HEALTH EDUCATION Monitoring and Assessment
Under the Health Promotion Strategic Plan, monitoring refers to the ‘achievement of activities/ initiatives’.
Monitoring the implementation of activities will be done twice a year using the activity feedback form from
the implementers at the district and state levels. Feedback will be compiled twice a year or six-monthly.
Progress will be reported at health promotion programme management meetings through result-based
outcomes (OBB), the Ministry of Health KPI report, and the 12th Malaysia Plan. In addition, field
monitoring is done by state programme/ activity audit on a rotation basis.
The findings of national surveys such as the National Health Morbidity Survey (NHMS) measure the
impact/ success of the initiative being developed. In collaboration with the Institute for Health Behavioural
Research, the Health Education Division is developing a Healthy Living Index to measure healthy living
practices in the community and conduct an impact evaluation of the programmes related to social and
behavioural change.
The Health Promotion Strategic Plan will be reviewed every two (2) years to ensure that the goals, plans
and strategies are met.
184 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Detailed Implementation Plan for Health Education HEALTH EDUCATION
The allied health profession’s Detailed Implementation Plan (DIP) outlined in this Strategic Plan is divided into three (3) tiers
which are:
(A) Strategic Framework - Medical Programme
The activities/ indicators/ achievements will directly be monitored under the Head of Services, and the allied health
profession involved will report to their respective service in the Medical Programme/ Public Health Programme or other
relevant departments.
(B) Medical Framework - Allied Health Sciences Division
The activities/ indicators/ achievements will be monitored by AHSD, and then will report to the Medical Programme/
Public Health Programme or other relevant departments.
(C) Allied Health Sciences Division - Profession
The activites/ indicators/ achievements will be monitored by AHSD for internal report and discussion between AHSD and
allied health professions.
(A) Strategic Framework - Medical Programme
No Profession Strategy
(B) Medical Framework - Allied Health Sciences Division
No Profession Strategy
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 185
(C) Allied Health Sciences Division - Profession Health Education
Focus: Strengthening Health Awareness and Community Empowerment
Strategy 1: Enhancing Health Literacy and Health Awareness Among Malaysian
Initiative Activity Indicator Target
2021 2022 2023 2024 2025
1.1 Development of Malaysia’s A Malaysia's Healthy - Completed - - -
Healthy Lifestyle Index Lifestyle index is developed
1.2 To increase awareness and Numbers of information +5% from +5% +5% +5% +5%
accessibility of health disseminated through previous 80% 85% 90%
HEALTH EDUCATION promotion information various media and health year
through various channels education materials achievement
and media published
Initiative 1 : Percentage of agencies
Strengthening Population- disseminated healthy 60% 70%
based Health Literacy lifestyle messages through
various platform
1.3 To increase awareness and Percentage of reach of 40% 40% 40% 40% 40%
knowledge among infographic related to 40% 40% 40% 40% 40%
Malaysian toward diseases communicable diseases in
social media.
Number of reaches of
infographic related to
promoting healthy lifestyle
behaviour in social media
1.4 Increase health literacy Number or community has ≥5,000 ≥5,000 ≥5,000 ≥5,000 ≥5,000
through capacity building been trained in Healthy
among community lifestyle skills
Strategy 2: Advocates strategic partners to provide universal/ comprehensive health service initiative
Initiative Activity Indicator Target
2021 2022 2023 2024 2025
Number of NGOs applying 60 70 80 90 100
Initiative 2 : for financial grants from
Improving NGO initiatives 2.1 Train NGOs in the MOH
to implement health implementation of health
promotion activities and
promotion interventions interventions Number of NGOs 55555
in the community implementing health
education interventions
Initiative 3: Advocates 3.1 Engagement with the
agencies (public sector) to
public sectors to implement implement any healthy Number of agencies
healthy lifestyle initiative implement 22222
lifestyle activities in
at workplace/ among staff workplace/ among staff
186 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Strategy 3: Empowering individuals, families and communities for self-management of health/ self-health
management
Initiative Activity Indicator Target
2021 2022 2023 2024 2025
4.1 Encourage communities to Number of COMBI teams
establish COMBI teams in established 118 118 118 118 118
their localities
4.2 Train COMBI leaders with Number of COMBI leaders 660 660 660 660 660
leadership training and trained
planning for health
Initiative 4 promotion and education % of COMBI teams trained 50% 55% 60% 70% 80% HEALTH EDUCATION
Health Promotion and activities to implement education and
prevention of prevention activities of
communicable diseases dengue fever
4.3 Train COMBI volunteers as Numbers of COMBI +1% +1% +1% +1% +1%
health advocates for volunteers
communities in their
respective localities
Initiative 5 : 5.1 Empowering overweight Percentage of successful 20% 20% 20% 20% 20%
Body weight management and obese target groups to IFitEr participants that lose
through the IFitEr manage their weight well their weight at least 10%
Programme through the IFitEr from baseline weight
programme
Strategy 4: Strengthening an environment that supports the empowerment of individuals, families, and communities
Initiative Activity Indicator Target
2021 2022 2023 2024 2025
6.1 Empowering communities Numbers of Wellness Hub 30,000 30,000 35,000 35,000 35,000
through healthy lifestyle clients
Initiative 6: practices
Wellness Hub as a Percentage of Wellness
community empowerment 6.2 Empowering communities Hub clients who underwent
centre to undergo health risk health risk screening for 55% 60% 65% 70% 75%
screening for healthy
lifestyles healthy lifestyle
Initiative 7 : 7.1 Strengthen mobile health 3,700 3,750 3,800 3,850 3,900
Strengthen Health promotion unit and Wellness Number of outreach
Promotion through mobile Truck for health promotion activities
unit and education activities
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 187
188 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
MEDICAL
GENETICS
MEDICAL GENETICS
190 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce
In Malaysia, genetic services have expanded 20Ye2ar 0 4
across government and private sectors (hospitals
and laboratories), including the universities. Year HOSPITAL
Genetic services in the Ministry of Health (MOH)
started in the Institute of Medical Research (IMR), 1998 19INSTITUTION
Kuala Lumpur, in the 1970s to investigate rural 1HOSPITAL
health problems. The main activities continued to CADRE POST 1
be research, training and referral diagnostic
laboratory services. Geneticists headed the Total : 1 Total : 24
laboratories and pioneered the development of
clinical diagnostic testing services in MOH. MEDICAL GENETICS
Chromosome studies for the peripheral blood and
bone marrow were offered in the 1990s with the
development of the Haematological Division in
IMR.
In 1997, one (1) geneticist post was created in a
hospital under the MOH. The job title for geneticist
in MOH was called Pegawai Sains (Genetik). In
contrast, in private sectors and universities,
genetic scientists were called with various names
such as laboratory scientist, research officers,
science officers and laboratory technologists.
Genetics laboratory service was first offered in
Hospital Kuala Lumpur in 1998, and it has evolved.
It has become one of the leading specialities in
paediatric and adult medicine as prioritised in
‘GENETIC SERVICES IN MALAYSIA — A
BLUEPRINT, 2008’. This blueprint was later
implemented as a guide in planning genetic
service in the MOH for the 10th MP and 11th MP.
The progress of genetic testing in the healthcare
system is one of the most rapidly expanding areas
of development across the world. This area of
medicine involves specialised applications in
diagnostic genetics to assist clinical experts in
determining medical treatment for complex genetic
diseases, including congenital disabilities and
inherited diseases, prenatal genetics,
haematological malignancy, immunogenetics,
neurogenetics and cancer genetics.
The clinical scientist (medical geneticist) (CSMG)
is responsible for assuring the high standards of
medical genetic diagnostic services, research,
consultation, education and continuous
professional scientific education of the team to
maintain the quality of the genetics services
provided.
CSMGs may work in (but not limited to) the
following workplaces: pathology laboratories in
private and public hospitals or universities,
government and non-government organisations,
welfare centres, independent practice and legal
settings.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 191
MEDICAL GENETICS Introduction continuously committed in this area and familiar
with artificial intelligence (AI) and machine
Medical genetics is the application of genetic learning (ML).
principles to medical practice, including studies of Dedicated CSMGs provide a wide range of routine
inheritance, mapping disease genes, diagnosis and specialised diagnostic services for Inherited/
and treatment, and genetic counselling. Birth Defect disorders, Duchenne Muscular
CSMGs are qualified professionals trained to Dystrophy (BMD) syndrome, Rett Syndrome,
perform cytogenetic, molecular genetics and Breast & Ovarian Cancer, Colorectal Cancer, Lung
biochemical genetics applications for diagnosing Cancer, Hematological Malignancy, α-thalassemia
diseases, provide advice in the related application and Inborn Error Metabolism disorders using
protocol. CSMGs use scientific skills in various techniques, e.g., Sanger sequencing,
experimental designs and problem-solving and real-time PCR, and Next Generation Sequencing
service development through research and (NGS).
investigations. Many external quality bodies such as the UK
National External Quality Assessment Service
Functions (UK NEQAS), Australasian Society of Diagnostic
Genomics (ASDG) Quality Assessment Program,
CSMGs play an essential role as trained and Genomic Quality Assessments (GENQA) and
registered practitioners in medical genetic ERNDIM (European Research Network recognise
diagnostic services (cytogenetics, molecular CSMGs in work related to evaluation and
genetics and biochemical genetics), research and improvement of screening, diagnosis and
development, and management in areas of clinical treatment of Inherited disorders of Metabolism)
laboratories. The CSMGs validate and implement External Quality Assessment schemes to provide
methodologies, ensure quality performance and robust and efficient genetic testing services
safety, provide technical interpretation, evaluation, across Malaysia.
verification and validation for diagnosis, treatment Workload/ Census
and surveillance, and is also involved in teaching,
training and consultancy.
The CSMGs work closely with other health care Genetic laboratory diagnostic services in our
and non-healthcare professionals in a country offer specialised laboratory tests, which
multidisciplinary team or interdisciplinary team to are very distinct from other clinical labs in the
provide comprehensive management. hospital. The Hospital Tunku Azizah (HTA)
Additionally, CSMGs also develop policies, genetics laboratory provides a wide range of
procedures, and standards of genetic diagnostic routine and specialised services for diagnostic,
services. carrier and predictive testing of a comprehensive
range of single-gene disorders, chromosomal
Performance and Achievements rearrangement, learning difficulties, prenatal
diagnosis, reproductive problems, cancer and
Enhancement of Service Delivery metabolic disorders. These factors have
Unceasing clinical demands towards diagnosis, positioned Genetics Laboratory in the Department
management and therapeutic strategies of of Pathology, HTA, as the referral centre for
genetically affected patients have demonstrated genetics diagnostic in Malaysia.
the need for comprehensive genetic testing CSMG conducts genetic testing focusing on
throughout Malaysia. Continuous medical and thalassemia disorders in HKL, while Hospital
scientific advancement through consistent high Ampang specialises in haematological
impact training of CSMGs are paramount in malignancy. The IMR offers genetic testing that
producing competent experts to generate a directs from research and is responsible for
reliable and accurate interpretation of genetic developing molecular diagnoses of genetic
testing. diseases, particularly IEM, mitochondrial
CSMGs works at the interface of medical genetics disorders, multiple myeloma, and many other
and genomics, whereby these domains are pivotal single-gene disorders. As of 2020, there is only a
in clinical reasoning for patient benefits. Genetic couple of CSMG position in each of these three
testing employs various complex techniques and (3) laboratories. While non-genetic professionals
platforms where expert interpretative, analytical are doing a significant fraction of work due to
skills are required. As bioinformatics is one of the inadequate availability of CSMGs post in MOH.
core principles in genetic testing, CSMGs are The CSMGs norms are dependent on several
factors, including the complexity of the technical
192 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
and analysis process, individual experience and officers previously offered this test in MEDICAL GENETICS
expertise, involvement of automation systems, Haematology Unit, Cancer Research Centre
laboratory management duties, and other (CaRC) Institute for Medical Research, NIH.
administrative duties. This refers to the 2012 However, starting in June 2019, the diagnostic
European Cytogeneticists Association (ECA) testing has been fully transferred to HTA due to
guidelines and standard technical requirements of the unavailability of experts for reporting. In
cytogenetic testing in Malaysia. September 2019, the Cytogenetic laboratory,
Below are the type of genetic tests carried out by Department of Pathology, HTA, started testing
CSMGs in the MOH, Malaysia: after 3 months of method validation and
technical training. Nonetheless, the transfer of
Cytogenetics & Molecular Cytogenetic Testing workload without additional CSMGs is critical
Peripheral Blood Cytogenetics as the cases doubled, and these have
Standard norms: inevitably overwhelmed our CSMGs.
According to Specific Technical Requirement
2.8 for Cytogenetics Testing (2017), a Molecular Genetics Testing
cytogeneticist do to 250 - 350 cases per year. The molecular genetic laboratory offers tests
The number of cases depends on the number based on the analysis of DNA, using various
of specimens processed, other duties such methods and strategies to confirm a clinical
as that person’s experience, the degree of diagnosis. It could also be used to provide
laboratory automation, and the complexity of pre-symptomatic diagnosis, prenatal diagnosis
the analyses. and carrier screening of various genetic
Fluorescence In Situ Hybridisation (FISH) disorders and cancers. Common indications for
Cytogenetics molecular genetic tests include inherited
Standard norms: metabolic disorders, mitochondrial disorders,
The norm for FISH study is approximately 400 genetic syndromes, neurogenetic disorders,
- 500 interphase/ metaphase cases, or 150 - DNA analysis for Thalassaemia syndromes,
220 specialised FISH tests (e.g., multiple haematological malignancies, lung cancer,
subtelomere) or 50 - 100 solid tissue FISH breast cancer, ovarian cancer and colorectal
(paraffin-embedded tissues) per CSMGs per cancer. Thus, the annual workload varies
year. according to the complexity of each test.
Bone Marrow Cytogenetics The number of genetic testing has escalated
Standard norms: tremendously since the service was first
The annual norm for the Bone Marrow offered. The annual workload for the last three
cytogenetics study is approximately 150 - (3) years as shown in Table 31.
250 bone marrow cultures. Research
Table 31: The Annual Workload of Clinical Scientist (Medical Geneticist) Year 2017 - 2019
Year 2017 2018 2019
Cytogenetics & Molecular Cytogenetics 5,260 5,388 5,600
sample/ test
Molecular Genetics sample/ test 22,810 23,224 26,558
Total numbers of sample/ test 28,070 28,612 32,158
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 193
Research/ Innovation/ Publication/ Presentation Azman, F., Mohd Yunus, N., Mohd Aris, N.
Research K., Ajmi, N. S., Farah Dura, S. Z., & Ariffin, R.
(2018). A case report of a Malaysian with
Research is an integral part of genetic service. WAGR syndrome. Asian Journal of Medicine
The laboratory and scientists also have a strong and Biomedicine, 67.
commitment to translational research and new Publications
services development and collaborate closely Standard operating procedures, training
with clinical, scientific and academic colleagues modules, guidelines:
within nationwide academic health science − Technical contribution in Specific Technical
centres and international, regional genetics
laboratories. Requirement 2.8 for Cytogenetic Testing
and SC 2.1 - Specific Criteria for
CSMGs support the research collaborations Accreditation in the Field of Medical
with clinical genetics/ another clinical speciality Molecular Testing for Department of
with local or international research programmes Standard Malaysia.
that translate research into clinical practice. − Garis Panduan Pembangunan dan
These include: Perkembangan Kerjaya Profesion Pegawai
Sains Genetik.
AstraZeneca Sdn Bhd - P1.01-80 ELIOS: A
Multicentre, Open Label, Molecular Profiling Articles and Oral/ Poster Presentation
Study of Patients with EGFRm and NSCLC
treated with Osimertinib. 2018 - 2022.
Human Clinical Research, MRC IGMM, CSMGs have been actively participating in
University of Edinburgh, Scotland – National and International Conferences. A few
Microcephalic Primordial Dwarfism. 2015 - topics presented and won in these
2017. conferences are:
− Two (2) CSMGs won the Best Oral
MEDICAL GENETICS Department of Human Genetics, Yokohama
City University, Japan - Early-Onset Presentation during 2019 Medical Genetics
EpilepticEncephalopathies (EOEE) Conference - National level.
Childhood Epilepsy. 2012 - recent. − The Dr Wu Lien-Teh Research Awards –
13th MOH AMM Scientific Meeting 2019 in
Howard Hughes Medical Institute, Harvard conjunction with 21st NIH Scientific
Medical School, USA – Congenital Seminar (Best Poster Award) - National
Anomalies of the Kidney and Urinary Tract level.
(CAKUT) Childhood Kidney Diseases and
related disorders. 2012. − Mohd Aris, N.K. 2019. Epidermal Growth
Advanced Clinical Research Centre, Institute Factor Receptor (EGFR) Gene Mutation
of Neurological Disorders, Shinyurigaoka Testing for Integrated Care and Treatment
General Hospital, Japan - Lysosomal Acid of Lung Cancer Patient in Malaysia. 13th
Lipase Enzyme Assay. 2017. MOH-AMM Scientific Meeting
NMRR-19-1913-49710 (Best Poster
Award).
Department of Molecular Genetics, The
Western Sydney Genetics program, The − Ahmad, N.A. 2017. Array Comparative
Children’s Hospital at Westmead, Australia - Genomic Hybridization (ACGH) – HKL
The Use of High Throughput Screening Experience. Medical Genetic Conference
Technologies for Gene Discovery in Kuala Lumpur (Best Oral Presentation).
Mendelian Disorders. 2017.
Ahmad, N.A., Raja Hedar, R.T.S., Anuar, E. Training
2019. Exploring The Genetics Profiling of
Primary Ovarian Insufficiency (Poi) Amongst The CSMGs profession has undergone rapid
Women In Malaysia (Joint Research with expansion in recent years. CSMGs with
Hospital Canselor Tuanku Muhriz UKM postgraduate qualifications have specialised
(HCTM). training in medical genetics, prenatal genetics and
foetal medicine and molecular genomics. Currently,
eight (8) officers in the CSMGs profession have
earned a master’s degree.
194 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Moreover, the need for CSMGs to pursue Organization, 2018). However, given the current
specialised training and attachment abroad is genetic dimension in our country, the ideal ratio of
mandatory to update knowledge and expertise in CSMGs needed is 1 in 100,000 populations to
medical genetics. Attachments such as in advanced ensure that genetic testing is available equitably to
technical and analysis for cytogenetics, prenatal the Malaysian population. Due to a scarcity of
genetics, array comparative genomic hybridisation available CSMG posts in genetics testing facilities,
(a-CGH), RT-PCR EGFR for non-small cell lung current clinical scientist vacancies from other
cancer (NSCLC), next-generation sequencing science backgrounds perform genetic testing. Due
(NGS) for inherited diseases and cancer genetics. to promotion, competent clinical scientists are
being transferred, impacting service provision.
> Advance Specialised Training : 9
> Masters : 8 Adequacy and Optimisation of Health
> PhD : 1 Resources
With rising workload and additional testing, there
Recognition/ Achievements is an insufficient number of CSMGs to perform
genetic testing in addition to limited resources for
Three (3) CSMGs were recognised by the Public reagents and consumables. An initiative to
Service Department (Jabatan Perkhidmatan distribute CSMGs to MOH hospitals/ institutions/
Awam, JPA) in 2019 as Subject Matter Expert regional centres that perform genetic testing
(SME) in the genetic subspecialty of would ensure the long-term viability of technical
Chromosomal Studies, Molecular Cytogenetics and interpretive competence. Additionally, allow a
and Molecular Genetics. clear job definition and delineation based on
technical and clinical qualifications and avoid role
Two (2) CSMGs were appointed as panel duplication across medical and allied health
evaluators (Ahli Panel Penilai) for Malaysia professionals for efficient financial and resource
Qualifications Agency (MQA). management.
Two (2) CSMGs as Technical Assessor were Strengthen/ Enhance Career Pathway MEDICAL GENETICS
appointed in Cytogenetics and Molecular The highest post of CSMGs in MOH is C48,
Genetics for Skim Akreditasi Makmal Malaysia although the service started in 1998. Thus,
(SAMM) - Department of Standards Malaysia. creating higher post grades is mandatory to
support the development of careers for technical
Issues and Challenges personnel and minimise the attrition rate.
One-third of CSMGs have obtained post-grad
Strengthen/ Enhance Service Provision qualifications in various genetics specialities.
Medical Genetics services involve a specific area Hence, a designated career pathway/ framework
of competence in a broad field of medicine. for these specialities should be developed to
Increased demand for medical genetic services complement the clinical needs in MOH.
corresponds to a rise in various medicine
sub-specialities in the country. Because clinical Limited Training Opportunity
teams rely heavily on CSMGs for technical and The field-specific diagnostic services for medical
laboratory data interpretation to assist them with genetics are currently still focused only in a few
patient treatment and care, CSMGs with advanced MOH hospitals and NIH. However, the clinical
expertise is required. However, the number of specialisation requirements for this service are
adequately trained CSMGs remains low. imperative and critical in line with the rapid
Human Resource Capability and Competency development of technology in diagnostic services.
The number of CSMGs is insufficient in MOH Diagnosis in medical genetics is very complex,
facilities. Malaysia has invested in genetic considering the use of various multifaceted
research in advancing genomic technology but not molecular technologies. The shortage of genetic
at par in the diagnostic field. Although individual scientists with in-depth knowledge and skills in
genetic disorders are rare, the prevalence of the new genetic techniques (i.e., whole exome
disease is still a significant turn-up, and there is sequencing (WES), whole genome sequencing
increasing demand for patient services. There are (WGS), bioinformatics and single cell analysis)
only 25 CSMGs in MOH, with the ratio of one (1) and data science applications are critically needed
CSMGs serving a 1,280,000 population. Ideally, to fulfil clinical demands. Therefore, it is required
according to the Global Health Workforce for CSMGs in the MOH to obtain an established
Statistics, 2018, there should be a ratio of 1 structured training/ attachments/ post-grads that
laboratory health worker per 1,000 populations involve specific laboratory testing, analysis and
(Global Health Workforce Statistics, World Health interpretation of technical and clinical lab data,
and exercise consultation services relevant to the
medical genetics field.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 195
MEDICAL GENETICS Lack of Collaboration Inter/ Interagency/ frequently unnoticed. An inherited disorder, which
Community affects 5 per cent of all pregnancies, is one of the
Collaboration with private genetic laboratories has most prevalent reasons. Hereditary disorders
been initiated voluntarily since 2013 through account for 15 per cent to 25 per cent of prenatal
Prenatal Genetic and Cancer Genetic services. and newborn mortality in developing countries.
However, there is slow growth and minimal The level of development of health care services
participation among private CSMGs due to lack of determined the prognosis for infants born with a
recognition on their contribution, absence of severe congenital condition. In low-resource
funding and lack of awareness of the settings, the absence or lack of suitable facilities
public-private partnership benefits. However, we for diagnosis and care causes most afflicted
provide services to all clinical disciplines in children to die undetected without accessibility to
Malaysia, engage with local and international services and therapy.
universities/ institutions, and charge private Furthermore, while individual genetic disorders
hospitals and laboratories. are uncommon, there are over 15,500 identified
genetic disorders. Congenital abnormalities affect
Increasing Disease Burden and Change of 3 - 5 per cent of all births. Genetic diseases
Demography account for 20 - 30 per cent of all newborn
Clinical treatment needs appropriate access to mortality. Mental retardation has a hereditary
high-quality laboratory genetic support as foundation in 50 per cent of cases.
recommended by the World Health Organization In adults, 15 per cent of all cancers are caused by
(WHO) since 1985. Developing countries started an inherited predisposition, and 10 per cent of
medical genetic services to help people with chronic illnesses (heart disease, diabetes,
genetic disadvantages live and reproduce as arthritis) in adult populations have a strong
normally as possible. hereditary component.
Cancer is one of the primary health issues in International prevalence estimated occurrences of
Malaysia, and with the country’s growth and recessive genetic disorders at 0.1 per cent,
advancement, it has become an increasingly autosomal dominant and X-linked (1%), irregularly
severe public health concern. The annual inherited (9%), and chromosomal abnormalities at
incidence of cancer is estimated to be 30,000, with 0.1 per cent (0.6%). Their fundamental frequency
most patients diagnosed at a late stage of the is comparable throughout the world. However,
disease. Genetic testing for hereditary cancer many developing nations, like Malaysia, have a
syndromes, e.g., Hereditary breast cancer with high prevalence of common red blood cell genetic
BRCA1 and BRCA2 mutations, Lynch syndrome, diseases (such as thalassaemia) and
and Li-Fraumeni syndrome, among others, consanguineous marriage.
enhances total healthcare in the country. Because
we are not only able to provide close surveillance Way Forward
but also provide comprehensive care.
With genetic testing, preventative treatments such Philosophy
as therapeutic intervention, such as prophylactic The clinical scientist (medical geneticist) adheres
mastectomy in families with highly penetrant to the MOH’s Vision and is fully committed to
BRCA1/ BRCA2 mutations or thyroidectomy in providing full access and delivering quality health
families with autosomal dominant MEN1 service to everyone. This is aligned with
syndrome, may be provided to the family and Sustainable Development Goal 3, which ensures
allow informed decisions. With the progress of healthy lives and promotes well-being for all
pharmacogenomics and, eventually, the ages. The profession prioritises the reform of
realisation of personalised medicine, many of our resource management that involves human
cancer patients are now benefiting from targeted resources and facilities to achieve the above
cancer therapy, which has repeatedly shown to objectives.
increase patient survival and quality of life in lung The profession also hopes to increase genetic
and breast cancer patients. testing accessibility to reach out to individuals and
Even though worldwide under-five mortality fell to community who have trouble accessing medical
41 deaths per 1,000 live births in 2016 from 93 in genetic services due to distance and financial
1990 (56% decrease) and neonatal deaths difficulties via providing specialised genetic
accounting for 46 per cent of all under-five deaths services in regional centres to achieve Universal
in developing nations. Much of this is attributed to Health Coverage (UHC), which intends to leave
infectious and dietary factors, although genetic no one behind.
contributions are becoming increasingly visible yet
196 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
In addition, the profession intends to foster New Issues - New Strategies
public-private partnership through collaboration with Genetic service accessibility in Malaysia
genetics laboratories, clinicians, NGOs and through regionalisation of genetics services.
commissioners in genetic testing, health
promotion, awareness and prevention of genetic A public-private partnership among genetic
related disorders programmes. laboratory services.
Principles Establish new genetic tests such as Prenatal
Current Achievement - Sustain/ Maintain Cytogenetics (amniocentesis), Skin Fibroblast
Existing cytogenetics and molecular genetics Cytogenetics, Prenatal Molecular
services. Thalassemia and expand cancer genetics
Knowledge, skills and competencies of testing.
CSMGs.
Existing issues that have not been solved -
Reform
Human resource for genetic laboratory
services.
Training specialised in medical genetics.
Conclusion : The strategic plan 2021 - 2025 for medical genetics aligns with MEDICAL GENETICS
the Ministry of Health’s vision to provide optimum healthcare services to all. It
covers a five-year plan with yearly reviews to reflect on changes and updates
in the profession’s priorities and initiatives. The strategic plan will be a road
map for the profession to develop and advance Genetic diagnostics in
Malaysia.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 197
Detailed Implementation Plan for Medical Genetics
The allied health profession’s Detailed Implementation Plan (DIP) outlined in this Strategic Plan is divided into three (3) tiers
which are:
(A) Strategic Framework - Medical Programme
The activities/ indicators/ achievements will directly be monitored under the Head of Services, and the allied health
profession involved will report to their respective service in the Medical Programme/ Public Health Programme or other
relevant departments.
(B) Medical Framework - Allied Health Sciences Division
The activities/ indicators/ achievements will be monitored by AHSD, and then will report to the Medical Programme/
Public Health Programme or other relevant departments.
(C) Allied Health Sciences Division - Profession
The activites/ indicators/ achievements will be monitored by AHSD for internal report and discussion between AHSD and
allied health professions.
(A) Strategic Framework - Medical Programme
Strategy 1: Strengthen healthcare service delivery in hospitals
Main Implementation Plan No. 4 :
Increasing accessibility and quality of care for cancer patient (adult & paediatric population)
Profession Activity Indicator Target
Implementation Plan
MEDICAL GENETICS 1. Shorten waiting time for To support public-private Number of public-private genetic At least 1 public-private
diagnostic genetic testing genetic laboratories towards laboratories collaboration concept genetic laboratories
prior to therapeutic integration of laboratory collaboration concept by
procedures for cancer service delivery via familial/ 2025
patients through public- clustered cancers testing
private partnership segregation arrangement 70% of diagnostic
genetic testing done
Percentage of waiting time within turnaround
annually
Main Implementation Plan No. 13 :
To enhance existing paediatric services to cater to the needs of special groups of paediatric population
Profession Activity Indicator Target
Implementation Plan
Number of new diagnostic testing via Development of at least
identification and selection of tests for one new genetic testing
2. Provide diagnostic services To consolidate with clinicians rare genetic diseases by 2025
for rare genetic disease and other genetic stakeholders
management programme in to enable rare genetic Development and method validation Development of at least
Malaysia diseases profiling of tests for rare genetic diseases one new method
validation by 2025
198 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Main Implementation Plan No. 14: To expand existing assisted reproductive technology (ART) services
Profession Activity Indicator Target
Implementation Plan
3. Expand genetics laboratory To establish confirmatory Development of prenatal genetic 1 facility by 2025
services for MOH genetic testing services for testing services for thalassemia
thalassemia disorder to disorder in Hospital Tunku Azizah
accommodate family planning (HTA)
through assisted reproductive
technology (ART) services
MEDICAL GENETICS
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 199
(B) Medical Framework - Allied Health Sciences Division
Strategy 1: Strengthen healthcare service delivery in hospitals
Main Implementation Plan No. 17: To consolidate and integrate laboratory service delivery in MOH facilities
Profession Activity Indicator Target
Implementation Plan
To strengthen postnatal, Number of structured training At least 1 training
prenatal and bone marrow module in postnatal, prenatal and module is developed by
cytogenetic services in Hospital bone marrow cytogenetics 2025
Tunku Azizah (HTA)
1. Implement genetics services
To strengthen molecular Number of structured training module At least 1 training
genetic services in MOH in molecular genetic services module is developed by
To support establishment of 2025
genetics testing services in
proposed MOH facilities Number of genetic laboratories set up 4 facilities by 2025
in regional centres
2. Regionalise genetic testing Number of CSMGs posts from C41 to Minimum 5 CSMGs
services in Malaysia C54 in regional centres post in each proposed
regional centre by 2025
To enhance genetic testing
services in proposed MOH Number of CSMGs trained Minimum 2 CSMGs
facilities trained in each
proposed regional centre
MEDICAL GENETICS by 2025
Strategy 2: Optimise resource management including facility, equipment and financing
Main Implementation Plan No. 22:
To optimise utilisation of existing underutilised/ unused facilities in tertiary hospital
Profession Activity Indicator Target
Implementation Plan
Number of CSMGs posts from C41 to 5 CSMGs post in HTA by
C54 2022
To establish Prenatal Genetic Number of CSMGs trained in Prenatal 5 CSMGs trained in
services in HTA Genetics Prenatal Genetics by
2025
3. Utilise existing Prenatal and Financial allocation for reagents and RM300,000 allocated to
Skin Fibroblast Laboratory consumables start service by 2025
set up in Hospital Tunku
Azizah (HTA) Number of CSMGs posts from C41 to 2 CSMGs post in HTA by
C54 2025
To establish Skin Fibroblast Number of CSMGs trained in Skin 2 CSMGs trained in by
services in HTA Fibroblast services 2025
Financial allocation for reagents and RM150,000 allocated to
consumables start service by 2025
200 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Main Implementation Plan No. 26 :
To optimise healthcare resources through interagency collaboration in service delivery
Profession Activity Indicator Target
Implementation Plan
4. Utilise and empower existing Development of module and Number of training modules 2 training modules by
collaboration of various training program for rare developed 2025
stakeholders in medical genetic disorders and cancer
genetics services on disease genetics Number of facilities implementing the 2 facilities by 2025
based genetic testing and training programme
counselling
Strategy 3: Enhance Capacity and Capability of Human Resource for Health
Main Implementation Plan No. 28: To ensure adequate supply of in-service competent medical personnel
Profession Activity Indicator Target
Implementation Plan
5. Optimise resource Appointment of permanent Number of permanent CSMGs Minimum 3 CSMGs per
management (human CSMGs officers appointed non-regional centre by
resource) 2025
Main Implementation Plan No. 32: MEDICAL GENETICS
To improve competencies and provide incentives for medical doctors involved in clinical governance,
public health practice, enforcement and other areas of special interest
Profession Activity Indicator Target
Implementation Plan
6. Enhance capabilities of Continuing professional Number of CBBP with HLP for Minimum 10% of CSMGs
CSMGs in core and areas of development of CSMGs CSMGs furthering MSc/ PhD
special interest to support through structured courses - every 2 years
clinical demand postgraduate qualifications
Continuing professional Number of CSMGs with certification Minimum 2 person to
development, including through or technical and analysis attachments obtain certification/
short courses/ workshops and attachment every year
seminars
Main Implementation Plan No. 33: To improve career pathway for medical personnel
Profession Activity Indicator Target
Implementation Plan
Submission by 2023
7. Improve career pathway for To establish career pathway Submission of framework paper At least one SME
CSMGs framework for CSMGs gazetted in every expert
area/ proposed speciality
8. Sustainability of SMEs Revision of SME specialities, Number of SME gazette for clinical by 2025
relevant to medical genetics propose for new SME field scientists (medical geneticist)
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 201
(C) Allied Health Sciences Division - Profession Medical Genetics
Profession Activity Indicator Target
Implementation Plan
To develop standard operating Number of guidelines developed Minimum 5 guidelines
1. Standardisation of genetic procedures/ guidelines for completed by 2025
testing procedure among CSMGs in genetic laboratories
genetic laboratories
2. Accreditation of Genetics To participate in MS ISO Number of genetic laboratories At least 2 genetic
Laboratory 17025/15189 certification participate in MS ISO 17025/15189 laboratories by 2025
programme of Medical
Laboratory
3. Ensure optimum numbers of To establish flexi CSMGs posts Paperwork submitted for endorsement Submission to Human
CSMGs to cater genetics C48/ C52/ C54 to ensure Number of flexi post approved Resources Division
laboratory services trained staff are retained MOH by 2023
Minimum 10 posts for
Create optimum number of Paperwork submitted for endorsement CSMGs by 2025
posts for CSMGs according to Submission to Human
norm and workload Resources Division
MOH by 2023
MEDICAL GENETICS
202 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
MEDICAL GENETICS
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 203
204 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
MEDICAL LABORATORY
TECHNOLOGY
MEDICAL LABORATORY TECHNOLOGY
206 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce
The profession of medical laboratory technology Year
initiated its journey as a laboratory assistant since
the establishment of the Institute for Medical 2020
Research (IMR) in 1900. Laboratory Assistants
(LA) played their roles to assist with the research HOSPITAL 3,742
in tropical diseases. Most of the preliminary
training in those days had been carried out in STATE HEALTH 81
respective divisions of the IMR by employing an DEPARTMENT
‘on the bench training’ method. Then in 1965, a
structured training programme based on the MOH COLLEGE 2
British system was introduced, accompanied by
an examination structure (certificate level) to HEALTH 2,207
replace the first departmental examination. CLINIC 452
The late Prof Dato’ Dr Ungku Omar Ahmad, the INSTITUTION
Director of IMR 1965 - 1969, thought it necessary
to have a structured course. He then initiated the 163PUBLIC HEALTH
school for the training of Medical and Health
Laboratory Technology in 1968. The School of LABORATORY
Laboratory Technology, which started with 41
students, was established with funds from Year 129NATIONAL
UNICEF.
A formal three-year training programme was 1968 BLOOD CENTRE
introduced in 1965 and accompanied by an
examination for the Medical Laboratory On Job Training MOH 4
Technology Certificate. The course includes basic Total: 41 HEADQUARTER
sciences, microscopy, medical microbiology,
biochemistry, haematology, blood banking, Total: 6,780
parasitology, and histopathology. Attachment in
bacteriology, biochemistry, histopathology, and In 1992, the Diploma in Medical Laboratory MEDICAL LABORATORY TECHNOLOGY
haematology was done in IMR. Under the Technology course curriculum was introduced,
supervision of chemical pathology experts, the and IMR did the training. The curriculum focuses
trainees also underwent direct attachment in blood on intensive training to produce multi-skilled
testing and clinical trials in Hospital Kuala Lumpur. graduates who excel in multiple disciplines. MLTs
In 1980 another milestone was achieved: The Post are stationed in major specialist hospitals, minor
Basic Medical Laboratory Technology examination specialist hospitals, non-specialist hospitals,
replacing the Second Departmental Examination. primary healthcare clinics, and major institutions
Post basic training and advanced diploma training such as the IMR, Respiratory Medical Institute
in specific disciplines such as laboratory (Institut Perubatan Respiratori, IPR), National
management, cytology, transfusion medicine, Cancer Institute (NCI), National Blood Centre
haemostasis, medical microbiology, and chemical (NBC), National Public Health Laboratory (NPHL),
pathology done further to enhance the efficiency and state public health laboratories.
and the capability of medical laboratory
technologist (MLT).
An opportunity arose during the Harun
Commission when the laboratory assistants in the
universities submitted a memorandum to request
a change in nomenclature, which is in line with
international practices to reflect the nature and
scope of its work. The commission fully agreed
with its representation and changed the
designation of laboratory assistant to medical
laboratory technologist. Unfortunately, this only
applies to those who work in the universities. It
was not until 1978 that the MOH agreed to change
the nomenclature for a laboratory assistant to an
MLT.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 207
Introduction trained healthcare professionals provide patient
care by performing laboratory analysis and
Medical laboratory technology is the branch of procedures in all areas of laboratory medicine.
medical science responsible for performing However, some are specialised, qualified by
laboratory investigations relating to diagnosing, unique undergraduate education or additional
treating, and preventing disease. An MLT is a training to perform more complex analyses. The
qualified practitioner with a minimum diploma specialities include clinical biochemistry,
qualification in Medical Laboratory Technology. haematology, microbiology, bacteriology,
MLT trained to perform routine laboratory testing toxicology, virology, parasitology, mycology,
such as microscopic examination/ analysis, immunology, immunohaematology (blood bank),
immunologic, microbiologic, haematologic, histopathology, histocompatibility, cytopathology,
cytogenetic, molecular and chemical testing on genetics, cytogenetic, electron microscopy,
blood, bodily fluids and tissue specimens to molecular diagnostics and in vitro fertilization
generate relevant results. (IVF). In small laboratories, they perform many
An MLT facilitates the diagnosis of diseases and types of tests. In contrast, those in a large hospital
the implementation and monitoring of therapies to laboratory generally specialise in one (1) of the
treat disease. Most MLTs are generalists, skilled in following medical laboratory sciences as
all areas of the clinical laboratory. These highly described in Table 32.
MEDICAL LABORATORY TECHNOLOGY Medical Laboratory Table 32: Type of Laboratory Tests
Medical Laboratory Tests
microbiology
Clinical chemistry Examining and identifying bacteria and other microorganisms
Transfusion science causing disease
Haematology
Analysing the chemical and hormonal contents of body fluids
Histopathology
Collecting, typing, and preparing blood and its components for
Cytology transfusions
Immunology Studying the structures and functions of the different types of
Virology blood cells
Examining tissue samples for abnormalities
Preparing body cells slides and examining them microscopically for
abnormalities that may signal the beginning of a cancerous growth
Examining elements of the human immune system and its response
to foreign bodies
Identifying infections and viruses such as hepatitis, dengue, HIV and
other viruses
Functions Standard 1: Professional Responsibility and
Accountability
MLTs have the skill and competency to perform MLTs are responsible for their professional
laboratory procedures, know the theory behind practice and conduct. The profession envisages to
laboratory analyses, and understand associated practice within the legal and profession ethical
clinical applications. They are competent, framework and continuously enhance individual
demonstrate sound judgment, and possess good competency, according to the Malaysian Allied
interpretive skills and need to adapt to evolving Health Professions Act 2016 (Act 774). MLTs also
situations related to various tests and outcomes, adhere to accepted standards within their
follow established laboratory methods, and profession and place patient welfare above all
adhere to relevant quality control protocols. other considerations. MLTs must promote
Moreover, MLTs must consistently demonstrate interdisciplinary collaboration with other health
appropriate professional conduct. professionals.
208 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Standard 2: Competent Application of and accurate results is given at the fastest
Knowledge possible time medical officer or physician to
MLTs possess a high degree of scientific ensure effective treatment. It is estimated 60 - 70
knowledge; they understand medical laboratory per cent of all decisions regarding a patient’s
analyses' theories, techniques, and clinical diagnosis treatment, hospital admission and
applications. They apply these skills and scientific discharge are based on the results of the test.
knowledge to current practice. They maintain The history of medical laboratory technology
continued competence, commit to lifelong services dates to 1900 during the establishment
learning, and sustain their professional skills. of the IMR and continues to grow to this day in
MLTs demonstrate competence as outlined in Act hospitals, health clinics, research institutions and
774 and General Medical Laboratory Technology public health laboratories. In the 10th Malaysia
Competency Profile. They correlate analyses, Plan (RMK10: 2010 - 2015), it has been clarified
diagnoses, clinical data, and treatment that several Pathology Specialty services are
information to improve and maximise patient established at the zonal (regional) level, Hospital
outcomes. MLTs apply institutional policies and Kuala Lumpur (HKL - reference hospital), major
procedures in day-to-day practice and adapt to specialist hospitals, minor specialist hospitals,
changing practice requirements within the clinical and institutions, where MLTs are needed to
environment. support specialty services such as:
Standard 3: Competence and Proficiency in Haematology and Genetic at regional level.
Laboratory Practice Anatomical Histopathology, Microbiology and
MLTs skilfully perform laboratory analyses. They Chemistry Pathology at HKL.
utilise sound judgment and advanced interpretive Clinical Pathology in major specialist hospitals
skills to effectively recognise and quickly respond and minor specialist hospitals.
to developing situations associated with Nuclear Medicine at the regional level.
laboratory methods and patient testing, including
troubleshooting equipment malfunctions, and MLTs are also assigned in health clinic MEDICAL LABORATORY TECHNOLOGY
reviewing abnormal quality control results. MLTs laboratories in primary health programs and
practice according to established protocols, maternal and child health programmes to conduct
safety guidelines, and existing legislation and laboratory tests for the purpose of detection,
regulations. They verify relevant data and ensure treatment, monitoring and surveillance. Apart from
that appropriate specimens are appropriately that, MLTs also work in the National Public Health
procured and handled. MLTs perform Laboratory under the infectious disease control
preanalytical procedures on samples from various programme such as dengue, malaria, filaria,
sources and apply applicable principles when influenza, MERS-CoV, SARS-CoV, rabies,
performing analytical techniques and validating cholera, typhoid, and other fields. While at IMR,
test results. They utilise scientific knowledge to MLTs also involved in research and diagnostic
interpret medical data. testing.
Standard 4: Communication and Collaboration
MLTs utilise effective communication skills and In addition to conducting routine tests in pathology
demonstrate strong teamwork abilities when laboratories, MLTs are also involved in conducting
interacting with patients and healthcare providers. tests that require high skilled or specialised tests
according to specific laboratories. Among the tests
Performance and Achievements require high technical skills and knowledge and
experience such as Molecular Testing Techniques
Enhancement of Service Delivery (PCR, genotyping, LPA, MIRU),
MLT is the backbone of the medical laboratory Immunofluorescence, FISH, Enzyme
service as they are involved at all levels of the Histochemistry, Pulsed-Field Gel Electrophoresis,
laboratory services from the pre-clinical, clinical HLA Typing, Gynae and Non-Gynae microscopic
right up to the post clinical stage. MLT is involved smear.
in the process of diagnosing for treatment,
rehabilitation, and prevention through clinical In the future, with the existence of the Medical
laboratory tests. They are responsible for Laboratory Science Officer Scheme, it can
ensuring the suitability of the specimen obtained improve and upgrade medical and health
from patients for the test that is to be performed laboratory services, and provide career
opportunities for MLT to be upgraded from
diploma to degree. This Science Officer scheme
can also be strengthened in terms of expertise
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 209
and promotion opportunities. This scheme has its Workload/ Census
own identity to improve the quality of laboratory The number of samples has grown tremendously
services and there will be no loss of expertise and since the service was first offered. The numbers of
skill (no brain drain). The benefits obtained in samples processed for the last three (3) years at
terms of delivery of Laboratory Services are very primary health clinics and hospitals as in Table 33.
high (service delivery).
Table 33 : The Number of Samples Attended by Medical
Laboratory Technologists in the Year 2017 - 2019
Year 2017 2018 2019
281,657,661
Samples attended by MLTs 209,767,949 246,839,947
Research/ Innovation/ Publication/ Presentation Table 34: The Number of Medical Laboratory
Technologists Pursue Bachelors and Masters
MLTs are involved in technical committees
such as: Grade Bachelors Masters
Working Technical Committee Group for U40 6 2
Requirement of Quality and Competence for U38 7 0
Primary Healthcare Laboratory for Department U36 19 0
of Standards Malaysia. U32 102 0
National Technical Committee Group for Training U29 274 1
Development in AHSD and MOH for Advance In Progress 238 2
Course.
Involved in preparing guidelines Total 646 5
Buku Panduan JTMP Penjagaan Kesihatan
MEDICAL LABORATORY TECHNOLOGY Primer, BPKK, 2006. Recognition/ Achievements
Buku Prosedur Amalan Piawaian JTMP dalam Ministry of Health Malaysia Innovation Award
Penjagaan Kesihatan Primer, BPKK, 2006. 2018 (Project: Smart Magic Pen) – National
Buku Panduan Keselamatan Makmal level.
Perubatan, BPKK, 2009. Gold Medal: Invention, Innovation and Design
National Point of Care Testing, Policy & Thinking 2019. Project MoSCo 2.0 and Smart
Guidelines, MOH, 2012. Magic Pen.
Handbook on Clinical Use of Blood – 3rd edition Design Thinking Association Malaysia Awards
2020, NBC & Malaysian Blood Transfusion 2019 (Future Forward) Project MoSCo 2.0 –
Society. National Level and interagency.
Training
Currently, 224 MLTs have post basic and Issues and Challenges
advanced diploma in various field such as
cytology, biochemistry, microbiology (parasitology, Strengthen/ Enhance Service Provision
mycology, and bacteriology), haematology, Extended and expanded scope required many
haemostasis, and laboratory management. additional tests, short turnaround time (TAT),
A total of 408 MLTs have bachelor’s degrees, and high demand from clients such as
and five (5) have completed masters in science, specialists and medical officers from the ward,
while 238 MLTs are pursuing degrees in specialist clinic, health clinic, and Surveillance
Biomedical/ Medical Laboratory Technology at Programme Public Health without additional
IPTA and IPTS (Table 34). MLTs.
Development of Laboratory Information System
(LIS) system in all health clinic laboratories and
networking between clinics and hospitals to
launch pathology and patient care laboratory
services.
210 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Need engineering studies to design health clinic Shortage of MLTs and uneven distribution at MEDICAL LABORATORY TECHNOLOGY
laboratories that are more in line with current health clinics and district hospitals.
needs and accordance with safety guidelines. Limited Training Opportunity
The number of MLTs attend advanced diploma
Human Resource Capability and Competency courses is limited.
It is difficult to maintain skilled and experienced
MLTs in specific fields due to a lack of promotion Need to establish advanced diploma for Primary
posts. Health Care Laboratory to improve the quality of
MLTs with advanced diploma or post basic service while adopting the new technologies in
qualification are not fully utilised according to primary healthcare.
service requirements, needs, and expertise.
There is a lack of skills among MLTs senior No Federal Training Scholarship opportunities for
supervisors in managing and implementing MLT MLTs to continue their studies to bachelor’s
training and competency programmes. degree.
MLTs trained in the diploma and advanced Increasing Disease Burden and Change of
diploma levels (haematology) not deployed in Demography
the unit related. The rise in the number of chronic patients
For MLTs to perform laboratory services skilfully, (non-communicable disease) such as diabetes,
they need additional specialised training in a hypertension, renal failures, infectious disease,
specific field to enhance quality in results. vector-borne disease, food & water-borne disease,
cancer, and others is causing an increasing number
Adequacy and Optimisation of Health of laboratory tests in hospitals and health clinics.
Resources Airborne and droplet diseases such as COVID-19
have led to adopting many new protocols to prevent
Lack of protective equipment such as biosafety infection while performing laboratory tests.
cabinets for infectious disease testing such as
TB tests and others. Way Forward
Need an additional budget to purchase reagents,
consumers, assets and plan preventive Philosophy
maintenance in the health clinic laboratory.
Strengthen/ Enhance Career Pathway Strengthen the organisation and governance
The improvement of medical and health structure of pathology laboratory services by
laboratories scheme has lagged far behind due upgrading MLT from grade U29 to U40.
to a lack of coordination compared to the more
effective and efficient practice in private medical Develop and expand the MLT profession to
and health laboratories. the Management and Professional Group
Poor retention of skilled and experienced MLTs, scheme to provide more efficient, fast, and
especially MLTs who have attended post basic/ effective service to clients in the MOH.
advanced diploma or technical training locally
and abroad. Strengthen the Science Officer Scheme in terms
There is a need to establish higher post U40, of expertise and promotion opportunities. It is
U38, U36 in each primary health division (state proposed to have the Medical Laboratory
health department), Tuberculosis/ Leprosy Science Officer Scheme to improve and upgrade
Control Programme, State Vector Control medical and health laboratory services and
Programme, all major and minor specialist provide career opportunities for MLTs and
hospitals, and district primary health. upgrade assistant scientist officers from diploma
There are no pathways or opportunities for MLTs to degree. This scheme has its own identity to
with a degree to hold Management and improve the quality of laboratory services, and
Professional Group positions in pathology there will be no loss of expertise and skills (no
services. brain drain). The benefits obtained in terms of
delivery of laboratory services are very crucial.
Principles
Current Achievement – Sustain/ Maintain
To sustain MLT’s involvement in research and
publication.
To sustain an advanced course for MLTs.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 211
To sustain short-term training programme To create more advanced diploma courses
including soft skill and technical for MLTs. such as an advanced course in an integrated
laboratory.
Existing issues that have not been solved – To remap existing posts for U36/U38 and U40
Reform at the state level and specialised facilities.
MLTs are insufficient to meet the increasing To create new U36/U38 and U40 posts at the
need for laboratory tests in hospitals, health state level.
clinics, and institutions. To create new U36/U38 and U40 posts under
Proposals to improve the MLTs scheme to blood transfusion activity.
establish graduate MLTs (Management and To optimise MLT with a multi-skills degree by
Professional Group) posts are still under study expanding sub-specialties.
by the authorities. To strengthen competency through structured
The creation of flexi post and other career competency module.
pathways to maintain the expertise,
experience, and knowledge of these MLTs in
pathology services.
New Issues – New Strategies
To extend the flexi post to different specialised
facilities such as National Blood Centre and
Hospital Kuala Lumpur.
MEDICAL LABORATORY TECHNOLOGY Conclusion : The strategic plan 2021 - 2025 for medical laboratory
technology is in line with the MOH’s vision to provide optimum laboratory
services to all. It covers a five (5) years plan with yearly reviews to reflect on
changes and updates in the profession’s priorities and initiatives. The support
from Pathology Service, Human Resource MOH, Allied Health Sciences
Division, and the Public Service Department (Jabatan Perkhidmatan Awam,
JPA) is expected to achieve targets in the implementation plan.
The strategic plan will be a road map for the profession to develop and
advance medical laboratory services in MOH.
212 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Detailed Implementation Plan for Medical Laboratory Technology
The allied health profession’s Detailed Implementation Plan (DIP) outlined in this Strategic Plan is divided into three (3) tiers
which are:
(A) Strategic Framework - Medical Programme
The activities/ indicators/ achievements will directly be monitored under the Head of Services, and the allied health
profession involved will report to their respective service in the Medical Programme/ Public Health Programme or other
relevant departments.
(B) Medical Framework - Allied Health Sciences Division
The activities/ indicators/ achievements will be monitored by AHSD, and then will report to the Medical Programme/
Public Health Programme or other relevant departments.
(C) Allied Health Sciences Division - Profession
The activites/ indicators/ achievements will be monitored by AHSD for internal report and discussion between AHSD and
allied health professions.
(A) Strategic Framework - Medical Programme
No Profession Strategy
(B) Medical Framework - Allied Health Sciences Division
Strategy 3: Enhance Capacity and Capability of Human Resource for Health
Main Implementation Plan No. 28: To ensure adequate supply of in-service competent medical personnel
Profession Activity Indicator Target
Implementation Plan
Appointment of contract MLT Numbers of contract MLT Minimum 2 person per
specialist hospital yearly
1. Ensure optimum number of Propose to extend the flexi Numbers of flexi posts created Minimum 5 flexi posts for
medical lab technologists post to different grades Percentage of posts remapped selected institutes & major
(MLT) to be made available Remapping of existing posts specialist hospitals by
2025
70% of selected major MEDICAL LABORATORY TECHNOLOGY
hospitals and selected
state health departments
by 2025
Main Implementation Plan No. 30: To advance clinical competencies of in-service competent medical personnel
Profession Activity Indicator Target
Implementation Plan
To provide advanced diploma/ Number of MLTs undergone training in 30 MLTs per session for
2. Enhance and strengthen post basic training specific module each specific module
competency and skills yearly
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 213
(C) Allied Health Sciences Division - Profession Medical Laboratory Technology
Profession Activity Indicator Target
Implementation Plan
1.Strengthen medical laboratory To identify the number of MLT Number of new MLT posts created in Minimum 2 posts by
technology services in state/ according to the highest grade state/ district Primary Health and also programme for each
district Primary Health/ required for each JKN, major included under the TB/ Leprosy facility by 2025
hospitals, including the TB/ specialist hospital, minor Control, State Vector Control Minimum 1 post at
Leprosy Control and State specialist hospital and health programme and transfusion services each KK Type I & II
Vector Control programme clinic, including transfusion by 2025
services
2.Establish MLT grade U41/ Create new posts for U41/U42 Number of MLT U41/U42 post
U42 in Primer Health at KK Type I & II established at health clinic type I & II
MEDICAL LABORATORY TECHNOLOGY
214 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
MEDICAL LABORATORY TECHNOLOGY
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 215
216 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
MEDICAL PHYSICS
MEDICAL PHYSICS
218 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce
MEDICAL PHYSICS
A general radiographic system was the first FORENSIC SCIENCEYear124
radiation device installed in Malaysia. In 1897, it
was placed in Hospital Taiping. In the meantime, 2020
both Hospital Kuala Lumpur (HKL) and Hospital HOSPITAL
Pulau Pinang received their first radiation
apparatus in 1910. INSTITUTION 42
Medical physics service began when the
Department of Radiotherapy & Oncology and Year 45MOH
Nuclear Medicine, HKL, installed a simple X-ray
machine (50kV) in 1955. Later in 1965, the 1960 HEADQUARTER
department received additional irradiation (300 kV 3HOSPITAL
orthovoltage) treatment machine. Total : 3 54STATE HEALTH
The first medical physicist to serve was at HKL in
1960, with only three (3) posts. Since then, the DEPARTMENT
medical physics profession has been growing in
both government and private sectors in Malaysia. Total : 265
The basic qualification to become a medical
physicist is at least a Bachelor’s Degree in Medical
Physics or any related physics field from local or
international institutions recognised by the Public
Services Department (Jabatan Perkhidmatan
Awam, JPA), Malaysia.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 219
MEDICAL PHYSICS Introduction Functions
Medical physics is the application of physics The roles and responsibilities of medical
concepts, theories and methods to medicine or physicists working in the Departments of
healthcare. Traditionally, medical physics deals Radiotherapy & Oncology, Nuclear Medicine,
chiefly with ionising or non-ionising radiation in the and Diagnostic Imaging are to provide excellent
diagnosis and treatment of diseases. Medical medical physics services to ensure patients are
physicists are professionals with education and diagnosed and treated effectively and safely using
specialist training that combines principles of ionising radiation at appropriate doses. The scope
physics with biology and medicine. The Ministry of of work includes generating patient computerised
Health (MOH) established the medical physics treatment plans, supervision and monitoring of
service in the 1950s. The service was created to radiation equipment (treatment and imaging
ensure safe, accurate and effective use of ionising equipment), conducting periodic quality
radiation for diagnostic and therapeutic purposes. assurance/ quality control (QA/QC) testing,
Medical physics service in the MOH is divided into develop and implementing departmental radiation
(2) two main services; clinical support services and safety programmes, measuring and analyse
regulatory body. Medical physicists are placed in patient dosimetry, manage the safety and security
the radiotherapy & oncology department, radiology of radioactive source, providing advice and
department and nuclear medicine department for expertise in medical physics.
clinical support services. Medical physics may be
classified into several sub-fields (specialities), Performance and Achievements
including Radiation Oncology Physics, Medical
Imaging Physics and Nuclear Medicine Physics. Enhancement of Service Delivery
At present, there are 265 medical physicist posts in Medical physics services are currently available at
MOH, of which 60 per cent are based in hospitals 32 state hospitals, including hospitals with
as clinical medical physicists. The remaining 40 specialists under MOH. Our service is focused on
per cent of posts are placed in the MOH strengthening the existing programmes in
headquarters and state health department as radiotherapy & oncology, nuclear medicine, and
regulatory body personnel. Their role is to regulate radiology. They are also enhancing service
the Atomic Energy Licensing Act 1984 (Act 304) for delivery through the utilisation of information
medical purposes. communication technology.
This strategic plan focuses mainly on clinical Workload
medical physics services in MOH hospitals. The number of services done by medical
physicists for the past three (3) years is as stated
in the table below (Table 35):
Table 35 : The Workload of Medical Physicists for Year 2019
Field Services Total Workload
Managing and monitoring of irradiating apparatus 793 machines
Radiology Managing and monitoring of radiation workers 3,376 workers
Radiotherapy Managing and monitoring of patient dose (CT Scan and 31,034 patients*
& Oncology Fluoroscopy)
Managing and monitoring of irradiating apparatus 32 machines
Managing and monitoring of radiation workers 461 workers
Managing and generating Patient Treatment Planning 11,655 cases
Nuclear Managing and monitoring of irradiating apparatus 13 machines
Medicine Managing and monitoring of radiation workers 291 workers
Managing and monitoring of radioiodine patient 2,676 patients
*Data from Medical Radiation Surveillance Division (BKRP) for the year 2019
220 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Research/ Innovation/ Publication/ Presentation Human Resource Capability and Competency MEDICAL PHYSICS
Medical physicist actively involved in innovation Lack of trained staff in the radiology department
and has successfully participated as finalist in leads to low-quality services. To improve capability
Anugerah Inovasi Kebangsaan KKM, 2018 with and competency, newly appointed staff shall have
the project ‘Smart Shield’. in-house training. A short course or attachment is
In 2017, the medical physicist was awarded planned to address these issues.
second runner-up in Karnival Inovasi BSKB, Adequacy and Optimisation of Health
with ‘Lead Tunnel’. Resources
Training Lack of Clinical Supervision and Test Equipment
Currently, a total of 75 medical physicists has a Newly appointed officers who work alone,
master’s degree and six (6) medical physicists especially in physics radiology, have very
have a PhD. minimal supervision. Although there is a training
Specialised training with International Atomic module in place, the implementation is
Energy Agency (IAEA): four (4) officers completed ineffective due to the absence of supervision.
the training programmes in Radiotherapy Oncology Therefore, officers received insufficient training
for Medical Physicist (ROMP), and one (1) officer and a lack of clinical skills to perform duty. There
completed the training programme for Diagnostic is also inadequate equipment in some radiology
Radiology for Medical Physicist (DRMP). centres.
The ongoing programme involves 11 officers, Optimisation of Resources in Radiology
which are seven (7) residents in ROMP, three (3) Physics Services
residents in DRMP and one (1) resident in Nuclear All MOH hospitals have radiology departments
Medicine for Medical Physicist (NMMP). to provide clinical support services. Currently,
Recognition/ Achievements 31 hospitals are equipped with in-house
As of March 2019, two (2) medical physicists have physicists at their radiology departments.
been recognised by the JPA as: However, there are still 12 hospitals with a total
of 159 irradiating apparatus that need medical
Subject Matter Expert (SME) of Radiotherapy radiation protection surveillance. Therefore,
Physics. medical physicists from cluster hospitals are
Subject Matter Expert (SME) of Radiology suggested to provide medical physics services
Physics. to related hospitals to overcome this issue.
However, due to an insufficient workforce, this
Issues and Challenges will not be easy to do.
Class H consultants handle current practice in
Enhancement in Service Delivery through performing QC tests in radiology departments.
Technology Hence, this impacts the development of skills
All radiotherapy centres are fully equipped with and expertise among in-house medical
Oncology Information System (OIS). However, the physicists due to limited resources to
systems are not fully utilised by users in terms of independently perform QC tests of irradiating
data statistics collection. apparatus in radiology services.
Patient dosage data is currently analysed
manually in radiology. This requires much time for Way Forward
data collection and analysis due to a huge number
of patients. A more accessible method needs to be Philosophy
introduced to monitor patient dose more In line with MOH’s Vision and Mission, medical
effectively. physics services strive to provide safe and
effective service delivery to the nation through
ensuring safe use of radiation in radiology,
radiotherapy and nuclear medicine for patients,
staff, and the public.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 221
MEDICAL PHYSICS Towards achieving this, practices are ensured to Existing Issues That Have Not Been Solved -
comply with the Atomic Energy Licensing Act 1984 Reform
(Act 304) and its subsidiary regulations. Also, No in-house medical physicists perform annual
Standard Operating Procedures (SOPs) are QC tests on irradiating apparatus in the
aligned with international agencies’ guidelines and radiology department. As a result, reformation is
technical documents, i.e., IAEA, United Nations required to strengthen radiology physics
Scientific Committee on the Effects of Atomic services in MOH hospitals by optimising the use
Radiation (UNSCEAR). of test tools by in-house physicists and lowering
Principles the cost of outsourcing expertise (Class H
consultant).
Current Achievement - Sustain/ Maintain New Issues - New Strategies
To improve the number of SMEs in radiology, Patient dose data collection and analysis
radiotherapy, and nuclear medicine. requires much time due to a huge number of
patients. Thus, patient dose analysis software is
To sustain the ongoing international needed in hospitals’ radiology departments.
collaboration training programme, ROMP,
NMMP and DRMP.
To improve the number of officers with
master’s qualification.
To enhance the usage of OIS in all
radiotherapy departments for physics
services.
Conclusion : The requirement of a medical physics position is crucial in
ensuring the use of radiation in the medical field is safe and does not affect the
quality of service. To holistically deliver excellence in the healthcare system,
the rapid development of advanced irradiating apparatus requires further
improvements in medical physics services.
222 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Detailed Implementation Plan for Medical Physics MEDICAL PHYSICS
The allied health profession’s Detailed Implementation Plan (DIP) outlined in this Strategic Plan is divided into three (3) tiers
which are:
(A) Strategic Framework - Medical Programme
The activities/ indicators/ achievements will directly be monitored under the Head of Services, and the allied health
profession involved will report to their respective service in the Medical Programme/ Public Health Programme or other
relevant departments.
(B) Medical Framework - Allied Health Sciences Division
The activities/ indicators/ achievements will be monitored by AHSD, and then will report to the Medical Programme/
Public Health Programme or other relevant departments.
(C) Allied Health Sciences Division - Profession
The activites/ indicators/ achievements will be monitored by AHSD for internal report and discussion between AHSD and
allied health professions.
(A) Strategic Framework - Medical Programme
No Profession Strategy
(B) Medical Framework - Allied Health Sciences Division
Strategy 2: Optimise resource management including facility, equipment and financing
Main Implementation Plan No. 22 :
To optimise utilisation of existing underutilised/ unused facilities via Hospital Cluster platform
Profession Activity Indicator Target
Implementation Plan
1. Optimise human resource To integrate radiology physics Number of clusters with radiology 5 clusters by 2025
usage within cluster hospital services services
2. Optimise usage of test tools To mobilise the test tools to Percentage of QC test conducted by 25% yearly
for QC by in-house physicists hospitals without the facility via in-house physicists
cluster hospitals
Strategy 3: Enhance capacity and capability of human resource for health
Main Implementation Plan No. 28: To ensure adequate supply of in-service competent medical personnel
Profession Activity Indicator Target
Implementation Plan
Number of newly appointed officers Minimum 2 person per
3. Ensure adequacy of medical To appoint medical physicists profession per specialist
physicists in MOH facilities on contract basis hospital by 2025
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 223
MEDICAL PHYSICS Main Implementation Plan No. 30: To advance clinical competencies of in-service medical personnel
Profession Activity Indicator Target
Implementation Plan
4. Enhance capacity and To provide medical physicists Number of officers undergoing 10 officers yearly
capability of newly appointed with coaching/ attachment at coaching/ attachment 20 by 2025
medical physicists appointed centres Number of trained officers
To conduct training in
collaboration with international
agencies, i.e., International
Atomic Energy Agency (IAEA)
(C) Allied Health Sciences Division - Profession Medical Physics
Profession Activity Indicator TarTgaertget
Implementation Plan
To expand and monitor the Minimum 5 guidelines
1. Enhance radiotherapy implementation of Oncology completed by 2025
physics services Information System (OIS) in Percentage per facilities implemented OIS 50% by 2025
radiotherapy physics services
2. Improving radiation nationally Paperwork endorsed At least 2 genetic
protection To prepare paperwork for dose laboratories by 2025
analysis software procurement
for Hospital IT By 2022
Introduce patient dose analysis Number of hospitals analyse data using SSRRuueebbss5oommhuuiiossrrccssseeiipoossinntaDDttlsooiivvbiiHHssyiiuuoo2mmnn0aa2nn5
software in hospitals’ radiology software MMOOHH bbyy 22002233
department
224 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
MEDICAL PHYSICS
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 225
226 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
MEDICAL RECORD
MEMDIECDIALCARLERCEOCRODRD
228 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Background Workforce
Medical record service was developed in 1985 in Year 405
government hospitals, where the first group of
pioneers, consisting of grade C9 medical 2020
assistants, were offered as assistant medical
records officers grade B11. Since then, this HOSPITAL
profession has been established in the Ministry of
Health Malaysia (MOH) headquarters, state health INSTITUTION 26
departments, hospitals, special medical institutions,
and several district health offices. MOH 25
In 1986, the position was offered to diploma and HEADQUARTER
higher education certificate holders, and
subsequently, they were placed under the grade STATE HEALTH 44
B11 Assistant Medical Record Officer Scheme. DEPARTMENT 2
The scheme was classified as a closed-door DISTRICT
service by MOH with the title of assistant HEALTH OFFICE
administrative officer (medical record) grade N6
when the New Remuneration System (Sistem Year PUBLIC HEALTH 1 MEDICAL RECORD
Saraan Baru, SSB) was implemented. The LABORATORY 1
management and professional position of 1985 NATIONAL
administrative officer (medical record) N41 was BLOOD CENTRE
established on 1 Aug 2005. Total:
The following is a list of the functions by this No data recorded Total: 504
profession:
Management of Patient Medical Records.
Medical Report Management.
Management of the Medical Board.
Health Statistic Management.
Communication and Collaboration.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 229
MEDICAL RECORD Introduction Established one (1) centralised storage of
medical records in Johor.
Medical record service is a clinical support service Achieved target in the timeliness of medical
in the MOH. Medical records officer and assistant report prepared within the stipulated time
medical records officer are the two (2) schemes (91.4% from target 90%: 236,799/ 59,250) for
that made up this profession. The main purpose is 2019.
to contribute to the quality of patient care through Achieved target in despatching medical records
the development and maintenance of a within 72 hours after patient discharge (93.74%
comprehensive centralised medical records from target 95%: 2,417,445/ 2,576,698) for
management system. 2019.
System utilisation of Sistem Maklumat Rawatan
Functions Pelanggan (SMRP) for 2019:
Medical record officers are responsible for In-patient : 95.47 per cent (Total Discharges:
maintaining and securing all written and electronic 2,662,821/ 2,789,128).
medical records, management of medical reports, Day care : 83.22 per cent (Total Discharges:
medical boards, health statistics information and 1,534,916/ 1,844,373).
casemix system. They are also responsible for
making coding decisions for diagnosis and System utilisation of casemix:
procedures using the International Statistical Casemix : 81.4 per cent (Total cases: 1,205,024/
Classification of Disease (ICD). 1,479,647) for 2018 (data for 2019 not available).
Performance and Achievements Workload/ Census
Table 36 shows the workloads of medical record
Enhancement of Service Delivery officers and assistant medical record officer for the
Medical records services already achieved a few of past three (3) years.
the profession’s goals:
Developed number of skilled coders:
Level 1 : 76 officers.
Level 2 (expert coders) : 3 officers.
Table 36 : The Workloads of Medical Record Officers and
Assistant Medical Record Officer in the Year 2017 - 2019
Year 2017 2018 2019
2,723,972
Number of medical records 2,605,595 2,729,323 259,250
(based on admission) Not Applicable Not Applicable
Number of medical reports processed 1,621
(based on application) 1,340 1,474
Number of medical board processed
(based on application)
Research/ Innovation/ Publication/ Presentation Training
Participated in a poster exhibition titled ‘A Study Medical record officer (degree as entry-level)
to Identify the Need to Create a Psychiatric RPP Master’s : 6
Digitisation System’ at the 12th Allied Health Assistant medical record officer (certificate/
Scientific Conference 2018. diploma as entry-level)
Finalist in innovation competition Johor state for Degree : 156
Sistem Permohonan Laporan Perubatan (eLP)
year 2018. Master’s : 7
230 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
Issues and Challenges Principles MEDICAL RECORD
Current Achievement - Sustain/Maintain
Human Resource Capability and Competency Increase more number of skilled coders in
Lack of human resources for ICD coding. levels 1 and 2 (expert coders).
No appropriate and suitable training for human Develop more state record-keeping centres at
resource development. Terengganu and Perak.
Adequacy and Optimisation of Health Existing issues that have not been solved -
Resources Reform
Limited storage space for records keeping. Limited storage space.
Unstandardised system in medical records Lack of training.
services within all health facilities in Malaysia. Lack of Manpower.
Strengthen/ Enhance Career Pathway Unstandardised system.
No Subject Matter Expert (SME) for ICD coder.
New Issues - New Strategies
Way Forward Outsourcing services for ICD coding.
To build a record-keeping centre for each
Philosophy state.
The medical record service is one of the factors To develop a standard system for medical
that must be strengthened for better health record use in all facilities.
services across the country, according to the Enhance the workforce development
MOH’s 2016 - 2020 Strategic Plan; Second programme.
Strategic Pillar, to improve governance, health
system, and organisational capacity. The service
can be more effective and efficient in providing
safe and accessible medical records by focusing
on the quality of medical records personnel and
equipping them with good skills.
Conclusion : Medical record profession is determined to successfully
implement the strategic plan. To achieve this, full support from the relevant
stakeholders is very much needed. The medical record career path can be
improved with enough human resources and training to develop experienced
and highly qualified individuals. In addition, the quality of the medical records
system shall be improved, which will enhance the quality of healthcare service
nationwide. These initiatives can be extended to other programmes within the
MOH as there is a high demand for services.
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 231
MEDICAL RECORD Detailed Implementation Plan for Medical Record
The allied health profession’s Detailed Implementation Plan (DIP) outlined in this Strategic Plan is divided into three (3) tiers
which are:
(A) Strategic Framework - Medical Programme
The activities/ indicators/ achievements will directly be monitored under the Head of Services, and the allied health
profession involved will report to their respective service in the Medical Programme/ Public Health Programme or other
relevant departments.
(B) Medical Framework - Allied Health Sciences Division
The activities/ indicators/ achievements will be monitored by AHSD, and then will report to the Medical Programme/
Public Health Programme or other relevant departments.
(C) Allied Health Sciences Division - Profession
The activites/ indicators/ achievements will be monitored by AHSD for internal report and discussion between AHSD and
allied health professions.
(A) Strategic Framework - Medical Programme
Strategy 6: Leverage the Use of Information Technology to Improve Efficiency
Main Implementation Plan No. 56: To Enhance Quality and Standard of Care Through Use of Technology
Profession Activity Indicator Target
Implementation Plan
To develop in-house Percentage of hospitals without IT 60% of manual hospitals
1. Develop standard system standardised system with System establish Medical Records (Hospitals with no IT
for medical records in all cooperation from Information Management System System) by 2024
facilities Management Division, MOH Percentage of hospitals without IT 60% of all manual
System establish Medical Reports hospitals (Hospitals with
Management System no IT System) by 2025
232 Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025
(B) Medical Framework - Allied Health Sciences Division
Strategy 3: Enhance Capacity and Capability of Human Resource for Health
Main Implementation Plan No. 28: To Ensure Adequate Supply of In-service Competent Medical Personnel
Profession Activity Indicator Target
Implementation Plan
1. Optimise resource Appointment of contract/ Numbers of contract/ sessional ICD Minimum 2 persons by
management (Human sessional officers coders appointed per specialist 2023
Resource) hospital
Main Implementation Plan No. 30: To Advance Clinical Competencies of In-service Medical Personnel MEDICAL RECORD
Profession Activity Indicator Target
Implementation Plan
2. Develop competent, To engage with public Number of agencies or inter-agency Number of agencies/
knowledge base, creative institutions of higher learning collaborations collaboration
and innovative workforce for collaborations in human
capital training development
(i.e., UiTM and UKM)
Main Implementation Plan No. 33: To improve career pathway for medical personnel
Profession Activity Indicator Target
Implementation Plan
Appoint Subject Matter Expert Number of expert coders appointed 30 by 2024
3. Enhance the workforce (SME) in medical records Number of coders been trained 146 medical record
development programme services with smart partnership Number training modules officers by 2024
with other agencies or 1 training module by
countries for coding ICD 2022
(C) Allied Health Sciences Division - Profession Medical Record
Profession Activity Indicator Target
Implementation Plan
2 centres at Terengganu
1. Build records keeping centre/ To identify unused premises for Number of record-keeping centres and Perak by 2024
infrastructure at each state records storage purposes built
Strategic Plan of the Allied Health Sciences Division and Allied Health Professions Ministry of Health Malaysia 2021 – 2025 233
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