Loss of records reveals weakness in IT system

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KUALA LUMPUR: A recent IT disaster at the Sungai Buloh Hospital causing significant loss of patient data raises a question over the utility of an expensive information integration system adopted by the Ministry of Health. Sources told The Edge Financial Daily that following a server crash on Sept 25, hundreds of records from the hospital’s database of over 50,000 patients have been inaccessible.

The fully integrated system, which is designed to allow doctors and specialists to communicate via the hospital Intranet and have access to patient records such as X-ray images, is known as the Total Hospital Information System (THIS). It is a computerised healthcare management system that links the various departments within the hospital. The system, which is operated by Syarikat Permodalan Kebangsaan Bhd (SPK), also integrates with the finance and administration departments. The two-year defect liability period has expired and a new contractor, ISOFT, is now managing the system.

The core component of THIS is a patient tracking system — which doctors and staff of Sungai Buloh Hospital said had been compromised. THIS was introduced in stages in 26 government hospitals from 2001 at a cost of between RM80 million and RM100 million per hospital. The Sungai Buloh Hospital was fully integrated in 2008. However the latest experience raises questions about the system’s durability and effectiveness.

It is understood that a number of other hospitals have also experienced server breakdowns but nothing as severe as the one experienced by Sungai Buloh.

Doctors also said the absence of a back-up system has aggravated the situation. “At times we have to take pictures of the X-Ray and send the picture to our colleagues via WhatsApp,” said a senior staff member at the hospital, referring to the popular social media application.

The hospital was in the news last year when a fire in one of the operating theatres (OTs) caused a short circuit that affected the Uninterruptible Power Supply (UPS) system, which in turn caused all of its 12 OTs to shut down. For that episode, Sungai Buloh Hospital director Dr Khalid Ibrahim said the latest incident is nothing to be concerned about.

“We were conducting maintenance work on our IT system and sometimes one system is shut down but the other systems are okay. It’s quite common and is not a major issue among us. There was no such thing as patient data getting lost. It was not a shutdown and the system didn’t collapse,” he said.

The 620-bed Sungai Buloh Hospital is also the national referral hospital for orthopaedic, cataract and neurology cases, and is famed as the national leprosy treatment centre.

Dr Khalid said patients who came for treatment when the system was offline had their data recorded manually and once the system was online again, the doctors and medical personnel keyed in and updated their records. “There was no loss ... everything was completed within 24 hours.”

But another senior staff member had this to say: “When an IT system collapses in an IT hospital, it means we cannot access X-rays, clinics cannot run and even OTs can’t run.” He said there are still issues with the system which the hospital management has yet to sort out and some patient records remain inaccessible.

The ambitious project also requires all wards to be hooked up to computers, and doctors and specialists equipped with laptops to enable immediate access to patient records. However a visit to the Sungai Buloh Hospital recently indicated that some of the hardware was not functioning. Several units had batteries that had not been replaced since 2006.

System to be upgraded

A health ministry official said they are aware of the problems plaguing THIS. He said the main problem is that the system is old and needs upgrading.

The official said the ministry is now trying to find a more permanent solution to this problem.

“What we are looking at is how the system can cope in the long run and what can be done to improve it,” he said. “The high cost of the system is of great concern to us.”

He said plans to address the issues are in working papers for the 11th Malaysia Plan, which is due to be launched next year.

This article first appeared in The Edge Financial Daily, on October 21, 2014.