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Towards a Successful Implementation of e-Health Strategies in Malaysia: Getting Everyone on Board

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Towards a Successful Implementation of e-Health Strategies in Malaysia: Getting Everyone on Board

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    1. Towards a Successful Implementation of e-Health Strategies in Malaysia: Getting Everyone on Board

    2. Malaysia Vision 2020 : Information based society Knowledge economy Multimedia Super Corridor (MSC) initiative

    3. Multimedia Super Corridor (MSC)

    4. MSC Flagship Applications

    5. Malaysia’s Telehealth blueprint Multimedia Super Corridor project Three-month consultation (full-time) 23 companies (17 foreign. e.g. IBM, SUN, Nortel, NTT, etc) Project of applying ICT in the health system, that sets the foundation for the health system of the future Approach: Telehealth as the technology enabler to achieve the Vision for Health.

    6. Malaysia’s Vision 2020 By the year 2020, Malaysia is to be a united nation with a confident Malaysian society infused by strong moral and ethical values, living in a society that is democratic, liberal and tolerant, caring, economically just and equitable, progressive and prosperous, and in full passion of an economy that is competitive, dynamic, robust and resilient,

    8. Mission for Health (MOH) To build partnerships for health, to motivate and facilitate the people to: attain fully their potential in health appreciate health as a valuable asset take positive actions to improve further and sustain their health status to enjoy a better quality of life.

    9. Health Services Goals for the Health System of the Future Wellness focus Services to promote individual wellness throughout life Person focus Focus services on the person and ensure services are available whenever & wherever required Informed person Provide accurate & timely information and promote knowledge through personalised education services to enable individuals to’ make informed health decisions Self help Increase ability of individuals & families to manage own health through knowledge transfer and interactive network-based health management tools

    10. Health Services Goals for the Health System of the Future Care provided at home or close to home Distributed multimedia networks to provide physical and virtual services into homes, health settings and community centres Coordinated, continuous, seamless care Manage and integrate care across different settings and episodes of care throughout life Services tailored as much as possible Customise services to needs of individuals and groups with special circumstances Effective, efficient affordable services Enhanced access, integration and timely delivery of quality services at affordable cost.

    11. Guiding Principle:

    12. Health System of the Future Re-organisation of the health system Patient-centred, customised, personalised services Redesign services to be delivered – includes more virtual, integrated, distributed services – close to person – person-specific information, knowledge – person/patients involvement Changing roles of healthcare providers.

    13. The Four Integrated Telemedicine Pilot Projects

    14. Lifetime Health Plan (LHP) To facilitate continuum of care for the lifetime: health data in state of wellness and illness, systematically captured and available to healthcare providers – ensuring patient focused and continuous care Lifetime Health Record to be Created.

    15. Personalised Lifetime Health Plan ANC Post-NC Child Adolescent Adult Geriatric

    16. Transformation of Healthcare System Management of Change: Reorganisation of Healthcare System e.g. Integration of Wellness, 1°, 2°, 3° CARE Development of Patient Centred Services Implementation of LHR/LHP.

    17. Transformation of Healthcare System Facilitate Innovative Knowledge Management throughout System Implement CPGs, Clinical Protocols Use of Call Centres Review Role of Healthcare Providers and Training Program Management of Quality, Outcome Assessment Etc.

    18. Promoting the Health Paradigm

    19. Promoting the Health Paradigm Emphasise preventive and promotive aspects of healthcare Support individuals/families make lifestyle choices that best maintain health Provide services during state of wellness to support maintenance of health Health system should “invert” the healthcare pyramid – secondary & tertiary care, curative services should support preventive, promotive services at primary care level, and care should be brought to the home.

    20. Promoting the Health Paradigm Essential health services : ? patients centred ? information driven Need to build real partnerships – ?shared information partnerships: ? health planners ? healthcare providers ? consumers Need for integration : information - gathering - management - dissemination.

    21. Leading Healthcare into the Information Age - Malaysia’s Telehealth Blueprint

    22. Telehealth Integration of information, communications, human-machine interface technologies with health and medical technologies to provide services to promote health and provide healthcare National enterprise-wide health information system, which includes person management and health information, and which facilitates the sharing of health information and knowledge in healthcare settings, and which facilitates the management of health from the beginning to the end of life.

    23. National Health Information System Total Health Information System allows information sharing to facilitate the implementation of a National Health System to proactively manage wellness and illness with adequate and appropriate support for healthcare planning and financing system. Such an infostructure will be : goal focus, clinical outcomes, clinical eficiency, cost efficiency, episode and facility costs, condition specifics and risk related costs, total consumer-based costs National Health Information System : Strategic Approach.

    24. Health Services of the Future Paradigm shift Provider focus to person focus. Facility management to community management. Borderless, seamless, continuous care. Integrated Health Services Sharing of health information and management plan. LHR is the focal point of integration. Health Informatics Standards is vital to achieve integrated health service. Telehealth is an enabler to maintain lifelong wellness.

    25. Lifetime Health Plan (LHP) Summary of Features National Enterprise-wide Master Person Index (MPI) Integration to MyKAD TELEHEALTH Data Dictionary Lifetime Health Record Enterprise Wide Order Management Standard Documents (Visit Summary, Referral Form, Lab Test Request etc) 7. Lifetime Health Summary Browser 8. Customization of Dataset For Clinical Clerking 9. GDS For Hospital And Health Care Facility Management.

    26. National Enterprise-wide Health Information Network Integration potential: Improve quality and efficacy of healthcare information, test results, etc. from throughout the network available for healthcare providers to deliver effective care. Reduce duplication of testing, unnecessary procedures, quicker decision-making and implementation of care. Reduce administrative work Standardisation of information, and electronic transfers reduces need for human action and reduces errors and costs.

    27. National Enterprise-wide Health Information Network Examples of information transmitted through the network

    28. National Enterprise-wide Health Information Network Examples of information transmitted through the network

    29. National Enterprise-wide Health Information Network Comprehensive national information infrastructure Set of technologies, standards, applications, systems, values and laws – that support all facets of individual health, healthcare and public health Not a centralised govt, database, but a “rules for the road” - to connect distributed health data.

    30. Building Integrated Healthcare Services … through Telehealth

    31. Current Scenario…Facility-based IT

    32. LHR : The Focal Point if Integration

    33. Levels of Integration Policy : LHR shall provide seamless care Processes, protocols and clinical pathways : BPR, SOP, CPG, care pathways Functionalities : operational and system Data : health data dictionary, data set, code set Technical : HL7, IEEC, DICOM for connectivity Services : provision of enterprise wide person management (at individual level) for life long wellness.

    34. Integration Plan for Health

    35. Health Informatics Standards ……..vital element for integration Domain Standards Business Functional Model & BPR Standard Operating Procedure Clinical Care Pathways Naming Convention /Vocabulary Data Sets and Code Sets Health Data Dictionary Facility Code Standards National Drug Database

    36. Some Issues to be Addressed Telehealth Blueprint Lifetime Health Plan (LHP) critical & strategic pilot project Lifetime Health Record (LHR) to be developed for all individuals.

    37. Some Issues to be Addressed Lifetime Health Record (LHR) Issue of Equity - need for national policy For public good: ? potential of LHR repository – used for benefit of all ? all individuals can contribute & benefit ? if individuals allowed to opt out for privacy consideration – they still benefit, without contributing; if too many opt out, quality suffers. LHR: available to all funding by government.

    38. Some Issues to be Addressed

    39. Some Issues to be Addressed

    40. Some Issues to be Addressed

    41. Telehealth Technology enabler to realise: • 8 health services goal • vision for health Integration to: MyKAD egov (MAMPU govt. data dictionary) National Health Information System Platform to integrate all stakeholders in health.

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