- This topic has 31 replies, 15 voices, and was last updated 2 years, 11 months ago by
Pimthong Sinchai.
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2021-09-01 at 12:07 pm #30923
Saranath
KeymasterDuring the COVID-19 outbreak, information technology has played an important role in outbreak management. Many health information systems, Applications have been developed which aim to assist the outbreak monitoring and control. In your point of view, is there any Health IT project that you think could perform better if we applied some public health informatics knowledge and skills on it?
-Give an example of the existing project
-Problems or limitations of the project
-What knowledge and skills of health informatics could help improve the project?
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2021-09-07 at 8:01 am #31176
Sri Budi Fajariyan
ParticipantIn Indonesia, several information systems have been built to overcome COVID, including :
1. The new all record application (NAR), which records data on all PCR examinations in Indonesia, whether in hospitals, health centers or laboratories, or private clinics that have been integrated with the hospital information system so that patient identity data does not need to be re-entered if it is already in the information system hospital. This application has also been connected to the Protect Care application which is an application for the community so that the public immediately knows the results of the PCR examination. The data variables taken in the all-new record include the number of specimens taken, positive, negative examination results, and date of examination. Through this application, the positivity rate indicator can be known.2. Pedulilindungi application, this application is a mobile-based application that can be installed on everyone’s mobile phone to track people’s journeys via GPS. This application has been integrated with the all-new record so that the data on the results of the covid examination can be known and integrated with the vaccination information system so that information on the status of the vaccine can be known. Starting September 2021, pedulilindungi application will also be used as a health passport or health alert card (HAC), so that every airplane passenger is required to fill out the pedulilindungi application before traveling by plane.
3. Silacak is used as an information system to record the results of tracking the close contacts of Covid patients obtained from pedulilindungi application
The information system in handling covid is good but still needs to be improved, at first the results of the antigen examination were not included in the all-new record so that many fake antigen test results were found. The Ministry of Health is currently developing an all-new record for recording antigen test results.
pedulilindungi application has received a lot of criticism from the public in recent weeks because the presidential vaccination certificate is accessible to the public, meaning that the security of the application is still low. if we have a person’s residence number then we can access that person’s data through the application. the government has now updated the security system to maintain the confidentiality of resident data.
The health information system in Indonesia is still segmented so that it becomes a challenge in dealing with covid, the government needs to develop a new information system in handling covid. This is an opportunity for malaria and other programs to integrate data into one big application
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2021-09-10 at 6:26 am #31249
Saranath
KeymasterCOVID-19 really helps to accelerate the IT application in healthcare. In a positive way, these applications can be later applied to other diseases as well. Data security is a big issue in health IT project. When there is an incident of data leakage, this would jeopardize people’s trust on the system.
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2021-09-10 at 7:42 pm #31258
Karina Dian Lestari
ParticipantFajar has thoroughly mentioned the information technology that has been used in Indonesia to help tackle the COVID-19 pandemic.
I want to add that the database also changed a lot from the first COVID-19 appearance until now. There are some additional variables that are now included. So if we were to analyse the data, some variables may have many missing values.
PeduliLindungi app is a nice app with some flaws. One flaw is its security, as mentioned above by Fajar. Another one is their database structure, in this case, the format of date is unclear. Some of the certificates have month and date flipped, so instead of 1 December (1/12) it will read 12 January (12/1). The other is its optimization. The app keeps asking for location even when it is not needed and drains the phone battery. I think the app urgently needs fixing and improvement on the more robust security system, structured and standardise database, and software optimization.
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2021-09-14 at 6:22 am #31301
Saranath
KeymasterDate format is always a challenge in database structure and data analysis. Many times, I have seen that the database developer (the programmer) did programming only for getting data input; they did not think beyond whether how the data structure can be used for the analysis or interpretation. Therefore, communication among stakeholders is very crucial when developing the project.
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2021-09-10 at 8:11 pm #31259
Auswin Rojanasumapong
ParticipantThe existing project that I involve in my current work is COVID-19 Vaccination for Lampang City (Amphoe Muang District). Lampang Provincial Hospital, together with Lampang Provincial Public Health Office, aims to widen the COVID – 19 vaccination coverage to the entire province. We have developed the system to manage the vaccination system, including vaccine reservation, appointment, registration, and follow-up after vaccination. For all of the activities mentioned, the main concept is paperless (and some activities are “less-paper”, which means using paper as low as possible) to avoid redundancy, save cost, and reduce contamination while touching documents from the patients. The data is executed online in real-time and transferred to the main national server automatically. This system reduces the error that might occur if the data is not input in real-time (Lost documents, error from the person who input the data)
However, while the system is very easy to use, there are some limitations of this system. The system needs hardware to be configured and often needs IT experts in order to use this system outside the main clinic. The need of using the system outside the clinic is high due to the high demand for vaccination outside the main clinic in the hospital (e.g. for bedridden patients that need vaccination on-site or for primary care units outside the city area).
Knowledge and skills that could help to improve the project are application designing and programming to be compatible with many devices, and easier to install.
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2021-09-14 at 6:30 am #31302
Saranath
KeymasterLampang province has very good system in managing COVID-19 cases and vaccination. I guess that the system has been developed within a short period. It would be great if you know what can be done and what cannot be done and how hard it is to be done in programming. This would really help you to manage and prioritize modules in the system.
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2021-09-10 at 10:45 pm #31265
Tossapol Prapassaro
ParticipantFrom my point of view, the COVID-19 pandemic initiates the development and implementation of telemedicine infrastructure rapidly. Many outpatient clinics have to adopt these patient-facing technologies because of the restricted protocol to reduce the exposure risk of patients at the hospital.
The telemedicine project has just been launched during this pandemic to facilitate the outpatient visit in my department. However, there are some limitations and problems, for example, the familiar of doctor to give consultation online, telemedicine cannot replace in-person visits because it did not provide enough information for the doctor to make an accurate diagnosis, the maximum capacity of patients is limited because the telemedicine process takes time, telemedicine is not suitable for everyone, especially the one who cannot access the internet mobile.
For the knowledge and skill that can be used to improve the projects, firstly, the development of teletriage which uses technology to create a screening tool for screening appropriate patients who need to go to the hospital to receive proper management. Moreover, developing portable or wearable devices that can send patient health data to hospitals to monitor patient status might facilitate telemedicine. Additionally, some companies have developed handheld examination kits, such as digital stethoscopes or other digital-physical examination tools, which might help physicians gain more information from patients remotely. Lastly, creating a data center for gathering patient health information will help telemedicine for further analysis.
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2021-09-14 at 8:08 am #31303
Saranath
KeymasterYes, telemedicine becomes popular and acceptable by hospitals and patients. If there is no COVID-19 situation, I don’t think that the telemedicine will be as much as acceptable. One challenge for health informatics is that we have that the IT implementation will not compromise patient’s safety.
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2021-09-15 at 7:43 pm #31320
Arwin Jerome Manalo Onda
ParticipantI share the same sentiments on the limitations of telemedicine. My dad has diabetes and I can see the difficulty of conducting teleconsultations because the physician can’t even auscultate the patient. He still need to go to clinics to have his laboratory tests done.
The pandemic accelerated the adoption of telehealth systems but leaves inequity to some demographic sectors, like Tossapol said, those who don’t have access to mobile data.
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2021-09-11 at 9:22 am #31267
TARO KITA
ParticipantThere have been health information systems in Japan, but several ones have been newly developed to deal with COVID-19 pandemic. According to the media coverage, there were a number of challenges reported in the initial stage of the pandemic.
There is HER-SYS that has been developed to enhance the system for monitoring COVID-19 outbreak, and NESID for conventional infectious disease surveillance. However, it has been reported that in the early stages of the COVID-19 pandemic in Japan, many healthcare workers preferred the latter’s notorious handwritten & fax-based reporting system because the newly developed system, which reflected the opinions of outbreak experts, had too many fields to fill out.
For monitoring medical resources such as bed availability for COVID-19 patients, there is EMIS, which was developed to support Japan’s domestic disaster management system, and G-MIS, which was designed to supplement the former’s missing functions for specific information on infectious disease outbreaks. Since some of the required information was covered by the former system, healthcare workers had to enter information in both systems that required the same core information to be entered.
There are V-SYS and VRS, both developed to support the national COVID19 vaccination program, the former to monitor the supply and control the allocation of vaccines, and the latter to register those who have been immunized. Interestingly, the two systems were not systematically linked and health workers had to manually enter the V-SYS while referring to the VRS reports.
All of the above challenges were gathered from web-based media reports, and further observation is needed especially with regard to the current situation to see how they are being improved. However, one can say that interoperability was compromised, and that the voices of more stakeholders could have been reflected in the early stages of the system development.
[Abbreviations]
EMIS: Emergency Medical Information System
G-MIS: Gathering Medical Information System
HER-SYS: Health Center Real Time Information-Sharing System on Covid-19
NESID: National Epidemiological Surveillance of Infectious Diseases
VRS: Vaccination Record System
V-SYS: Vaccination System-
2021-09-14 at 8:15 am #31304
Saranath
KeymasterThanks for sharing! I think we face the same situation in Thailand. There are many Apps and systems developed. Each one seems to working well within the system. However, lack of interoperability among system is the main concern; this could cause a large burden to the users.
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2021-09-16 at 12:56 am #31336
Anawat ratchatorn
ParticipantI am very interested to hear about health IT aspect in Japan.
I guess that problem about many stakeholders and interoperability are very challenging for many countries.
Thank you for sharing.
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2021-09-13 at 7:51 pm #31290
Arwin Jerome Manalo Onda
ParticipantA perfect example of this is the StaySafe mobile/web application. It is a mobile application developed as a contract tracing app for COVID-19. While it has a promising intentions, it fell short on the implementation.
• First, it was aimed for individuals who have smartphones. While it is acceptable for use in the cities and metros, it created inequity for individuals who have feature phones and/or unable to download the application. Likewise, the elderly have had difficulties adapting to this technology.
• Second, while it is the national contract tracing app, other businesses and cities have adopted other applications or web apps which were not interoperable with StaySafe platform. Others have used Google Forms, created their own contact tracing app, etc. StaySafe came late as others have rolled out their own ways of contact tracing. This is problematic since workers travel across cities and would require filling-up separate applications/web apps
• Third, we are unsure how data collected are handled. The StaySafe database is handled by a third-party private company which, we are unaware of.
• Fourth, StaySafe is complicated to use. Despite creating an account, it always asks me to login everytime I use it.
• Fifth, internet connection is required for StaySafe to function. In the Philippines, there are cellular deadspots even in the metro and cities on mobile data.The list goes on and on and recently, the government admitted that StaySafe, the national contact tracing app, had minimal or no impact on tracing contacts of infected COVID-19 individuals.
I believe that there are several knowledge and skills in health informatics that would have had helped in building/adopting this platform.
• By simplifying the interface and accessibility of the app, a greater consumer adoption would have helped in pushing it as the national contact tracing app.
• Understand the demographics of the users and tailor the features to respective consumers
• Extensive communication with city informaticians and IT personnel could establish interoperable systems – which would eliminate multiple contact tracing apps and integrate it with StaySafe
• Publicize how data are handled and ensure that data collected are secure and transferred over private networks
• Communicate with telecommunications companies to enable StaySafe as free to browse application and would not require usage of cellular data for loading of interface-
2021-09-14 at 8:24 am #31305
Saranath
KeymasterThanks for sharing! Health IT project can both create and reduce the inequity issue. Like your example, having the App as the national contract tracing program would make people who cannot properly access to the smart phone. In Thailand, the government also launch a mobile App for those with low-income or got impact from the COVID-19 to register and receive supported money from the government. There are lots of people in rural areas, particularly elderly who cannot get access to the App. The government came up with the Plan B that ask these people to go to a bank to do all of these procedures. There was load of people packed in the bank during that period.
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2021-09-14 at 6:15 am #31299
Navin Prasai
ParticipantDuring this pandemic, E-health(electronic health) plays a significant role in the healthcare sector. Telemedicine is widely used in remote areas for virtual healthcare consultation and online pharmacies. Artificial intelligence models are used for scanning the images and it makes it way easier for health practitioners. Various mobile application devices are used for data collection, surveillance, and dissemination of the proper information. The e-learning helped people to educate virtually and also follow the COVID safety guidelines.
Recently, Canada started virtual COVID testing for travelers. People can take the COVID kit home and the swab collection procedure is later instructed virtually . Public health informatics with the advancement of technology can reduce COVID cases but there is still more to improve regarding the privacy and data security issues. -
2021-09-14 at 10:46 pm #31313
Napisa Freya Sawamiphak
ParticipantIn Thailand, Mor Prom is an application launched by the Ministry of Public Health, Thailand. It is the app to track and register for vaccination services. I used this app to track my vaccination status and it is a good application in my opinion. The users can choose the nearest hospital/setting they prefers and make an appointment for vaccination. It will support staff in avoiding crowd and queue management. Once the vaccination is done, Date/Vaccine type/Lot will be recorded in the system together with the next appointment date for the 2nd shot. It also has post-vaccination monitoring to check for side effects.
The limitations of the application are the users need to access via mobile application only. This may not be suitable for everyone, especially in elderly population who are not familiar with mobile applications. Creating an additional web-based platform with data connectivity to the app might help in this case, however, it still doesn’t cover someone who cannot access the internet. Data privacy with appropriate consent should be considered in this case.
I am also wondering about the management of adverse event reports found during post-vaccination monitoring (I have seen from the user’s view only). It would be nice if the system can connect to Thai FDA safety database and hospitals to report/track AEs on a real-time basis. This information will be useful for analyzing the trend on AEs occurred in each population/vaccine type and can be applied in future practice. I think we can use the knowledge on interoperability and data exchange in this case.
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2021-09-17 at 5:28 am #31348
Saranath
KeymasterI agree that Mor Prom is a good App for vaccination program. At the beginning, there were some miscommunication between vaccine supplier, hospitals and vaccination centers, and Mor Prom admin. This created frustration among stakeholders. But overall, I think the App itself is very good.
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2021-09-19 at 11:47 am #31420
Pimthong Sinchai
ParticipantI agree with you about Mor Prom project is very good but it also have a limitation to improve.
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2021-09-14 at 11:12 pm #31314
Ashaya.i
ParticipantThere are many application applied to cope with COVID-19 outbreak, for example, application for vaccine reservation, COVID-19 confirmed case tracking, hospital searching etc. Still, all of these application need to develop for the better healthcare performance. An example of the existing project from my workplace is called ‘Health Up’ application, which is an application from the hospital group which allow patient to access their personal health history, make an appointment, receive health examination and laboratory report, vaccine reservation, telecare, and so on. Patient who has not serious health condition can access to healthcare provider even though they don’t come to the hospital. By doing this, patient must accept the privacy notice to access the data they want under the terms of use. The limitations of the project are included it is limited for patient who has personal health data within hospital group and patient who can use smartphone and electronic device, also, it needs internet access all the time. Another limitation of the project, it is require the IT professional to maintain and develop the application together with healthcare professional which require knowledge of health data privacy and security, skill of database management and expertise in data interoperability along with the innovation creating skill to serve the patient’s need and promote the better health status appropriately. Moreover, I think the application that private sector create should be linked to government sector to improve the service performance.
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2021-09-15 at 6:36 am #31316
chanapong
ParticipantBased on my experience on using telemedicine application of my hospital during the outbreak for OPD case, it is the mHealth that can increase accessibility to healthcare when people don’t want to visit the hospital by themselves and decrease the crowded of patients to prevent the virus from spreading. It is a very useful application, but there are some limitations. It is not easy to use by the clients, especially the elderly, and have to receive advice from the officers before using the application, It cannot link the data about healthcare coverage and previous medical record from the hospital database, and have to register some data before using. And it is not a one-stop service application, so we have to externally open the other link to using some functions, such as fee payment or video call. Lastly, there is a shortage of devices provides to healthcare providers to use this telemedicine. So, there is a limited number of patients receiving telemedicine at the same time.
To improve this telemedicine project, I think using EA at the beginning of the project can help solve these issues. The application should link to the hospital database and provide a one-stop service in a single application. And the application should be design to be user-friendly, especially for the elderly, and provide service on the other platforms, not only on mobile phones. And the device provides to healthcare professionals for using telemedicine should be properly adjusted to the demands of patients of each department.
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2021-09-15 at 8:09 pm #31324
Auswin Rojanasumapong
ParticipantI agree with you about the limitation of mHealth, especially for elderlies who can get benefit from this system. Many elderlies who are home-bound or bedridden cannot visit the hospital due to difficulty in transportation. However, my experience with mHealth with elderlies involves working with their family and their caregivers who are younger and have some level of digital literacy. For the younger generation and after the COVID-19 situation I think mHealth would be one of the mainstream health care services.
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2021-09-15 at 8:41 pm #31327
Theekhathat Huapai
ParticipantMy experience as a physician in a provincial public health government that doesn’t have a specific region like a community hospital. My two current projects are working in a supporting role in a community hospital.
The first project is covid vaccination. We use a Mhor Prom application to manage a vaccination program in Nakhonsawan city. This program is working quite well. Vaccine availability and bug are major problems.
The second project is home isolation. We are using the Dietz program. This program is a well-developed application that can record health information from patients and report directly to personnel who are in charge. They are several limitations of this program. This program is web-based only and doesn’t have a built-in telemedicine function. We need to use Line’s official account for communicating with patients.A different health informatics system is a major obstruction for good interoperability.
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2021-09-16 at 12:53 am #31335
Anawat ratchatorn
ParticipantDuring the COVID-19 Pandemics, As a physician and an CIO for a private hospital in northeastern of Thailand, I’ve been experiencing in few health IT projects. I am a project owner for some projects and a user for some projects.
1. Health monitoring application for Hospitel.
My hospital built many hospitels for mild-illness covid-19 infected patient. The major problem that worsen work process of healthcare providers is we cannot examine or take care of patients without wearing PPEs. It’s quite struggle for healthcare provider to wear PPE to examine about 200patient twice or 3 times a day.That’s why we decided to create a application that can connect between patients and healthcare providers without physical contact. The application provide features that enable patients to fill their own vital signs, self-monitor finding, and surveillance questionnaire (Such as 2Q and 9Q the evaluate MDD) via their mobile device. Then our staffs can reach all of collected data via our web-application that contain user-authorization needed, alert feature when there are some abnormal sign to be concerned, etc.
Although this application is running smoothly, there are some issue that can be improve with knowledge about health informatics.Now, the application is just a standalone and specific purpose built. It would be good if we integrate knowledge of interoperability, Enterprise Architecture to make the application can communicate with our HIS and other application in own systems.
2. Projects relevant to Vaccination
2.1 Mor-Phrom is one of projects that I’ve been experiencing as a user. This project, in my opinion, have a good design for user. Unfortunately, it have some bug and some struggle with communication that affect negatively to user such as appointment problems. That made very weird event happen, many provinces in Thailand build their own xxxx-Phrom application to manage their own vaccination plan. This event create redundant and complicated of data. The health informatics skills that can help this issue might be about
– communication skill to solve problem about appointment.
– knowledge about Enterprise Architecture and good planning might prevent the happening of XXXXX-Phrom Phenomena in Thailand2.2 MOPH-IC, Co-Vaccine and Vaccine Management Application for CRA – These application is built for management of Vaccination process. MOPH-IC and Co-Vaccine are working well together to collect all patient data, create report, collect vaccine data and cover all about vaccination process. Although there are some bug and some downtime, it’s still working well and smoothly in the real situation for my hospital.
When it comes to CRA Vaccine Management Application, the application aim to build its own system to manage process of vaccination and healthcare provider must use the system in parallel with existed application, MOPH-IC and Co-Vaccine , thus increase work-load of healthcare providers and increase in redundancy of data. but at the end of the day, we can go back to use only MOPH-IC and Co-Vaccine to manage vaccine from CRA.
Again, in my opinion, the limitation and major problem is about the lacking in implementation in Wide-Enterprise Architecture, interoperability and communication between organizations. These factor can reduce redundancy, repetitive and unnecessary stuffs and can also improve quality of data and application performance.
2.3 Vaccine Reservation System – For this kind of project, I am a project manager. Basically, vaccine reservation application should be just a simple application that collect simple data from patient. Unfortunately, the most challenging factor are timeliness and high-traffic due to very high demand. There are a lot of problem for this application such as system downing, inaccuracy data, many bugs and also incoming problems about data management and utilization. Knowledges about health informatics might help me a lot such as project management skills to mange the project on time and reach good efficientcy, implementing good Enterprise Architecture that will be a back bone for this and further projects.
Addintional
I think that the another same limitation for all application is about ease to use. Application should be designed not only for well-trained user but for all healthcare providers.At the end of the day, I can say that knowledge about health inforamatics would help us a lot in improving health IT project.
– Interoperability will improve quality of healthcare and healthcare IT in many aspect and there are many things to do to reach it.
– Enterprise Architecture and also Wide-Enterprise Architecture that can make a decent overall backbone for all application.
– Good information system design can help reducing redundancy, repetitive and unnecessary stuffs.
– Communication between organization and intra-organization are very important to improve every aspect of Health IT-
2021-09-16 at 9:59 pm #31343
Napisa Freya Sawamiphak
ParticipantSeveral applications are developed to manage the COVID-19 situation. Sorry to hear that you faced some issues with Mor Phrom, creating xxxx-Phrom application sounds so cool for me and so is your project: Health monitoring application for Hospitel!!. Thank you for sharing. I will look forward to your new health IT project.
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2021-09-17 at 5:44 am #31352
Saranath
KeymasterGreat! Thanks for sharing! The communication is a critical factor to determine successfulness of the project. Many Apps have been developed, but lack of communication may create problems when using is.
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2021-09-19 at 10:52 am #31419
chanapong
ParticipantI really agree with you about your Health monitoring application for Hospitel to connect to HIS. It is very useful for an app to automatically update data to a database timely. It can also help to manage not only the patient but also other resources.
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2021-09-19 at 1:15 am #31412
Pimthong Sinchai
ParticipantIn my opinion, I think during the COVID situation there are a lot of health IT project that launched into public and have less efficiancy such as More phrom from Ministry of Public Health, and other vaccine-reserved website.
Mor Phrom is the application that user can tracking there vaccine history and also inform a lot of good informations about health care such as how to protect yourself for COVID. But there are some limitation of More Phrom, for my own experience, my university announced new date of AZ second dose, but there are nothing update in More Phrom. Also vaccine-reserved website, the limitation is there are specifically in some area. Moreover, I think the vaccine and other platform should be available and accessible for everyone because the government exactly have our data. This part should be improve from the developer of application/website and government, what if they can sharing the information to each other lead to facilitate and improve health care of people.
Another Health IT project that I think is quiet good is Thai Rhuu Su COVID Facebook page from Government too. Because there are another platform that in from the information of the number of case daily updated. But this platform should improved in visualization and presentation of the information, due to sometimes the infographic is make confuse instead of understand.
Thank you.
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