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Integrating Information and Communication Technology for Health Information System Strengthening: A Policy Analysis

Marzuki N, Ismail S, Al-Sadat N, Ehsan FZ, Chan CK, Ng CW

Asia Pac J Public Health, 2015 Nov;27(8 Suppl):86S-93S.
PMID: 26085477 DOI: 10.1177/1010539515590180

Despite the high costs involved and the lack of definitive evidence of sustained effectiveness, many low- and middle-income countries had begun to strengthen their health information system using information and communication technology in the past few decades. Following this international trend, the Malaysian Ministry of Health had been incorporating Telehealth (National Telehealth initiatives) into national health policies since the 1990s. Employing qualitative approaches, including key informant interviews and document review, this study examines the agenda-setting processes of the Telehealth policy using Kingdon's framework. The findings suggested that Telehealth policies emerged through actions of policy entrepreneurs within the Ministry of Health, who took advantage of several simultaneously occurring opportunities--official recognition of problems within the existing health information system, availability of information and communication technology to strengthen health information system and political interests surrounding the national Multimedia Super Corridor initiative being developed at the time. The last was achieved by the inclusion of Telehealth as a component of the Multimedia Super Corridor.
Fulltext High proportion of knowlesi malaria in recent malaria cases in Malaysia

Yusof R, Lau YL, Mahmud R, Fong MY, Jelip J, Ngian HU, et al.

Malar J, 2014;13:168.
PMID: 24886266 DOI: 10.1186/1475-2875-13-168

Plasmodium knowlesi is a simian parasite that has been recognized as the fifth species causing human malaria. Naturally-acquired P. knowlesi infection is widespread among human populations in Southeast Asia. The aim of this epidemiological study was to determine the incidence and distribution of malaria parasites, with a particular focus on human P. knowlesi infection in Malaysia.
Development and validation of the intention to use the ICD-11 questionnaire in the Malaysian medical records context

Ooi ECW, Md Isa Z, Abdul Manaf MR, Ahmad Fuad AS, Ahmad A, Mustapa MN, et al.

PLoS One, 2024;19(9):e0308403.
PMID: 39240890 DOI: 10.1371/journal.pone.0308403

As health systems transition to ICD-11, it is essential to gauge the readiness and improve existing transition efforts. Assessing the intention to use ICD-11 and factors influencing it is imperative to encourage the use of ICD-11 among the medical record officers (MROs) and assistant medical record officers (AMROs). This study aims to develop and validate a questionnaire on the factors influencing the intention to use ICD-11 among MROs and AMROs in the Ministry of Health, Malaysia. This study comprised a questionnaire development and validation involving 292 participants nationwide from Ministry of Health Malaysia facilities. The questionnaire was developed based on items adapted from the literature. Forward and backward English-Malay translation was done. Then, the questionnaire was examined for content validity, internal consistency reliability, construct validity, face validity, convergent validity, discriminant validity and confirmatory factor analyses. The final version of the questionnaire consists of eleven domains represented by 50 items. The content validity index and modified kappa were excellent for all domains. The Kaiser-Meyer-Olkin sampling adequacy value was appropriate, with a value of 0.790. The questionnaire also demonstrated good internal consistency reliability with Cronbach's alpha values between 0.850 and 0.992. Confirmatory factor analysis showed a reasonable fit for this eleven-factor model. In conclusion, this questionnaire provides a reliable tool for investigating the intention to use ICD-11 among MROs and AMROs. Positive findings from the psychometric properties support the validity of the questionnaire. This instrument can potentially support personnel in charge of ICD codification, guide the ICD-11 transition at various levels and facilitate research on support dynamics among the MROs and AMROs.
From data collection to downstream data use: Malaysia's experience with ICD-11

Ooi ECW, Md Isa Z, Abdul Manaf MR, Ahmad Fuad AS, Sidek HF, Mustapa MN, et al.

Health Inf Manag, 2024 Nov 23.
PMID: 39578964 DOI: 10.1177/18333583241295717

BACKGROUND: The transition of systems to the International Statistical Classification of Diseases 11th Version (ICD-11) allows access to comprehensive data that accurately portray the complexity of morbidity and mortality data in Malaysia.
OBJECTIVE: To demonstrate Malaysia's experience in implementing ICD-11, from data collection to downstream data use applications.
METHOD AND IMPLEMENTATION: We describe improvements to existing data source systems and downstream data applications. For non-HIS and HIS (ICD-10) systems, data were manually entered into the health management information system equipped with ICD-11 or automatically mapped from ICD-10 to ICD-11. Following these system improvements, we collected and reported ICD-11 data from all hospitals nationwide, regardless of the individual systems' status in ICD-11 use.
DISCUSSION: Lessons learnt related to legacy systems; ICD-11 releases and system updates; mapping; reporting; human resources and related applications.
CONCLUSION: With careful planning, standardisation of the collection and use of ICD-11 data can be accomplished with limited resources and in a complex environment with heterogeneous systems.
IMPLICATIONS: Use of ICD-11 data in downstream data applications improves data quality to answer specific business or research questions.
Personalised management of Chronic Obstructive Pulmonary Disease (COPD): Malaysian consensus algorithm for appropriate use of inhaled corticosteroid (ICS) in COPD patients

Marzuki NM, Jaeb MZM, Ban A, Ismail AI, Ali IAH, Razali NM, et al.

Med J Malaysia, 2020 11;75(6):717-721.
PMID: 33219183

BACKGROUND: Regarding the long-term safety issues with the use of inhaled corticosteroids (ICS) and the clinical predominance of dual bronchodilators in enhancing treatment outcomes in chronic obstructive pulmonary disease (COPD), ICS is no longer a "preferred therapy" according to the Global Initiative for Chronic Obstructive Lung Disease except on top of a dual bronchodilator. This has necessitated a change in the current therapy for many COPD patients.
OBJECTIVE: To determine a standardised algorithm to reassess and personalise the treatment COPD patients based on the available evidence.
METHODS: A consensus statement was agreed upon by a panel of pulmonologists in from 11 institutes in Malaysia whose members formed this consensus group.
RESULTS: According to the consensus, which was unanimously adopted, all COPD patients who are currently receiving an ICS-based treatment should be reassessed based on the presence of co-existence of asthma or high eosinophil counts and frequency of moderate or severe exacerbations in the previous 12 months. When that the patients meet any of the aforementioned criteria, then the patient can continue taking ICS-based therapy. However, if the patients do not meet the criteria, then the treatment of patients need to be personalised based on whether the patient is currently receiving long-acting beta-agonists (LABA)/ICS or triple therapy.
CONCLUSION: A flowchart of the consensus providing a guidance to Malaysian clinicians was elucidated based on evidences and international guidelines that identifies the right patients who should receive inhaled corticosteroids and enable to switch non ICS based therapies in patients less likely to benefit from such treatments.