Healthcare digitalisation

Malaysia’ s National Heart Institute, IJN, is embarking on a major expansion and upgrade of its world class facilities, underpinned by state-of-the-art technological innovation and the highest standards in electronic medical record management

“ Our first try at EMR in our early days of digital transformation was less than successful, but we learned. We realised that the journey was complicated.”

According to Dr Ezani, part of this technological evolution will involve a significant shift in healthcare management to digital patient records. Coordinated care inside a hospital now goes from intake to treatment or care to patient transfer between units within a hospital for complex procedures to medication prescription, and the root of all this is the electronic health record, better known as the electronic medical record( EMR) in Malaysia.

When we sat down with him in late 2024, one of his major concerns was the complexity and challenges IJN faced in implementing a seamless EMR solution. Unlike other private hospitals, IJN’ s patients have diverse funding sources, including private patients, those who are government-funded, and patients on subsidised care.

“ To have a system that is applicable within our ecosystem has been challenging, as it requires customisation of our clinical systems. We did not have the information technology workforce in-house, and this meant engaging a third party to run and manage the data integration for us. This was not cost effective, and we needed to make changes to overcome this,” he said.

Those changes came quickly, as not more than a month after our interview, IJN set a groundbreaking precedent as the first hospital in Malaysia to achieve the much sought-after EMRAM( Electronic Medical Record Adoption Model) Stage 6 validation from the Healthcare Information and Management Systems Society( HIMSS). To become a Stage 6 hospital like IJN requires a focused, directionally-aligned, and steadfast commitment to improving safety, minimising errors, and prioritising implementation of the hospital’ s IT systems.

EMRAM Stage 6 Leading the process to achieve EMRAM Stage 6 status has been Professor Dato’ Sri Dr Alwi

Mohammed Yunus, the Clinical Director of Health Informatics and the Head of Department, Cardiothoracic and Vascular Surgery at IJN.

“ Our first try at EMR in our early days of digital transformation was less than successful, but we learned. We realised that the journey was complicated. In order for us to implement our solution at an acceptable speed and reach the outcome that we desired, we needed a new formula, a new approach. So we had to reengineer our processes and ensure all hospital equipment interfaced to the EMR,” he said.

Dr Alwi then shared with great passion the steps and the pivotal strategy that IJN undertook to achieve the milestones needed to obtain Stage 6.“ This technology will continue to evolve, and we will need to keep pace with further progress. The people using the technology are also the people who develop them. So it is important to have our current workforce come from the various disciplines and departments. It is our own workforce that develops, implements, and uses our EMR,” he explained.

IJN’ s EMR journey dates back to 1998 with the use of the Health Information System( HIS) designed by MedTrack. In 2013, it completed the Clinical Documentation for Paediatric Cardiology – PaedsCare. Following that, in 2016, the Clinical Research Database, which compiled data for Cardiothoracic Surgery and Anaesthesia, was established. Its patient care application, IJNCare( Phase 1), then went online in 2023. After a long journey, it all came together in 2024 with the EMRAM project.

The success of IJN’ s EMRAM efforts is the result of several internal and external factors. A tireless internal working committee, the engagement of foreign expert consultants, the supervision of a Taskforce Core Team, and the accessibility of equipment and structured planning on IT manpower and budgets were just some of the key ingredients.

“ We acquired biometric finger readers, smart card readers, and integrated e-invoicing systems, as well as ECG, CT, MRI, and angiograms, and linked them to our EMR system. We’ ve also gone as far as expediting the purchase of equipment to be in time for the EMRAM evaluation. It requires the whole hospital to come together to achieve the vision, quite literally,” Dr Alwi said.

Building on this achievement, IJN is now focused on further elevating its digital capabilities to achieve

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