Malaysia's Ministry of Health will be starting a pilot project to integrate the health records of all Malaysians into one database, which can be accessed by both government and private healthcare providers in five years.

The project on integrated Enhanced Primary Healthcare (EnPHC) will begin in July and is set to store medical records of 300,000 Malaysians at 20 health clinics in Selangor and Johor before gradually expanding nationwide, according to Health Minister Datuk Seri Dr S Subramaniam.

He also said the electronic medical records (EMR) of 30 million Malaysians would be introduced to ensure a seamless transition of care between the public and private sectors after five years.

A more proactive and preventive approach

With the patients' health history easily accessible, it is convenient for doctors to assess their health conditions, including their prevalence for non-communicable diseases (NCD) such as diabetes, high blood pressure and heart-related diseases, therefore diagnosing and treating the patient quicker before their condition deteriorates.

This would shift the focus to a more proactive and preventive approach to the population's overall wellbeing, said Dr Subramaniam.

"We want a healthy Malaysian society as the prevalence of NCD have risen especially in heart diseases, diabetes, obesity, hypertension and effects of drug abuse, alcohol and smoking," he added.

The prevalence of diabetes has tripled from 6.3% to 17.5% from 1986 to 2015 and hypercholesterolemia has doubled (23% to 48%) from 2006 to 2015.

"More alarmingly, more than 50% of these cases are not diagnosed and the number continues to increase," said Dr Subramaniam.

Project to increase productivity through different measures

The government has spent RM22.6 billion in direct and indirect expenditure in 2010, including hospitalisation and medication costs, and treatment of complications as a result of NCDs. Therefore the project was formed to increase the country's productivity.

"In the first phase, a population profiling database will be done through data given by the Healthy Community Empowers the Nation (Kospen) programme, non-governmental organisations (NGOs) and health clinic advisory panels," Dr Subramaniam explained. "With the information, healthcare providers can suggest treatments and interventions according to the patient's health condition."

The project will also see patients assigned to Family Health Teams (FHT), where patients will be seen by the same team led by the same doctor at every visit, which will provide a thorough and risk-based screening to determine the proper intervention required.

“This would enable a quick response to incoming patients and reduce congestion and wait times during registration," Dr Subramaniam said.

Care coordinators to enhance personalised care

Government hospitals will also have care coordinators to ensure that healthcare needs for each person are met, providing a personalised engagement at each touch point.

“The care coordinator will be the bridge between the multidisciplinary team including dieticians, NCD educators and physiotherapists,” he added.

The utilisation of standardised NCD records will also be expanded to enhance the current referral and counter-referrals system across various healthcare providers from government clinics to hospitals and vice-versa.

Dr Subramaniam also acknowledged that challenges such as high costs and increase of manpower will be involved in implementing these features. MIMS

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