Sunday, April 02, 2006

National Cardiovascular Disease Database (NCVD)

The National Heart Association of Malaysia (NHAM) is meeting this weekend at the KL Hilton. The STAR carried a report on the launching of the NCVD by the NHAM. This database is long overdue. It should have been set up earlier and the Ministry of Health or the deaprtment of statistics should have shown some leadership in this area. However, better late then never.

That it has been launched does not necessarily mean that it will achieve its lofty objectives. I certainly hope it does, as we need it. We need a database on Cardiovascular Disease (CVD) in Malaysia. When we teach, we now rely on databases from first world countries. Databases, where the culture and standard of living is very different, that may not reflect the situation here.

A few concerns exist. Firstly, who will provide data? I am certain that the government hospitals will cooperate and be very forthcoming in helping the NCVD, but the weakness again is the private hospitals, as the NCVD is voluntary at the moment. Perhaps one could consider the IJN a private heart center and I am sure that they can be convinced to co-operate. As for the rest, the fully private hospitals without any government links, they may need some coaxing. These hospitals guard their patient information and management information very jealously due to many fears. Among these are the fear of being challenged, the fear of competitors analyzing their workload, the fear of patient confidentiality being compromised, and so on.

Managment of the database is another issue. That this project is under the NHAM adds to the problem. The NHAM carries their own baggage, not least of which is the heavy politics happening in the NHAM. The NHAM being "GP heavy" may have diffculty commanding the confidence of the cardiology community, whether in public health or private practice.

Also, if we are called upon to contribute data then it is important to ask at the outset who has the right to the database? Are we to contribute now and have no access later? Or will we have to put our hats in our hands and ask for a small helping like young Oliver Twist?

Not so long ago, they also tried to keep a registry of angiogram and angioplasty procedure in the country with very limited success. I wish the NCVD all the best as it is a move in the right direction. Launching it with a bang is one thing but hopefully, with all apologies to Elliot, it will not end in a whimper.

No comments: