The evolution of healthcare digitalisation policies in Malaysia: A four-decade narrative review (1985-2025)

This study examines Malaysia's healthcare digitalisation policies from 1985 to 2025 and their impact on the country's dual public-private healthcare system. Through a narrative review of policy documents, reports, and statistics from authorities and verified industry news as well as peer-reviewed publications, the study compares Malaysia's experience with selected developed nations (Sweden, Denmark, United Kingdom, and Estonia). Despite initialising its digitalisation agenda in the 1990s alongside these nations, the Malaysian public healthcare sector shows limited implementation with only 24% of public hospitals equipped with hospital information system (HIS) and only 7% of health clinics were equipped with clinical information system by 2019. In contrast, the private sector, which is driven by market forces, demonstrates a higher capacity of digital solution adoption. The growth of health technology companies providing various digital services such as virtual services, e-prescription, and medication delivery is fundamentally reimagining and transforming healthcare delivery models by providing disruptive digital healthcare services. However, regulatory uncertainty remains as a significant barrier to comprehensive digital transformation. Though regulatory sandboxes may provide an innovative solution to these regulatory challenges, the need for a more comprehensive and permanent regulatory framework remains. This study reveals how government policies and healthcare system structure influence digitalisation outcome and demonstrates the importance of policy and governance in shaping the digital health ecosystem, offering valuable insights for countries with a similar dual healthcare system.