in RMK-11 (2016-2020)

1
Develop National eHealth •Focus on establishment of EA, integration and
Strategy Health Data Warehouse

2
Implementation of •Focus on strengthening the current health
infrastructure and systems system with robust ICT infrastructure/systems

3
Lifetime Health Record: •Focus on integration & interoperability,
‘1 person 1 record’ accessibility to data and patient engagement

4 Establish Health IT
Workforce Development •Focus on capacity and capability building
Program
5
Collaboration and Smart •Focus on delivering core business and tapping
Partnership strength of others

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The activities for each initiatives (2016-2020)
 Patient Care/ Health Information System
Client/ Population Care
Citizen National
Staff
Patient Ward/Clinic Order Management
Management Management Management MyHIX/LHR
(Rostering)
Health Portals
RIS
Medical Record Billing & Administrators Case Mix
Diet & Catering N
eScheduling/ Management Payment Tool
a
eAppointment
eGov Apps t
(Adm/HR/Fin) i
eFollow-up/ o
eConsultation PhIS LIS BBIS CSSD OTMS FMIS PACS Cardio MS n
Surveillance/
Monitoring a
Personalized l
CLINICAL DOCUMENTATION BI/EIS LDR
Lifetime Health Monitoring/
General Specialties Evaluation D
Plan Clinical Decision
(inc QA) a
Support System CCIS OIS/RT
Sub-Specialties t
Self Monitoring Disease/Patient a
Registries
W
Institutional systems
HIMS a
Health Apps r
PRIMARY CARE
Teleconsultation e
Patient & Remote Population Health Financing h
Clinical Notes & Health
Management Monitoring o
Dental Charting
Note: System & Billing Professional u
Integration Registries s
1. Order Personnel e
Management Management HR
2. Integration to external Development
systems is also required; Health Regulation/ Licensing/ / Training
however not reflected School Enforcement Credentialing
Education & EIS
here Health
Counselling 25
 DATA JP
SOURCEN MOH

National Health Data Warehouse

Client Licensing/
Registry Credentialing

Provider Shared Wellness Monitoring &

Patient Evaluation
Registry Records Services
Portal
(LHR) (Personalized)

Facility Regulation/
Registry Enforcement

Terminology Promotion/
Services Surveillance

Information Exchange Infrastructure Services Security Privacy

1Care Access Layer Management Management
(HIE)

Registration Scheduling Enrolment Prescription

Verification Registration View

QUICK
Eligibilit
y Check
Prescription
Visit
Summary
Referral
Capitation &
Risk Adjustment
Quality
Fin & Acct
Penalty
Eligibility
Check
Interaction
Dispensing
Allergy
Claim Incentive Claim Adverse Claim
WINS
Wellness
s

Provider (Public & Provider Payment Community

Private) Pharmacy
Future ICT Architecture Overview (Conceptual)
 ‘Quick Wins” for MOH

Note 2 MOH: <30% with HIS system

Hospitals

Note3 MOH: <10% with TPC

Note1
WAN Health Clinics

Note 3 MOH: <5% with OHCIS

Dental Clinics

Note 3
LAN and DEVICES required

Supporting Facilities

1 2 3
LAN DEVICES APPLICATIONS
Note 1: WAN Connectivity is undertaken by MAMPU under 1Gov*Net
Note 2: SPP development/roll-out for MOH hospitals commenced
PhIS development/roll-out for MOH facilities commenced
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Note 3: TPC/OHCIS development & roll-out commenced
 Infrastructure & Connectivity

Internet

Note:
MyLoca Data
1.MOH*Net in final
MOH*Net Centre
stages of migration to Cyberjaya
1Gov*Net
2.Managed services by
MAMPU
3.MyLoca Data Centre 1Gov*Net
to be migrated to
Putrajaya (Monitored via
Public Sector Data 20Mbps
Centre
Campus NKEA CCI)
Network
4.70% facilities (PCN)
connected to Hospitals
1Gov*Net
20Mbps 6Mbps 10-30 Mbps
5.Target of connectivity
100% by 2015

Health Office/
MOH HQ State Health Clinics/ Labs &
Health & Dental Institution
28 Dept
Illustrative In Summary……..
$ Capex
Multimedia Super
Corridor GTP & ETP STP & Digital Economy

Towards health system transformation

4 MSC pilot projects
Numerous achievements Nationwide roll-outs of major systems
‘Busy & rich’ times Connectivity Capex to Opex model
Turnkey projects Ongoing O&M Integration & Consolidation
Direct negotiations 9MP projects Managed services
“Silo” implementations Upgrades
Government Shared Services
 THIS ‘Big bang’ approach Pilots/POCs
Collaboration/Public Private Partnership
Telehealth services Roll-outs
Cloud deployment models
Lull Scaling
reviewed Mobile Health
MyHIX Conventional
Social Media
TPC pilot & roll-outs “Crawl, walk,
Big Data & Open Data
run” approach
Realignment
1996 2010 2012 2013 2015 2016 2017 2020 TIME
7MP to 9MP 10MP 11MP

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THANK YOU
dr_fazilah@moh.gov.my

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