KUALA LUMPUR, March 26 — Health Minister Dzulkefly Ahmad today illustrated his grand plans for a national electronic medical records (EMR) system that encompasses both public and private health care facilities nationwide.
Dzulkefly targeted completing the national EMR or lifetime health records (LHR) system – a project which he initiated during his first term in office as health minister from 2018 to 2020 – within four to five years.
“The ministry is taking a new perspective in the planned transformation of digital health by creating a Digital Health Division that will be responsible for creating a holistic, future-ready, and future-proof health digitalisation plan,” Dzulkefly told the Dewan Rakyat during Question Time.
“Our approach will be based on the ‘Reform, Relook, Recalibrate, and Realise’ strategy. This includes consolidating digital units in the Ministry of Health (MOH), reviewing all digital systems in the MOH, setting a new digitalisation strategy based on the latest tech updates, and then to implementation and monitoring.”
Dzulkefly explained that a national EMR system enables precision medicine, as patients would have portable health or medical records to carry them seamlessly between health care facilities, whether public or private, covering personal health data like drug allergies and medical data like diagnostic tests and procedures done.
Big data analytics from the system, he said, can be used for precision public health by looking at different populations and enabling optimum resource allocation.
Currently, comprehensive data on public health is derived from the MOH’s National Health and Morbidity Surveys (NHMS) that are only conducted once every four years. In terms of geography, data in the NHMS is only disaggregated down to the state level.
The health minister acknowledged that setting up a national EMR system would be expensive, but denied that it would cost billions of ringgit.
He said 50 public health clinics currently use subscriptions to an off-the-shelf solution, while he aims to pioneer the EMR system for hospitals in Selayang Hospital that once had the “Rolls Royce” of digital systems from the United States.
“But it’s almost non-functional today. We want to restore it and prove that an end-to-end EMR system can be done in Selayang.”
CodeBlue reported in February last year that Selayang Hospital’s flagship EMR system, which was the first tertiary hospital in Malaysia and even the world to go fully electronic with a comprehensive total hospital information system (THIS) in 1999 – has fallen into disrepair, due to the lack of system updates.
Dzulkefly previously told Bandar Kuching MP Dr Kelvin Yii Lee Wuen, in a written Dewan Rakyat reply on March 14, that the initiative to strengthen digital health services through an enterprise architecture (EA) approach for the national EMR project is aimed at realising the concept of “One Individual, One Record”.
“The development of an integrated health information system or electronic medical record (EMR) towards having a lifetime health record (LHR) and the development of the health big data analytics ecosystem are key initiatives under the scope of applications and data.
“Through this initiative, it can support the need for evidence-based decision making and enhance data visualisation in genomic-based research,” Dzulkefly said.
The health minister said upgrading ICT infrastructure in hospitals and clinics is also prioritised to improve the efficiency of public health care services and to improve virtual access capabilities through virtual clinics in hospitals and clinics.
Dzulkefly’s answer in Parliament today did not explain what kind of legislative amendments are needed to bring the national EMR system to fruition. There is currently no Act specific to health care digitalisation and patient data.
Private GP clinics and hospitals, as well as university hospitals, all have their own individual EMR systems or solutions.
Another potential complication is that government health clinics and hospitals under the MOH are not regulated, unlike private health care facilities and public university hospitals that are regulated (by the MOH) under the Private Healthcare Facilities and Services Act 1998. The Personal Data Protection Act (PDPA) 2010 also exempts the government.
Hence, it’s unclear how a national EHR system encompassing all health care providers in the public and private sectors will be regulated.
