The recent debate around e-MCs, e-prescriptions, and telemedicine is an important one. Malaysia is modernising, and digital health will undeniably shape our future.
But in medicine, progress must be guided, not romanticised. Technology can amplify care. But technology cannot replace the fundamentals of medicine.
Across every responsible digital health system in the world, one principle remains unchanged: a diagnosis is a clinical act, not a digital transaction.
International comparisons are often cited, but context matters. These countries operate within mature ecosystems where:
- National electronic medical records (EMRs) are unified.
- Gatekeeping is enforced.
- Malpractice and accountability frameworks are uncompromising.
- Triage standards are universal.
- Patients know when telehealth is appropriate, and when it is not.
In spite of what some may have us believe, Malaysia is only still building these foundations. I don’t believe anyone, for example, can honestly claim that we have a solid, unified national EMR platform at the moment.
Physical examination has anchored medical practice for centuries for a simple reason: you do not know whether an examination will change your decision until you examine.
It is the soft wheeze, the subtle dehydration, the delayed capillary refill, the guarded abdomen, the barely audible crepitation or murmur on auscultation, the faint red flag in the patient’s face — the quiet signals that no camera, checklist, or questionnaire or even AI-assisted tools will ever catch.
And it is folly for anyone, especially doctors, to trivialise the importance of sound clinical examination. As doctors, we are bound by the very basic Hippocratic ethos, “First, do not harm.”
Telemedicine is powerful. But it is powerful only when used within the boundaries of safe clinical judgement and evidence.
The basis of making a diagnosis are symptoms (which the patient tells a doctor) and signs (which are observed and elicited by a doctor during a physical examination), and it is immature and wreckless to claim that telemedicine can adequately satisfy these fundamental criteria at this stage.
Agreed, we should digitise boldly. We should innovate confidently. But modernisation must come with structure, governance, and clinical guardrails, not acceleration for its own sake or the perpetuated fear of being “left behind”, or worse, for commercial gains.
If Malaysia is to build a digital health ecosystem worthy of national trust, then:
- Triage must be regulated.
- Digital documentation must carry the same accountability as physical.
- Examinations must be required when clinically indicated.
- Diagnosis must always remain the doctor’s responsibility — not a platform workflow designed for convenience.
Progress is not digital for digital’s sake. Progress is when innovation strenghtens patient safety, not weakens it.
Malaysia now stands at a decisive moment. The path we choose will determine whether we build a system that is modern and safe — or modern-looking but structurally fragile.
As we move forward, our decisions must be guided by evidence, ethics, and clinical reality — not fear of “falling behind,” and not the pressure to bend medicine to fit the shape of technology.
Digital health must not outrun clinical truth. It must evolve with it. That is how we advance — not regress.
The author is country CEO of Qualitas Health.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
