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Information technology has become an essential part of outbreak management, but its true value shows when it is adapted to local realities/contexts. During the COVID-19 response in refugee camps, I witnessed how health informatics could make a meaningful difference despite many challenges. Camps were overcrowded, people moved frequently, electricity and internet were unreliable and much of the response relied on trained camp-based assistants such as medics and community health workers. To address these challenges, we developed a Health Information System (HIS) for our team/organization (including managers, HIS/database officers, M&E, lab, nurses, community outreach) tailored specifically to this setting.
Outbreak Detection: With no reliable online platforms, community health workers recorded symptoms and case information on paper, which were later entered into the HIS whenever connectivity was available. The system was not sophisticated but it allowed us to detect unusual clusters of fever or respiratory illness quickly and act before situations escalated.
Response: The HIS also helped us allocate scarce resources more effectively. By tracking suspected and confirmed cases across camp zones, we could prioritize where to send test kits, open isolation areas, or reinforce protective measures. Sharing this same data with partners and authorities improved coordination and reduced duplication, ensuring more consistent and timely responses. By doing so, this helped us avoid problems of fragmentation such as duplicated or inconsistent data, communication gap, and delays in response. Using the same data across partners also made coordination and collaboration smoother.
Control: Just as importantly, the information proved useful for the communities themselves. When clusters were identified, community health workers used the data to deliver targeted health messages in affected areas. This built trust and encouraged adherence to preventive measures, an essential factor in such fragile environments.
From this experience, I learned that health informatics is about having systems which can be integrated, interoperable, sharing, collaborative, and representative that can turn information into effective action. In refugee camps, a locally designed HIS combined with the dedication of community health workers became one of our most effective system for COVID-19 detection, response, and control.
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During the COVID-19 pandemic, we saw the full extent of technology usage in health management. Although it is pandemic, it started as small outbreaks in my country especially, we called them first and second waves of COVID-19. At the beginning, positive case detection is very critical. At the onset, timely detection of positive cases was crucial. Laboratory confirmations were typically available by early evening, reported to the central disease control unit shortly thereafter, and followed by immediate quarantine measures by local authorities. Such rapid outbreak detection and response were enabled by digital reporting platforms and real-time information dissemination systems.
Vaccination is the most effective control method in COVID-19. In Myanmar, first batch of vaccination was conducted to healthcare workers as they are the front line personnels during the pandemic. The certification and validation of massive vaccination in short period can be only possible by modern technologies. In Myanmar, unique identifier (Master Patient Index – MPI) was planned to roll out with the nationwide vaccination campaign. Digital vaccination card, anonymous contact tracing features released by Apple and Google for their iOS and android platforms and event or location check-in using QR code were considered for more effective and efficient contact tracing. Although those plans were shattered by the country’s political instability, it evidently showed that technology became a vital tool for outbreak management of any communicable diseases.
Moreover, telemedicine and robotic delivery proved to be very useful in monitoring and treatment of complicated patients during COVID-19 pandemic. It evolves into a new culture of virtual training and virtual meetings. Those are quick and effective ways of outbreak detection, response and control as compared to conventional training and meetings.
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Due to increased travelling, climate change and antimicrobial resistance, the remerging and emerging of diseases and microorganism, the world population is frequently faced from the pandemic and epidemic outbreak of the diseases. Paralleling, the information technology is developing in every sector and become vital in such outbreak management. So, health sector adapts the IT into public health and many health professionals use health informatics to collect the data via systematically application of IT for public health intervention. According to current conflicts in our country, the health sector in some regions is not function its routine preventive and curative services. Due to economic restriction, the community cannot fully focus on their health status, not give attention to health education and easily acquire the communicable diseases. Therefore, we submit the proposals to donor for diseases monitoring and timely response to prevent the mass causalities.
The nature of outbreak is fast and highly contagious among the people, so the real time data is crucial to manage them. Currently, our organization is implementing the early warning, alert and response system to monitor the outbreak of communicable diseases in the project coverage area. By using the health and management competency from health informatics, the health staff in field level used case definitions and alert threshold to monitor the potential of outbreak. They always send the real time data to regional HIS team to track the trend of the disease. The HIS team include public health officer, technical manager and HIS officer to get the complete analysis and report of monitored diseases. We trained them to use offline data reporting with mobile application to us; this is the application of computing science from health informatics. When the data reach server, we directly view and analyze whether it needs case investigation and follow up interventions or not. From this system, the errors in data reports become decreased and the field team can understand the real time data is very efficient for outbreak control and get better case management. After that we share this data among the project team, field team and external professional to get comprehensive management. I think this will be interoperability between teams and use the data efficiently without data redundancy.
For example, we got one signal (They have a suspected measles case) through KOBO application report from our field team last year. We did case investigation using online call, directly see the patient, confirmed case diagnosis and instruct the treatment and preventive measures to field team. That patient recovered from the illness without suffering from measles complication and no other children from that community got infected. Although there are many requirements in our system, we initiated the first step of outbreak control with some knowledge of health informatics. We can create the better one if we use enterprise architecture in our organization, we will have consistent vision with compact blueprint to develop the health system in our coverage area.-
Hi Hteik Htar!
Thanks for sharing your experience with case investigations and management by using KOBO application. We did also utilize KOBO app in malaria case screening, early diagnosis and follow-up by training camp-based attendants. The app is easy to use, and monitor via the system, as well as case reporting purposes. But sadly, we did stop using KOBO app for malaria case detection and management as we shifted to use the app instructed by national malaria team, to streamline the system.
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The usage of advanced information technologies in outbreak management is on the rise in this era. Besides, knowledge and skills in health informatics are strengthened in outbreak detection, response, and control.
Starting from outbreak detection, health informatics allows real-time surveillance by collecting data from healthcare workers, hospitals, laboratories, etc. The recent case of the COVID-19 outbreak has given an opportunity to showcase that these technologies have the capacity to produce accurate, real-time, and reliable predictions on issues as serious as a pandemic outbreak. According to the article (1), BlueDot and Metabiota managed to correctly predict the spread route of the virus days before such events happened and were officially announced by the World Health Organization. This case highlights how the usage of information technology and health informatics enhances early detection of outbreaks and outbreak responses.
The health information system (HIS) can also strengthen the outbreak response. With the help of HIS, like contact tracing, caseload mapping, the government officials can identify the high-risk group for early vaccination, lockdown townships, and quarantine facilities, and promote evidence-based decision-making and resource allocation during the COVID-19 pandemic in Myanmar.
Data visualizations, dashboard helps the authorities to track progress and adjust the strategies and policies. For example, Johns Hopkins COVID-19 Dashboard gave global, real-time updates that guided policy and public awareness to policymakers.
In conclusion, health informatics transforms raw health data into actionable knowledge, making early outbreak detection, easier response, and control effective.
1. Allam Z. The Rise of Machine Intelligence in the COVID-19 Pandemic and Its Impact on Health Policy. Surveying the Covid-19 Pandemic and its Implications. 2020:89–96. doi: 10.1016/B978-0-12-824313-8.00006-1. Epub 2020 Jul 24. PMCID: PMC7378493.
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According to WHO, the Philippines has one of the highest tuberculosis incidence rates in Southeast Asia and the fourth largest TB burden in the world. One of the ways the Department of Health use health informatics to strengthen outbreak detection, response, and control of tuberculosis is through the Integrated Tuberculosis Information System (ITIS).
ITIS is a web-based application (accessed through itis.doh.gov.ph) wherein in all health facilities in the Philippines (both public and private) are required to record all TB patients registered in their facility for treatment. Some of the features of ITIS include:
ITIS Lite – a lighter version of the platform used by private physicians to report patient data;
CareTB – aids in patient screening and contact tracing and provides a patient interface for reporting and accessing data, and
RaceTB – a TB dashboard for different stakeholders to access and review indicators at multiple levels.
Aside from patient records, inventory of TB drugs in the health facility are also recorded in the ITIS app. Health facilities can monitor how much TB drugs is in their stock on hand, its expiration date, and source (either donation, from DOH, or purchased by the local government unit).ITIS is a very useful tool in strengthening outbreak detection, response, and control of tuberculosis. A health facility with staff that has a comprehensive knowledge and skills on the use of ITIS will have a good database containing important information on TB cases in their area. Private health facilities can share their records to public health facilities online, and stakeholders can easily access and review data. Monitoring of TB patients and status TB drugs will also be easier.
Reference:
Philippines. (n.d.). Stop TB Partnership. Retrieved September 7, 2025, from https://tbassessment.stoptb.org/Philippiness.html-
Hi Jenny! It’s very interesting and seems very practical to manage TB cases at national level by integrating TB information. As you mentioned, all TB service providers registered via the system, which is essential for the national level to continuously monitor the case load and treatment status. Also, TB dashboard provides current trends at multiple levels, which will support future planning, monitoring and decision-making for continuum of care, to prevent/minimize of MDR-TB occurrence. Similar to the Philippines, TB incidence rate in Myanmar is increasing due to several factors including political instability, resource limited settings, deteriorating socio-economic status. But, based on the current situation in MM, it would be very challenging to develop such kind of integrated TB information system at national level. So yeah, it’s great to know that the Philippines is practicing such a good system to tackle TB burden in the country đŸ™‚
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Hi Jenny, this is really good for your country having integrated system like ITIS for TB program. I just want to know does it also covers MDR-TB and XDR-TB cases. If it covers, is it also includes lab result reporting as it is critical for those cases. I think, if we have a study paper about ITIS, we can all learn, and other countries will also benefit from your country’s experience.
Thanks
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Health informatics play a vital role in outbreak management, especially in settings where vulnerable populations: such as children with disabilities need protection. During COVID-19 pandemic, many children with disabilities were at higher risk due to weak immunity and difficulties in accessing health services. I believe, through health informatics, early detection systems such as syndromic surveillance and real-time dashboards could be adopted to monitor infections also among these vulnerable groups. By developing skills in data analytics and interoperability, I could help design systems that ensure people with disabilities are not missed in the first stages of an outbreak, supporting both families and healthcare professionals, and community workers in real-time information.
In the response phase, digital tools like contact tracing apps and GIS can guide targeted interventions. To link with my current project, I have seen families struggle to reach health facilities due to mobility, financial, or communication barriers. Information skills would enable me to use GIS mapping to identify communities where children with disabilities live, so that vaccination for them or mobile clinics can reach out to their area. Mobile health applications could also be developed for parents. These technologies can make outbreak responses more inclusive and effective.
Long-term outbreak control and prevention can also benefit from health informatics. Immunization Information Systems (IIS) for example, can help track vaccination coverage and highlight children who might otherwise be overlooked in mass compaigns. -
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Skills and knowledge in health informatics could help with outbreak detection, response and control in different roles. If certain system is setup to monitor specific disease condition, early detection of outbreak can be achieved, for examples, identifying disease trends in EHR. Syndromic surveillance systems monitoring symptoms rather than diagnosis can help with early disease detection. As in outbreak response, with good information system, information of certain disease can be shared among each part of healthcare personnel and response to the disease outbreak could be done effectively and timely. As for disease control, prediction model can help plan vaccination strategy to prevent disease outbreak for example seasonal Influenza vaccine.
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In outbreak management, the roles of health informatics and information technology are vital to detect outbreaks early and respond timely. In my recent experience on a suspected whooping cough outbreak in a hard-to-reach village with a lack of internet connection. The first case was a school-aged child identified at the village tract health center. His mother informed the health worker that there were also many cases like her child in her village. Therefore, the health worker notified the surveillance focal and submitted the case report via Kobo Collect to the server. After receiving the alert, the surveillance focal reviewed the patient data from the server and verified with the health worker. In that process, the data focal person played a vital role as the health informatician to be the smooth flow of information to detect the outbreak early and ease the review of the data for surveillance focal by using information technology.
After case verification, the rapid response team (RRT) conducted the initial meeting to plan the investigation and response. The team decided to send a mobile clinic team to that village for the active case finding and treatment. During the mobile clinic session, health worker used their mobile phone in offline mode to collect the whooping cough cases (~70) including children and adults across 4 nearby villages. Then, the team returned to the internet access area for the submission. In the case, we can see the role of health informatics’ skills on mHealth app set up to be ready for the offline data collection even in the situation of no internet connectivity.
Then, the team carried out contact tracing and provided health education to the community in these villages. After exploring existing immunization data from the immunization database, it was found that those villages were outside of immunization coverage. So, the team coordinated and collaborated with the local authorities and an implementing partner for the outbreak response immunization (ORI). With the support of some organizations, ORI activities were conducted in that area. Eventually, the outbreak was controlled. The whole process was documented in the database. After that outbreak, we analyzed the existing immunization data to identify the immunization coverage and to advocate the donor organizations to fill immunization gaps and to consider those areas for priority in the upcoming projects.
In conclusion, even in a resource-limited setting, health informatics can strengthen and play a vital role in the outbreak detection, response, and control process by using IT, communication, and collaboration across different units.
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Knowledge and skills in health informatics are very important for outbreak detection, response, and control. By using health informatics, data can be collected, stored, and analyzed quickly, which helps health workers to detect unusual patterns of disease.
One of my experiences of telehealth during the COVID-19 outbreak in Myanmar was volunteering for national call center of MOHS which was “2019” from all mobile operators. We around 200 volunteers answered calls from public using “Port Sip” mobile app answering average of 7000 calls per month till the end of 2021 January.
Moreover, digital reporting using google drives, sheets and mobile applications like Rakutan Viber were used to report daily case numbers and track contacts. This made it easier for health authorities as well as public to quarantine as well as getting the most updated information of treatment and care facilitaties. During COVID Pandemic, telehealth helped alot in controlling the spread and treatment of disease.
Health informatics can also help in data sharing between hospitals and public health offices in other countries. If laboratories and clinics report cases into a central electronic system, decision-makers can access real-time information and send resources like medicines, N95 masks or oxygen to the places most in need. These systems can support better control of diseases like tuberculosis, and malaria, where electronic medical records and GIS (Geographic Information System) mapping can identify hotspots and guide prevention programs in the “very” long term of Myanmar. -
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Due to increased population movement across borders and weakening of routine health services in conflict-affected areas, malaria continues to be a major public health concern in Myanmar. At the same time, information technology has rapidly developed and become vital in outbreak management, particularly in remote and hard-to-reach areas where health systems are fragile.
The systematic application of information technology in health has been increasingly used by health organizations in Myanmar to improve data collection, disease surveillance, early outbreak detection and timely response. In areas where routine services are disrupted, such as in parts of Kayin or Sagaing, malaria transmission often increases due to lack of preventive measures like insecticide-treated nets, health education and early diagnosis.
To address this, our organization and other partners are adopting mobile-based and digital systems to strengthen malaria surveillance and response. For example, the Community-Based Health Application, mobile application, is being used by field volunteers and community health workers to report malaria test results and case details in real time even from areas with poor internet connectivity. Once the phone connects to a network, data is sent to the central database. This allows the regional mobile medical teams to analyze trends and spot outbreaks much faster than before.
We recently received an alert from a mobile report in eastern Myanmar where a high number of Plasmodium falciparum cases were detected within one week. The mobile medical team immediately conducts the investigation. Through coordination between HIS, mobile medical teams and community health workers, we distributed bed nets and conducted the active case detection (ACD) together with health education within a few days. Within two weeks, no new cases were reported from that village. Without real-time data and digital systems, such a response would have taken much longer.
We also emphasize training and capacity building in digital reporting tools among our staff and community volunteers. Many of them now understand the value of real-time data and actively use these tools in their daily work. As a result, data quality has improved, errors have decreased, and the response time to outbreaks is much faster.
Although our current system is still developing, we see that applying health informatics in malaria outbreak response has already shown clear benefits. If we can further develop this with enterprise architecture and national-level integration, we will have a strong foundation for eliminating malaria in Myanmar. -
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As health informatics combines people and IT, it can support the detection, response, and control of infectious diseases, such as in the following scenario: Influenza in school children in Bangkok.
Detection: School absence data collected through electronic or mobile systems show a rise in influenza-like illness. Hospital pediatric units also observe a spike of influenza cases and report to the local public health organization through electronic reporting system and share dashboard.
Response: Local public health teams identify the outbreak using real-time data dashboard. Therefore, they investigate the schools, and alert teachers, parents, and surrounding communities through digital communication platforms.
Control: Preventive measures such as health education, hygiene promotion, and temporary class closures are introduced to stop further spread. These can be supported by IT tools such as e-learning, mobile educational message, electronic tracking of prevention effectiveness.
In summary, health informatics helps bring the data sources (school absence, clinical and lab reports) into an early detection system that leads to public health action supporting by IT tools communicating among people.
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This is the innovative way to interlink between the differnet data systems. From your comment, we can collect the data not only from hospital but also form schools, workplace and others. Thanks for your discussion.
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Information plays vital role not only in outbreak situations but also in any emergency conditions. Immediate response or Specific information are importance to design outbreak response program. We can’t provide effective services without identifying the community needed or ground situations. In term of Flood response, We created real time data collection tools via KOBO platform to get the update data from the community. Our team conducted rapid need assessment and submitted data via link. Moreover, we also collected information from other local stakeholders to get the affected House hold list including status of safe drinking water. We could provide chlorination tablets to the affected household to prevent waterborne disease. Later on, By using the affected HH list, We also could provide latrines construction and hygiene awareness promotion as three month post-flood response project. As summary, Informatics is important to disseminate and advocate in outbreak/emergency situation.
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Our organization is operating in hard-to-reach area with challenging transportation and communication. Malaria remains highly fatal due to limited access to medications and inadequate preparedness. Reports are donor-driven, and data is fragmented, flowing through separate channels. Data is lacking integration, making it difficult to capture the situation and making analysis and early preparedness.
We aim to implement digital health transformation to streamline data flow and effective usage, improve preparedness, optimize resource allocation and ultimately reduce mortality.
Outbreak detection
By developing an effective HIS, we will be able to get real time data, which will facilitate timely decision-making and supply/HR allocation.
The data collected over time will give us insight into the trend of malaria, like seasonal trends, geographical hotspot, etc.
Outbreak response
Efficient allocation of limited resources (drugs, test kits, bed nets, human resources) is critical in hard-to-reach areas.
Digital health records capture each patient’s test result, treatment given, and follow-up schedule.
We can also implement preventive measures in high-alert villages. (like spraying, distribution of mosquito nets, repellents and resource planning)
Informatics ensures that outbreak response is data-driven, timely, and targeted.
If our HIS system is integrated into LMIS, we can also detect stock level and immediate action planning, to avoid stock out of essential medicines & commodities.
Outbreak Control
We can monitor the real time situation, case management and outcomes through the dashboard.
Information systems will no longer be fragmented with the ability to capture the whole picture of health status in coverage areas.
The data will be properly analyzed and will guide future planning on HR/supply allocation, staff training and preventive measures. -
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