- This topic has 15 replies, 16 voices, and was last updated 10 months, 3 weeks ago by
.
-
Posts
-
-
-
For this discussion, I would like to bring up the “Newborn Screening on Web Application” again.
The main factors such as Data, Cost, Operation, Design, and People that make the newborn screening system successful or fail can be explained below:
Data: The system be accurate and up-to-date. This data is used to identify newborns who may be at risk for certain conditions and allow healthcare practitioners to take action in time.
Cost: The system must be cost-effective to implement and maintain. To reduce delays in implementation or the likelihood of making a system that does not meet the requirements of the hospital.
Operation: The system must be accessible and reliable for healthcare providers, as this could affect diagnoses and treatment time. Also, the system should be able to integrated with other systems, to improve efficiency and reduce the risk of errors.
Design: The system should be designed to meet the specific needs of the hospital to input data, review results, and make timely decisions efficiently.
People: The system must be supported and maintained by IT staff who can help healthcare providers use the system productively. So healthcare providers must be willing to use the system and confident in its effectiveness and reliability. -
An example of a successful HIS in the Ministry of Health, Myanmar, is the electronic Health Management Information System (eHMIS). This system was implemented nationwide using DHIS2 open-source software, which was adopted as the National Platform in Myanmar in 2014. The eHMIS collects real-time data reported by Basic Health Staff from the township level.
It has been successful in providing reliable and timely health information for timely decision-making to ensure an equitable, effective, efficient and responsive health system. It provides real-time data access to the users with key health indicators, such as disease prevalence, maternal and child health outcomes and immunization coverage.A number of factors might contribute to the success of the eHMIS, including:
Data: The eHMIS uses standard data definitions and reporting formats, which ensures that data is collected and managed consistently. The system also includes a number of data quality checks to ensure that the data is accurate and complete.
Design: The eHMIS is user-friendly and secure. It is also accessible to a wide range of users with system-created accounts. It was built on the DHIS2 open-source platform, which is flexible and compatible for use in a wider context.
Operation: The eHMIS is hosted on a secure and reliable server. It is also regularly updated with new features and functionality. It also provides technical support and training for users.
Cost: The eHMIS is relatively affordable to implement and maintain as it was built using open-source software. However, the exact cost details should be mentioned on the webpage.
People: The eHMIS has been implemented with the support of a dedicated team of staff at the Ministry of Health and other partner organizations. The HMIS unit works closely with users to ensure that the system meets their needs and is easy to use. However, detailed information about user satisfaction or attitudes towards the system should be mentioned.However, while these factors contribute to the success of the eHMIS, challenges may still arise in each of these areas. Continuous monitoring and improvement are necessary to ensure the sustainability of the system.
Source:
Electronic Health Management Information System – Ministry of Health.
https://www.mohs.gov.mm/Main/content/page/electronic-health-management-information-system -
I would like to introduce the ‘Si vWORK’ application and website, exclusively designed for employees of the Faculty of Medicine, Siriraj Hospital, and created by the Siriraj Information Technology department. This system offers several features that enhance communication and collaboration within the hospital. Whether it’s accessing all employees’ contacts for chatting and sharing files, broadcasting news and announcements, creating posts, checking income, or making appointments for influenza vaccines. In my opinion, this application is successful in the following factors:
Data = The announcements and news are credible and released daily, providing up-to-date information. The released information covers activities and important announcements that all employees need to know.
Cost = The website and application are created and developed by the organization, so maintenance costs should be minimal.
Operation = The Siriraj Information Technology department provides sufficient technical support for users, allowing them to report problems by creating a post on the IT board.
Design = The design of both the website and application is user-friendly and highly secure as it requires SAPID (Siriraj Employee ID) to create a username and password for system access.
People = The Faculty encourages all Siriraj Hospital employees to download this application to their devices, leading to extensive usages.
Overall, as a user, I think Si vWORK is a successful system. It facilitates communication among employees without the need for personal contacts, provides fast and accurate information from the organization, and allows users to ask questions or report concerns etc. These features of the systems aim to improving workflows and other aspects within the organization.
-
In this discussion, I would like to address the DR CAN application, which was utilized for the follow-up and screening of non-communicable diseases.
Several key factors, including data management, costs, operational aspects, design, and stakeholder involvement, contributed to the failure of the DR CAN application:
Data: There was a lack of timeliness in the early phases of development, as it required synchronization with ID cards and phone numbers, which took a significant amount of time. Additionally, some data was not imported into the app, even though patients wanted access to it.
Cost: The application required a substantial initial investment, and although it provided a prototype, it still took a long time to develop and respond to all customer needs. This resulted in indirect costs and delays.
Operation: This aspect was critical because the project needed to be launched on time, but there were initial delays in developing the prototype application. As a result, time was lost in terms of education, training, and communicating with customers when implementing the application for many patients.
Design: Our failure in this area was related to the alarm system for medication reminders, which was not user-friendly. Patients had to click it repeatedly, causing frustration. Additionally, we initially did not involve patients in the project’s development, which was an error on our part.
People: Involving doctors who would use the project in patient care during the development process was not an error. This collaboration provided significant advantages during the development process.
-
I would like to give an example for implementation of ERP software which is planned to use within our organization to streamline and enhance our operational efficiency. The system is intended to integrate various departments, automate processes, and provide real-time data for informed decision-making. Since ERP systems are complex and require multi-dedicated focal for coordination, there was a bit of a delay in implementation, to utilize the software effectively and properly. The following contributed to the delay implementation of the software:
Data – The first challenge we faced was the data where various departments are using their unique structures, formats, and standards. The lack of standardized data made it difficult to properly integrate information into the ERP system. This requires the heavy burden of cleaning the data and much effort to map them so that the data are ready to process and utilize effectively.
Cost – Another factor is that the organization has a limited budget to implement the process which is a constraint to the implementation of ERP. The full feature software comes at a remarkable price and thus the organization have to choose public software which adopts most of features as it comes with and only customizing where it needs to be. That causes the implication on the scope of the system and the number of users who could benefit from the software. And the system cannot adapt to changing needs since the specific requirements were not discussed intensively.
Operation – The communication and support were not clear and not properly address that cause much resistance and the transition was not smooth. The training was not provided properly to test users and they cannot navigate well and utilize the system. Consequently, the system workflow was not much in line with the existing one and many adjustments had to be made for the full capabilities of the software. The feedback from users was not assessed and there were delays identifying the gaps and improvement areas.
Design – Though the original system was well-structured and capable of customizing the needed area, the failure in alignment with the internal process workflow resulted in the effectiveness of the system. To adapt to changing needs, it would require thorough evaluation and customization to meet our specific needs.
People – Most of the management team and focal were unaware of the benefits of the ERP system. There were needs in effective communication, training, follow-up as necessary, and commitment to the implementation. The users resist change and lack of engagement among staff and management team significantly affects the successful implementation.
-
I want to describe an electronic immunization registration and reporting system developed by my former organization. The purpose of the system was to replace paper-based records with electronic records related to immunization in the project areas.
Design: Users participated at the beginning of the project. Thus, it was designed by easy to record and track the immunization data of day-by-day activities. When we established the project, the required IT equipment was supplied to the project areas.
Operation: The training had been rolled out before launching the product to the front-line midwives. We have the huge support of senior-level management to implement the project. Good communication has been established at the beginning of the project. There was an assigned technician available at the central office and IT issues or other technical issues were solved by an operational team.
Cost: It was fortunate that we had special funding to upgrade electronic records in the project. Thus, we had a chance to hire a consultant to develop databases for immunization and other registration tools during that fiscal year. In the following year, we found some challenges in fixing bugs and errors in the system because hiring a consultant burdened the organization.
People: Users were satisfied with the electronic registration system which they weren’t required to use any longer for paper-based registration and reports. They had some inconveniences in earlier the system establishment, but the workflow became efficient and effective as things were moving on. High staff turnover had a negative impact on system workflow in later years and regular training had been limited due to constraints of the budget.
Data: There were standard indicator definitions and local vaccination guidelines to take reference for registration and reporting. Accurate and complete data could be updated in real time with the development of the new system. However, some vaccination schedule was slightly different from one area to another, completeness of certain vaccine was quite hard to standardize among project areas. -
I would like to provide an example, an Electronic Data Capture (EDC) that is a computer-based system for collecting, managing, and storing clinical trial data in electronic format. The success or failure of a system, like an Electronic Data Capture (EDC) system have several factors as follows.
Data – Ensuring data quality, accuracy, and security is essential for success. Reliable and error-free data is a must, and robust security measures are crucial to prevent unauthorized access.
Cost – Managing costs is key. Staying within budget and ensuring that the benefits of the system outweigh the expenses are vital considerations.
Operation – The system should be user-friendly, reliable, and scalable. Usability, uptime, and adaptability are significant aspects of operational success.
Design – A well-structured architecture and a user-friendly design are imperative. An efficient system architecture and a positive user experience contribute to overall success.
People – Adequate user training, engagement, and support are important. Users need training to use the system effectively, and their engagement and support structures play a major role in its success.
-
The Health Data Center (HDC) of the Ministry of Public Health (MOPH) has a mixed track record. On the plus side, it boasts an extensive, nationwide database that is highly representative of demographic data, making it invaluable for central-level monitoring and policy-making. Financially, it has a consistent budget, albeit high, and the data engineering team is well-versed in the hardware and software. However, the system faces significant challenges in timeliness, often delaying data for months, which impacts its completeness. Furthermore, local health officers have shown low acceptance of the system. Their reluctance is largely due to the additional work burden and the lack of applicability of HDC in their day-to-day operations. In summary, while HDC is quite successful at the central MOPH level, it struggles with timeliness and local-level acceptance, which affects its overall efficacy.
-
An example of a system in my organization (FDA) is e-consult service. It is an online system where consumers (i.e., entrepreneurs and researchers) can consult the regulatory authorities. The main services include health product classification and regulatory consultation. The consumers can raise a question and support relevant information then wait for the response from authorities. The factors that contributed to the success of this system include Data, Cost, Operation, Design, and People.
1. Data: The information on the platform is mostly confidential commercial and trade secret information. Therefore, role-based access control is utilized to protect critical data, improve operational efficiency, and help certify regulatory compliance.2. Cost: To develop this system, the amount of budget and resources was spent. However, the system is intended to enhance the competency of consumers and increase domestic production. Therefore, e-consult service is likely to be cost-effective.
3. Operation: The system was developed to be user-friendly and adaptable. Working on this system for a few years, it is reliable and scalable.
4. Design: The system was designed to be a modern platform that is flexible to respond to future technologies and the evolving needs of operating teams.
5. People: one of the challenges to generalizing this system in the organization is people. Many staff are more comfortable working on paper rather than online platforms. The engagement of staff is our room for improvement.
-
I am going to discuss the electronic Logistics Management Information System (eLMIS) that was experienced in one organization. The use of it is about the management of health commodities throughout the townships’ health centers by the application of mSupply software. In my view, this system implementation provided certainly not complete failures, but less than completely successful as other health informatics implementation. The factors that had happened at the system as follows;
Data: The system are designed to receive the complete, accurate and timely data. The availability of the data is great but not 100% complete, some errors and delay receiving than the set timeline were occurred. But, I could say this was only about 10-20% and didn’t also happen the information overload.
Cost: The project received initial investment and fund supported along the process. This can hire the outsourced IT team to run the system and server maintenance. I think this helped for the system success and also reduce the burden of the other project staff.
Operation: The system down time is already set with regular timeline, also the alert for some emergency maintenance and that are great. The proper technical training provision to the relevant staff including the refresher training which contributed to the success of the system to some extent.
Design: The system’s infrastructure, encompassing both software and hardware components, was seamlessly integrated into the health centers. This improved user engagement and accountability but I think the data security measures was a concern.
People: This was varying between the users. The ones who are interested to use the new system were more effective and efficient in system implementation outputs. Users who resisted change expressed dissatisfaction with the system. The establishment of efficient online communication channels facilitated collaboration among staff and led to overall improvement in results.
-
In my organization, the laboratory information system in pathology has been implemented for several years (more than 10 years). The system is used for specimen registration, tissue block sending between lab., slide preparation, reporting diagnosis, consultation. According to long use of this system, it seems to be successful by these following factors:
– data: The storage of data has integrity and accuracy. The timestamp is made in each step of the laboratory process. These data can inquire when users would like to immediately demand.
– cost: This system is developed and maintained by in-house programmers, so the expenditures tend to not be much.
– operation: The system has IT personnel who support when the system has problems.
– design: the system has easy to use interfaces and covers almost all laboratory processes.
– people: the users are satisfied to use this system for several years.The former statement showed that this system seems to be successful. On the other hand, the system is out of date in some aspects, such as
– old technologies in program coding and databases that cannot be applied to new tasks or services which use the new technologies.
– inappropriate or overlapping process, for example, the system has reporting and approval tasks which are overlapping and may cause confusion when using this data to calculate turn around time.
– some paper-based works that are not stored in the main system, but they are scanned and stored in separate hard drives.According to these events, this system has to change for updating and supporting the new technologies particularly in the digital era.
-
In my organisation, we currently use an Electronic Medical Record (EMR) system. While this system was implemented many years, it has undeniably been helpful in organising vast amounts of patient information. However, based on my experience and my colleagues, we have encountered various issues that have left not likely satisfied as users. We hope these concerns can be addressed and improved in the future.
To outline the specific factors influencing the system’s performance, I will provide examples as follows:1. Data: The EMR system deals with a substantial volume of data daily. On one hand, this transition from paper to electronic records has improved the organisation and security of patient data, as it is stored on secure servers. On the other hand, due to certain operational requirements, paper formats are still necessary. This redundancy leads to extra work for us as we must write on pre-printed papers and then scan the data back into the EMRs, which can be quite burdensome.
2. Cost: As mentioned previously, the continued need for paper represents a financial cost, both for the paper itself and for maintaining the EMR system. Although the system contributes to improved patient outcomes, satisfaction, and reduced hospital costs by shortening patient stays, the resource investment such as paper material remains high.
3.Operation: The system has notably enhanced intra-hospital communication by centralising patients’ medical records, allowing multiple departments to access them simultaneously. This convenience is a significant improvement over the past when only paper records were available. However, further efforts are needed to enhance interoperability and facilitate the exchange of patient information among other hospitals.
4. Design: The system’s usability features need to be improved. Fortunately, recently they are paying attention on these issues and try to solve it. Collaboration with many users can address what they are really need.
5. People: People are the most important factor of the system’s success. Although it can be a burden for users, the implementation of EMRs, in my opinion, has improved the quality of patient care compared to the past. To enhance both patient and user satisfaction, the human factor should be considered as the primary element before implementation, as it ultimately determines the system’s success.
-
I would like to again focus on the Hedley Environmental Index Dashboard provided by the University of Hong Kong. The determinants that constitute its success are described as follows,
Data: The dashboard system collects data from surveillance stations in real time and provides updates daily. This makes sure that the data is of high-quality, realiable, and up-to-date.
Cost: The dashboard is developed by the school with a humble amount of budget. The project is an update of algorithm and existing surveilance stations. Not a lot of money needs to be invested for the project to be done.
Operation: The dashboard is hosted on the University’s servers and are maintained by the school’s IT staff. The data collection and presentation pipeline is fully automated, meaning the dashboard is able to complete itself fully autonomously. The project itself doesn’t require a lot of personnel to maintain
Design: The dashboard is very intuitive and well designed, with detailed statistics by region. This provides a good user experience for everyone who is a layman or first time using the site.
People: The dashboard is open to the public, and has served useful purpose to provide public health information. Researchers, policy makers, and any citizen who is interested in learning about the air quality of that day and the potential health damage incurred could learn so from the dashboard.
-
My previous example of mobile app for MDR-TB contact screening and tracking is a good example of a successful system. The app has the potential to significantly improve MDR-TB contact screening and tracking in resource-limited settings. The program found significant improvement in contact trancing activity completion rates and referral rates, and also the reduction in reporting error.
Here are some of the factors that contributed to the success of the app:
* **Data:** The app uses an algorithm to identify suspects or determine if they require other tests, such as a CXR or sputum testing. This algorithm is based on global and local criteria for identifying suspects, and it is frequently updated. This ensures that the app is using the most up-to-date information to identify suspects, which leads to better outcomes.
* **Cost:** The app is relatively inexpensive to develop and implement. This makes it a feasible solution for resource-limited settings.
* **Operation:** The app is easy to use for both volunteers and patients. Volunteers can go to an MDR-TB patient’s home to record the household contacts and their neighbors/close contacts. After entering an individual’s sociodemographic information, TB clinical symptoms, and risk factors, the app uses an algorithm to identify suspects or determine if they require other tests, such as a CXR or sputum testing.
* **Design:** The app is designed to be used by volunteers with low levels of education and experience with mobile apps. The app is also designed to be used in resource-limited settings, where there may be limited access to internet and electricity.
* **People:** The program trained volunteers on how to use the app. This training was essential for the success of the app, as it ensured that volunteers were able to use the app effectively. -
-
You must be logged in to reply to this topic. Login here