Diagnosing what ails digital medical records
PETALING JAYA: Although Malaysia has made significant efforts to digitalise its public-healthcare system over the last three decades, recurring barriers have hampered the establishment of a nationwide system, says Khazanah Research Institute (KRI).

In its latest publication Digital Health Records In Malaysia: The Journey and the Way Forward, KRI said the challenges include deciding to build or buy systems and the associated maintenance and upgrade costs, along with outdated legacy infrastructure that require upgrades to become proper digital facilities.

“Other challenges were issues with system design impacting efficiency of hospital work processes, reluctance of end-users to use the system and adapt to new workflows, the need for effective change management to encourage system adoption, variations in system architecture, coding and formats resulting in issues of data integration, as well as the lack of laws and regulations that explicitly address health data and patient rights,” the report said.

A part of KRI’s research on Malaysia’s digital transformation and digital policy, the publication draws on KRI’s previous research on the nation’s efforts in healthcare digitalisation over the last 30 years.

With regard to patient access to data, KRI stated questions around data storage and data access arise, notwithstanding data ownership, as the Health Ministry (MOH) transitions towards cloud-based systems that support health-information exchange.

“In Malaysia, it appears that patients have little control over how their medical data is subsequently managed. At the time of writing, the country does not have a law explicitly governing health-data privacy,” the report said.

KRI added governance includes digital rights such as patient confidentiality, autonomy and anti-discrimination. Currently there are no requirements for healthcare providers or MOH to inform patients of any leaks of their personal health data.

“Patients in Malaysia have no formal mechanisms to empower them to give consent or approval to transfer data, nor power to decide how this data is used even when it is for their own benefit,” the report stated.

Additionally, KRI said the main challenges of the implementation of electronic health records (EHR) are adoption, standardisation and interoperability, with adoption often requiring seamless integration across public and private institutions.

“One approach to addressing interoperability may be to implement cloud storage of health data and to access the data using web browsers or mobile applications. An example is Covid-19 vaccination records being accessed by patients regardless of type of mobile device,” it said.

The country’s previous record-sharing platform, MyHix, met with low uptake. KRI noted that MyHix was mostly implemented in a few large, public hospitals in scattered locations in Peninsular Malaysia.

“A more patient-centric approach can be seen in the latest developments in Malaysia’s journey towards an EHR system in the public sector, for example MySejahtera and the National Electronic Medical Records initiative.

“It is important to ensure that EHR systems and policies promote inclusivity, focusing on benefiting the many instead of the few,” the report said.
Healthcare,MyDigitalHealth,EHRChallenges,PublicHealthcare,DataPrivacy,CloudHealth,MySejahtera,Interoperability,PatientEmpowerment
Although Malaysia has made significant efforts to digitalise its public-healthcare system over the last three decades, recurring barriers have hampered the establishment of a nationwide system, says Khazanah Research Institute (KRI).