Materia Medica Malaysiana

May 29, 2007

E-MEDICINE’S HERE: Now you can fall sick anywhere in Malaysia

Filed under: Uncategorized — malaysianmedicine @ 9:39 am

NST: 38 hospitals across the country are linked by digitised telecommunications under an RM27 million programme. The system not only helps patients get the best treatment without having to physically see a specialist, but also saves time, travel, cost and bed use.

KUALA LUMPUR: The idea of a patient being “examined” by a doctor in a hospital hundreds of kilometres away is no longer in the realm of science fiction.
It has become a reality under a RM27 million tele-medicine system that uses digitised telecommunications to link 38 hospitals across the country.
Doctors and specialists receive online access to the diagnosis and medical history of patients whom they may never see in person.
A pilot project has proven successful in, among others, using radiographs, ECGs, laboratory results, echocardiograms and coronary arteriograms to determine the health of patients.
It also allows for second opinions, exchange of views among doctors treating a patient and referrals to be made from any of the 38 locations.
Deputy Health Minister Datuk Dr Abdul Latiff Ahmad said the move would not only help patients get the best treatment without having to physically see a specialist but also save on time, travel, cost and bed use.
For a start, teleconsultation, one of the major applications of telemedicine, is being used for five disciplines — radiology, cardiology, dermatology, accident and traumatology and neurosurgery.
Put in place by WorldCare Health (Malaysia) Sdn Bhd, it also allows for peer-to-peer transmission of film-based radiological images as well as scanned paper documents, voice annotations, digital images and ECG scans.
Dr Abdul Latiff said teleradiology enabled physicians to seek primary and secondary diagnosis of radiological images, such as X-ray films, computed tomography (CT), magnetic resonance imaging (MRI) scans and ultrasound imaging.
“If the patient is at the Grik Hospital, the doctor will transmit it to the radiologist in Ipoh Hospital who will then interpret and provide a diagnosis and appropriate patient management and treatment strategies.
“If a second opinion is needed to refer a patient for treatment, it would also be given,” he told the New Straits Times.
Dr Abdul Latiff said patients could be treated faster and more effectively without the need to be sent by an ambulance to where the specialist concerned was located.
“If a patient needs to be referred immediately for surgery or examination, then it can be done without delay.”
He said specialists and doctors in hospitals had already started using the system.
“If the programme proves a success without hitches, it will be extended to other hospitals nationwide.
“We want to optimise the programme with the co-operation of doctors and specialists who also have to make IT part of their working life,” Dr Abdul Latiff said.

WorldCare senior manager Yusmar Yahaya said the teleconsultation services were designed to be user-friendly around the clock.
Responses can be expected between 30 minutes and 24 hours of a request being made. “The services can be transmitted over ordinary telephone lines,” he added.
The government launched the teleconsultation pilot project with WorldCare managing and operating it from April 2000 to October 2002 under a RM20 million allocation.
The service was continued until July 2003 when it was temporarily disrupted. It was reactivated in June 2005 with an allocation of RM6.3 million for maintenance, upgrading of equipment and telecommunications services.
The first seven months of the pilot project were used for implementation and network commissioning with the Malaysian Teleconsultation Network fully operational in November 2000.
Malaysia’s Teleconsultation Network is powered by the US FDA approved OpenMed™ Manager switching matrix, while OpenMed™ Capture serves as the platform for capture and acquisition of medical modalities.
Viewing and reporting of teleconsultations is done through the web-based OpenMed™ Viewer, allowing for geographical barriers to be broken.
Yusmar said high-resolution X-rays, MRIs and CT scans were sent through the industry standard DICOM protocols to the OpenMed™ Radiology application for viewing on high-resolution diagnostic work stations.
Health Ministry Telehealth Division assistant director Dr Vijayan Kannan said a doctor who wanted to do teledermatology could use high-resolution digital cameras to acquire images of focal skin lesions or rashes.
These can then be transmitted to a dermatologist for interpretation.
He added that at a resolution of 3.5 megapixels to 5 megapixels, the size of images could range between 640×480 pixels and 1024×768 pixels.
“Similar technology is used in other disciplines. The idea is to deliver patient focus health services to the public.
“People in rural areas no longer have to come to the city or towns for referrals or to see a specialist.”
Dr Vijayan said the introduction of teleconsultation had helped save ambulances for emergency cases.
“This can also save time besides costs in terms of ferrying patients to hospitals.”
Dr Vijayan said referrals had been reduced by 50 per cent after the system was introduced.

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