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  1. Tailoring teleconsultation to meet the current needs of neurosurgical services: a multimodality oriented neurosurgical consultation
    Narenthiranathan NR, Adnan JS, Haspani MS
    Stud Health Technol Inform, 2010;161:112-21.
    PMID: 21191164
    Teleconsultation in Neurosurgery was introduced in Malaysia in 2006 with the aims of enhancing quality services in the field of Neurosurgery. The present teleconsultation system is equipped with user friendly features which allow physicians to send and neurosurgeons to gain access to patient data in a swift and effective manner. In the past, teleconsultation in neurosurgery was tied with teleradiology, however we have now developed a multimodality system to cater specifically for neurosurgery. In Malaysia, the teleconsultation service is gaining momentum as evidenced by the large volume of cases channeled through this system. 944 cases within a span of 4 months were recorded on the system. 54.5% of the cases were trauma, 33.2% stroke, 6.1% intracranial tumours, 2% of cases were of spinal pathology, 2% pediatric anomalies and 2.2% intracranial infections. 50.2% of the referrals were after regular working hours reflecting the need for dedicated teleneurosurgery consultative services and the ability to review referrals outside of hospitals. Only 36% of cases needed emergency transfers and 9.9% of the cases were managed remotely at distant hospitals. Another 9.4% of the cases were either transferred electively or brought to the clinic for consultation. The above findings emphasise the importance of teleconsultation as a means to provide wide medical coverage within the region.
    Matched MeSH terms: Telemedicine/organization & administration*
  2. An overview of the national telehealth initiative in Malaysia
    Maon SN, Edirippulige S
    Stud Health Technol Inform, 2010;161:95-103.
    PMID: 21191162
    Malaysia's national health statistics for the last half century show a remarkable improvement in the nation's health status. One important factor for this improvement is the Malaysian government's proactive intervention in the health sector. Among others, e-health has played a vital role in delivering and managing healthcare services in Malaysia. While the Government has integrated telehealth in its national digital infrastructure re-design, it has heavily invested in telehealth. The enactment of new laws to facilitate telehealth practices can also be noted as an important measure.
    Matched MeSH terms: Telemedicine/organization & administration*
  3. A security framework for nationwide health information exchange based on telehealth strategy
    Zaidan BB, Haiqi A, Zaidan AA, Abdulnabi M, Kiah ML, Muzamel H
    J Med Syst, 2015 May;39(5):51.
    PMID: 25732083 DOI: 10.1007/s10916-015-0235-1
    This study focuses on the situation of health information exchange (HIE) in the context of a nationwide network. It aims to create a security framework that can be implemented to ensure the safe transmission of health information across the boundaries of care providers in Malaysia and other countries. First, a critique of the major elements of nationwide health information networks is presented from the perspective of security, along with such topics as the importance of HIE, issues, and main approaches. Second, a systematic evaluation is conducted on the security solutions that can be utilized in the proposed nationwide network. Finally, a secure framework for health information transmission is proposed within a central cloud-based model, which is compatible with the Malaysian telehealth strategy. The outcome of this analysis indicates that a complete security framework for a global structure of HIE is yet to be defined and implemented. Our proposed framework represents such an endeavor and suggests specific techniques to achieve this goal.
    Matched MeSH terms: Telemedicine/organization & administration*
  4. 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.
    Matched MeSH terms: Telemedicine/organization & administration*
  5. Fulltext Rural health care in Malaysia
    Ariff KM, Teng CL
    Aust J Rural Health, 2002 Apr;10(2):99-103.
    PMID: 12047504 DOI: 10.1046/j.1440-1584.2002.00456.x
    Malaysia has a population of 21.2 million of which 44% resides in rural areas. A major priority of healthcare providers has been the enhancement of health of 'disadvantaged' rural communities particularly the rural poor, women, infants, children and the disabled. The Ministry of Health is the main healthcare provider for rural communities with general practitioners playing a complimentary role. With an extensive network of rural health clinics, rural residents today have access to modern healthcare with adequate referral facilities. Mobile teams, the flying doctor service and village health promoters provide healthcare to remote areas. The improvement in health status of the rural population using universal health status indicators has been remarkable. However, differentials in health status continue to exist between urban and rural populations. Malaysia's telemedicine project is seen as a means of achieving health for all rural people.
    Matched MeSH terms: Telemedicine/organization & administration*
  6. Novel technique for reorganisation of opinion order to interval levels for solving several instances representing prioritisation in patients with multiple chronic diseases
    Mohammed KI, Zaidan AA, Zaidan BB, Albahri OS, Albahri AS, Alsalem MA, et al.
    Comput Methods Programs Biomed, 2020 Mar;185:105151.
    PMID: 31710981 DOI: 10.1016/j.cmpb.2019.105151
    CONTEXT: Telemedicine has been increasingly used in healthcare to provide services to patients remotely. However, prioritising patients with multiple chronic diseases (MCDs) in telemedicine environment is challenging because it includes decision-making (DM) with regard to the emergency degree of each chronic disease for every patient.

    OBJECTIVE: This paper proposes a novel technique for reorganisation of opinion order to interval levels (TROOIL) to prioritise the patients with MCDs in real-time remote health-monitoring system.

    METHODS: The proposed TROOIL technique comprises six steps for prioritisation of patients with MCDs: (1) conversion of actual data into intervals; (2) rule generation; (3) rule ordering; (4) expert rule validation; (5) data reorganisation; and (6) criteria weighting and ranking alternatives within each rule. The secondary dataset of 500 patients from the most relevant study in a remote prioritisation area was adopted. The dataset contains three diseases, namely, chronic heart disease, high blood pressure (BP) and low BP.

    RESULTS: The proposed TROOIL is an effective technique for prioritising patients with MCDs. In the objective validation, remarkable differences were recognised among the groups' scores, indicating identical ranking results. In the evaluation of issues within all scenarios, the proposed framework has an advantage of 22.95% over the benchmark framework.

    DISCUSSION: Patients with the most severe MCD were treated first on the basis of their highest priority levels. The treatment for patients with less severe cases was delayed more than that for other patients.

    CONCLUSIONS: The proposed TROOIL technique can deal with multiple DM problems in prioritisation of patients with MCDs.

    Matched MeSH terms: Telemedicine/organization & administration*
  7. Fulltext Personal health records: mobile biosensors and smartphones for developing countries
    Simon SK, Seldon HL
    Stud Health Technol Inform, 2012;182:125-32.
    PMID: 23138087
    A target of telehealth is to maintain or improve the health of people outside the normal healthcare infrastructure. A modern paradigm in healthcare, and one which fits perfectly with telehealth, is "person self-monitoring", and this fits with the concept of "personal health record" (PHR). One factor in maintaining health is to monitor physiological parameters; this is of course especially important in people with chronic maladies such as diabetes or heart disease. Parameters to be monitored include blood pressure, pulse rate, temperature, weight, blood glucose, oxygen saturation, electrocardiogram (ECG), etc. So one task within telehealth would be to help monitor an individual's physiological parameters outside of healthcare institutions and store the results in a PHR in a way which is available, comprehensible and beneficial to the individual concerned and to healthcare providers. To date many approaches to this problem have been fragmented - emphasizing only part of the problem - or proprietary and not freely verifiable. We describe a framework to approach this task; it emphasizes the implementation of standards for data acquisition, storage and transmission in order to maximize the compatibility among disparate components, e.g. various PHR systems. Data from mobile biosensors is collected on a smartphone using the IEEE 11073 standard where possible; the data can be stored in a PHR on the phone (using standard formats) or can be converted in real-time into more useful information in the PHR, which is based on the International Classification for Primary Care (ICPC2e). The phone PHR data or information can be uploaded to a central online PHR using either the Wi-Fi or GSM transmission protocol together with the Continuity of Care Record message format (CCR, ASTM E2369).
    Matched MeSH terms: Telemedicine/organization & administration*
  8. Developing a Web 2.0 telemedical education system: the AJAX-Cocoon portal
    Mohammed S, Orabi A, Fiaidhi J, Orabi M, R. Benlamri
    Int J Electron Healthc, 2008;4(1):24-42.
    PMID: 18583294
    Web 2.0 technologies such as wikis, podcasts/vodcasting, blogs and semantic portals could be quite effective tools in e-learning for health professionals. If effectively deployed, such tools can offer a way to enhance students', clinicians' and patients' learning experiences, and deepens levels of learners' engagement and collaboration within medical learning environments. However, Web 2.0 requires simplicity of use as well as integration with modern web technologies. This article presents a Web 2.0 telemedical portal, which provides a social community-learning paradigm from the desk of the physician, the student, the hospital administrator, or the insurer. The presented portal utilises RESTful web services and techniques like content syndication, mushups and Asynchronous JavaScript API and XML (AJAX). The designed portal is based on the Apache Cocoon RESTful framework for sharing Digital Imaging and Communications in Medicine (DICOM) medical case studies. Central to this article is the integration between Cocoon and AJAX. The proposed AJAX-Cocoon portal utilises a JSP portlet architecture, which manages the interaction dynamics and overcomes the shortcomings of the JSR 168 and WSRP 1.0 standards.
    Matched MeSH terms: Telemedicine/organization & administration*
  9. Electronic health records approaches and challenges: a comparison between Malaysia and four East Asian countries
    Abd Ghani MK, Bali RK, Naguib RN, Marshall IM, Nilmini S. Wickramasinghe
    Int J Electron Healthc, 2008;4(1):78-104.
    PMID: 18583297
    An integrated Lifetime Health Record (LHR) is fundamental for achieving seamless and continuous access to patient medical information and for the continuum of care. However, the aim has not yet been fully realised. The efforts are actively progressing around the globe. Every stage of the development of the LHR initiatives had presented peculiar challenges. The best lessons in life are those of someone else's experiences. This paper presents an overview of the development approaches undertaken by four East Asian countries in implementing a national Electronic Health Record (EHR) in the public health system. The major challenges elicited from the review including integration efforts, process reengineering, funding, people, and law and regulation will be presented, compared, discussed and used as lessons learned for the further development of the Malaysian integrated LHR.
    Matched MeSH terms: Telemedicine/organization & administration*
  10. Integrated telehealth: putting it all together and addressing the challenges
    Harum H
    Stud Health Technol Inform, 2004;104:75-86.
    PMID: 15747966
    The Integrated Telehealth Project of Malaysia is considered a principal enabler for the nation's Vision 2020 as well as the National Health Vision. Being in such an unenviable position, of being not only the pioneer for such an integrated project, but also with no benchmark to compare with, the project implementers have faced manifold challenges along the way. This chapter deals with some of the challenges and lessons learnt that have accumulated as the project progressed.
    Matched MeSH terms: Telemedicine/organization & administration*
  11. E-leadership in the digital age: the equilibrium, the codes and the digital gap
    Harum H
    Stud Health Technol Inform, 2004;104:30-40.
    PMID: 15747961
    Malaysia's experience in implementing the Integrated Telehealth Project has placed her way ahead in the arena of world Telehealth. Thus, she has become the focus point, reference point and benchmark for similar endeavors around the world. In fact, it would not be presumptuous to state that the Integrated Telehealth project is a trail-blazing pioneer with e-leadership experience and skills developed over the last few years. It is hoped that the Integrated Telehealth concept will find acceptance and credence globally.
    Matched MeSH terms: Telemedicine/organization & administration*
  12. Governance and management of national telehealth programs in Asia
    Marcelo A, Ganesh J, Mohan J, Kadam DB, Ratta BS, Kulatunga G, et al.
    Stud Health Technol Inform, 2015;209:95-101.
    PMID: 25980710
    Telehealth and telemedicine are increasingly becoming accepted practices in Asia, but challenges remain in deploying these services to the farthest areas of many developing countries. With the increasing popularity of universal health coverage, there is a resurgence in promoting telehealth services. But while telehealth that reaches the remotest part of a nation is the ideal endpoint, such goals are burdened by various constraints ranging from governance to funding to infrastructure and operational efficiency.
    Matched MeSH terms: Telemedicine/organization & administration*
  13. Malaysia's 21st century goal: IT-based health gains for one and all
    Spohr MH
    Healthc Inform, 2000 Apr;17(4):49-52, 54.
    PMID: 11066568
    Matched MeSH terms: Telemedicine/organization & administration*
  14. Role of teleconsultation in moving the healthcare system forward
    Yusof K, Neoh KH, bin Hashim MA, Ibrahim I
    Asia Pac J Public Health, 2002;14(1):29-34.
    PMID: 12597515
    The equitable access to quality healthcare by Malaysians has consistently been the primary objective of the Ministry of Health (MOH). The epidemiological transition to chronic illnesses, advances in medical technology, escalating healthcare costs and rising patient expectations has necessitated the strategic use of information systems in healthcare delivery. Malaysia has broken new ground by implementing a nationwide network to address inadequate access to healthcare, as well as to lower costs and achieve better health outcomes. Teleconsultation refers to the electronic transmission of medical information and services from one site to another using telecommunication technologies. This technology transforms the healthcare system by rapidly matching patient needs with the appropriate level of care however geographically remote they may be. Our findings suggest that even in these early stages of implementation, teleconsultation has led to cost savings, a more efficient allocation of resources, enhanced diagnostic options and better health outcomes.
    Matched MeSH terms: Telemedicine/organization & administration*
  15. Categorizing the telehealth policy response of countries and their implications for complementarity of telehealth policy
    Varghese S, Scott RE
    Telemed J E Health, 2004;10(1):61-9.
    PMID: 15104917
    Developing countries are exploring the role of telehealth to overcome the challenges of providing adequate health care services. However, this process faces disparities, and no complementarity in telehealth policy development. Telehealth has the potential to transcend geopolitical boundaries, yet telehealth policy developed in one jurisdiction may hamper applications in another. Understanding such policy complexities is essential for telehealth to realize its full global potential. This study investigated 12 East Asian countries that may represent a microcosm of the world, to determine if the telehealth policy response of countries could be categorized, and whether any implications could be identified for the development of complementary telehealth policy. The countries were Cambodia, China, Hong Kong, Indonesia, Japan, Malaysia, Myanmar, Singapore, South Korea, Taiwan, Thailand, and Vietnam. Three categories of country response were identified in regard to national policy support and development. The first category was "None" (Cambodia, Myanmar, and Vietnam) where international partners, driven by humanitarian concerns, lead telehealth activity. The second category was "Proactive" (China, Indonesia, Malaysia, Singapore, South Korea, Taiwan, and Thailand) where national policies were designed with the view that telehealth initiatives are a component of larger development objectives. The third was "Reactive" (Hong Kong and Japan), where policies were only proffered after telehealth activities were sustainable. It is concluded that although complementarity of telehealth policy development is not occurring, increased interjurisdictional telehealth activity, regional clusters, and concerted and coordinated effort amongst researchers, practitioners, and policy makers may alter this trend.
    Matched MeSH terms: Telemedicine/organization & administration*
  16. Root Exploit Detection and Features Optimization: Mobile Device and Blockchain Based Medical Data Management
    Firdaus A, Anuar NB, Razak MFA, Hashem IAT, Bachok S, Sangaiah AK
    J Med Syst, 2018 May 04;42(6):112.
    PMID: 29728780 DOI: 10.1007/s10916-018-0966-x
    The increasing demand for Android mobile devices and blockchain has motivated malware creators to develop mobile malware to compromise the blockchain. Although the blockchain is secure, attackers have managed to gain access into the blockchain as legal users, thereby comprising important and crucial information. Examples of mobile malware include root exploit, botnets, and Trojans and root exploit is one of the most dangerous malware. It compromises the operating system kernel in order to gain root privileges which are then used by attackers to bypass the security mechanisms, to gain complete control of the operating system, to install other possible types of malware to the devices, and finally, to steal victims' private keys linked to the blockchain. For the purpose of maximizing the security of the blockchain-based medical data management (BMDM), it is crucial to investigate the novel features and approaches contained in root exploit malware. This study proposes to use the bio-inspired method of practical swarm optimization (PSO) which automatically select the exclusive features that contain the novel android debug bridge (ADB). This study also adopts boosting (adaboost, realadaboost, logitboost, and multiboost) to enhance the machine learning prediction that detects unknown root exploit, and scrutinized three categories of features including (1) system command, (2) directory path and (3) code-based. The evaluation gathered from this study suggests a marked accuracy value of 93% with Logitboost in the simulation. Logitboost also helped to predicted all the root exploit samples in our developed system, the root exploit detection system (RODS).
    Matched MeSH terms: Telemedicine/organization & administration*
  17. Based Real Time Remote Health Monitoring Systems: A Review on Patients Prioritization and Related "Big Data" Using Body Sensors information and Communication Technology
    Kalid N, Zaidan AA, Zaidan BB, Salman OH, Hashim M, Muzammil H
    J Med Syst, 2017 Dec 29;42(2):30.
    PMID: 29288419 DOI: 10.1007/s10916-017-0883-4
    The growing worldwide population has increased the need for technologies, computerised software algorithms and smart devices that can monitor and assist patients anytime and anywhere and thus enable them to lead independent lives. The real-time remote monitoring of patients is an important issue in telemedicine. In the provision of healthcare services, patient prioritisation poses a significant challenge because of the complex decision-making process it involves when patients are considered 'big data'. To our knowledge, no study has highlighted the link between 'big data' characteristics and real-time remote healthcare monitoring in the patient prioritisation process, as well as the inherent challenges involved. Thus, we present comprehensive insights into the elements of big data characteristics according to the six 'Vs': volume, velocity, variety, veracity, value and variability. Each of these elements is presented and connected to a related part in the study of the connection between patient prioritisation and real-time remote healthcare monitoring systems. Then, we determine the weak points and recommend solutions as potential future work. This study makes the following contributions. (1) The link between big data characteristics and real-time remote healthcare monitoring in the patient prioritisation process is described. (2) The open issues and challenges for big data used in the patient prioritisation process are emphasised. (3) As a recommended solution, decision making using multiple criteria, such as vital signs and chief complaints, is utilised to prioritise the big data of patients with chronic diseases on the basis of the most urgent cases.
    Matched MeSH terms: Telemedicine/organization & administration*
  18. An analysis of the healthcare informatics and systems in Southeast Asia: a current perspective from seven countries
    Nguyen QT, Naguib RN, Abd Ghani MK, Bali RK, Lee IM
    Int J Electron Healthc, 2008;4(2):184-207.
    PMID: 18676343
    This paper presents an overview of the healthcare systems in Southeast Asia, with a focus on the healthcare informatics development and deployment in seven countries, namely, Singapore, Cambodia, Malaysia, Thailand, Laos, the Philippines and Vietnam. Brief geographic and demographic information is provided for each country, followed by a historical review of the national strategies for healthcare informatics development. An analysis of the state-of-the-art healthcare infrastructure is also given, along with a critical appraisal of national healthcare provisions.
    Matched MeSH terms: Telemedicine/organization & administration*
  19. A comparative review of mobile health and electronic health utilization in sub-Saharan African countries
    Bervell B, Al-Samarraie H
    Soc Sci Med, 2019 07;232:1-16.
    PMID: 31035241 DOI: 10.1016/j.socscimed.2019.04.024
    This study distinguished between the application of e-health and m-health technologies in sub-Saharan African (SSA) countries based on the dimensions of use, targeted diseases or health conditions, locations of use, and beneficiaries (types of patients or health workers) in a country specific context. It further characterized the main opportunities and challenges associated with these dimensions across the sub-region. A systematic review of the literature was conducted on 66 published peer reviewed articles. The review followed the scientific process of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of identification, selection, assessment, synthesis and interpretation of findings. The results of the study showed that m-health was prevalent in usage for promoting information for treatment and prevention of diseases as well as serving as an effective technology for reminders towards adherence. For e-health, the uniqueness lay in data acquisition and patients' records management; diagnosis; training and recruitment. While m-health was never used for monitoring or training and recruitment, e-health on the other hand could not serve the purpose of reminders or for reporting cases from the field. Both technologies were however useful for adherence, diagnosis, disease control mechanisms, information provision, and decision-making/referrals. HIV/AIDS, malaria, and maternal (postnatal and antenatal) healthcare were important in both m-health and e-health interventions mostly concentrated in the rural settings of South Africa and Kenya. ICT infrastructure, trained personnel, illiteracy, lack of multilingual text and voice messages were major challenges hindering the effective usage of both m-health and e-health technologies.
    Matched MeSH terms: Telemedicine/organization & administration*
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