An Integrated and Distributed Framework for a Malaysian Telemedicine System (MyTel)

  • Mohammad Abd Ghani

    Student thesis: Doctoral ThesisDoctor of Philosophy


    The overall aim of the research was to produce a validated framework for a Malaysian integrated and distributed telemedicine system. The framework was constructed so that it was capable of
    being useful in retrieving and storing a patient’s lifetime health record continuously and seamlessly during the downtime of the computer system and the unavailability of a landline
    telecommunication network.

    The research methodology suitable for this research was identified including the verification and validation strategies. A case study approach was selected for facilitating the processes and
    development of this research. The empirical data regarding the Malaysian health system and telemedicine context were gathered through a case study carried out at the Ministry of Health
    Malaysia (MOHM). The telemedicine approach in other countries was also analysed through a literature review and was compared and contrasted with that in the Malaysian context. A critical
    appraisal of the collated data resulted in the development of the proposed framework (MyTel) —a flexible telemedicine framework for the continuous upkeep of patients’ lifetime health records.

    Further data were collected through another case study (by way of a structured interview in the outpatient clinics/departments of MOHM) for developing and proposing a lifetime health record
    (LHR) dataset for supporting the implementation of the MyTel framework. The LHR dataset was developed after having conducted a critical analysis of the findings of the clinical consultation workflow and the usage of patients’ demographic and clinical records in the outpatient clinics. At the end of the analysis, the LHR components, LHR structures and LHR messages were created and proposed. A common LHR dataset may assist in making the
    proposed framework more flexible and interoperable.

    The first draft of the framework was validated in the three divisions of MOHM that were involved directly in the development of the National Health ICT project. The division includes the Telehealth Division, Public and Family Health Division and Planning and Development Division. The three divisions are directly involved in managing and developing the telehealth application, the teleprimary care application and the total hospital information system respectively. The feedback and responses from the validation process were analysed. The observations and suggestions made and experiences gained advocated that some modifications were essential for making the MyTel framework more functional, resulting in a revised/final framework.

    The proposed framework may assist in achieving continual access to a patient’s lifetime health record and for the provision of seamless and continuous care. The lifetime health record, which
    correlates each episode of care of an individual into a continuous health record, is the central key to delivery of the Malaysian integrated telehealth application. The important consideration,
    however, is that the lifetime health record should contain not only longitudinal health summary information but also the possibility of on-line retrieval of all of the patient’s health history whenever required, even during the computer system’s downtime and the unavailability of the landline telecommunication network.
    Date of Award2008
    Original languageEnglish
    Awarding Institution
    • Coventry University
    SponsorsUniversiti Teknikal Malaysia Melaka, Ministry of Higher Education, Malaysia & Public Services Department of Malaysia
    SupervisorRajeev K Bali (Supervisor), Raouf Naguib (Supervisor) & Ian Marshall (Supervisor)

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