PLEADING THE CASE FOR A STRATEGICALLY PLANNED AND THOUGHTFUL TRANSITION TO A MALAYSIAN PUBLIC HEALTH CARE SYSTEM THAT WILL BE ENHANCED BY DIGITAL TECHNOLOGY FOR THE PROVISION OF CARE AND PUBLIC ACCESS TO ESSENTIAL HEALTH SERVICES
Prepared By:
Committee for Strategic Communications and Digital Health, Office of the Pro Vice Chancellor (KL Campus)
Dr. Husyairi Harunarashid. Clinical Epidemiologist
Dr. Afifah Mohamed, Medical Imaging Lead
Dr. Fatimah Hani Hassan, Neurogenic Communication and Speech Language Disorder Lead
22nd August 2024.
The digital transformation of the healthcare sector, be it in the public service domain or the lucrative private hospital industry, is inevitable. However, the driving force behind it arguably is dominated by market forces, setting up novelty traps in every conceivable direction and choices. Without careful planning, investments in upgrading the systems supporting the healthcare services may result in higher cost and additional problems rather than yielding good solutions to unresolved issues; or worse, push the system into a position where it could not ever respond to challenges and crises in a timely and effective manner.
Digital health means many things to many people, and can be interpreted in many ways. But this government cannot afford to go forward with the much-needed modernization, being swayed by narratives heavily influenced by special interest groups not necessarily aligned with the social protection agenda. Now is the best opportunity to introduce a shared understanding that keeps the interest of industry players and developers as well as healthcare practitioners and consumers, while also prioritizing the importance of choosing the right technological adoption to maximize the value adding advantages of digital technology and biomedical advances that can address the problems plaguing the services.
Digital health for the rakyat means accepting the reality that the provision of essential healthcare services, and more importantly, the means to access these services, highly depends on reliable digital technology that supports its operations. Not only do policymakers need to fully embrace the responsibility of finding the right digital solution to solve the inefficiencies and bottlenecks that exist, but they also need to be mindful of the fact that the introduction of new technology and digitally bound processes in clinical healthcare will also bring new problems that must also be tackled preemptively using anticipatory risk-managed approach. For this transformation to be successful and achieve the promise of true which is meaningful positive change in the quality of services provided for the people, there must be several enablers; 1) trained individuals with the right attitude to help ease the process of transition to a fully digital work environment, 2) a policy ecosystem which supports digitally enhanced healthcare that is comprehensive, useful and thoughtful for all the stakeholders of the services, 3) developers and solution providers who listen and make design decisions that fit the need of the people who run the operations and not the ones who pay for them, 5) communities of regular people who are both health and digitally literate, and 6) technology that suits the social, economic, geographical, and cultural landscape of Malaysia.
The rakyat demands better access, improved quality and outcomes, and better experience throughout the interaction in getting the care they need. The rakyat do not want digital transformation for the sake of transformation alone, and neither do all the doctors, nurses, healthcare workers and support personnel in healthcare facilities. To ensure this digital transition will be inclusive for all and achieve the best cost-efficient gains of modernization of the healthcare services, the following potential frameworks are suggested:
Stated Policy Objectives. The government adopts and promotes a definition of Digital Health for Public Good that insists achieving the outcomes of improvements in widening access to all members of society, and the overall quality of service provision are the primary goals of digital transformation and adoption of new digitally enhanced healthcare technologies.
Public Accessibility. The inclusion of a “public access guarantee” clause for all digital technology solutions procurement tenders intended for digitalisation of existing healthcare services, where it demands objective evidence by the supplier to ensure the necessary changes and adaptation need are done to cater for all groups of patients affected directly by the introduction of the product.
Effective Communication. The inclusion of the requirements for “enhanced communication for clinical care” in the procurement of Electronic Health Record software packages, where it demands objective evidence of the solution provider to commit in addressing the communication needs of all users of the system necessary in the delivery of healthcare, including those with diverse sensory, physical, cognitive, and intellectual abilities.
Digital Health Code of Practice. The development and introduction of a digital health code of practice and related training for all healthcare providers that stress on the importance of optimising value-adding advantages of digital technology to solve existing problems and improve access to healthcare, adapt to changes in governance and processes, empower the healthcare workers and support staff on their roles and responsibilities when operating in a digitally enhanced workspace, and address threats and risks of digital health and its implications to services as a whole.
Local Talent Training and Support. The provision of support to local talents in developing digital solutions to enhance access to healthcare services and improve consumers’ experience while seeking care in healthcare premises, and education to the society to improve their perceptions, attitudes and health-seeking behaviours by the utilization of digital means.
IT systems and Data Sharing. The promotion of using digital technology to enhance problem discovery and clinical audit for patient safety and practice development in developing a ubiquitous network of easily accessible, trustworthy health promotion knowledge resources for members of the public by recruiting existing social institutions, such as public libraries, places of worship and community centers through a whole-of-government approach, and collaborating with various forms of media, including public advocacy, influencers, and celebrities to encourage the public improve both digital and health literacy.
Financing and Reimbursement. Implementing the digital health systems necessitates a strategy for sustainable financing and long-term reimbursement of consultations which includes establishing clear policies for how insurers will reimburse digital health services.
References:
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