SPE-185248-MS

Smart Strategy to Face New Norms: Efficient Management of Medical Data,

Health Performance Analysis and Monitoring.

Zulkifli Mohamad Yunus, PETRONAS

Copyright 2017, Society of Petroleum Engineers

This paper was prepared for presentation at the SPE Asia Pacific Health, Safety, Security, Environment and Social Responsibility Conference held in Kuala Lumpur,
Malaysia, 4–6 April 2017.

This paper was selected for presentation by an SPE program committee following review of information contained in an abstract submitted by the author(s). Contents
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Abstract
"Smart" Strategy to Face New Norms: Efficient Management of Medical Data, Health Performance Analysis
and Monitoring.
A visionary PETRONAS Stewardship, Health, Information & Environment Linked Database (SHIELD)
Project was launched in March 2014. One of main modules is Occupational Health (OH) Database System
that delves into the efficient management of employee's medical data and health performance indicator
analysis. Sub modules consist of Fitness-To-Work, Medical Surveillance and Substance Misuse Testing.
Development of database system has been divided into several waves, spanning over a five-year period.
The main objectives of OH Database System are:

• Creation of centralized platform to systematically manage medical data and records.

• Simplification of medical assessment processes, data mining and health performance analysis via
system automation to save time and minimise error.
• Secure data storage capability in compliance to standards and legal requirements.

In order to ensure these objectives are met while keeping it practical and user friendly, the system is
designed based on seven "smart" guiding principal namely Synergistic, Systematic, Streamline, Secure,
Sustainable, Simplification and Save Cost. As an example, among functionalities developed for medical
assessment process are:

• Integration with human resource database system to address matters related to employee's
recruitment and mobility.
• Automated employee selection process of Medical Surveillance via integration with Industrial
Hygiene Module.
• Process flow developed to comply with PETRONAS and relevant requirements.

• Selected forms and reports streamlined for PETRONAS use.

• Automated medical assessment due date generation.

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• Notification email generation to employee and employee's supervisor from system.

• Automated audiometry analysis process.

• Occupational Health performance indicator dashboard generation from raw medical data.

• Secure and robust data management system with dedicated IT back-up functionality and controlled
user access.
Efficient management of medical data entry into the system will be made possible with the development
of e-Health functionality. This functionality channels semi-analyzed medical data and reports submission
from medical service providers directly to the system via a dedicated web based network. This replaces
effort of manual data entry which is currently done by PETRONAS users. PETRONAS users are mainly
staff from medical department, human resource (HR) department and line supervisor who will benefit from
workload reduction and more focus can be given to data verification and analysis. Among other benefits of
e-Health functionalities are faster processing time, paper less transaction and reduction in hard copy data
management especially from aspect of record storage.
Substance Misuse Testing sub module is being developed to support random employee selection
requirement. Integration of OH and HR database will enable random selection based on specific percentage
decided by user and secure system will ensure selection integrity.
Among the many challenges faced during system establishment so far was the change management
aspect. Therefore, the most important step is to inculcate a belief in relevant stakeholders which will ensure
establishment of system usage in operating facilities. Good system will not provide its optimum value if
not fully used as it intended to.

Introduction
SHIELD, short for Stewardship, Health, Information and Environment Linked Database, was developed
to further integrate HSE risk management practices across PETRONAS. SHIELD paves the way for an
enterprise-wide database on HSE from which relevant risks can be managed holistically from the Business,
Operating and Holding Company's perspective, based on the PETRONAS HSE Management System.
In 2014, SHIELD was kicked off with three core areas or modules namely Occupational Health (OH),
Industrial Hygiene (IH) and Product Safety and Stewardship (PSS), covering Employee Medical Records,
Health Risk Assessment (HRA) and the consolidation of all PETRONAS product Safety Data Sheets (SDS).
SHIELD's roll out was divided into several phases or waves, spanning over a period of five years (Refer
Fig.1). Wave 1 OH modules was launched in 2014 and completed in March 2015 with the implementation
at five Operating Units (OPUs) in Malaysia. SHIELD continued into Wave 2 in 2015, with deployment of
SHIELD at nine additional OPUs. Wave 3 phase in 2016 has sucessfully expanded deployment of SHIELD
across domestic OPUs and was completed in 2016. International OPUs roll out is anticipated moving
forward, with ongoing improvements to the current system functionalities.
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Figure 1—OH module (SHIELD) project timeline by phases.

Business Case
In the middle of an evolving technical and business climate, there is a drastic need to review and challenge
current practices while managing stakeholders' expectations. Most important, industry advance should be
manage without compromising Health, Safety, Security and Environmental aspect.
Industry should timely respond to and stay ahead of emerging technical, regulatory, reputational and
societal challenges in safe, secure and sustainable ways thus creating a strong business case for initation
of SHIELD project (a project to establish an enterprise wide system for integrated risk management).
Establishment of a system which customized to business needs (fit for purpose) is definitely a "smart"
moves, a crucial part of Company's stepping up strategy to face new norms.
Among objectives and benefits of OH Database System are:

• Standardised, systematic and integrated management of OH and medical data throughout

PETRONAS group wide
• Effective execution and simplification of OH and medical assessment processes thus significantly
reduces turnaround time and assures accuracy in comprehending data collated from various
resources
• System process flow has been design in compliance with standards and legal requirements thus
minimize exposure to non-compliance issues
• Ensure integrity, security and confidentiality of medical data in compliance with regulations

• Facilitate extensive mining capabilities for OH and medical data analysis and tracking

• Provide easily retrievable, long term, robust data storage via dedicated back-up functionality

• Protects PETRONAS against potential liabilities by systematically managing risks from various
aspect
• Provide user-friendly functionality on data input and analysis via auto trigger, auto reminder and
auto calculation tools
• Provide auto triggering mechanism to notify medical screening due date

• Provide easy access to employees to view their relevant OH and medical information

• Establish the foundation for integration with relevant system such as Industrial Hygiene, Human
Resource (HR) and Incident Management

Strategy of System Development

In order to ensure objectives of OH Database System are met while keeping it practical and user friendly, the
system is designed based on seven "Smart" guiding principal namely Synergistic, Systematic, Streamline,
Secure, Sustainable, Simplification and Save Cost (Refer Fig.2).
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Figure 2—Seven "Smart" guiding principal for development of OH Database System

Selected stakeholders ranging from management, experts, health advisors, medical professionals,
operation personnel, human resource and the actual implementer of medical assessment processes were
involved as working committee in designing the blue print and subsequently tested the system before the
actual production can be used by identified user at company facilities.
Involvement of various level of stakeholder especially the facility manager, implementer and actual
user in system development, created an ownership phenomena thus giving positive impact from change
management aspect. Despite how good the system has been design, it is well known that user "Buy-In" is
key to successful system implementation.

The OH Database System

The Occupational Health (OH) module supports the OH and medical healthcare for PETRONAS employee.
This includes the planning, execution, medical records submission to PETRONAS from medical examiners,
data analysis, performance monitoring and final data archiving of three sub-modules namely:

• Fitness to Work

• Medical Surveillance

• Substance Misuse

Fitness to Work is a structured medical assessment of a workers' physical and mental status to determine
his/her suitability for the assigned tasks (Refer Fig.3)
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Figure 3—Type of Fitness to Work (FTW) Health Assessment in PETRONAS.

Industry required to perform medical surveillance for employees who are significantly exposed to certain
influences of chemical, physical, or biological nature at their workplace, or who perform activities that
pose a health hazard. These surveillance processes and records are required to be manage in accordance
with relevant requiments such as Occupational Safety & Health Act 1994, Use & Standard of Exposure
of Chemical Hazardous to Health Regulations (USECHH) 2000, Factories & Machinery Act 1967 and
PETRONAS Technical Standards.
PETRONAS is committed to provide a substance misuse free workplace as substance misuse will impair
employees' work performance, health and safety of one's self and fellow workers. All testing should be
aimed to deter substance misuse amongst employees through the following:

• Pre-employment testing or testing before entry into a workplace/ premise

• Regular unannounced random and mass screening tests

• Testing for cause for employees involved in accidents or being suspected of substance misuse, to
rule out substance of misuse as the cause and help prevent similar incidents in the future
Substance Misuse Testing sub module is being developed to support random employee selection
requirement. Integration of OH and HR database will enable random selection based on specific percentage
decided by user and secure system will ensure selection integrity.
Integration with IH & HR Database System and the link with Employee's Health Portal & email
notification were among customization functionality being build to enhance efficiency and stakeholder
experience (Refer Fig.4).
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Figure 4—OH Database System: integration with IH & HR Database

System and the link with Employee's Health Portal & email notification.

Figure 5—Main Functionalities of OH Database System

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Efficient management of medical data entry into the system will be made possible with development
of e-Health functionality. This functionality channels semi-analyzed medical data and reports submission
from medical service providers directly to the system via a dedicated web based network (Refer Fig. 6).
This replaces effort of manual data entry which is currently done by PETRONAS users. PETRONAS OH
Database System users are mainly staff from OH or medical department, who will benefit from workload
reduction and more focus can be given to data verification and analysis. Among other benefits of e-Health
functionalities are faster processing time, paper less transaction and reduction in hard copy data management
especially from aspect of record storage.

Figure 6—e-Health functionality which enable medical report submission directly to OH Database System.

Medical data and reports submitted to system by medical service providers will be channel automatically
to identified users at Operating Unit (OPU) or Business Unit (BU). In term of overall system governance,
users play role in verification of data integrity and accuracy. Certain approval task such as endorsement of
Fitness to Work for special cases, Company Health Advisors as the identified authority are able to issue
approval via on-line system. Refer to Fig.7 for illustration of medical data / reports flow and distribution of
AMEs, BUs and OPUs throughout PETRONAS Malaysia Operation.
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Figure 7—Infrastructure Supporting e-Health and Medical record/data flow.

Achievement
Among achievements at point of completion of Wave 3 system roll-out in December 2016 were:

• High usability of system by users documented by creation and verification of 11,550 medical
assessment files which finally archived in system. Assessment ranges from Fitness to Work,
Medical Surveillance and Audiometry analysis.
• Statistical analysis of Fitness to Work and health risk parameters among employees (Body Mass
Index, Cholesterol level, status of Hypertension and Diabetes) being used to design Company group
wide wellness initiative for year 2017 – 2018.
• Noise medical surveillance activity (Audiometry assessment to workers exposed to significant
noise hazard) for 10 OPUs already being established using the system. Relevant findings which
require reporting to Company and authority were captured and archived accordingly.
• Successfuly tested e-Health functionality with pilot medical service provider.

Challenges
Among many challenges faced during system establishment so far was the change management aspect.
Therefore, the most important step is to inculcate a belief in relevant stakeholders which will ensure
establishment of system usage in operating facilities. Most important is to involve key stakeholders
during development process and periodic engagement / feedback session should continue throughout
implementation phases. Good system will not provide its optimum value if not fully used as it is intended to.

Specific Definition of Terms

• Operating Unit (OPU) – PETRONAS operating or manufacturing plant or facility at site

• Business Unit (BU) – PETRONAS corporate unit which govern OPUs and provide an oversight
on operation matters
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• Approved Medical Examiner (AME) – Registered medical practitioners appointed as medical

service providers to conduct OH and medical assessment for PETRONAS employees
• Company Health Advisor – Registered medical practitioners employed by Company to provide
specialist advice on OH and medical matters