DG of Health Opening Address: The 2nd Telemedicine Conference 2016 (16 August 2016)

The 2nd Telemedicine Conference 2016, 16-18 August 2016 with the theme “Shaping Tomorrow’s Healthcare Today” was held at Swan Convention Centre, Sunway Medical Centre. It was well attended by almost various stakeholders and key players of Information and Communications Technology (ICT) industry, as well as relevant ministries/agencies.

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Today, I am indeed very delighted to be here again to officiate the second telemedicine conference. Congratulations to the Organising Committee. The conference theme of Shaping Tomorrow’s Healthcare Today, offers a more pragmatic approach to discuss and address key issues on the ground to help propel Malaysia into the information technology age. I am very pleased to note the significant progress made since the last conference which I would like to share with the audience today.

In the conference last year, I spoke of Malaysia’s vision of an equitable health care for all Malaysians. I spoke of our aspiration for Malaysia to be a nation of healthy individuals, families and communities through a robust health system, which is equitable, affordable, efficient, technologically appropriate, environmentally adaptable and consumer friendly. It should emphasize on quality, innovation, health promotion, respect for human dignity and community participation towards an enhanced quality of life. Integration of public and private healthcare deliveries is also very much required to optimise healthcare resources for more choices and availability of providers in a multidisciplinary teams approach and for better quality of care. In short, a healthcare that is affordable, available, accessible, and more importantly sustainable.

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This simplistic vision is in reality a hugely complex and challenging undertaking and beyond any individual or agency. I emphasised this too during the conference last year, that there is a need for all of us to come together to realise this vision. The various healthcare sectors from the industry, the researcher, innovators, the academics to the policy makers, regulators and service providers should not work in their individual silo. Each stakeholder has its strengths and shortcomings, and there are considerable overlap among the stakeholders.

By coming together, not only we avoid duplication, we could also unlock the synergy between us. We could achieve more if we could collaborate to combine and coordinate our individual effort. That was the aims of our conference last year, to bring together key stakeholders namely policy makers, industries, academia, medical practitioners and the medical providers to deliberate, discuss and collaborate on key issues and challenges faced by the field of telemedicine. I am happy to note that this was achieved successfully. There are increased stakeholder participation in this year conference. In addition, some of the existing stakeholders have also increased their involvement.

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Ladies and Gentlemen

Following the conference last year, we had several meetings to put this vision into action. After much discussion and deliberation, we conclude that the healthcare scene in Malaysia is complex and pluralistic. To be effective, a collaborative approach will be more engaging and a unified and centralised ecosystem to support this vision will indeed align very well with the government’s effort to elevate our economy into a knowledge economy. I am therefore very pleased to announce to the audience today that we have set in motion a telemedicine development group, TDG in short, for the country.

The primary aim of TDG is to form and nature an ecosystem with multi stakeholders’ collaboration to support development, research and innovation of telemedicine / telehealth initiatives in Malaysia.  I have agreed to accept the invitation to chair this group and invite all stakeholders to join me to realise this vision. TDG will be inclusive and not exclusive. We promote active participation from all stakeholders. I emphasise the need for an active public-private partnership where I envisage the industry to help innovate ICT solutions in healthcare.

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The MOH with its stables of hospitals and health clinics will follow up to evaluate these products or application with clinical and solutions trials; and other agencies providing financial solution and supports where appropriate. We have in fact started on this journey already. We hope to be able to engage our industry partners like Stethee and Hypoband to name a few, in some of our healthcare transformation programme which MOH will embark. We also expected to encounter legislative and regulatory issues in our endeavour and will look to our partnering regulators and policy makers for guidance.

TDG will also participate and collaborate in other national initiatives. The National Internet of Things (IoT) strategic roadmap launched in July 2015 has also been focusing on healthcare as one of its iconic project, with CREST leading its implementation. TDG will be an active participant in this initiative.

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Ladies and Gentlemen

I have always advocated a patient-centered approach in my patient care. The days of a paternalistic approach to patient care are numbered. Patient’s welfare should be utmost priority in our mind. This could also be an important approach in the era of digitalisation. What I mean here is the patient’s medical data. Doctor hopping is a norm in many countries including Malaysia and this resulted in data scattering which is a huge problem as sharing is not a common practice among medical practitioners.

However, the scene is changing. With a health financing scheme, all medical practitioners will be compelled legally to provide and share the medical data of their patients. Consequently, we need only to overcome the technology hurdle in medical data sharing. Centralisation of data is also being strategized nationally in MOH for the coming years with the Lifetime Health Record project and Malaysia Health Data Warehouse. Both would have portals for the consumer or patients. I understand that there are projects among the academics to research into Patient Centred Electronic Record or PACER in adult and in children. This bottom-up approach focus on the patient owning and managing the data. I am therefore hopeful that this approach will be successful.

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One may ask if our patients are ready. I think some are.

A survey by Dr Wong’s team in this hospital shows that the majority, 75%, of patients attending Sunway Medical Centre received tertiary education (75.74%) and working at the administrative and executive levels. This surveyed also shows that many owned more than one smart device (>100%) and the technology literacy is high among those surveyed. 70-75% were comfortable with wireless communication and searching for information online.

I am also pleasantly surprised to note the position acceptance of incorporating telemedicine in healthcare. More than half of the patients surveyed (55.14%) were comfortable with healthcare professionals monitoring their health through mobile health devices.

This cohort survey is however not representative of the Malaysia population. We have to make sure that the rural folks and remote communities are not marginalized in our quest for digitalization. More education is required to educate the public on the effectiveness and safety of telemedicine, and it is important that the infrastructure and coverage are in place.

The TDG similarly conducted a survey of undergraduate students in health care related courses. This cohort is likely to be future providers of telemedicine / telehealth services and I understand that some of them are here today, sponsored by TDG and Clinical Research Centre of MOH.

Besides all owning a smart phone, majority (75%) also wear a fitness band or smart watch. Most (> 65%) are in favour of bringing smart, convenient & affordable health care to the home and are comfortable with using applications and services such as Doctor on the Go and Book Doc.  Many also indicated their interest to develop system/application in their respective field of interest. Majority (92%) are also aware of the barriers or challenges in implementing Telehealth and the ethical issues relating to telemedicine / telehealth.

Both surveys suggest that the many end users are ready and it is up to the industry to bridge the technology and infrastructure gap in order to implement nationwide telemedicine / telehealth initiatives.

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Ladies and gentlemen,

Now, moving on from telehealth to health issues challenges globally, the unfinished agenda of Millennium Development Goals (MDGs) and the public health issues of acute epidemic diseases, escalating epidemic of non-communicable diseases, mental health disorders, conflicts and inequalities in all parts of the world are among of the notable important issues that need to be strategically addressed. The MDGs were about a set of human development targets up to 2015, set by the United Nation (UN) for its member countries. The UN’s new Sustainable Development Goals (SDGs) which came into effect this year to 2030 has broader and more ambitious goals. The SDGs cover the economic, environmental and social pillars of sustainable development with a strong focus on equity.

Out of 17 goals, the 3rd goal specifically devoted to health is to “Ensure healthy lives and promote well-being for all, at all ages”. However, all other goals have direct or indirect effect on health; thus all sector is health sector.  Monitoring these goals in itself will be a challenge and opportunity to all countries. Alignment of funding and technical support for a strong health information system are essential. We need standards, tools and repository of information. We need to strengthen country systems for monitoring programmes and accountability, and, better reporting national and global progress on SDG. Hence information communication and technology play a vital role, more so now than ever.

The SDGs has strong emphasis on universal health coverage and access to quality health care. This place Universal Health Coverage (UHC) as the target that underpins and is key to achievement to all the other health targets.

To this note, it is crucial to transform the Malaysian health system to serve the people better and to ensure improved health outcomes for the population. Besides the strategies we have included in the 5-year Malaysia Plans, we are currently planning the health system reform holistically by restructuring the services delivery, organisation and financing mechanism of the health system. As I have mentioned in this same conference last year of our engagement with Harvard School of Public Health for Malaysia Health System Research, we have completed the phase 1 findings. The Ministry have started the roadshow of this findings. Now we are in the midst of designing strategic transformation options for the country. These options will have to ensure social justice, appropriate care, fair financing and financial protection for its citizen. The health transformation is to develop a sustainable health system which addresses the needs of Malaysia, now and in the future.

In transforming the health sector, we will need to innovate. We will have to move away from the normative approach and embrace a new model. And we must do this by taking into account local and historical perspectives, while preserving the strengths of the current system. Leaders, in public and private sectors that shape the health system; must come together to collaboratively design the reforms with the above values. There is a need to enhance smart-partnership that aims on a win-win arrangement, among agencies in government, private and NGOs, resting on a mutual understanding and shared-benefit. The use of available health resources in the public and private sectors should be optimised by strengthening the collaborative mechanisms. And I see the TDG as one of the important platform in moving towards health reform.

Distinguished Guest, Ladies and Gentleman

Finally, immerse yourself in this 3-day event to learn and share your experiences and knowledge, and network with your fellow participants. Let this be the platform to cross-fertilise ideas and create a potpourri of solutions in Malaysian Telemedicine with focus on mobile health (mHealth), Big Data and Internet of Things (IoT).  Specifically, the conference has introduced the “From Idea to Product” session on the 3rd day to bring together the entrepreneurs, start-ups and ecosystem builders for the benefits of those who like to translate their dreams and novel ideas into leading edge healthcare solutions. The panel will share their respective experiences and offerings on how anyone could play in this innovation sandbox and progress systematically toward successful health innovation is a brilliant idea. This session will definitely be helpful for the Telemedicine Innovation Challenge participants, perhaps as the next step in their innovation journey. I must congratulate the TIC participants for taking the courage and passion to work relentlessly since March 2016 and translate their creative ideas into working prototypes to be showcased and judged today. This clearly demonstrates how the creative and inventive minds of Malaysians are able to rise to the occasion and innovate leading edge healthcare solutions.

Once again, I congratulate the organising committee for its visionary approach and I am very pleased indeed to note that my colleagues in other relevant agencies share my view and are participating in this conference as well.

Last but not least, let’s envisioned Malaysia’s Future Health System with a restructured integrated health system that is responsive and provides choice of quality health care, expanding universal coverage for the health care needs of the population based on solidarity and equity. Let us all, as a nation work together for better health.

I wish you all a successful conference and hope this annual conference will continue.

Thank you.

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