Log the doctor on

Healthcare IT projects need to involve the medical staff right from the onset.


The absence of doctors and allied healthcare professionals in the decision-making process is one of the biggest challenges faced by hospitals and healthcare facilities in the implementation of healthcare IT (HIT) projects.

According to International Medical University Professor Dato Dr A Jai Mohan, physicians are the lead persons when rolling out healthcare projects. “Past experience showed we have rolled out more successful IT systems when physicians are involved from the very start,” he said, adding that clinicians actively convinced colleagues at their workplace to adopt technology.

Mohan cited Hospital Selayang and Hospital Putrajaya as examples of successful IT implementation that had buy-in from doctors, nurses and other allied health professionals from the start. Hospital Selayang’s rollout of the electronic medical records (EMR) system was among the early success in Malaysia’s telemedicine project (see sidebar).

Mohan, who is also vice-president of the Malaysian Health Informatics Association, pointed out that it is important to explain to physicians that IT is an enabler.

“Physicians are not bothered about data, they see patients one at a time and what is important to them is what has been done with the patient in the past. Once physicians see the value of the patient information, then they can appreciate how useful data can be to them,” he added.

Meridian Project Management Sdn Bhd’s chief executive officer Dr Mohd Azrin Zubir concurred. He said that physicians are able to relate their medical experiences and encounters which can be integrated in the design and development process for a workable HIT project.

“What IT people do is sell a system and they fail to look at providing a solution to the doctor and how a doctor can use IT to support their work of treating patients. “Understanding how doctors work and operate is important to delivering an IT solution that supports their work. And IT people can do that if they have a greater understanding of healthcare informatics,” he said.

Both experts underlined the importance of defining achievable health outcomes and to match efforts required to meet the outcomes before cost improvements and efficiencies arising from IT are outlined.

A US study of 256 hospitals found that only four achieved targeted health outcomes. The remainder showed improved automation of processes.


Azrin and Mohan were part of the three-man panel at the Microsoft healthcare roundtable held in Kuala Lumpur recently. About 25 doctors and industry veterans attended the closed-door session moderated by Microsoft’s public sector healthcare industry director for Asia Pacific, Gabe Rijpma.

Among the issues discussed included benefit of health IT adoption and lifetime health record, managing labour shortage, the impact of consumerism and lifestyle on healthcare, the changing mode of healthcare and best practices in health reform.

Rijpma argued that roughly 75% of consumers go to Google to look for medical information which maybe handy yet a dangerous practice. “Consumers have become smarter but this also means they expect more when they see their doctor.”

Mohan contended that the establishment of the lifetime record system as one of the five pilots under the national telemedicine project had panned out because it was focussed on keeping people well through prevention or early intervention during the onset of a disease.

“But it turns out that most people are healthy most of the time. So we had to shift our focus on capturing what they are doing which was eating, drinking and exercise and to see how they managed when they fell sick.”

Telemedicine was one of the seven flagship applications of the Multimedia Super Corridor (MSC) launched in 1997. The lofty project aimed at transforming healthcare through IT also included four other pilots which are mass customised or personalised health information and education; continuing medical education and teleconsultation.

“The biggest cost we face today are caused by lifestyle diseases such as diabetes, heart disease and cancer, and a personal health record is necessary to monitor such ailments,” said Mohan who also led the steering committee on telemedicine.

Rijpma proposed cloud computing as an avenue that hospitals can use to experiment and gauge consumer expectations. “The growing population on Facebook is an indicator of what is possible in cloud computing.

Consumers want to have access to their medical records regardless of providers and hospitals can consider enterprise grade cloud services to match it,” he said.

He added that it was ironic that consumers can go online to buy a book, download music, connect on Facebook or conduct banking transactions yet get a shaft of written reports or x-rays when they seek treatment at hospitals and healthcare facilities.

“Hospitals will gain the highest benefit if they integrate their administration and financial system with the clinical system and move towards a model that matches the demands of savvy consumers.”

What do I get?

Systematic Conglomerate Sdn Bhd Dr Syed Amin Husaini Abdullah Al-Edrus said that IT vendors need to clarify to physicians “what’s in it for them” in order to jump on the cloud bandwagon.

“I believe that the healthcare sector is ready but we have not told the doctors what are the benefits of doing so. In healthcare adoption, we often look at the patient and nursing point-of-view but not from the doctor’s viewpoint,” he said.

MDC Sdn Bhd senior manager for telehealth and e-government Gayah Gulam Haidar agreed, adding that with many medical professionals are already using smartphones or conducting online transactions. “I don’t care who manages the system” but I want to know what can I get out of it.”

Azrin disclosed that doctors are already sharing patient information via e-mail and shifting over to the cloud would be a matter of time given the growing size of Internet subscribers in Malaysia. (About half the population have Internet access today).

“There are apps on devices like the iPhone that allow people to monitor and manage their weight or diet. Our main limitations are the lack of good broadband, reliable datacentres and of course, the security of the service provider who must conform to international standards.”

He added that competitive pricing would encourage users to move to the cloud because currently 50% of the cost in cloud computing goes to its infrastructure, which many hospitals felt can be better spent on a datacentre or helpdesk.

Rijpma agreed adding that building the right infrastructure is necessary to support healthcare.

“Consumers have embraced the cloud and hospitals, like any other enterprise, have the option to use a private cloud or share the public space.

“Ensuring data sovereignty, security and identity management would require commercial collaboration from a reliable partner,” he said.

(Editor’s note: Anita Matthews is a freelance writer and a former In.Tech assistant editor.)

Related Stories: Pillars for building a successful healthcare system

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