This article first appeared in Digital Edge, The Edge Malaysia Weekly on May 23, 2022 - May 29, 2022

The use of technology in healthcare has undoubtedly aided the organisation of data and accessibility to systems, but the reality is that many users still have problems achieving interoperability efficiencies in their systems.

An estimated 55% of hospitals in the US still have issues with interoperability. Meanwhile, in Southeast Asia, the use of technology in healthcare varies from country to country, but it continues to grow and mature across the region.

Antonio De Castro, senior industry consultant for health and life sciences at SAS, says the pandemic accelerated the adoption of technology in the healthcare industry, allowing for siloed hospital management systems and software solutions to come together.

Interoperability is the ability of various information systems, devices and applications to exchange, integrate and cooperatively use data in a coordinated manner, De Castro explains.

“A hospital may have a separate system for financials and claims and a different system for electronic health records. Devices in hospitals have their own systems and providers too, and integrating all of these is difficult because it involves different systems,” he says.

“This is what we have seen in the pandemic. Hospitals need to optimise their medical resources to gain a holistic view of the effects of the pandemic so they can act accordingly, which is very important.”

Data sharing is becoming increasingly prevalent in the healthcare industry as it serves a myriad purposes, such as a lower rate of medication errors, facilitating preventive care, more accurate staffing and, most importantly, providing a comprehensive view of patients.

The traditional use of data in a hospital is keeping patient medical records safely, making sure that the data is secure and the privacy of patients is protected. But now, hospitals are starting to use it for other purposes, particularly to better understand the collective health of the population, says De Castro.

“Again, with the case of Covid-19, it is important to share information on patients to understand what is going on at a regional and global level. That, for me, was one of the hurdles. But we are seeing a change in behaviour, where the industry is moving out of that comfort zone,” he says.

Moreover, the information exchange between private and public health facilities optimises a patient’s healthcare experience, De Castro stresses.

While efforts are being made to drive public-private integration, many challenges remain.

Singapore’s National Electronic Health Record (NEHR) is the benchmark of interoperability, says De Castro. The NEHR is a patient data exchange system that enables clinicians and healthcare professionals to view patient health records across the national healthcare network, which supports them in making clinical decisions when treating patients.

De Castro says the key question that should be asked is, “How do I make sure that I am giving the best possible care to a patient?” The use of technology in the healthcare industry is not about the quantity, but the quality of healthcare provided, he adds.

“Having a data platform and analysing the data can unlock a lot of things, such as proving how one treatment is more effective than another, because the most popular treatment is not necessarily the most cost-effective and may not provide valuable health outcomes,” he points out.

Covid-19 has also shed some light on the convergence of the life sciences industry with the healthcare sector. Hospitals are working hand-in-hand with research institutions, making use of their data to develop vaccines faster and learn about the efficacy of vaccines in the real world, says De Castro.

“A lot of healthcare organisations and institutions have realised that they are sitting on a lot of data and thinking of how to operationalise and make use of it,” he adds.

This is happening in Malaysia already, with the Ministry of Health publishing the data on the number of Covid-19 cases in the country. The ministry has broken down the figures into two sets of data — based on the categories of positive cases (Cat 1 to Cat 5) and the methods in which Covid-19-positive people are seeking treatment (at home, in quarantine centres or in the hospital).

With the rise of cybersecurity attacks on healthcare systems, data sharing, consent and monetisation will inevitably be scrutinised even more, given that interoperability technologies are vulnerable during data transfers.

Cyberattacks are launched to steal sensitive information, which is not a big concern in the healthcare sector, as attackers mostly target banks and insurance companies. But as the unscrupulous realise there is also money to be made in having sensitive data, more and more healthcare organisations will become more proactive in protecting themselves.

More than protecting data from cyberattacks, De Castro’s main concern revolves around the access and traceability of patients’ data. “The first barrier of protection comes back to access to data. For example, the doctor needs to know the name of the patient and the medical details, among others.

“But if I am transferring this data to a research institute or someone else in the same hospital, they may not need to know some of the private information there. They would just need to know the status of the patient and the condition they are in. So, having proper and clear rules about access to data is important.”

When it comes to regulation of the exchange of data in the healthcare sector, De Castro says while policies like the US’ Health Insurance Portability and Accountability Act of 1996 (HIPAA) are still in force, the General Data Protection Regulation (GDPR) plays a role too because data is involved.

“Regulation is continuously evolving, especially with what is happening in the world right now. There is merit in the exchange of data [which is why] guidelines and regulations should also evolve,” he says.

“But coming back to the issue of transparency of the data in use, it is tricky because while it has to be protected, data is everywhere. For example, some people post their Covid-19 test results on social media, telling people they are positive or negative.

“To some extent, this information can be exploited by others. So, having guidelines and best practices really comes back to who needs access to the data and noting what is being done with the information.”

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