However, we have also seen the emergence of foundational shifts arising from COVID-19. Needle mover initiatives are being made globally by both public and private sectors, recognising the need to relook healthcare ecosystem modernisation towards a comprehensive, integrated digitisation and digitalisation. New coping strategies, involving the accelerated adoption of telemedicine, smart health and other technologies, are considered as imperatives. Amid these dynamics, public sectors, healthcare providers, players, and other stakeholders around the globe are being challenged to pivot, adapt, and innovate at speed to amplify the reach and effectiveness of healthcare.

The Digital Front Door 

A smart health approach typically makes use of interconnected technologies to embrace the entire spectrum of healthcare providers, consumers and researchers to ensure the delivery of cutting-edge care that is comprehensive, collaborative, efficient – recognising the needs of patients and their families as well as healthcare practitioners and administrators. The use of telemedicine, complemented by analytics, artificial intelligence (AI), data protection and scalable cloud ecosystem is gaining traction. The pandemic has opened doors for AI and other digital technologies to solve complex clinical and non-clinical problems.

A recent report published by McKinsey & Company highlights that telehealth utilisation has stabilised at levels 38X higher than before the pandemic. Similarly, consumer and provider attitudes toward telehealth have also improved. Investment in virtual care and digital health have broadly skyrocketed. Additionally, virtual healthcare models and business models are continuing to evolve.

However, some hurdles, such as concerns around technology security, need to be addressed. TM One has innovated a complete ecosystem of healthcare solutions, which is modular and interoperable with external systems connected via TM One Cloud α (pronounced as Cloud Alpha) and TM One Cybersecurity (CYDEC) to ensure world class security. McKinsey points out that, the ‘digital front door’ will not be closing as patients and providers have appreciated and embraced the convenience and flexibility of this type of care especially during the healthcare crisis. As we gradually move through and onwards into recovery, a key concern for any health system will be scaling and sustaining these digital interactions.

Driven by Human Experience

Consumers expect industry leaders to leverage on the momentum created in the pandemic to continue to propel healthcare forward, especially as good healthcare services is a key hallmark of sustainable future ready nation building. According to Deloitte, collaborations and the human experience are two (2) of six (6) pressing sector issues that are expected to shape and navigate the healthcare industry into and through the evolving ‘next normal’.

Healthcare technologies, which especially appeal to the digital first generation, has inspired deeper levels of activity, engagement and enhanced patient experience. A visit to the doctor is already a worrying experience for some without having to deal with the paperwork, hours of waiting time and patient care. On a wider front, consumers are using technology to monitor their health, measure fitness, order prescriptions and schedule doctor’s appointments. Eighty percent (80%) of consumers report that they are most likely to have another virtual visit even post pandemic. Pandemic experience has shown that the best path to effectively enabling digital solutions requires various levels of smart collaboration moving away from siloed record systems. Providing a comprehensive end-to-end integrated patients experience management platform with insights, one which is truly beneficial for consumers and patients -- calls for collaborative arrangements, which embrace data platforms, disruptive entrants, public/private partnerships, and health system platforms integration.

TM One Healthcare understands the complexities of the healthcare industry. It will simplify the electronic medical records platform, and channel patients, healthcare providers and funders into a single, secured, standardised and cost-effective solution. With extensive experience in rolling out clinic management systems and electronic medical records, together with a dedicated team to maintain and provide adequate support to end users and partners, TM One Healthcare will ensure the best experience for all stakeholders.

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It takes a range of tech tools to accomplish all of the above, but one tool in particular makes it much easier. The cloud places all information and services on a centralised platform, instead of in a single computer. Anyone with an internet connection and the necessary authorisation can easily access this data. Cloud users don’t have to fret over software upkeep, as cloud providers will take care of that.

This tech has huge potentials in transforming the healthcare sector, among others. We look at how the cloud can improve patient experience, enable virtual consultations and speed up medical research processes.

1. The data challenge for enhanced healthcare

An increasingly critical challenge for the healthcare sector rests in uncoordinated and outdated patient data, which can lead to extended waiting times. In a 2015 study by Malaysia’s Ministry of Health¹, less than 40 per cent of patients were satisfied with waiting times in hospitals. This is not surprising – as it can take up to five (5) hours for a patient to receive outpatient treatment at a public hospital, reported The Malay Mail².

Longer waiting times may also resulted from various inefficiencies including tedious paperwork and unnecessary procedures³. Cloud can address these issues by drawing together relevant information from hospitals, and other crucial services such as pharmacies and test providers, to ensure that healthcare workers can access “a holistic view of a patient’s journey”, said Brian Owens, tech chief at a US-based health tech company⁴.

Medical professionals could more safely and easily transfer data between organisations by utilising the same cloud network⁵. While patients move across departments and hospitals, medical professionals will still be able to safely access patient medical records and provide a well-rounded treatment.

Patients will also be able to easily access their personal medical records on the cloud at their convenience, thus benefit from being able to make better decisions about their own health. Health IT Outcomes reported that making data accessible to patients “leads to informed decision making by acting as a tool for patient education and engagement.⁶”

The cloud also allows doctors to monitor patients in real time, allowing for faster intervention. This is critical in healthcare, where saving lives could depend on seconds.

2. Increase healthcare accessibility with telemedicine

Storing data on a cloud makes data accessible anytime, anywhere. This opens up worlds of possibilities for telemedicine, which is now ripe for rapid expansion given the country’s high broadband connectivity - every Malaysian has an average of 1.29 devices connected to high-speed internet⁷.

Doctors will be able to offer virtual consultations, benefitting patients who may not be able to travel. These include elderly patients with disabilities, or patients who have to care for others at home, no longer have to miss their appointments, and doctors can check as well as are able to monitor their conditions more regularly.

Hospitals would also be in a position to extend their expertise to remote areas with limited access to healthcare services. Patients could take a picture of their condition, then upload it onto the cloud, so doctors or relevant Artificial Intelligence (AI) systems may examine it and offer appropriate advice⁸.

These abilities rely substantially on smooth video live streaming, allowing doctors to examine a patient’s condition accurately. In addition to connectivity, which is a prerequisite, cloud will help run such processes faster than a local computer server, and videos will not be disrupted by low bandwidth or network noise.

Telemedicine has been an important area of exploration in this country over the last three decades, and the potential for greater and more sophisticated use to reap its full benefit remains massive. As illustrated above, telemedicine is an important driver to increase healthcare accessibility, and also offers greater distribution of resources so that doctors in less demanding areas can assist their counterparts in the busier areas, alleviating issues of overstretched medical professionals especially in major hospitals.

Telemedicine is already proving its usefulness during the country’s Covid-19 lockdown measures. Malaysians have been seeking advice from doctors using these virtual channels, reported Computer Weekly⁹. The article also mentioned about a medical video consultation portal that is accessible seven (7) days a week, and is free to use.

3. Maximising returns on research

Malaysia spent RM1.2 billion (US$309 million) on healthcare research in 2015 alone¹⁰. Cloud computing can help to maximise the return on Research and Development (R&D) spend as well as accelerate the go-to-market of medicine for the benefit of the public.

In addition to handling massive amounts of data, cloud can process that data more quickly with its integrated AI and machine learning capabilities¹¹. For instance, hospitals can process multi-dimensional images of organs in 10 minutes instead of 90, shared Datamation. This could help to dramatically improve care pathways efficiency and enhancing coordinated activities among healthcare workers – a welcome change to address issues of long queues and waiting times at Malaysian hospitals.

Besides saving time on hospital operations, the cloud will speed up medical research. AI is able to analyse large data sets, and identify population health trends that may have gone unnoticed otherwise. Data analytics processing of patient records also enables more personalised treatments and care¹². For example, doctors in Europe are currently working on a system to consolidate and analyse data to administer personalised treatments for Alzheimer’s disease and lung cancer¹³.

Securing data with blockchain

Medical records are sensitive and need the highest level of protection against cyber threats. These records often include address history, identification numbers and financial data. Hackers can use this personal information for identity fraud¹⁴ - applying for loans, purchase medical equipment, file false insurance claims under fake identities, or even selling it to third parties for profit.

In September 2019, Greenbone Network revealed that close to 20,000 patient records, along with 1.2 million linked images, from Malaysia were publicly accessible on the Internet¹⁵. Cloud services can be integrated with Blockchain to ensure patient data doesn’t fall into the wrong hands.

Blockchain is a secure way of storing digital information - its records cannot be deleted and it tracks all changes made on a document. This allows patients’ records to be shared without concerns about false changes. Blockchain can even be used to verify a doctor’s credentials in telemedicine consultations, according to ReferralMD¹⁶.

TM One, Telekom Malaysia Berhad (TM)’s enterprise and public sector business arm, recently launched its Cloud Alpha¹⁷ service, which integrates AI, Internet of Things (IoT), big data and Blockchain. This system is designed to provide a seamless transition to the cloud by offering a variety of cloud models to suit every need.

In a scenario where unstructured, isolated data could result in more lives being lost, digital action must be taken. The situation today is that more and more hospitals around the world are rapidly turning to cloud services to improve patient care, serve more people, and conduct research more efficiently.

References

[1] http://iku.moh.gov.my/images/IKU/Document/REPORT/NHMS2015-VolumeIII.pdf

[2] https://www.malaymail.com/news/malaysia/2017/08/22/hours-long-hospital-waits-driving-some-to-abandon-treatment/1447711

[3] https://penanginstitute.org/publications/issues/cut-the-queue-a-basket-of-solutions-for-malaysian-hospitals/#ftn7b

[4] https://www.healthcareitnews.com/news/next-gen-cloud-computing-how-healthcare-can-prepare-future

[5] https://solutionsreview.com/cloud-platforms/8-benefits-and-risks-of-cloud-computing-in-healthcare/

[6] https://www.healthitoutcomes.com/doc/ways-cloud-computing-is-impacting-healthcare-0001

[7] https://www.mcmc.gov.my/skmmgovmy/media/General/pdf/3Q_CM_2019.pdf

[8] https://www.datamation.com/cloud-computing/cloud-computing-for-healthcare.html

[9] https://www.computerweekly.com/news/252481183/Malaysias-telemedicine-vision-gets-fresh-boost

[10] https://www.who.int/research-observatory/indicators/gerd_gdp_October_2018/en/

[11] https://solutionsreview.com/cloud-platforms/8-benefits-and-risks-of-cloud-computing-in-healthcare/

[12] https://www.healthitoutcomes.com/doc/ways-cloud-computing-is-impacting-healthcare-0001

[13] https://cordis.europa.eu/article/id/417984-big-data-to-personalise-therapy-for-lung-cancer-and-alzheimer-s-diseases-analysing-data-with-

[14] https://www.advisory.com/daily-briefing/2019/03/01/hackers

[15] https://codeblue.galencentre.org/2019/10/10/malaysia-patient-data-leak-came-from-private-entity-moh-says

[16] https://getreferralmd.com/2018/09/can-blockchain-technology-improve-the-healthcare-industry/

[17] http://jetpack.tmone.com.my/solutions/cloud-services

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The brainchild of Azran Osman Rani, ex-CEO of Iflix and AirAsia X, Naluri was borne out of a self-confessed obsession to improve the fitness of Malaysians. Backed by a team of doctors, psychologists, dieticians and fitness coaches, the app seeks to provide holistic solutions for users who are overweight or facing stress, anxiety or depression.

Earlier this year, National Diabetes Institute (Nadi) Executive Chairman, Datuk Dr Mustaffa Embong warned that Malaysia has the greatest prevalence of obesity in Southeast Asia as well as one of the highest rates of diabetes in the world. Approximately one in three Malaysian adults also suffers from a mental health condition or is at risk of developing a diagnosable mental illness, according to the country’s last National Health and MorbiditySurvey in 2015.This makes holistic and preventative care an important healthcare priority for the country.

Predicting readiness to change

Yet making a lasting impact can prove challenging as health risk assessments, reward programs and personal fitness apps “only work for about 20% of the population”, says Osman Rani. “This 20% of the population tend to be the ones who are achievement-oriented and goal focused,’’ he says. ‘’You give them the tools and off they go. But 80% of the population really struggle to make these things stick.’’

In order to make sure its users stay motivated, Naluri uses artificial intelligence to “multiply the productivity of each professional psychologist or dietician by 10 if not 20, 30 times’’.

By analysing patterns of behaviour and performance, the app can almost predict a user’s readiness to change and level of resilience, says Osman Rani. And if a user is likely to disengage, a coach can intervene at the right time and in the right context or tone that works best for that person.

Using technology to heighten the efficacy of Naluri’s healthcare professionals also gets around the severe lack of clinical psychologists in Malaysia. In 2017, there were 2.87 clinical psychologist per million people, a slight increase from 2.82 in 2011. But Naluri’s technological innovations hopes to expand the reach for this small group of psychologists.

Other visual AI functions on the Naluri app is a food journal where users can snap photos of meals and receive nutritional information or healthier substitutions. The local element of Naluri becomes imperative as while there are dozens of existing dieting apps, most would not be able to recognise local dishes be it a mee goreng or a nasi lemak.

You cannot just take the western model of kale, quinoa, chia seeds, Fitbit, yoga, and meditation, says Osman Rani about changing users’ lifestyle and behaviours. It just doesn’t work beyond our little urban enclaves.

Pay as you lose

While the end goal is the consumer, interestingly Naluri, which means instinct in Bahasa, is mainly a B2B player whereby insurance companies and corporate employers bring in the users. If Naluri is able to produce clinically significant outcomes, such as a 5% weight reduction, the companies will then pay Naluri a success fee of a few hundred dollars.

This pre-emptive approach appeals to employers and insurance companies as the average yearly cost to treat someone with diabetes, or heart disease is far in excess of the success fee. The information that the app is collecting could also prove to be a data treasure trove in terms of addressing chronic health problems.

Osman Rani admits that some psychologists and behavioural scientists have expressed doubts about his app, believing that nothing can replace traditional face-to-face conversations. Yet he counters that Naluri is complementary to traditional therapy methods and is not meant to be a replacement.

“I’m not trying to get everyone healthier,’’ says Osman Rani. ‘’I’m specifically focusing on the mass market who are struggling with making changes even when they know this is good or that is not good for them. Overwhelmed with work, middle-class, white-collar workers who are just really struggling to get by in life.’’

Insightful reads brought to you in partnership with MIT Technology Review Insights.

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