Institut Jantung Negara Achieves HIMSS EMRAM Stage 7, Reducing ICU Mortality to 2.1%

Institut Jantung Negara (National Heart Institute), Malaysia's largest cardiac hospital with 433 beds and over 300,000 annual outpatients, has achieved the country's first HIMSS Electronic Medical Record Adoption Model Stage 7 validation. The journey to Stage 7 required formalizing core modules into dedicated subcommittees under the Information Management Committee, with each led by a clinician and supported by subject matter experts and IT leads. Key digital implementations included closed-loop medication management, real-time medical device data capture, improved data sharing via health information exchange, and the IJNCare mobile platform for patient engagement. A major focus was improving operating theatre and ICU efficiency using digital infrastructure. In 2021, the hospital's operating theatre had a 7.6% surgery cancellation rate due to unavailable ICU beds caused by prolonged patient stays and preventable infections. The hospital implemented structured EMR capture and integrated data repositories through a central data mart combining records from the hospital information system, critical care information system, and clinical databases. Dashboards built with Microsoft Power BI enabled tracking of trends, case drilling, and executive scorecards. By 2025, surgery cancellations fell from 7.6% to 3.9%, with cancellations specifically due to unavailable ICU beds dropping from 3.4% to 0.1%. Ventilator-associated pneumonia decreased from 1.7 to 1.0 per 1,000 ventilator days, and catheter-related bloodstream infections fell from 3.8 to 1.7 per 1,000 line days. Average ICU length of stay reduced from 3.7 days to 2.8 days. ICU mortality dropped from 7.4% in 2021 to 2.1% in 2025. Medication errors reaching patients declined from 3.1 to 2.8 per 100,000 orders. The shift to a fully paperless environment reduced costs and administrative burden. The hospital is now focused on sustainability, optimization, and value realization, prioritizing advanced analytics and AI enablement.