4 research outputs found

    An Integrated and Distributed Framework for a Malaysian Telemedicine System (MyTel)

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    The overall aim of the research was to produce a validated framework for a Malaysian integrated and distributed telemedicine system. The framework was constructed so that it was capable of being useful in retrieving and storing a patient's lifetime health record continuously and seamlessly during the downtime of the computer system and the unavailability of a landline telecommunication network. The research methodology suitable for this research was identified including the verification and validation strategies. A case study approach was selected for facilitating the processes and development of this research. The empirical data regarding the Malaysian health system and telemedicine context were gathered through a case study carried out at the Ministry of Health Malaysia (MOHM). The telemedicine approach in other countries was also analysed through a literature review and was compared and contrasted with that in the Malaysian context. A critical appraisal of the collated data resulted in the development of the proposed framework (MyTel) a flexible telemedicine framework for the continuous upkeep o f patients' lifetime health records. Further data were collected through another case study (by way of a structured interview in the outpatient clinics/departments of MOHM) for developing and proposing a lifetime health record (LHR) dataset for supporting the implementation of the MyTel framework. The LHR dataset was developed after having conducted a critical analysis of the findings of the clinical consultation workflow and the usage o f patients' demographic and clinical records in the outpatient clinics. At the end of the analysis, the LHR components, LHR structures and LHR messages were created and proposed. A common LHR dataset may assist in making the proposed framework more flexible and interoperable. The first draft of the framework was validated in the three divisions of MOHM that were involved directly in the development of the National Health JCT project. The division includes the Telehealth Division, Public and Family Health Division and Planning and Development Division. The three divisions are directly involved in managing and developing the telehealth application, the teleprimary care application and the total hospital information system respectively. The feedback and responses from the validation process were analysed. The observations and suggestions made and experiences gained advocated that some modifications were essential for making the MyTel framework more functional, resulting in a revised/ final framework. The proposed framework may assist in achieving continual access to a patient's lifetime health record and for the provision of seamless and continuous care. The lifetime health record, which correlates each episode of care of an individual into a continuous health record, is the central key to delivery of the Malaysian integrated telehealth application. The important consideration, however, is that the lifetime health record should contain not only longitudinal health summary information but also the possibility of on-line retrieval of all of the patient's health history whenever required, even during the computer system's downtime and the unavailability of the landline telecommunication network

    The adoption of ICT in Malaysian public hospitals: the interoperability of electronic health records and health information systems

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    There have been a number of researches that investigated ICT adoption in Malaysian healthcare. With the small number of hospitals that adopt ICT in their daily clinical and administrative operations, the possibility to enable data exchange across 131 public hospitals in Malaysia is still a long journey. In addition to those studies, this research was framed under six objectives, which aim to critically review existing literature on the subject matter, identify barriers of ICT adoption in Malaysia, understand the administrative context during the pre and post-ICT adoption, and recommend possible solutions to the Ministry of Health of Malaysia (MoHM) in its efforts to implement interoperable electronic health records (EHR) and health information systems (HTIS). Specifically, this research aimed to identify the factors that had significant impacts to the processes of implementing interoperable EHR and HTIS by the MoHM. Furthermore, it also aimed to propose relevant actors who should involve in the implementation phases. These factors and actors were used to develop a model for implementing interoperable EHR and HTIS in Malaysia. To gather the needed data, series of interviews were conducted with three groups of participants. They were ICT administrators of MoHM, ICT and medical record administrators of three hospitals, and physicians of three hospitals. To ensure the interview feedback was representing the context of EHR and HTIS implementation in Malaysia, two hospital categories were selected, which included the hospitals with HTIS and non-HTIS hospitals. The government documents were then used to triangulate the feedback to ensure dependability, credibility, transferability and conformity of the findings. Two techniques were used to analyse the data, which were thematic analysis and theme matching. These two techniques were modified from its original method, known as pattern matching. The originality of this research was presented in the findings and methods to transform them into solutions and provide recommendation to the MoHM. In general, the results showed that the technological factors contributed less to the success of the implementation of interoperable EHR and HTIS compared to the managerial and administrative factors. Four main practical and social contributions were identified from this research, which included synchronisation of managerial elements, political determination and change management transformation, optimisation of use of existing legacy system (Patient Management System) and finally the roles of actors. Nevertheless, the findings of this research would be more dependable and transferable if more participants had been willing to participate especially among the physicians and those who managed the ICT adoptions under the MoHM

    A Flexible Telemedicine Framework for the Continuous Upkeep of Patient Lifetime Health Records (F2U-LHR)

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    International audienceThe lifetime health record, which correlates each episode of care of an individual into a continuous health record, is the central key delivery of the Malaysian integrated telehealth application. A lifetime health record for an individual is the integration on his/her life timeline of all is/her electronic health records from healthcare centres he/she has been to since birth. The electronic medical records to be collected that form the lifetime health record, can be gathered from various spectrums of health information systems and healthcare levels, implying the necessity to handle diverse communications and information technology infrastructures. Most important consideration, however, is that the lifetime health record should contain not only longitudinal health summary information, but also the possibility of on-line retrieval of all patient health history whenever required, even during computer system downtime and unavailability of landline telecommunication network. It is only with such comprehensiveness of health records that the risk of inappropriate delivery of care may be reduced, and most of all the true continuum of care may be achieved. This paper proposes the first draft of a flexible framework for an integrated and distributed telemedicine system in Malaysia, intended to cope with these requirements. Brief overview on the high-level framework is provided, followed by a concise description of the three major components of the framework

    A flexible telemedicine framework for the continuous upkeep of patient lifetime health records (F2U-LHR)

    Get PDF
    The lifetime health record, which correlates each episode of care of an individual into a continuous health record, is the central key delivery of the Malaysian integrated telehealth application. A lifetime health record for an individual is the integration on his/her life timeline of all his/her electronic health records from healthcare centres he/she has been to since birth. The electronic medical records to be collected that form the lifetime health record, can be gathered from various spectrums of health information systems and healthcare levels, implying the necessity to handle diverse communications and information technology infrastructures. Most important consideration, however, is that the lifetime health record should contain not only longitudinal health summary information, but also the possibility of on-line retrieval of all patient health history whenever required, even during computer system downtime and unavailability of landline telecommunication network. It is only with such comprehensiveness of health records that the risk of inappropriate delivery of care may be reduced, and most of all the true continuum of care may be achieved. This paper proposes the first draft of a flexible framework for an integrated and distributed telemedicine system in Malaysia, intended to cope with these requirements. Brief overview on the high-level framework is provided, followed by a concise description of the three major components of the framework
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