- This topic has 18 replies, 16 voices, and was last updated 2 years, 6 months ago by Saranath.
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2021-10-01 at 9:28 am #31772SaranathKeymaster
Please give an example of a system in your organization (either successful or fail). What are main factors that make the system successful or failure (Data, Cost, Operation, Design, and People)?
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2021-10-07 at 8:11 pm #31956Arwin Jerome Manalo OndaParticipant
In my previous organization, the Department of Health collaborated with the Department of Information and Communications Technology to launch a central database for storing COVID-19 tests and results. It is called COVIDKaya. While I am not part of the team that built it, I can say that it does a decent job (moderately successful) in fulfilling its role as a repository for COVID-19 records.
In terms of data, COVID-19 designated laboratories and hospitals have access to the database where they can upload and transmit their records for the day.
In terms of cost, the Philippine government enacted a law to facilitate funding of the said project in the early months of the pandemic. Hence, there is a financial support so cost wasn’t the problem.
In terms of people, personnel were trained to use the system. There was no issue on adopting a new system for COVID-19 case reporting; hence, there is positive attitude towards it.
In terms of design, the splash screen requires entering of registered user credentials. This adds a layer of security on the data in terms of accessibility. The Department of Information and Communications Technology mainly overseas COVIDKaya. However, I cannot make comments on matters like infrastructure nor level of protection of stored and transmitted data since there is no published information regarding these matters.
In terms of operation, recently, there were technical issues with COVIDKaya resulting to delayed publication of COVID-19 case bulletins. In the long run, this may affect decision-making of policy makers given the ever-evolving nature of the virus. The Department of Information and Communications Technology has continually providing technical support to the system.
Collectively, these factors are essential in declaring that a system is successful or a failure. A problem on one pillar may be cross-cutting; hence, should be resolved as soon as possible. Otherwise, it will slowly creep on other pillars – leading to the total collapse of the system.
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2021-10-08 at 5:09 pm #32002TARO KITAParticipant
Please allow me to reflect on the introduction of an EMR in my former organization. I remember that the introduction of the system was successful, although it took several months to get the system functioning effectively as planned.
Data: the new system contributed to increasing accuracy and completeness of data entry, and improving management and access to patients’ data storage.
Cost: initial investment with adequate budget planning was properly conducted, although unexpected HR cost to support the system were incurred
Operation: IT support department, led by a senior hospital manager, was established to support the whole operation in terms of maintenance, problem-solving, and also providing necessary training
Design: a system model that is already widely used in other hospitals was chosen, and core hospital staff members with good knowledge in ICT were involved in the introduction of the new system
People: opportunities were provided for staff members who had difficulty handling the system with additional consultation and training as needed -
2021-10-08 at 11:12 pm #32024Sri Budi FajariyanParticipant
We have a malaria information system called SISMAL. the initial development of SISMAL was carried out in 2010, excel-based from the service level to the center. but this system does not work well because it is not user-friendly. The mechanism for merging excel files requires the same file and folder names so that errors often occur in data recap. it makes users feel frustrated. in 2018 SISMAL V2 was launched which is used until now. input data in the form of an excel file that is uploaded to the web. for some data there is already online input. users are happier because it is easier to use, SISMAL V2 has been used by more than nine thousand health facilities. The following are some aspects that affect the success of SISMAL V2:
1. Data analysis is easier to do because there are dashboard tables, graphs, and maps available.
2. The existence of a source of funds to socialize the system also has an effect.
3. The existence of the IT team and the team from the monitoring and evaluation division who became the contact center user had difficulties
4. Engage all programs (surveillance, vector, treatment, diagnostics, communication) for digitizing all recording and reporting
5. collaborate with other parties such as UNICEF, WHO and UNDP, and universities for technical assistance-
2021-10-13 at 9:52 pm #32095Napisa Freya SawamiphakParticipant
Thanks, Fajar for sharing. It is an interesting system and I like the way it collaborates with other parties such as UNICEF, WHO and UNDP, and universities for technical assistance. It will support the system and drive for a successful launch.
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2021-10-08 at 11:28 pm #32025Theekhathat HuapaiParticipant
Ministry of Health developed the H4U app. H4U app is a digital health record platform for patients. Users who use this app can see health data such as blood pressure, blood sugar level, vaccination history. Users can book an appointment with a doctor. This app is usually used in rural hospitals. There are many difficulties in this app as follows.
Data: First, data come from different data sources. Many health data was gathering by primary health care. A yearly health examination was recorded by village health volunteers. They have their own program. This data may not display in the H4U app. The second, Complexity of health data. Health data come from different situations. Blood pressure may come from ER visit or IPD admission. The nature of these two situations is drastically different. So we need to carefully select data for uploading to the H4U server.
Cost: The cost of development in a countrywide program usually has a high price and high maintenance cost.
People: We have three groups of people to consider. Medical professions, Patients, Developers. Each group has a difference in health and IT knowledge, socioeconomic, etc.
Operation and design: A countrywide program need to has a careful operation design. Different between each health platform should be considered. -
2021-10-09 at 11:38 am #32027Weerada TrongtranonthParticipant
I’d like to share my experience in the organization. I participated in Health predictive project. The main problem of doing these kind of projects is Data. The Data kept in Thai healthcare system are quite hard to adopt because of quality of data. Lacking of quality came from filling pattern, lack of data and information, The data are ambiguous.
Improving quality of data health records should be considered to gain more benefits from health data. -
2021-10-09 at 7:29 pm #32029Auswin RojanasumapongParticipant
My former organization had a project to change all of the medical records from the written form into electronic-based medical records. Before this project, they tried to change the system by storing all the medical records in written form into digital images, which is easier for the users. The users can still practice in their familiar way without worrying about typing the information. However, changing to 100% electronic medical records changes how physicians and nurses practice entirely. Physicians have to type the patients’ history and examination results and they struggle, especially older staffs who have lower skills in computer. The negative feedback is too much and they have to change the system back to the old one (handwritten-based medical record, scanned and stored for further use).
The factors that make this project fail are
– The design of the system is not so user-friendly. While the developer tried to design to make it user-friendly, it still had certain limitations, such as no place to draw or sketch in the system, no word prediction for patients’ history typing
– The people using it is not motivated, and not ready to change especially old staffs who are used to practicing the old way and have low computer literacy.
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2021-10-10 at 12:52 pm #32040Tossapol PrapassaroParticipant
An example of the system in my organization was eHIS which is the electronic medical record (EMR) that our organization would like to adopt into inpatient workflow management. However, eHIS for the inpatient department could not be adopted entirely or successfully because of many factors.
The main factor would be the operation and design of the system. Even though there are many end-user training courses and technical IT support, the system’s complexity is not user-friendly, so it is hard to adopt in our routine use. The other aspect of design problems was lacking infrastructure because many users were using it simultaneously during the ward round, but there were not enough laptops.
For the people factors, the operation and design problems mentioned above make an unsatisfaction to end-user. Although, the system manager was tried so hard to communicate and manage the change. If the end-user were not into it, the changes could not happen, especially in the big organization.
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2021-10-13 at 7:22 pm #32086Auswin RojanasumapongParticipant
Not having enough equipment to use the system (laptop, PC, tablet) is one of the problems that my organization has faced. We have to share the laptop and often slow down the ward round process. Supporting the equipment is also very important for the system.
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2021-10-11 at 12:07 pm #32053chanapongParticipant
My previous organization had implemented EMR in both outpatient and inpatient departments. But its function was not fully used in inpatient departments. In contrast, proper adaptation to the new system was accomplished in the outpatient department. The factors associated with success and failure are described following.
1. Operation
-All Officers do not receive proper training on how to use the system. Only a few officers related to the IT department received hands-on training. When problem-related to the system occur, we have to contact directly to maintenance support of the EMR company because we don’t have a position to hire an IT officer who could manage this problem.2. Design
-The system was designed to specifically use in outpatient. The inpatient system has some functions as laboratory management and medication management. Other functions like medical records or vital sign records are not included in this system. Hence, the staffs have to use both traditional paper systems along with the EMR system.
-Its GUI is not easy to use by the general staff. And its system requires the registration of redundant data causing a burden to the users. Alert fatigue is also a problem related to improper notifications.3. Cost
– Initial investment budget is not sufficient to provide EMR to both departments. Choosing the EMR that can partially operate in an inpatient department while fully function in the outpatient department is the reason for this implementation.4. People
– Some officers have their own opinion to not change to the new system. Reasons for not to change are the current system running smoothly and how difficult to adapt to the new system. Communication to the officers about the importance to change the system and how they can adapt by providing time and training is essential. -
2021-10-13 at 1:43 pm #32078Navin PrasaiParticipant
In my previous Organization, Electronic Medical Record System was implemented which replaced the paper-based system. As the system was in the initial phase the cost was within the limit but later with load shedding exceeded the budget. On the operational side, there was proper frequent training and good assistance from the IT expert. People were happy as it was reliable, fast, and accurate. Data were secured and easily assessed in different departments. The successful projects in different Organizations were researched in terms of their application and designed accordingly.
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2021-10-13 at 6:10 pm #32081Napisa Freya SawamiphakParticipant
There was a new pharmacovigilance database in my formal organization. I was involved in planning, early implementation, and training during that period. It was launch successfully but it took time for the people in the organization to get used to it.
Data: The system can gather huge data from data intake and storage it in the cloud system. Data intake was received from all employees individually.
Cost: The budget was planned ahead to cover all possible expenses since the early planning phase and there was also another budget for maintenance costs during the first launch with 2 years
Operation: All employees are involved in the data intake process, the local patient safety department needs to validate the completeness and accuracy of the data, IT department supports the system and storage process. The system is own by global safety department; therefore, all issues were still reported to the global site.
Design: A system model is on mobile application and web-based platform, restricted access for internal employees. It is easy to use, and all employees will be assigned the training before start using it.
People: The system provides an easier platform for employees to report adverse events, however, some employees didn’t want to change the process/new system. The training was needed in the early implementation phase.-
2021-10-13 at 9:24 pm #32094Anawat ratchatornParticipant
Thank you for sharing about this interesting project.
It seems like people are one of challenging factors.
In my organization, the people factor is aways the most challenging issue and also the most important one.
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2021-10-13 at 7:42 pm #32089Ashaya.iParticipant
An example of system in my organization is the (semi-)automatic health report system implemented by division of medical statistics collaborated with division of information technology and outsource IT organization. This system was installed to help retrieving health data report easier. This system run quite well although there is still some flaw among system. The main factor that make this system success included;
Data: The data was transferred from EMR system which have to recheck the completeness and correctness of the data before send to the system.
Cost: The initial investment was support by the hospital. In terms of indirect cost, time and outsource personnel to establish the system has to be invested.
Operation: Among operation support, there is technical support from contract outsource to maintain the system and provide the training support as well as support from management level.
Design: The interface of the system is easy to use and have adequate IT support.
People: The system meets user satisfaction because they aware of the benefit from changing to the new system. -
2021-10-13 at 9:53 pm #32096Anawat ratchatornParticipant
The most recent project that I managed in my organization is reservation application for COVID rt-PCR test for driving thru. The aim of this project is to reduce workload, collect accurate data, and reduce waiting time for patients. Data, Cost, Operation, Design, and People
Data – In term of data, patients’ data will be collected from patients. Then collected data will be matched with data from current HIS to register in HIS automatically if possible. Matched data contain more data than what patient filled that make officer can receive more data to provide proper services. Furthermore, data collected when patients arrive will be updated on both application and current HIS.
Cost – This project was developed by our company’s officer, so it can be calculate in term of man-hour. This project took about 2 days to develop with 2 programmers and myself as a project manager, so it shouldn’t take too much cost. Other costs might includes IT department shared resources eg. server resource.
Operation – This is the most influent factor for this project. Changing from paper-based and traditional walked-in to this digital reservation affected our work-flow significantly. Overall work-flow had changed eg.
1) every patient should make a reservation in advance before driving to hospital.
2) officers had to check for reservations periodically to know when the patients would come.
3) officers had to use the application instead of traditional way. But this application was used specifically in this task, we had enough time to train.Design – The application was web-based application that contained website for officer to manage and public website for patients.
people – Many people struggled to work along this new-workflow but fine to use application. Patients were the people factor in this project too. As I known, they was fine about using the application.
At the end of the day, this project was not completely success. In my point of view, the most influent factor was operation. Every this project affected a lot in term of work-flow. It changed how people work and how patients get services. Me, as a project manager, should use Agile to delivery and get feedback more frequent to reach more user satisfaction. Other than about application, cross-functionality and multidiscipline team should work together to get the proper work-flow by using some tools such as LEAN Process.
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2021-10-15 at 11:22 pm #32193Karina Dian LestariParticipant
We tried to develop a health information system that can help us to manage, visualise, and analyse data that we have been collected for several years. We want to change from having to use different software/platform to only use one platform for all. We used an open source and free platform that have a good and intuitive user interface. However, the development unfortunately did not successful. Several reasons for the failure were:
– In operation aspect: the technical support was sometimes hard to reach because they live overseas, and we have different time zone. Solving a problem could take days because of this issue making the development process become longer.
– In cost aspect: Although the system can be used freely, this is a totally new thing for our team member. We need to learn while we were working with it, so this makes the development slow.
– In people aspect: Other than this project, our team members also have several projects going on. -
2021-10-16 at 2:19 pm #32199Pimthong SinchaiParticipant
For Mahidol University, They successfully provide the vaccination system for staffs and students. More than 90% of staff are got fully vaccinated following by student. I think the majority factor that make system reaching the goals is operation and people. We work as a team to promote and cooperate the program.
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2021-10-18 at 6:14 pm #32254SaranathKeymaster
Thanks everyone for sharing!
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