Brief introduction about health informatics project

In my previous organization, we implemented a malaria elimination project under the Regional Artemisinin-Resistance Initiative (RAI3E), in close collaboration with PR-DDC Thailand. The project aimed to accelerate the elimination of Plasmodium falciparum malaria in the Greater Mekong Subregion by achieving high coverage of key interventions through area-based micro-stratification and targeting high-risk areas. The goal was to eliminate local transmission of P. falciparum cases by 2023 and all malaria by 2024. Additional focus was placed on active P. falciparum foci and high-burden provinces, which accounted for most malaria cases, as well as on nine temporary shelters along the Thailand–Myanmar border, to intensify elimination efforts.

This project was funded by the Global Fund through PR-DDC Thailand. As part of the initiative, the organization introduced an online malaria case reporting system using the ‘MIS’ application, integrated with the National Malaria Information System (MIS) managed by the Bureau of Vector Borne Diseases (BVBD). The MIS provides real-time, geo-located data on malaria cases and vector information, enabling timely analysis and response by public health officials at all levels. At our organization, we recorded all malaria screening cases, including both positive and negative results on a daily basis and synchronized them with the national MIS. Any positive cases were reported to the national system within 24 hours. This system replaced paper-based reporting, ensuring faster data transmission and strengthening Thailand’s malaria elimination strategy.

How can this health informatics project help to improve the current practices?

This project contributes to malaria elimination by reducing costs, improving user satisfaction, and achieving superior outcomes:
Cost: The system reduces expenses related to human resources for data collection and storage, as well as paper costs compared to traditional paper-based reporting. It also accelerates reporting and streamlines workflows, helping governments and agencies avoid the high costs of uncontrolled outbreaks and epidemics. The automated functions in the MIS minimize expenses linked to delayed outbreak detection and response. For example, when we reported a P. falciparum positive case within 24 hours to the national MIS, national officials could immediately detect the location, geography, and case classification (imported, indigenous, etc.), allowing them to take prompt and effective action.

User Satisfaction: The project delivers real-time or near real-time data, which builds trust and usability for organizations and decision-makers at BVBD, PR-DDC, and MOPH. It reduces workload through automation and synchronization with the national MIS, where reported data can be easily shared, stored, analyzed, and monitored. In addition, it strengthens preparedness for outbreak management and disease prevention.

Superior Outcomes: By providing real-time data to the national MIS, health authorities can respond to outbreaks more rapidly and improve public health outcomes through faster data analysis and timely interventions.

Are there any challenges or difficulties in implementing the project?

Challenges in implementing the project include:

1.Poor internet access in some remote areas, which prevented real-time data reporting. Instead, cases had to be entered into the system once internet became available, often requiring front-line health workers to work overtime or outside regular hours.
2.Because malaria cases must be notified within 24 hours, front-line health workers experienced work–life imbalance due to the urgency of reporting.
3.Delayed IT support when system errors occurred at the project level, which caused interruptions and delayed reporting.
4.staff turnover, which slowed project progress since training new staff to become familiar with the system required additional time and resources.
5.At times, data synchronization issues between the project-level system and the national MIS led to missing or delayed reports, causing reporting discrepancies.

Introduction of the health informatics project

I have experience in developing and setting up electronic medical records (EMR) for three clinics in Yangon, Myanmar. We worked with the three developers: an architect, a back-end developer, and a front-end developer. This project aims to replace paper-based records with a digital platform that could store patient histories, laboratory investigation results, prescriptions, and referrals in a standardized format. This system enhances data compilation, analysis, and supports informed decision-making.

How does the project help to improve the current practices

Efficiency and cost savings: Doctors, Nurses, and receptionists spent less time searching for paper files, reducing delays. The data entry staff spent less time on data entry. Integrated visualizations into the EMR application improved data compilation, validation, analysis, visualization, and evidence-based decision-making.

Patient satisfaction: Patients benefited from shorter waiting times and fewer repeated investigations.

Better outcomes: Service providers could make more informed decisions and ensure continuity of care across different facilities.

Challenges or difficulties in implementation

Technical issues: Application errors and a poor internet connection were among the challenges. We have a standby developer to solve the application error promptly.

Resistance to change: Some healthcare providers were resistant to change and required extensive advocacy and training to use the system effectively. Frequent advocacy and training sessions were conducted.

Interdisciplinary gap (communication gap): Differences in knowledge, language, and perspective between healthcare professionals and developers. Weekly, bi-weekly check-in meetings between healthcare professionals and developers to bridge this gap.

Interoperability issues: Challenges in exchanging data with different systems.