Digitization and Hospital Management
As part of digital move introduced by the former Prime Minister of Malaysia Tun Dr. Mahathir Mohamed, Selayang Hospital underwent a major transformation, introducing the THIS – Total Hospital Information System. This system was aimed to provide a comprehensive hospital solution that covers imaging and patient information. Based on research done to gauge the acceptance level and satisfaction amongst nurses in the hospital, the research shows marked improvement in turn around time and satisfaction level on the efforts of digitization.
That was early 2000.
In May 2019
Come to current times, in May 2019, New Straits Times reported that technical problems plaguing the once famed THIS solution that is deployed in Selayang Hospital. Since May 4th2, some 40% of elective surgeries were rescheduled due to system failure.
Ministry of Health was quoted by Bernama, stating that the elective surgeries had to be postponed due to lack of access to the pathological reports, critically for cancer patients. The technical issues also affected the hospital’s ability to service patients seeking outpatient treatment. The ministry added that patients seeking inpatient service, emergency treatment and surgical emergency had to be carried out manually (not sure what’s meant by manually…).
THIS system has had its challenges, however staffs working in the hospital mentioned that the experience in the 2019 outage was the longest that they had ever experienced (I read that as the system has failed before, just not that long).
A doctor was quoted to say that the computerization was done long time ago (quote year 2000) and the system has had numerous instances where the system was down, forcing the staff to manually chart down details. System downtime would last 6-7 hours. (Wow!)
Deputy Health Minister (then) Dr. Lee Boon Chye confirmed that it s an old system that needs to be upgraded and its being done as he is being quoted (2019). Patients were given the option of whether to continue or not with their appointment, which may lead to longer waiting time , or opting to reschedule at a later date.
Come January 2021
On 5 January 2021, Malaysiakini carried the report stating that Selayang Hospital had another downtime. The hospital had to access the records manually for the past 3 days due to failure of its IT system, burdening the already overloaded hospital operations. This time a system called PowerChart was blamed for the issue (Is PowerChart part of THIS? Or is a replacement?) PowerChart has been down since January 6, 2021. Hospital officials was quoted saying that the system is used to record everything, from patient history and their progress. This included lab investigations, CT scans, blood test results and reports.
Looking at what has happened, I’m wondering what’s happening at the Selayang Hospital. The hospital is already facing a pandemic situation, and IT system reliability is causing additional headache to the overburdened staffs.
Is this new?
There seems to be a spat of technology issues covering Malaysian healthcare. About one year ago, I wrote about issues plaguing Sg Buloh hospital which had IT issues due to continued use of Windows XP. Sg Buloh hospital was reported to be using Windows XP as their server platform, instead of Microsoft Server operating systems. This is also due to 32bit operating system limitation which had caused the problem to occur. I covered this in extensive detail in this article.
Some glaring questions on the system
- Is PowerChart a replacement for THIS? Or is it part of it?
- Has MOH completed the system upgrade, which it stated in 2019?
- Constant failures of IT systems at a critical national infrastructure warrants a relook at how these systems are selected, deployed and whether the effectiveness is there over time.
- Based on the 2019 report, it seems that the system may not have the necessary hardware or software upgrades. Is capacity management and system availability tracked, measured and actioned upon?
In order for healthcare to serve the population effectively, there is a serious need for healthcare systems to be functioning and working in prime condition. There can be no lapse, as these situations create more opportunity for healthcare failure and workforce exhaustion. Systems are meant to ease the burden and workload of the hospital staffs, and should rightfully function in effective manner.
- Malaysiakini (9 Jan 2021) – Selayang Hospital’s IT system down for 3 days and counting – https://www.malaysiakini.com/news/558254
- New Straits Times (17 May 2019) – 22 year old Selayang Hospital getting much needed technical upgrade – https://www.nst.com.my/news/nation/2019/05/489365/22-year-old-selayang-hospital-getting-much-needed-technical-upgrade
- Rosnah H., Zubir M.A., Akma Y.N. (2004) International Perspective Selayang Hospital: A Paperless and Filmless Environment in Malaysia. In: Ball M.J., Weaver C.A., Kiel J.M. (eds) Healthcare Information Management Systems. Health Informatics Series. Springer, New York, NY. https://doi.org/10.1007/978-1-4757-4041-7_11
- Mohamad Yunus, N., Ab Latiff, D., Abdul Mulud, Z., & Ma’on, S. (2013) Acceptance of Total Hospital Information System (THIS), International Journal of Future Computer & Communications
- Sg Buloh Hospital: Jan 2020 Case Study – https://www.drsuresh.net/2020/01/sg-buloh-hospital-jan2020-case-study/