Bagan Specialist Centre is a private hospital located in Butterworth, Penang in Malaysia and the first hospital to embark on a fully automated early warning scoring system in the APAC region in July 2018. Oriental Melaka Straits Medical Centre is a 300-bedded, fully-integrated multidisciplinary specialist centre located at the beach area of Klebang, Melaka in Malaysia. 

Ahead of the Malaysia Digital Health Summit, HIMSS APAC’s first ever virtual summit happening from 7-8 July 2020, Dr Tan Hui Ling, Managing Director, Bagan Specialist Centre and Oriental Melaka Straits Medical Centre shared with Healthcare IT News her thoughts on the private healthcare scene in the country, as well as how health IT can empower care teams at the hospitals she oversees.

Could you tell us more about your role(s) as Managing Director at Bagan Specialist Centre (BSC) and Oriental Melaka Straits Medical Centre (OMSMC)? 

I focus on the strategic direction for the growth of these two hospitals and ensuring we are progressing to fulfil our hospitals’ vision.

What would you say are the challenges and opportunities in the management of private hospitals in Malaysia?

The focus on private healthcare service in the past 10 years has been in meeting the rising market demand in terms of volume. The last two to three years, more private hospitals have expanded or entered the market with increasing competition in the private healthcare industry, and this has forced hospital players to also start focusing on the quality and efficiency of service delivery. Hence I see that there are plenty of opportunities for innovative disruption in the traditional healthcare service delivery model and especially in tapping on technology such as artificial intelligence and smart learning.

What are your thoughts on the use of Health IT in empowering the care team at the hospitals that you oversee? Could you give us some examples of use cases at your hospitals and the workforce challenges in implementing new processes?

It is important to use technology to our advantage especially in terms of improving quality of care and work efficiency at an affordable cost. One of the challenges in implementing IT is the cost for initial purchase, maintenance and regular updates, and over the years this has reduced significantly with more local/ Asian made solutions and expertise available. But the biggest challenge is in human, the mindset, expectations and the ability to visualize how to digitalize our routine work and how to use technology to improve our work process or quality of care.

Both our hospitals have implemented electronic medical record EMR. For OMSMC we started using EMR as a new hospital 5 years ago in 2015, and BSC we converted from manual to electronic 2 years ago in 2018. When we launch EMR, we ensure it is integrated with the Hospital Information System (HIS), Financial Information System (FIS), radiology Picture Archiving and Communication System (PACS). This is to make sure all the core work flow from clinical to non-clinical are linked, and have seamless and immediate exchange of information and data to enable improved efficiency and accuracy. 

As a number of our staff and doctors are not familiar with healthcare IT system, we need to handle two groups of people, one who is excited to embrace IT and one who is resistant to change. We need to handle both groups differently, getting the excited ones to influence and help train the nonchalant ones, and getting the experienced ones to be opinion leaders and input during the set up and for continuous upgrade. At the same time, we need to prioritize working on feedback which will create high value improvement in the work flow, and mediate the different expectations and ‘wishlist’ from different users.

We have also launched our own mobile application which is integrated to our HIS. This allows our patients to view our services available, and make immediate appointment at their preferred time slot. The similar app, also enables the patient to check-in and skip the physical registration queue. They can also follow a live queue wherever they are in the premises.

In terms of clinical side, we were one of the first in Asia to adopt an automated Early Warning Score (EWS) system that is integrated with our EMR. This system through a patient vital sign monitoring device, after the measurement of the vital signs, will automatically calculate the EWS score and risk stratify the patients to how likely they might deteriorate or how much closer monitoring they need in the general ward according to our clinical protocol. Apart from that it will also automatically trigger rapid response team if the score is under high risk. This has empowered our nurses and doctors to make decisions and act promptly to patients’ medical needs.

The ongoing COVID-19 pandemic has demonstrated the importance of healthcare providers in being digitally ready and capable, such as using integrated systems to effectively manage patient cases as well as protect their own staff. What lessons have you learnt from your own hospitals’ handling of the COVID-19 situation?

This COVID-19 pandemic has affirmed our move to be digitally ready. Our online appointment app with live queue is very useful in reducing patients’ waiting times and hence minimize crowd in the public waiting area, and allow us to safely implement social distancing. Besides the convenience of having an integrated EMR and HIS which is easily accessible anywhere on site, we have further tapped into our app, by launching a teleconsultation service. 

This allows our patients to receive medical consultation at their convenience in their own home or office, if their condition does not require a physical examination. At this same period, we also manage to convert our entry and admission COVID-19 health screening form and contact tracing form to be digital and reduce unnecessary physical touch points and waiting. All implementation is possible in a short period, as we already have our hardware and core IT systems in place.

On top of being a specialist in internal medicine, you are also trained in public health. What roles do you see the private healthcare sector playing in terms of contributing towards public health initiatives?

I think we have a very big role to play in reducing the public health burden such as promoting lifestyle modification and creating awareness to reduce the burden of chronic diseases in Malaysia. I believe as a healthcare institution, our role is not just a place to heal, it is also a place to create health, fitness and wellness. Hence our services do not just focus on healing, but also preventing illness and chronic disease, and promoting wellness and health.

Dr Tan is a speaker at the session titled ‘Empowering and Protecting the Care Team’ happening from 3pm-4pm (GMT +8) at the upcoming Malaysia Digital Health Summit happening from 7-8 July 2020. Registration details for the Summit can be found here.