Since the launch of its National Telemedicine Blueprint back in 1997, Malaysia’s healthcare digital transformation has been on a rocky journey.

After several delays, the roll-out of its nationwide Electronic Medical Record (EMR) system – a key piece of infrastructure towards digitalisation – is targeted for completion by 2026, according to the Malaysian Ministry of Health.

Mr G Saravanan, Group Chief Information Officer of Thomson Hospital Kota Damansara, has witnessed and also been part of the nation’s digital healthcare initiatives over the years. He was previously IT consultant to several local healthcare facilities and the Malaysia Digital Economy Corporation, alongside other technology- focused roles across Southeast Asia and Middle East.

Mr G Saravanan

 

In his view, while Malaysia’s healthcare transformation has undergone a welcome acceleration over the COVID-19 period, it cannot afford to lift the foot off the pedal.

The pace of healthcare digitalisation in the region is picking up, he noted, pointing to Indonesia’s mandate for all public hospitals to implement EMR by 2024, which will be integrated with the country’s national health insurance system BPJS. Vietnam has also doubled down on its digital health initiatives, with a e-prescription system piloted countrywide in 2021.

Meanwhile, there are signs of digitalisation efforts slowing down in Malaysia post-COVID, due to challenges such as rising costs and lack of staff, he revealed.

 

Focus on the processes, rather than the product

Drawing on his experience, Saravanan suggested several strategies for healthcare stakeholders in their ongoing digitalisation drive.

One is the need for regulators and hospital IT heads to focus on drawing up clear and stringent processes, rather than on the product or solution.

“A lot of software projects fail – in fact, the estimate is that 50% of large-scale IT projects fail. But in healthcare, that goes up to 80%. The reason is because the regulations and standards are not there. For example, there are no clear regulations around how medical records should be stored and shared. This contrasts with fintech and banking sectors which are tightly regulated,” said Saravanan.

“IT products and systems change rapidly. But what does not change and should not change easily are your processes backed up by regulations, standards, legal framework and enforcement, which are sorely lacking in healthcare.”

To this end, he welcomed news that amendments to Malaysia’s Personal Data Protection Act are in progress, which could see clearer regulations for the healthcare setting.

 

Change management as the essential first step to success

Next, he raised the importance of change management in any digital or IT project.

Said Saravanan: “When you introduce a new system or technology into a hospital, you are actually changing how people work and the culture of the organisation. With how complex healthcare organisations are, not taking the right steps in manage such change is the number one mistake that leads to failure.”

He suggests the first step for any project is establishing a Medical Council with the Medical Director and doctors. Any new IT initiative should have the buy-in of the Medical Director, and at least 10% to 15% of the consultants to be off to a good start.

 

Keep cybersecurity top of mind

Finally, Saravanan flagged the need for care providers to constantly update and strengthen their cybersecurity measures in the face of rising threats.

“Cybersecurity risks are definitely increasing, especially with the rise of AI which means you are literally fighting with the robots.

“Healthcare is particularly vulnerable because its data is more valuable and sought after than any other industry; but many healthcare organisations in this part of the world are not paying enough attention to compliance standards. As they move along with digitalisation and start using more systems and data, they will pay a heavy price security-wise because they don’t have a good foundation.”

In the rush to digitalise, there is a risk for hospitals to overlook the cybersecurity aspect. However, this should instead be kept top of mind when assessing any IT purchase, he asserted. Hospitals should also refer to mature and established cybersecurity frameworks, such as those by HIMSS, USA’s NIST, or UK’s NHS, to regularly assess and enhance their cybersecurity measures.

 

The rise of the Housepital

Rapid technological advancements in recent years, from AI to big data and cloud computing, has enabled the rise of Hospital at Home care model – or “Housepital”, as coined by Saravanan.

This envisions the delivery of care in patients’ homes, without compromise on the quality and standards expected of hospital services.

Housepitals will be the “way forward” for healthcare systems to address the multiple pressing challenges they face today, Saravanan argued.

“Hospitals are facing three key challenges, abbreviated as LEA – lack of Labour, rising Expenses and Ageing populations. During the pandemic, we saw how schools entered our homes to educate our children. Similarly for healthcare, physical hospital walls will be broken down for hospital care to enter homes. This will allow us to care for patients who need hospital-level care but are stable enough to be cared at home, and alleviate capacity pressures.”

Coupled with remote monitoring capabilities, home-based care can reduce costs for patients, providers and payers, he added. By monitoring patients’ conditions regularly – from their blood sugar levels, weight, sleep patterns and so on – providers can anticipate potential hospital admissions and take early interventions to prevent them. The cost of an emergency admission and stay can be three times that of managing the patient at home, highlighted Saravanan.

The next step for expansion of the Housepital model is bringing the different stakeholders to the table, to iron out details around data sharing, legal and liability, and payment models, he opined.

“But honestly, these are the nitty gritty to be sorted out in the coming years. This is definitely the model going forward. I believe this is a paradigm shift in healthcare which will deliver patients with comforts of their home alongside the efficiency and precision of hospital care that they are already familiar with.”