This year, Malaysia's Ministry of Health is moving to the next phase of its digital transformation with a different approach.
In one of the sessions at HIMSS25 APAC, Dr Mahesh Appannan, head of the Digital Health Division of the MOH, shared their strategies and plans to digitalise the Malaysian health system in the coming years.
When the MOH digital health division was set up last year in March, it had to make immediate changes in its digital transformation strategy, one of which was turning from a build model to a subscription model, with data assets as its leverage.
"Technology is moving just too fast. Each day, something new comes up, and we want systems that we [can] subscribe to quickly adapt to change… and it has to be as agile as possible," said Dr Appannan.
Government rules previously hindered the ministry from applying IT upgrades to existing systems, as it required a new development budget application.
" We are not going to build systems anymore… We've always been building systems for the past 20-25 years, but we [just] do not have the capacity or capability to do so."
To its potential technology partners, Dr Appanan emphasised that they must prove value when coming up with proposals for proof of concepts or pilots.
"We can't be having them doing redundant stuff… We want something novel," he added.
"You need to come up with a solution that fills our gaps and meets our wants, and not give us a catalogue of 20 different solutions and have us choose. That's a big red flag for me and for us at the MOH," he stressed.
The MOH's ultimate goal is to build a "person-centric and sustainable digital health ecosystem", with precision public health as its purpose.
"We hope that the entire government's primary care will be digital. We want to start sending records to patients, which we've already done in the first phase [of the national EMR project], and we want to continuously move and scale at a rapid speed.
"At present, only 14% of hospitals in Malaysia have been digitalised, though none of them have been connected yet. Not even a tenth or only 6.8% of primary healthcare clinics are connected and digital – and this figure drops to 0.7% if rural and community clinics are included. Moreover, 11.3% of dental clinics are digital.
"We have a four-year horizon, and we aim to digitalise all our hospitals by the end of 2028."
For its One Record, One Citizen national EMR project, MOH intends to break the country into four different zones with four different EMRs to cover each. The first request for proposal, which will be issued soon, will cover 16 hospitals from three regions; the open tender will stipulate a simulation test and user evaluation.
Not another layer of standards
In reforming its digital architecture, the MOH will adopt various globally recognised standards, including FHIR, with the HIMSS digital maturity models, particularly the HIMSS Electronic Medical Record Adoption Model (EMRAM), serving as a guiding framework.
"Malaysia will be using HIMSS guidelines to ensure that we have our solution ready and safe to be deployed to our hospitals so our patients get the best healthcare outcome… This would give us the benchmark for us to ensure that we are also on the global playing field," Dr Appannan said.
Simon Lim, HIMSS APAC EVP and managing director, clarified that the HIMSS EMRAM is "not about adding a layer of standards in deployment, but helping hospitals and the users to optimise outcomes from using the technology."
"Standards are not just about checklists. It's… to make sure that you have a system that is safe, that works, and is able to demonstrate return on investment on your healthcare organisation," added Dr Jason Tee, senior manager of Digital Health at HIMSS.
" When we became a Stage 6 [EMRAM] hospital, many people thought we bought a system called EMRAM within Malaysia. That's the perception. We had to explain that it's not a system, it's a framework," shared Dr Alwi Mohamed Yunus, who led the EMRAM programme at Institut Jantung Negara (IJN). The heart hospital is the first hospital in Malaysia to get validated at Stage 6 of the HIMSS EMRAM.
" The second thing that people thought was that you only engage with HIMSS when you are a mature organisation. We were a paper-based organisation at that time," he added.
IJN encountered the EMRAM model as a requirement for becoming a flagship hospital for healthcare tourism in Malaysia. In 2023, the Malaysia Healthcare Travel Council, which promotes the country's healthcare travel industry, partnered with HIMSS to enable the digital transformation of hospitals through EMRAM validation, among other things.
Dalvin Loh, HIMSS APAC VP, emphasised to vendors the importance of understanding the digital maturity models before offering solutions to health organisations.
"You need to understand the model first… so that when you go out to the market to offer, you are aligned with the MOH and with what the hospital wants, and be able to optimise their investment, and we are able to measure the success of what you have been able to recommend to them."
Dr Alwi highlighted the cost savings from adopting the HIMSS digital maturity framework. "By [adopting] the framework, we ticked a lot more boxes than we would otherwise have ticked if we engaged a vendor."
"The lesson learned from this is that the cost of all of this was extremely small as compared to buying your own system."
HIMSS is the parent company of Healthcare IT News.
