How this Malaysian hospital predicted Covid-19 test loads
By Yun Xuan Poon
Interview with Professor Dr Tunku Kamarul Zaman, Chairman, Data Management, Control & Security Committee, University Malaya Medical Centre.
As hoards of patients rushed in to get tested and treated, hospital beds started filling up and supplies ran low. One hospital in Malaysia turned to predictive analytics to forecast the resources they would need, and plan ahead to ensure their patients had everything they needed to get better.
The usage for analytics is “immense”, says Professor Dr Tunku Kamarul Zaman, former Director of the University Malaya Medical Centre (UMMC) in Malaysia. He shares how the public hospital is preparing for a new age of digital health.
Prescriptive analytics
UMMC is “heavily dependent on big data analytics”, and this came in especially useful during the pandemic, says Tunku, who is now Chairman of the hospital's Data Management, Control & Security Committee. The hospital used data to predict how many tests were needed, and how many staff members had to work on it to ensure results would be ready within 24 hours, he shares.
The hospital also predicted the number of Covid cases from Malaysia’s first wave of the crisis. This helped staff to forecast the number of face masks they needed, so they could get the inventory ready.
Beyond the pandemic, the hospital uses analytics to predict the number of patients coming in each day to manage patient load. UMMC’s 1,600 beds serve approximately 1.3 million patients a year, Tunku notes. Knowing how many people to expect helps the hospital distribute resources more effectively and minimise patients’ waiting time.
UMMC will explore prescriptive analytics in the next year, Tunku shares. The system would be able to suggest how to solve any issues that predictive analytics highlights, he explains. For instance, if the hospital is expected to run out of beds that night, a prescriptive analytics tool might suggest doctors to put new patients in a particular ward to free up additional beds.
Connecting hospitals with the cloud
Cloud computing will be a big priority for UMMC’s tech transformation in the next year. One of the biggest issues is to ensure connectivity between UMMC and its partner hospitals, Tunku says.
The cloud allows hospitals to easily share health data. This opens up more treatment options for patients, as they can consult any hospital. “Now, each patient is not particularly dependent on just a single hospital,” he says.
Doctors can share their expertise across the cloud as well. For instance, UMMC offers one of the best surgical care treatments in Malaysia. UMMC doctors can share a patient’s treatment plan with partner hospitals, so the patient can continue their care at a hospital nearer to them, Tunku explains.
The cloud will also enable mobile healthcare. Hospitals can make patients’ basic health records, referrals and blood test results available for them online.
This could be an important health service in the future. “A lot of patients want to be better informed,” Tunku notes. Mobile healthcare and the cloud will allow patients to have more ownership of their health.
Telehealth in Malaysia
Telehealth is one of the big trends that arose from Covid-19 globally, but UMMC has seen low takeup for it. Tunku shares three challenges they will have to figure out before telemedicine takes off.
First, doctors will need new skills to administer care over a digital medium. “In telemedicine, what you communicate is only about 30 per cent of what you can get face to face,” he says. Doctors would have to spend more time listening to make up for the loss of nonlinguistic cues, such as eye contact or how the patient moves.
Even a small involuntary cringe can be telling. But depending on image quality, doctors may not be able to pick that up through a screen, he points out.
A wonky internet service can also spell trouble. “You cannot assume just because you said something, the patient will automatically pick that up,” Tunku says. A short disconnection of just a few seconds can lead to patients missing a huge part of their healthcare.
Second, Malaysia’s telehealth laws make it tricky to implement in hospitals. The laws were written in 1997 and amended once in 2006, shares Tunku. But tech has changed a lot since then.
For instance, the law doesn’t mention if informed consent for using a telehealth service can be given digitally, he explains. Patients have to physically sign in. Doctors need to understand these limitations carefully before they can start offering virtual consultations, he warns.
The third issue is security and identity authentication. Doctors will need a way to verify the identity of the person they’re seeing before they start sharing personal medical information over the call.
Before UMMC implemented telemedicine, “we made sure that there was a devil’s advocate amongst us”, Tunku says. Keeping things simple for the patient is important, but the hospital had to look out for legal and security concerns as well.
Tech for Covid
Tech was a core part of UMMC’s strategy to cope with Covid-19. Aside from using predictive analytics, the hospital offered a questionnaire and risk scoring system for the public on its website and app.
If patients are at a certain risk level, the system immediately alerts the hospital, and a medical team would get in touch with them. The app can also automatically register high-risk patients for a test at the hospital.
UMMC implemented a screening software to control patient crowds and keep staff safe. Both staff and patients have to fill in a form for an entry “visa” each time they come to the hospital. Patients could also check simple reports like their blood test results online, so they didn’t have to come down in person.
Tech has been key to Malaysia’s fight against the pandemic, and will continue to help hospitals provide better care beyond the current crisis. For UMMC, data analytics and the cloud are paving a clear way to a new age of digital health.