Published by Hospital Management Asia

IJN CEO, Prof. Dato’ Sri Dr. Mohamed Ezani Md Taib, outlines how IJN is expanding capacity, leveraging digital innovation, and boosting preventive care to meet surging cardiac care needs Malaysia’s Institut Jantung Negara (also known as National Heart Institute, and IJN for short) has sounded the alarm on the country’s rapid rise in heart disease. In 2019, ischaemic heart disease (also known as coronary heart disease) accounted for 15% of all deaths, or a total of 16,374 deaths. By 2023, this figure has risen to 29,741 deaths. As Malaysia’s premier cardiovascular centre, IJN has seen patient loads rising in tandem. In 2024, the 437-bed facility handled approximately 320,000 patient visits and 18,000 admissions, with over 4,500 cardiothoracic surgeries conducted (a 1.9% increase year-on-year). Besides the rising number of patients, IJN CEO Prof. Dato’ Sri Dr. Mohamed Ezani Md Taib highlighted a concerning shift in patient demographics.

“In the 1990s and early 2000s, around 40% of adult surgeries were heart valve surgeries for rheumatic heart disease caused by rheumatic fever. However, these cases have declined significantly over the years. Today, the majority of our cases are coronary heart disease, where plaque or fatty deposits cause artery blockage,” he said. Furthermore, “the patients we saw 20 years ago were usually above 60 years old. Now, we’re seeing some as young as 30.” According to a 2019 study, the average age of CVD patients in Malaysia was between 56-59 years, as compared to 63-68 years in advanced countries. Almost 1 in 4 patients were aged below 50 years old.

Ramping up cardiovascular care capacity

To meet rising demand for cardiac care, IJN has embarked on a two-phase expansion project at its facility in Klang Valley. Phase 1 involved adding a new kitchen, childcare facilities for staff members, and expanding the patient care park. Phase 2 will see the outdoor carpark converted into several buildings housing between 150 to 200 new beds, additional ICUs, operating theatres, cath labs and imaging centres, essentially ‘replicating (the existing) IJN in a new block’, said Dr Ezani. Construction is set to start by late-2025 or early-2026. There are also plans to extend its reach to other parts of Malaysia to bridge the gap in advanced cardiac care, with talks ongoing for potential openings in Penang, Borneo (Sabah, Sarawak), and Johor. Manpower will be the key challenge here, Dr Ezani noted. IJN will need to recruit more healthcare staff – including oncology specialist doctors and nurses – to staff these new centres, while contending with growing competition from other players.

“There’s a huge market for cardiac care in the country, and we know other healthcare providers want to develop their own cardiac centres. The problem is, of course, the lack of qualified manpower, which means they may turn to IJN staff,” he said.

He has identified IJN’s education arm, the IJN College, as the key to ensuring a reliable, long-term pipeline of skilled healthcare workers. The college offers a range of cardiac specialty courses, such as advanced diplomas in cardiac nursing and cardiac emergency, and graduate certification in cardiovascular and thoracic science. It is set to be approved as a full-fledged university college by this year, with a wider range of courses – from post-graduate courses to specialty courses in renal, respiratory medicine and more – in the works.

Electronic Medical Records system at IJN boosting efficiency and safety

In December 2024, IJN set a groundbreaking precedent as the first hospital in Malaysia to achieve Stage 6 EMRAM (Electronic Medical Record Adoption Model) validation. EMRAM is an established model assessing the maturity of EMR from Stage 0(lowest) to 7 (highest), developed by Healthcare Information and Management Systems Society (HIMSS).  With this milestone, IJN joins the ranks of select hospitals in the region, such as Singapore’s Khoo Teck Puat Hospital, Indonesia’s Kasih Ibu Hospital, and Taiwan’s Chung-Ho Memorial Hospital, who have demonstrated ‘advanced data exchange and interoperability’ in their EMR.

IJN’s digital transformation is even more impressive considering the speed at which it was achieved. In just over a year, IJN transitioned from a partially digitised system—featuring PACS (Picture archiving and communication system), CPOE (Computerized Provider Order Entry) for outpatient medication orders, and a basic EMR limited to certain departments—to a nearly fully automated EMR. This advanced system is now supported by real-time medical device integration, closed-loop medication administration, and clinical decision support. “It is an incredible effort from the team, to have made this remarkable journey within a very short period of time. It was definitely not easy, but they made it happen,” he shared. The project’s success was also driven by strong support from management, including investments into new equipment and hardware designed for integration with the digital systems. So far, these efforts have paid off, with efficiency drastically improving along the replacing of manual processes with digital ones.

The advanced EMR has also helped enhance patient safety by minimising human errors, streamlining clinical workflows, and enabling real-time data access for better decision-making. For example, iBlood, IJN’s closed-loop system for blood product administration, has cut blood transfusion errors to zero. The hospital is also working on several other technology projects, including AI-powered analysis of chest images, a patient mobile app, and remote monitoring of blood pressure.

Strengthening CVD prevention efforts

Preventive care is also a top priority, Dr Ezani emphasised. Risk factors of CVD, such as hypertension, hypercholesterolemia and obesity, have been increasingly prevalent in Malaysia. Notably, obesity rates among children under 18 surged from 6.1% in 2011 to 14.8% in 2019. To strengthen preventive care capabilities, IJN has trained several specialists in preventive cardiology management. In addition, it conducts free health screenings throughout the country. Dr Ezani estimates that over the last 10 years, around 60,000 free screenings have been conducted in over 170 locations in Malaysia, including remote islands. Travelling on mobile clinics equipped with ECG and ultrasound machines, staff help screen the local population for common conditions such as hypertension and diabetes as well as heart disease. Talks to raise public education and awareness around heart disease are also held on-site.

“Constant education is important. We need to educate people on the consequences of failing to manage their heart health. We show them photos of people who had surgery, people on dialysis, so that leaves an impression on them,” Dr Ezani explained.

“The younger generation are more concerned about their health and have been more receptive to the education, so that is a good sign for the future.” Meanwhile, the hospital is also collaborating with the Ministry of Health to set up cardiovascular risk reduction clinics, with IJN as the pilot location. “Without proper interventions, people with early diabetes will go on to develop complications whether in the heart, kidney or brain,” Dr Ezani explained.

“The idea (of these clinics) is to help these patients, identified to be at higher risk, better manage their condition and reduce their risk of CVD. Different from other clinics, patients at these risk reduction clinics will be holistically managed by a team comprising of a doctor, dietician, physiotherapist and pharmacist.

“That’s a key strategy we are adopting, because it is not sustainable for the country and the people if we do not take steps to change the status quo. We need to help the current and the future generations better understand the disease and adopt a healthier lifestyle.”