- This topic has 27 replies, 13 voices, and was last updated 1 year, 6 months ago by Tanatorn Tilkanont.
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2022-09-15 at 9:43 am #38071SaranathKeymaster
We can consider that health informatics can help to increase value of healthcare practices, in terms of cost, user satisfaction, and superior outcomes. The papers provided in the reading assignment also discuss on how public health informatics can help to improve disease surveillance and the challenges of the implementation, particularly changing from paper-based to electronic-based surveillance system.
Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
How can this health informatics project help to improve the current practices?
Are there any challenges or difficulties in implementing the project?
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2022-09-20 at 10:28 am #38184PREUT ASSAWAWORRARITParticipant
I would like to introduce one of the big changes in my hospital during my first year internal medicine residency training. It was about implementation of the electronic health records (EHR) in clinical use. Combination of the EHRs with laboratory information system (LIS) and radiology information system (RIS), that had been previously implemented, let medical personnel have several benefits from these systems. They could review patient’s data from anywhere in the hospital at the same time. There was no waiting time for the documents to be transferred. Laboratory and radiology results could be link to the EHR. They could reduce time spending on writing on the paper which some handwriting was difficult to read. However, there were some challenges and difficulties. Some senior staffs were familiar with paper-based system and requested to continue writing on paper. The system was not stable with some bugs in it. The IT staff could not solve many problems that occurred during early implementation.
Nowadays, everyone is happy and enjoy using the electronic based system.
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2022-09-24 at 5:34 pm #38320SaranathKeymaster
I’m glad to hear that the system is accepted by users.
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2022-09-27 at 11:57 pm #38381Tanyawat SaisongcrohParticipant
Thank you for sharing. Your scenario is so relatable. Fortunately when the system is more stable and all of us are familiar with it, we reach the full benefits in our practices both service and research.
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2022-09-20 at 5:51 pm #38195ABDILLAH FARKHANParticipant
At the beginning of the Pandemic, calculating the exact positivity number of Covid-19 had been facing a severe problem that was the source of controversy in Indonesia. Weak reporting pathways sometimes made the mismatch of Covid-19 data between central and local governments, and some surveillance data were underreported. It occurred because the manual surveillance report used bottom-up streams (from local to national surveillance systems) where every District Surveillance Officer (DSO) are obliged to make the daily report by using their cellphone internet data which is costly.
After the electronic form had been introduced nationally in early 2021 to be implemented at all health facilities either primary or secondary care, the performance of case detection that revealed the updated trends and figures of Covid-19 situation was significantly improved. Although the quality of surveillance data was influenced by the obedience of healthcare staff in recording all people being examined, but in terms of superior outcomes, the existence of electronic form created a piece of real-time information and reduce potentially biased data that led to underreported cases. Moreover, no cellphone data was used from both healthcare staff and DSO to send the daily report.
However, as the data is stored only in the end user which is government health officials, the function of electronic form is limited only to recording and inputting individual data without a meaningful dashboard that summarizes Covid-19 situation locally and nationally. This limitation makes healthcare staff could not gain any updated cases from the data they had been recording.
I think to enhance the role of health informatics, the knowledge used to maximize this electronic-based surveillance is by developing a dashboard. Dashboard in health informatics is useful to expose timely information and implement good dissemination practices. The dashboard visualizes public health surveillance data at a glance so that healthcare officers can easily focus on the data they record rather than searching for information from different sources.
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2022-09-22 at 7:50 pm #38241Siriphak PongthaiParticipant
Yes, I agree with you. Dashboard is a very good method in representing and summarizing data not only to healthcare providers but also population. Well designed dashboard could make one understand by just glimpsing at the display.
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2022-09-24 at 5:38 pm #38321SaranathKeymaster
Totally agree with you. Data visualization dashboard (user-friendly of course) is a useful tool to disseminate data, particularly at the operational level. They will see the benefit of data collection.
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2022-09-20 at 7:38 pm #38197Zarni Lynn KyawParticipant
Have you ever observed a health informatics project in your (other) organization?
In my organization we started a health informatics project in collaboration with Ethnic Health Organizations (EHOs) in Eastern border of Myanmar (ehssg.org). This project implementation was accelerated with the onset of pandemic, although there are several challenges, we manage to leverage the data gained from the project to provide regular updates of the situation in Eastern border of Myanmar.
The project started with advocacy to health leaders in ethnic health organizations about the importance of health informatics and getting the buy-in from leaders at different level (HQ to clinics) is necessary for successful implementation.
After successful advocacy, we piloted the initiative in a small, selected numbers of clinics with good internet connection and we try to improve the project using iterative approach and feedback from the health workers.
In the third phase, we are scaling up to more clinics and we successfully formed quality assurance teams to make sure the quality of data is verifiable.
Finally, we are currently applying for more funding to expand the project to more clinics and use interoperable standards like HL7/FHIR for future proofing the project.
How can this health informatics project help to improve the current practices?
During the pandemic, we compare the paper-based clinics and clinics which use electronic systems, we found that clinics which use electronic systems
1) Provide more timely data
2) Cost of data collection was minimal
3) Data accuracy is improved
4) Health leaders use the data much more
5) Data were analyzed much easilyAre there any challenges or difficulties in implementing the project?
At the start of the project, we made sure that health leaders are well advocated but challenges exits
1) In areas with low network coverage, syncing the data is a challenge
2) Low IT literacy of health workers present a challenge in scaling up the system
3) Sometime unwillingness to share health data by the health leaders prove to be a challenge
4) After the coup ethnic political leaders are afraid that some of the population data (although in all of the COVID-19 information shared by EHSSG was only a summary) maybe used by the Tatmadaw to target civilians
5) Massive migration and mobile population in Myanmar poses a difficult challenge -
2022-09-22 at 5:11 pm #38240Boonyarat KanjanapongpornParticipant
A health informatic related project which I have recently involved with is contraceptive distribution at an individual pharmacy store. Every woman between 15-59 years old can check the neighboring health care units involved and book the appointment via Krungthai health service mobile-application. This is one of the projects which is the cooperation between government organization (National Health Security Office) and private health unit (Individual pharmacy and clinic) to reduce crowded hospitals and increase accessibility for patients to the health support project. Web-based application is used for the end healthcare user to connect data such as Patient’s information, Health ID, booking list and reimbursement.
From my experience, most of the patients notice this health support from checking mobile application which is especially convenient for young patients. They don’t have to travel to hospital to receive this basic healthcare support, in this case, possibly they can book and get contraceptives with medical counselling for free at pharmacies in the mall when they go shopping. As well as saving cost and time for the patient, this cooperation creates extra income and elevates health service in small health care units.
This project would create better outcomes in health and other aspects of society. These easily accessible contraceptives would increase safety, enhance cooperation in medicine used and reduce the nonprevention pregnancy rate which will benefit people, and reduce many health and sociological problems later. Moreover, the number of patients receiving contraceptive pill and other related information could be tracked for further analysis.There weren’t many challenges for me as the end user to understand and use this web-based application. Anyway, this is possibly a time consuming and self-adjusting process for some health care workers.
Furthermore, based on my experience, there were mainly young adults in the center of the city who used this health support via mobile application. Patient users in rural areas with low internet connection or limited IT knowledge might not be noticed and receive this health benefit. Mobile application is more familiarly used by young adults but there have to be other communication and connections which suit other demographics to create equality reach for health care support.-
2022-09-24 at 5:43 pm #38323SaranathKeymaster
Thanks for sharing. The App is very interesting. I think their main target users would be young adults- mobile app would be fit to this target group.
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2022-09-25 at 1:35 pm #38339Kansiri ApinantanakulParticipant
This application is very useful.
Personally, I think to project developer chose the platform wisely. The use of mobile application fit well with target group. This might be the reason why the implementing this project is not challenge in patient perspective.I think this project not only added the value to the pharmacy themselves. It would allow pharmacist to gain the digital literacy and help in HCP-patient relationship building.
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2022-09-26 at 11:25 pm #38370Boonyarat KanjanapongpornParticipant
Thank you for all the comments 😀
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2022-09-22 at 10:00 pm #38246Siriphak PongthaiParticipant
I used to work at a hospital particularly in Clinical Oncology Pharmacy and Sterile Compounding Department. Most of oncologists are familiar in writing chemotherapy order regimen as well as progress note. However, chemotherapy and biotherapy are considered as highly toxic and hazardous drugs to cytotoxic classification.
This kind of drugs need safety handling since transporting, preparing, and administering. As oncologist prescribed by writing, then assistant pharmacist and pharmacist are helping in transcribing an order (drug name, dosage, route of administration, frequency, etc.) into computer system. This step of transcribing can easily bring on medical error “Transcription Error” due to illegible handwriting or human error thus consequently caused harm to patient.
Therefore, department has developed an electronic ordering system by creating classification of cancer, cancer stages, standard chemotherapy/biotherapy regimen, automatically calculated dose by BSA, next cycle date, provided pre-medication, home medication, follow-up date, and prerequisite blood testing.
In the early stage of system implementation, the rate of using are very low because oncologists are not familiar with electronic version but we extremely encouraged them to use because this is not only reduce medication error but also enhance standard care and safety for the patient.
Two years passed by, the rate of use electronic order is gradually increased. In my opinion, this is because the system is more stable. In addition, we updated and improved the system per oncologists’ comments. Yet, we improved the system more user friendly.
Lastly, by implementing electronic ordering system, we can analyze data and speculate trend as well as rate of drug dispensation. We can also use this information as part of drug inventory management to prevent drug shortage that caused delayed treatment for patients.
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2022-09-23 at 12:59 pm #38253ABDILLAH FARKHANParticipant
Such an interesting story I read. Electronic method in health has surely encouraged user participation and the data gathered by this method would bring simplicity for further analysis
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2022-09-24 at 5:45 pm #38324SaranathKeymaster
Thanks for sharing. The main factor for the successful project is that the users can see the direct benefits of using the system. Good one!
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2022-09-26 at 11:19 pm #38369Boonyarat KanjanapongpornParticipant
Thank you for sharing this interesting program, I could see many benefit from implement digital record to practice. It’s a great idea to keep improve system for a better user experience.
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2022-09-23 at 4:11 am #38251Kawin WongthamarinParticipant
During the COVID-19 outbreak, there has been a lot of development of various systems within the hospital. It will give an example of the process of requesting lab results after the examination.
In the past, Patients who wish to obtain documentation of laboratory results. Patients had to physically contact the medical record department at the hospital, causing more time-consuming and risk of contracting the coronavirus.
In addition, for patients who specific testing for COVID-19 by PCR (at the early phase of the pandemic) if those patients are found to be infected, there will be an automatic notification system that sent the necessary information to the patient via registered SMS, email, or LINE.
The system mentioned above makes the patient more convenient. Not only able to reduce the time that patients have to spend in the hospital. It can also reduce the risk of getting infected or spreading the infection to other patients.
For the personnel side, this system helps to reduce the number of people who provide services to patients. While the hospital can increase the number of patients per day without the bottleneck of waiting for lab results and giving advice.There are several challenges in using this system. The system was unstable in the beginning due to the heavy traffic that caused the website to delay response and crash for a period of time. Elderly people without smartphones do not understand how to use this system and choose to use the old method. Finally, security issues due to the use of less complex access passwords resulted in the risk of data leaks. However, many problems have been solved and developed until it works well today.
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2022-09-25 at 12:12 am #38331Hazem AbouelfetouhParticipant
Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
In my previous organization, we worked on a web-based and mobile drug safety reporting tool to facilitate adverse events reporting from hospitals, patients, and doctors to pharmaceutical companies and the Ministry of Health and perform signal detection on Individual Case Safety Reports (ICSR) to help observe safety signals on different market products and investigational drug in clinical trials.How can this health informatics project help to improve the current practices?
Using the drug safety database, we were able to perform signal detection on Individual Case Safety Reports (ICSR) to help observe safety signals on different market products and investigational drugs in clinical trials.Are there any challenges or difficulties in implementing the project?
It was difficult for all healthcare providers to move from a paper-based form to a web or mobile application and add additional data from patient medical history to fulfill the minimum required data in Individual Case Safety Reports (ICSR).-
2022-09-25 at 1:31 pm #38338Kansiri ApinantanakulParticipant
Thank you for sharing.
You story is interesting. I agree that safety signal detection is important in safety report process. -
2022-09-28 at 10:03 pm #38402SIPPAPAS WANGSRIParticipant
I agree upon your statement that it was difficult moving from paper-based to electronics since we already have a large amount of data beforehand, but we could start digitising them from now on.
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2022-09-25 at 1:21 pm #38337Kansiri ApinantanakulParticipant
Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
Please allow me to share the different perspective, I’m working as clinical research associate (CRA) so I would like to share the health informatics project in clinical research field.
In clinical research field, there is the requirement to file the essential document for each clinical study in electronic trial master file (eTMF).CRA is responsible to file the documents in their own project. However, some documents are needed to be filed in eTMF of multiple studies, for example the privacy agreement of site staff.
If particular site staff worked for multiple projects, His/her privacy agreement is needed to be filed to corresponding project eTMF.
At first, the privacy agreement was filed by each CRA creating hundreds of duplicate and inconsistency records in eTMF. This leads to the creation of the Privacy agreement tracker.The data were pulled from all studies eTMF and reconciled. This tracker also embedded the function of LOOKUP to allow bulk search of privacy agreement of site staffs.
How can this health informatics project help to improve the current practices?
This project is quite simple but this help CRA a lot in privacy agreement reconciliation and filing.
– There is no need for CRA to manually search for privacy agreement of each site staff.
– This project reduced workload of site staff to sign privacy agreement again and againAre there any challenges or difficulties in implementing the project?
– Since each study site would have new site staffs entered study. This tracker is “living” project which required timely update for new staff.
– Communication: project leader need to announce and get all CRA on the same page on how to use and maintain this tracker.My story would be new for those all you who might not familiar with clinical research field.
Please feel free to discussed with me 😊-
2022-09-26 at 11:30 pm #38371Boonyarat KanjanapongpornParticipant
Thank you for sharing, I could understand your story without deep CRA knowledge and agree with using some system to reduce redundant work. ☺️
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2022-10-03 at 8:57 pm #38507Tanatorn TilkanontParticipant
Such an interesting project! I used to work as CRA and at that time my organization still experiencing a manual search and sometimes redundancy in signing the agreements as well. This implementation is very useful, reducing costs for multiple signs and saving time. Thank you for sharing.
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2022-09-27 at 11:42 pm #38380Tanyawat SaisongcrohParticipant
Have you ever observed a health informatics project in your (other) organization?
In my hospital, they implemented EMR portal for physicians and nurses, use in OPD; including scanned medical records viewer, probable 10 years ago. In the past, IPD software system and PACs have been implemented but we still use “OPD card” to review all patient’s medical history. It was a big change. Before they launched, there were several meeting of IT teams and each department, like a tutorial about how to use it. The very first version was quite exhausting. We couldn’t access the old data and the system was not linked to other department like PACs, pharmacy. It took double time for review each patient and some senior staffs refused to use it. Fortunately, we have a strong IT team, the system has been improving days by days. Now the scanned medical records viewer, the PACs x-rays, laboratory, pharmacy are linked together and we have not use that OPD card anymore and everyone is familiar with the system even our senior staffs.How can this health informatics project help to improve the current practices?
Life changing, I would say. When most of us are familiar with the system, there’s a lot of benefit for everyone, doctors, nurses, technicians, administrators, the hospital and of course our patients, in terms of accessibility to the data from all departments, less time spend for case review, decreasing in human errors in every process especially drugs prescription and overall cost-effectiveness.Are there any challenges or difficulties in implementing the project?
Changing from paper-based to electronic-based system is quite challenging. There are some issues such as personal IT skills and preferences, especially senior staffs; excessive time spend per each case, missing old patient historical records; unlinked of some lab test and radiograph to the main system and overloaded system itself. When the system was down, the workflow had been paused. The first few months, IT staffs were around to support on site. At the clinic, each room a senior staff and junior nurse were paired to work together. We decided to decrease daily number of patients and Previous OPD cards were prepared and allowed to use in combination just in case. -
2022-09-28 at 9:08 pm #38398SIPPAPAS WANGSRIParticipant
Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
– The most obvious health informatics project to me is about MorProm and Thai-Chana project, established during COVID-19 outbreaks. Once, they were tools to help a government monitor the disease outbreak and significant contact locations (although, by concept it was a good idea). Thai-Chana project uses QR code in order to register people who are entering public places to count who, when, and where they are. In case of COVID-19 contact has been found, all people registered via QR code will be prompted. Yet, I have never seen an outcome or results with my own eyes.How can this health informatics project help to improve the current practices?
– Conceptually, it would help tracking infectious disease to prevent further spreading and also epidemiological purposes. People at risk are being notified.Are there any challenges or difficulties in implementing the project?
– There are, of course. First is about people’s trusts. Some people just do not cooperate with registering those QR code in fear of privacy concern. Second, not all people have a smartphone, including those who are an elderly or in need of special accessibility. -
2022-10-09 at 9:39 am #38598Tanatorn TilkanontParticipant
Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
When I was working in a clinical research organization, I have experience in various study designs. One of them was to investigate the use of the investigational product (medical device), to see the behavior, satisfaction, and any event that occurs before, during, and after using the product. By collecting information from the subject, one of the measurements is the responses from their diaries (questionnaire forms). The company decided to implement an electronic diary in this study. All the participants will register themselves in an application with a subject number and record the information by answering a questionnaire every time they use the investigational product via their own mobile phone. The information is real-time. Once it was recorded, the clinical research team (such as a project manager, data manager, and CRA) will be able to see the response immediately via a web-based application. The clinical user can also generate a report a with visualization of the data collected. The data can be extracted or pulled out at any time and at any location for analysis.How can this health informatics project help to improve the current practices?
I believe that earlier in other studies may use paper-based diaries, to record patients’ compliance and events. By using paper, the project team could not see information in real-time, the study coordinator will have to transcript from a paper-based diary to an electronic system. By using e-diary, it can reduce transcribing errors, reduce the cost of papers, less time-consuming, and real-time monitoring.Are there any challenges or difficulties in implementing the project?
One of the challenges that I found was the participants were sometimes not able to use the application properly per the instruction provided since the subject enrollment day. Therefore, the data collected was error sometimes. The study coordinator and the principal investigator will need to ensure that all subjects fully understand the instruction and keep evaluations at every study visit.
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