This document provides an overview of Malaysia's national eHealth strategy. It discusses the transformation of Malaysia's healthcare system and the role of information and communication technologies (ICT) in improving healthcare delivery and outcomes. Some key points include: - ICT can help enable a more efficient, equitable healthcare system by facilitating integrated care, data sharing, and patient empowerment. - MOH has implemented various healthcare IT systems but faces challenges around integration, infrastructure, skills, and funding. - The proposed eHealth strategy and 11th Malaysia Plan initiatives aim to strengthen ICT governance, develop interoperable systems, build workforce capacity, and foster collaboration to support health system transformation.

1. NATIONAL eHEALTH:
“Moving Towards Efficient
Healthcare”
By:
Dr. Fazilah Shaik Allaudin
Deputy Director
Telehealth Division
Ministry of Health MALAYSIA

2. Introduction
Health System Transformation
MOH’s Direction
Proposed eHealth Strategy
• Challenges
• Action Plan
• RMK-11 initiatives
• New strategies
Summary
Presentation Outline
2

3. 3
Executive Summary
 eHealth in Malaysia began actively with the era of MSC. We had an era of rapid
build-up and POCs and pilots, which today, is being hampered by budget
constraints.
 Today in healthcare facilities, we have manysystems and the numbers continue
to grow due to functional needs, but we continue to have a large gap on patient
care systems despite its obvious benefits.
 Healthcare is poised for its biggest shake up ever as its transformation to a more
better, efficient and equitable healthcare requires ‘quick wins’ in ICT to be
addressed.
 Today, MOH have promising patient care system (TPC, OHCIS & SPP) that
requires scaling.
 We need to take healthcare to the next level, one that embraces the need for
changes and uses ICT as an enabler.
 The confluence of Big Data, Cloud, Managed and Shared Services combined with
uncertain budgets compels us to rethink our business model.

4.  Wellness focus
 Person focus
 Informed persons
 Self-help
 Care provided at home/close
to home
Malaysia is to be a nation of
healthy individuals, families and
communities……..
4
Malaysia’s Vision for Health & eight (8) Health Goals
 Seamless, continuous care
 Services tailored as much as
possible
 Effective, efficient and
affordable services

5. 5
74% : 26%
49% : 51% HCDA study
NHMS2011 –
only medical visit)
Payment
Mechanism Line Item Budget
Fee for Service
Current Healthcare System

6. Primary health care is the thrust of
Malaysian health care system,
supported by
secondary care services which are
devolved & regionalized tertiary
care services
National
Referral
System
Greater
equity,
accessibility
& better
utilization
of resources
6
MOH’s Health Policies

7. 7
Primary Health Care as thrust of the Health System
7
Mother & child
Family planning
Outpatient
Environmental
School
Dental
Pharmacy
Lab
Child with Special Need
Reproductive Clinic
Elderly Clinic
Diabetic Clinic
Adolescent
Occupational Health
Emergency
Health Informatics
Hypertension
Rehabilitation Services
HPV
Needle Stick Exchange Programme
Methodone
STI/vice
PLKN
Penjara
K1M
DTS
2010
Mother & child
Family planning
Outpatient
Environmental
School
Dental
Pharmacy
Lab
Child with Special Need
Reproductive Clinic
Elderly Clinic
Diabetic Clinic
Adolescent
Occupational Health
Emergency
Health Informatics
2000
Mother & child
Family planning
Outpatient
Environmental
School
Dental
Pharmacy
Lab
1980
Mother & child
Family planning
Outpatient
Environmental
School
1960

8. 8
Growing Scope: Secondary & Tertiary Care in MOH
14 State Hospitals + HKL
(45 services)
27 Minor Specialist
Hospitals (10 services )
66 Non Specialist
Hospitals
(Visiting Specialists)
10 Special Institutions /
Hospitals
26 Major Specialist
Hospitals (26 services)
MOH Hospitals (as of Jan 2014)

9. 9
Distribution of Health Facilities in Malaysia
Distribution of Government Health Clinics Distribution of Private Health Clinics
Distribution of MOH Hospitals Distribution of Private Hospitals
Source : Mapping Study of Health Facilities & Services, IKU MOH, 2013

10. 10
Malaysia’s health informatics multi platforms
Political
Commitment
Multimedia Super
Corridor (MSC)
Flagship - 1996
Economic
Transformation
Programme (ETP) –
2010
Digital Malaysia –
2014 (absorbed into
NKEA)
National
Commitment
1Gov*Net (MAMPU)
1GovUC (MAMPU)
PDSA (MAMPU)
1Gov Cloud (MAMPU)
1GovEA (MAMPU)
Open & Big Data
(MAMPU)
Digital Opportunities
RMK-11 (EPU/SKMM)
Governance/Policy
Telemedicine
Blueprint 1997
HIMS Blueprint
2006
8,9 & 10th MP ICT
technical papers
National Health
Policy 2007
ICT Strategic Plans
(ISP)
RMK-11 Plan
Standards &
Interoperability
MOH LHR Business
Framework
Health Informatics
Standards
IHE Framework &
Malaysia
Connectathon
Malaysian Health
Information
Exchange (MyHIX)
SNOMED-CT
Country License

11. 11
A new era of political commitment
towards digital economy
Source : MAMPU

12. 12
NKEA projects offer …
The 12 National Key Economic Areas (NKEAs) are at the core of the ETP. A NKEA is
defined as a driver of economic activity that has the potential to directly and materially
contribute a quantifiable amount of economic growth to the Malaysian economy
High Income Nation by 2020: 6% growth thru 2020; Double GNI and reach per capita GDP of US$15K
12
Source : PEMANDU EPP Preso Pack
ETP as a platform for ICT in healthcare

13. Towards Health System
Transformation
13

14. And many
more….
Challenges in Health

15. 15
National Health System Transformation Agenda
A restructured national health system that is
responsive and provides choice of quality health care,
ensuring universal coverage for health care needs of
population based on solidarity and equity.
Service
Delivery
Organisational
Financing
Fully implemented transformation
Hospital reform
PHC reform
Public Facility autonomy
Strengthening of the current health system

16. 16
MOH’s Policy Direction 2013-2016
• Family doctor
• Preventive care
Strengthen PHC
• Engage GPs
Public Private
Integration
• Working with other stakeholders
• Self-empowerment
Community
empowerment
• Domiciliary care
• Step down care
Care closer to home

17. Focus Area/Strategies
1. Strengthening
Primary Healthcare
2. Health System
Delivery and Work
Process
Reengineering
3. Human Resource
and Organisational
Capacity
Development
4. Infrastructure
Planning and
Development
5. ICT Transformation
for Health
6. Public-Private/Inter-
agency Collaboration
7. Enhancing
Healthcare Financing
Mechanism
8. Creating a Healthy
Ecosystem towards
healthy lifestyle and
disease prevention
1. Quality, responsive
and sustainable
healthcare system;
2. Reduction on
disease burden
and risk factors
3. Healthy
environment and
food safety
17
IMPROVED
WELL BEING
OUTCOME
Planning for 11th Malaysia Plan (2016-2020)

18. Proposed eHealth Strategy
18

19. 19
ICT Challenges in MOH
Policy &
Procedures
• Standardisation
• Healthcare
information
sharing
• Governance
Infrastructure
• Limitation of
infrastructure
availability e.g.
LAN & Devices
• Obsolescence
System
• Integration &
Interoperability
• Performance
• Scalability
• Future readiness
• Support &
Maintenance
Cost
• High CAPEX for
implementation
of systems
• High OPEX for
O&M&S of these
systems
• Ongoing CAPEX
for continuous
upgrade
• Benefit
realisation in
monetary terms
People
• Clinical
Leadership
• Skills & Expertise
• Change and
adoption
Significant budget constraint;
ICT ~5% of total MOH CAPEX

20. 20
 Inadequate and inconsistent funding
 Fragmented ICT Implementation at MOH
 Incomplete readiness of ICT infrastructure at health
facilities
 Inadequate data for strategic planning and
management
 Inadequate ICT skills and competency
ICT Issues in RMK-10
People
Process
Technology
To be addressed in RMK-11

21. •Achieve better
outcomes
Citizen
•Improved population
health
Communities
•Decreased cost
burden
Nation
What is the enabler of MOH vision?
Integrated Healthcare Delivery
Integrated Healthcare IT System /
Connected Health
Key
Enabler!
A nation of healthy individuals, families and communities….

22. Action Plan for ICT
Leadership & Governance
Legal Framework & Policy
Standards
&
Interoperability
ICT
Infrastructure
&
Connectivity
Applications
&
Systems
Health
Information
Exchange
(HIE)
People
(Skills
&
Expertise;
Change
&
Adoption)
Monitoring
&
Evaluation
Sustainability
Health System Transformation
Foundation
Pillars
GOAL
Enterprise Architecture
National eHealth Policy & Strategy

23. 23
•Focus on establishment of EA, integration and
Health Data Warehouse
Develop National eHealth
Strategy
•Focus on strengthening the current health
system with robust ICT infrastructure/systems
Implementation of
infrastructure and systems
•Focus on integration & interoperability,
accessibility to data and patient engagement
Lifetime Health Record:
‘1 person 1 record’
•Focus on capacity and capability building
Establish Health IT
Workforce Development
Program
•Focus on delivering core business and tapping
strength of others
Collaboration and Smart
Partnership
Five initiatives in RMK-11 (2016-2020)
1
2
3
4
5

24. The activities for each initiatives (2016-2020)

25. Medical Record
Management
Patient
Management
Ward/Clinic
Management
Billing &
Payment
Staff
Management
(Rostering)
Order
Management
LIS
LDR
BI/EIS
CCIS
PACS
Diet & Catering
Administrators
Tool
National
Client/
Citizen
MyHIX/LHR
Case Mix
eGov Apps
(Adm/HR/Fin)
Surveillance/
Monitoring
Monitoring/
Evaluation
(inc QA)
Disease/Patient
Registries
HIMS
Health Financing
Health Portals
eScheduling/
eAppointment
eFollow-up/
eConsultation
Professional
Registries
Personalized
Lifetime Health
Plan
OTMS
Self Monitoring
25
Health Information System
N
a
t
i
o
n
a
l
D
a
t
a
W
a
r
e
h
o
u
s
e
FMIS
RIS
CSSD
Teleconsultation
& Remote
Monitoring
Population
Health
General Specialties
Sub-Specialties
CLINICAL DOCUMENTATION
Health Apps
Health
Education &
Counselling
Clinical Notes &
Dental Charting
Order
Management
Patient
Management
System & Billing
School
Health
Personnel
Management
EIS
PRIMARY CARE
Clinical Decision
Support System
Regulation/
Enforcement
Licensing/
Credentialing
Patient Care/
Population Care
Cardio MS
Note:
Integration
1.
2. Integration to external
systems is also required;
however not reflected
here
OIS/RT
BBIS
HR
Development
/ Training
Institutional systems
PhIS

26. Future ICT Architecture Overview (Conceptual)
Community
Pharmacy
Registration
Prescription
View
Eligibility
Check Dispensing
Interaction Allergy
Claim
Adverse
Provider (Public &
Private)
Registration Scheduling
Eligibilit
y Check
Visit
Summary
Prescription Referral
Claim
Wellness
1Care Access Layer
Information Exchange Infrastructure Services
(HIE)
Client
Registry
Provider
Registry
Facility
Registry
Terminology
Services
Privacy
Management
Security
Management
Shared
Records
(LHR)
Wellness
Services
(Personalized)
Provider Payment
Enrolment
Verification
Fin & Acct
Quality Penalty
Claim
Incentive
s
Capitation &
Risk Adjustment
JP
N
Licensing/
Credentialing
Monitoring &
Evaluation
Regulation/
Enforcement
Promotion/
Surveillance
Patient
Portal
MOH
DATA
SOURCE
National Health Data Warehouse
QUICK
WINS

27. LAN APPLICATIONS
Hospitals
Health Clinics
WAN
1
Note 1: WAN Connectivity is undertaken by MAMPU under 1Gov*Net
Note 2: SPP development/roll-out for MOH hospitals commenced
PhIS development/roll-out for MOH facilities commenced
Note 3: TPC/OHCIS development & roll-out commenced
Note1
MOH: <30% with HIS system
DEVICES
2 3
MOH: <10% with TPC
Dental Clinics
MOH: <5% with OHCIS
Supporting Facilities
LAN and DEVICES required
Note 2
Note3
Note 3
27
Note 3
‘Quick Wins” for MOH

28. MOH*Net
MyLoca Data
Centre
Cyberjaya
Internet
MOH HQ
State
Health
Dept
Health Office/
Health Clinics/
& Dental
Labs &
Institution
Hospitals
Putrajaya
Campus
Network
(PCN)
28
Note:
1.MOH*Net in final
stages of migration to
1Gov*Net
2.Managed services by
MAMPU
3.MyLoca Data Centre
to be migrated to
Public Sector Data
Centre
4.70% facilities
connected to
1Gov*Net
5.Target of connectivity
100% by 2015
20Mbps
20Mbps 6Mbps 10-30 Mbps
(Monitored via
NKEA CCI)
1Gov*Net
Infrastructure & Connectivity

29. 29
In Summary……..
$ Capex
TIME
Illustrative
7MP to 9MP 10MP 11MP
4 MSC pilot projects
Numerous achievements
‘Busy & rich’ times
Turnkey projects
Direct negotiations
“Silo” implementations
 THIS ‘Big bang’ approach
Telehealth services
reviewed
MyHIX
TPC pilot & roll-outs
Multimedia Super
Corridor GTP & ETP STP & Digital Economy
2010 2012 2013 2015
Nationwide roll-outs of major systems
Capex to Opex model
Integration & Consolidation
Managed services
Government Shared Services
Collaboration/Public Private Partnership
Cloud deployment models
Mobile Health
Social Media
Big Data & Open Data
Lull
Upgrades
Pilots/POCs
Roll-outs
Scaling
Conventional
“Crawl, walk,
run” approach
Realignment
2017 2020
Connectivity
Ongoing O&M
9MP projects
Towards health system transformation
2016
1996

30. THANK YOU
dr_fazilah@moh.gov.my
30