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A Nation Connected: Unifying Healthcare Data in Malaysia

A New Era of Healthcare in Malaysia

With a population of 34.2 million, Malaysia has long prioritized digital health as a national imperative. As part of its Vision 2020 strategy to become a self-sustaining, high-income nation, the Ministry of Health (MOH) is modernizing healthcare delivery through digitization, data interoperability, and system-wide integration—from the individual patient level to population-wide planning. The MOH is responsible for overseeing health services across public hospitals, clinics, and digital infrastructure. A key part of their modernization strategy is the use of international standards such as FHIR® (Fast Healthcare Interoperability Resources). 

About MHNexus

MHNexus is a key implementation partner for Malaysia’s digital health transformation. In 2022, they were mandated by the MOH to implement and manage a national FHIR-based Health Information Exchange (HIE). MHNexus selected Smile Digital Health for its FHIR-native architecture, scalable design, and proven ease of implementation.

About Smile Digital Health

Smile Digital Health is a global leader in HL7® FHIR and health technology implementations. Smile’s FHIR-native Health Data Platform is backed by pioneering in-house, open standards expertise. The team at Smile leads, and maintains HAPI FHIR, CQF‑Ruler and contributes to over 31 Technical Working Groups. The Smile Health Data Platform is a solution that unifies health data for interoperability, analytics, and digital health innovation.

Overview

Over a course of only 2 years (from 2022 up to 2024), MHNexus built 3 solutions on the Smile Health Data Platform:
  • National HIE Platform – enabling secure, standardized exchange of health information across healthcare facilities.
  • Practitioner Portal (RekodPesakit ‘Patient Record) – allowing authorized healthcare professionals to access patient records from the HIE.
  • Patient Portal & Mobile App (RekodSaya ‘My Record’) – enabling individuals to view and manage their own health records.

Each of these cloud applications uses the Health Data Platform as a unified data repository due to its completeness, versatility, and scale, significantly reducing time to market.

The initial phase was piloted at the state-level in Negeri Sembilan, with the potential for nationwide expansion. The HIE currently enables real-time exchange of clinical and administrative records between diverse systems.

The Challenges

Malaysia’s healthcare modernization journey faces pressures at both the federal and state levels, amplified by population health trends and rising service demands.

Federal-Level Challenges

1. Equitable Resource Allocation and Data Gaps Uneven digital maturity across healthcare facilities makes it challenging for the MOH to maintain a complete and accurate picture of national health. Data from facilities is often inconsistent, non-standardized, or incomplete, especially from areas with limited IT capability. These blind spots hinder accurate planning and budgeting, leading to over-resourcing in some areas and shortages in others.
2. Increasing Burden on the Health System The healthcare system is under growing strain from an aging population and a sharp rise in chronic conditions such as diabetes, hypertension, and cardiovascular disease. The increased demand for health services drives utilization up, inflates insurance premiums, and increases overall costs, resulting in a cycle of financial and operational stress that threatens long-term sustainability.
3. Limited Insight for Preventive Health Strategy Fragmented and siloed national health data limits the ability to generate timely, accurate insights on disease patterns and risk factors. Without clean (high-quality), integrated datasets, it has been a  challenge to proactively identify emerging public health threats and design targeted prevention programs that could reduce admissions, slow disease progression, and ease the burden on facilities.

State-Level Challenges

1. Limited Cross-Facility Coordination Without a shared, interoperable data backbone, facilities operate in silos with each maintaining its own systems, infrastructure, and workflows. This leads to inconsistent processes, duplicated technical investments, and a lack of coordination that delays treatment and compromises quality of care. 
2. Duplicated and Disconnected Records Siloed on-premise systems are often incompatible with each other and result in fragmented health histories scattered across multiple records. The growing use of patient-led mobile health apps that are often disconnected from clinical systems further compounds duplication, making it harder for clinicians to build a complete view of a patient’s medical history.
3. Variable Digital Readiness Across Facilities Some facilities have modern IT systems and trained staff, while others still rely on paper-based workflows or outdated infrastructure. This uneven readiness slows rollout timelines, creates integration bottlenecks, and means the benefits of digital health solutions are not realized uniformly across the state.
4. Inconsistent Data Capture and Coding Standards The lack of standardized clinical terminology creates significant interoperability issues across healthcare systems. Without a unified approach to recording, coding, and updating patient information, data becomes inconsistent or incompatible. This often leads to mismatches or errors when sharing information, requiring manual reconciliation and delaying critical decision-making.
5. Limited Change Management and User Adoption Technology upgrades alone do not ensure adoption. Without adequate training, ongoing support, and structured change management, clinical and administrative staff often revert to legacy processes. Resistance is often heightened by concerns over increased workload during the transition phase.

The Smile Way: A FHIR-Native Health Data Platform

To address the challenges facing Malaysia’s healthcare system, the Ministry of Health (MOH) and MHNexus partnered with Smile Digital Health to establish a unified, standards-based foundation (the Smile Health Data Platform to enable seamless interoperability across systems and supports scalable deployment at both state and national levels.

At the Federal Level

Number of public linked to the FHIR-based HIE over the 2 years.

156
Nation-wide Health Data Platform Smile’s FHIR-native engine unifies data from diverse systems into a single, secure source of truth. This standardization improves planning, budgeting, and equitable resource allocation by enabling national-level oversight. Over half the public hospitals in Malaysia are now integrated with the Smile Health Data Platform. 
Scalability and Digitization The high-speed digitization of records, processing over 255,000 transactions per second, operates at scale while also integrating with existing systems; this reduces workflow disruptions and streamlined processes. As a result, duplicate tests and unnecessary procedures were minimized, thereby lowering health delivery costs and pressure on rising insurance premiums.
Cross-Border Readiness with IPS and Clinical Intelligence The ability to generate International Patient Summaries (IPS) and provide embedded Clinical Decision Support (CDS) ensures Malaysians, including outbound travellers such as Hajj pilgrims, can have timely, structured access to their records. This closes a critical gap in preventive and population health management by enabling continuity of care for Malaysians - at home and abroad.
Holistic Analytics and Real-Time Dashboards With continuous data contributions from all facilities, the Health Data Platform enables advanced analytics and real-time dashboards. Policymakers can track trends, measure program impact, and allocate resources more effectively, down to the community level.

At the State Level - the Negeri Sembilan Pilot

1.4 Million Number of registered patients
1,000+ Number of clinicians with daily interactions

The Negeri Sembilan pilot was a successful model for rapid adoption and meaningful use. It achieved strong engagement from clinics, hospitals, practitioners, and patients alike.

The HIE now holds accessible and secure patients records in the FHIR format from national systems, including:

  • Medical Programme Information System (MIPS), the MOH hospital management system

  • Pharmacy Information System (PhIS), the MOH pharmacy system

  • Blood Bank Information System v2 (BBISv2), the MOH blood bank lab system

  • MySejahtera, the MOH mobile patient application

The Negeri Sembilan pilot was a successful model for rapid adoption and meaningful use. It achieved strong engagement from clinics, hospitals, practitioners, and patients alike. The high adoption within just 2 years of the pilot, and continued use today is driven by:

Collaborative Implementation
Close coordination with MHNexus, state health authorities, regulators, hospitals, and technology partners improved cross-facility coordination, ensuring a consistent approach to care and data sharing.

Tailored Local Strategies
Implementation aligned with existing workflows and local regulations which reduced resistance to change, and improved user adoption.

Impact Felt at the Points-of-Care
The impact of the pilot was visible where it matters most, at the points-of-care. Accessible, interoperable records gave clinicians timely access to patient data, reducing duplication and fragmentation. Operational dashboards which supported daily forecasting and transfer workflows, empowered clinicians and lowered manual burdens. 

The Next Phase of Evolution

With the technical foundation of Smile’s Health Data Platform in place, Malaysia is now positioned to unlock a new generation of healthcare capabilities, including but not limited to:

  • Lower Healthcare Delivery Costs Across Systems and States

  • Higher Patient Engagement and Ownership of Health Data

  • Better Outcomes from Care Coordination, Reduced Disparities Across Communities

  • Nation-wide Virtual Care Enablement for Under-served Communities

  • Integration with Insurance Functions to Streamline Coverage and Claims

Additional projects that enrich the health data set and move Malaysia towards value-based care include:

Value Exchange Integrated Networks (VEINS) 
Built on the existing HIE, MHNexus has developed a commercial version called VEINS, which is scheduled for deployment in September 2025 to support the Institut Jantung Negara (IJN).  IJN, Malaysia’s national cardiac centre, requires a streamlined method to discharge stable patients back to their initial referring MOH facilities. Through VEINS, this care transition workflow will be digitized, enabling secure information exchange and allowing the receiving MOH facility to be pre-booked for the patient’s continued care.

Smarter Public Health Monitoring
Real-time analytics and centralized reporting can now be run on clean, complete, and comprehensive data. The Electronic National Centre for Disease Control (eNCDC) is already planning to leverage the HIE platform for next-generation monitoring and response tools. This enables more precise responses to public health trends, and sets the stage for advanced disease surveillance capabilities. 


The Smile Health Data Platform is the FHIR-first Engine Behind Malaysia’s Health IT Modernization.

Talk to us about building your data strategy for interoperable, connected care.