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
MOHs Direction
Proposed eHealth Strategy
Challenges
Action Plan
RMK-11 initiatives
New strategies
Summary

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
3
business model.

Malaysias Vision for Health & eight (8)

Health Goals
Malaysiaisisto
tobe
beaanation
nation
Malaysia
ofhealthy
healthyindividuals,
individuals,
of
familiesand
and
families
communities..
communities..

Wellnessfocus
focus
Wellness
Personfocus
focus
Person
Informedpersons
persons
Informed
Self-help
Self-help
Careprovided
providedat
at
Care
home/close
to
home/close
to
home
home

Seamless,continuous
continuous
Seamless,
care
care
Servicestailored
tailoredas
as
Services
muchas
as possible
possible
much
Effective,efficient
efficientand
and
Effective,
affordableservices
services
affordable
4

Current Healthcare System

Payment
Mechanis
m

Line Item Budget

Fee for Service

74%
49%

NHMS2011
only medical
visit)

:
:

HCDA study

26%
51%

MOHs Health Policies

Primary health care is the

thrust of Malaysian
health care system,
supported by
secondary care services
which are devolved &
regionalized tertiary care
services
6

National
Referral
System

Greater
equity,
accessibility
& better
utilization
of resources

Primary Health Care as thrust of the Health System

2010

2000

1980
1960
Mother & child
Family planning
Outpatient
Environmental
School

Mother & child

Family planning
Outpatient
Environmental
School
Dental
Pharmacy
Lab

Mother & child

Family planning
Outpatient
Environmental
School
Dental
Pharmacy
Lab
Child with Special
Need
Reproductive Clinic
Elderly Clinic
Diabetic Clinic
Adolescent
Occupational
Health
Emergency
7 Informatics
Health
7

Mother & child

Family planning
Outpatient
Environmental
School
Dental
Pharmacy
Lab
Child with Special Need
Reproductive Clinic
Elderly Clinic
Diabetic Clinic
Adolescent
Occupational Health
Emergency
Health Informatics
Hypertension
Rehabilitation Services
HPV
Needle Stick Exchange
Programme
Methodone
STI/vice
PLKN
Penjara
K1M
DTS

Growing Scope: Secondary & Tertiary Care

in MOH

MOH Hospitals (as of

Jan 2014)
8

Distribution of Health Facilities in Malaysia

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

Distribution of Government Health

Clinics

Distribution of MOH Hospitals

Distribution of Private Health Clinics

Distribution of Private Hospitals

Malaysias health informatics multi platforms

10

A new era of political commitment

towards digital economy

Source : MAMPU

11

ETP as a platform for ICT in healthcare

me Nation by 2020: 6% growth thru 2020; Double GNI and reach per capita GDP

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

12

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.

e
pon
Com ts
n

Fully implemented transformation

Service
Delivery

Hospital reform
PHC reform

Financi
ng

Organisatio
nal

Public Facility autonomy

Strengthening of the current health system

15

Ph
a
es s

MOHs Policy Direction 2013-2016

16

Planning for 11th Malaysia Plan (2016-2020)

Focus
Area/Strategies
1.

Strengthening
Primary
Healthcare

2.

Health System
Delivery and
Work Process
Reengineering

3.

Human Resource
and
Organisational
Capacity
Development

4.

Infrastructure
Planning and
Development

5.

ICT
Transformation
for Health

6.

PublicPrivate/Interagency
Collaboration

7.

17

8.

Enhancing
Healthcare
Financing
Mechanism
Creating a

IMPROVED
WELL BEING

OUTCOME
1. Quality,
responsive
and
sustainable
healthcare
system;
2. Reduction on
disease
burden and
risk factors
3. Healthy
environment
and food

Proposed eHealth Strategy

18

ICT Challenges in MOH

Governance
Standardisation
Standardisation
Healthcare information sharing
Governance

Significant budget
constraint; ICT ~5% of
total MOH CAPEX
KEY AREAS TO BE ADDRESSED
19

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
Inadequate ICT skills and competency

To be addressed in RMK-11
20

What is the enabler of MOH vision?

A nation of healthy individuals, families and communities.

Citizen

Integrated Healthcare Delivery

Integrated Healthcare IT System / Key
Connected Health
Enabler!

National eHealth Policy & Strategy

Legal Framework & Policy

Leadership & Governance

Sustainability

Monitoring & Evaluation

People (Skills & Expertise;

Change & Adoption)

Health Information
Exchange (HIE)

Applications & Systems

ICT Infrastructure &

Connectivity

Standards &
Interoperability

Action Plan for ICT

Health System Transformation

GOAL

Pillars

Enterprise Architecture

Foundation

Five initiatives in RMK-11 (2016-2020)

1

Develop National

23

The activities for each initiatives (2016-2020)

Client/
Citizen
Patient
Management
Health Portals
eScheduling/
eScheduling/
eAppointment
eFollow-up/
eConsultation
Personalized
Lifetime
Health
Health Plan
Self
Self
Monitoring
Monitoring

Medical
Record
Management
PhI
S

LIS

Patient
Health
Care/
Population
Care
Ward/Clinic
Manageme
nt

Order
Management

Billing &
Payment

Diet &
Catering

BBI
S

CSS
D

Information System
Staff
Managemen
t
(Rostering)

CLINICAL DOCUMENTATION

General Specialties
Sub-Specialties

MyHIX/LHR

RIS

Administrat
ors Tool

FMI
S

OTM
S

Nation
al

Clinical
Decision
Support
System

Case Mix
eGov Apps
(Adm/HR/Fin)
(Adm/HR/Fin)

PACS

Cardio
MS

BI/EIS

LDR

CCIS

OIS/R
T

Institutional systems
Health
Health Apps

PRIMARY CARE

Patient
Clinical Notes
Management
& Dental
System &
Note:
Charting
Billing
Integration
1.
Order
Personnel
Management
Management
2. Integration to external
Schoo
systems is also required;
Health
l
however not reflected
EIS
Education
&
Healt
here
25
Counselling
h

Teleconsultati
on
& Remote
Monitoring

Regulation/
Enforcement
Enforcement

Population
Health

Surveillance/
Surveillance/
Monitoring
Monitoring
Monitoring/
Evaluation
(inc QA)
Disease/Patien
t
Registries
Registries
HIMS
HIMS
Health
Financing
Professional
Professional
Registries
Registries

Licensing/
Credentialing

HR
Development
/ Training

N
a
tt
i
o
n
a
l
D
a
tt
a
W
a
r
e
h
o
u
s
e

DATA JP
SOURCEN

MOH

National Health Data Warehouse

Licensing/
Credentialing

Client
Registry
Shared
Records
(LHR)

Provider
Registry

Wellness
Services
(Personalized)

Monitoring &
Evaluation

Patient
Portal

Regulation/
Enforcement

Facility
Registry

Promotion/
Surveillance

Terminology
Services

1Care Access Layer

Information Exchange Infrastructure Services

(HIE)

QUIC
K
WINS
Registration

Scheduling

Enrolment

Eligibility
Check

Visit
Summary

Capitation &
Risk Adjustment

Prescription
Wellness

Referral
Claim

Provider (Public &

Private)

Quality

Incentive
s

Verification
Fin & Acct
Penalty
Claim

Security
Management

Privacy
Management

Prescription

Registration
View
Eligibility
Dispensing
Check

Interaction
Adverse

Provider Payment

Future ICT Architecture Overview (Conceptual)

Allergy
Claim

Community
Pharmacy

Quick Wins for MOH

MOH:
MOH: <30%
<30% with
with HIS
HIS
system
system

Note 2
Hospitals

MOH:
MOH: <10%
<10% with
with TPC
TPC

Note3

Note1

WAN

Health Clinics

MOH:
MOH: <5%
<5% with
with OHCIS
OHCIS

Note 3
Dental Clinics

LAN
LAN and
and DEVICES
DEVICES
required
required

Note 3
Supporting Facilities
1

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

Note 3:

TPC/OHCIS development & roll-out commenced

27

Infrastructure & Connectivity

Internet
Note:
1. MOH*Net in final
stages of migration
to 1Gov*Net

MyLoca Data
Centre
Cyberjaya

MOH*Net

2. Managed services
by MAMPU

1Gov*Net

3. MyLoca Data
Centre to be
migrated to Public
Sector Data Centre

(Monitored via
NKEA CCI)

Putrajaya
Campus
Network
(PCN)

4. 70% facilities
connected to
1Gov*Net

20Mbps

Hospitals
20Mbps

5. Target of
connectivity 100%
by 2015
MOH HQ
28

State
Health
Dept

6Mbps

10-30 Mbps

Health Office/
Labs &
Health Clinics/
Institution
& Dental

In Summary..

Illustrative
$ Capex
Multimedia
Super Corridor

GTP & ETP

STP & Digital Economy

Towards health system

transformation
4 MSC pilot projects
Numerous
achievements
Busy & rich times
Turnkey projects
Direct negotiations
Silo
implementations
THIS Big bang
approach
Telehealth services
reviewed
MyHIX
TPC pilot & roll-outs
1996

7MP to 9MP

Nationwide roll-outs of major systems

Capex to Opex model
Integration & Consolidation
Managed services
Upgrades
Government Shared Services
Pilots/POCs
Collaboration/Public Private Partnership
Roll-outs
Cloud deployment models
Scaling
Mobile Health
Convention
Social Media
al
gh
Big Data & Open Data
Hi me
Crawl,
o
Inc tion
walk, run
Na
approach
TIME
2012 2013
2015
2016
2017
2020
Realignme
10MP nt
11MP

Connectivity
Ongoing O&M
9MP projects

Lull

2010

29

THANK YOU
dr_fazilah@moh.gov.my

30