- This topic has 31 replies, 15 voices, and was last updated 4 years, 4 months ago by imktd8.
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2019-09-26 at 11:30 am #13886SaranathKeymaster
As we learn that 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.
1. Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
2. Do you think that this health informatics project can help to improve the current practices, how?
3. Are there any challenges or difficulty in implementing the project?
- This topic was modified 4 years, 6 months ago by Manatsanan (admin).
- This topic was modified 4 years, 6 months ago by admin.
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2019-10-21 at 9:16 pm #15002ChalermphonParticipant
1.Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
Event based surveillance application from Department of Disease Control. Event based surveillance application is the programs to present infectious disease outbreak and health hazards all over Thailand follows the conditions of disease and hazards that the programs have data structure of data collect, such as patient data, investigation , Laboratory “input by related agencies” System processes to analysis and interprets data to summarize information and GIS of the outbreak and investigation.2.Do you think that this health informatics project can help to improve the current practices, how?
– improve quality of work. Systematically records event
– Reduce cost of paper. Online input data.
– improve system safety and privacy of data. Level to access3. Are there any challenges or difficulty in implementing the project?
– Data exchange of Laboratory surveillance from other department because of Laboratory surveillance have many departments for tests and results are follow later than input event.-
2019-10-21 at 11:10 pm #15003SaranathKeymaster
Hello Chalermphon! Good example! I think the electronic event-based surveillance system could potentially improve the timeliness of data for outbreak investigation (beside the delay in lab result). Timeliness is one of a key for successful outbreak control!
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2019-10-23 at 4:20 pm #15060tullaya.sitaParticipant
1. Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
In our hospital we try to integrated health informatics to improve our service. The big project of our hospital is e-his, it was an integrated health information system that connected the physician’s record, nurse record, physician’s order for laboratory and medication and also the billing system. It was first use in in patient department and soft launch as a tools for laboratory order and a medication order.2. Do you think that this health informatics project can help to improve the current practices, how?
If this project can fully operated it will help us much in many aspects such as
– The continuity of care and records of the patients who transfer to various department or have a lot of physician to involved
– Minimized the medication errors from prescription error
– Prevent loss from the billing department, such as the minor laboratory order that health care personnel may skip the cost3. Are there any challenges or difficulty in implementing the project?
There are many difficulties in this project. First of all, the resistance from health care personnel especially for physicians and nurses because it puts tons of work to them by change writing into typing input to the systems. And also the application is not user friendly it might be developed without the voices from end user, it makes the way to order is much more complicated than usual. At the end this project was withdraw for a while and it was come back after minor change. Nowadays it use as the way to order the laboratory test and still have a plan to full function in the future.-
2019-10-24 at 10:17 am #15078SaranathKeymaster
Hi Tullaya, Most HIT projects were launched with a confidence on the value of improving workflow, reducing medical error (Information & Health parts). But one of the values that we have to really consider is user satisfaction (People part). Many HIT projects are fail due to inappropriately handling people issues.
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2019-10-26 at 4:24 pm #15194Pyae Phyo AungParticipant
User friendliness is a very challenging part in implementing the project which might lead to project failure.
Most of the IT are struggling the database maintenance, software bugs and other feature and spend a little time to design for user friendly. Which may be due to insufficient IT staffs and funding.
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2019-10-23 at 5:07 pm #15063Pacharapol WithayasakpuntParticipant
1. Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
Actually, I have been in 3 district hospitals, using the same computer application. Nurses and pharmacists also use this same application. It helps managing during a visit, and between visits. It can also help to reduce paper, at the initial cost of scanning. It might also be able to lay an infrastructure for interoperability, by using the same application between different hospitals.
2. Do you think that this health informatics project can help to improve the current practices, how?
Of course, at least in a well-scanned hospital, it can help in proper management after hospitalization. However, one can easily see the lack of interoperability between hospitals using the same application.
If there is a good software with superior UX, it may help to minimize using papers, as inputting as digital right from the outset might be easier… just like in many restaurants using only tablets, nowadays.
3. Are there any challenges or difficulty in implementing the project?
– Standardization of framework model for this application
– Appropriate employment of workforce to implement the said model. Also, timeliness of working for inputting the data, e.g. before the next visit
– Make the parent company buy in to better the user experience for filling in the data for better interoperability
– Better models for interoperability might come from pre-existing works in Emergency Departments, where timeliness and interoperability between hospitals is the most important thing?
– On more focus on typing in, and less on scanning, hand-drawing and descriptive information are lost.
– Maybe some newer software, with OCR can help “cleaning” and “vectorizing” the data?As we learn that we can consider that health informatics can help to increase value of healthcare practices, in terms of cost, user satisfaction, and superior outcomes.
– Superior outcomes, will be satisfied, of course, but there is always cost of laying out the infrastructure.
– If end-user (patients)’s satisfaction is improved, there will be more drives for employees to work harder; however, in actuality superior public health outcome (such as TB control), does not always equate to immediate satisfaction (i.e. instant gratification), and patients have differing psyche, and might value long term satisfaction differently
– Sometimes patients deny hospitalization, fearing that they might lose employment or stability of income. I have heard this from admitting patients for tuberculosis control.
– Sometimes patients requests antibiotics, and denies RDU as well. High fever drives instant gratification, and denies longer term drug resistance control.
– I believe satisfaction should be the first drive.- This reply was modified 4 years, 6 months ago by Pacharapol Withayasakpunt.
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2019-10-24 at 11:21 am #15079SaranathKeymaster
Hi Patcharapol, I agree that user satisfaction is the main factor to consider value of an HIT project. “Users” should be considered as various stakeholders related to the project, not only patient side. Interoperability is another issue. We will learn about Health Information Exchange next week.
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2019-10-24 at 9:24 pm #15101AmeenParticipant
1. Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
I have never been directly observing health informatics projects. However, at our company, we are developing support services for wearable medical-alerts devices. The device is an in-house development but not at our business unit. The services we provided are to support the monitoring of the elderly and vulnerable.
2. Do you think that this health informatics project can help to improve the current practices, how?
As we all aware, Thailand is an aging society. We are gaining number of elder old but failed to keep the growth rate of working age. The question is, Who will take care of the elder?
In terms of cost, replacement of human carer with the device is cheaper. In terms of user satisfaction, it depends on who is the actual services-receiver. If it’s the elder themselves, they will feel safer which fulfills their needs. But if it’s their family member, the family for sure will feel fewer concerns about their parents when they are at work, but the elder may feel abandoned. In term of superior outcomes, such as aging-associated diseases. The faster the sign of life-threatening conditions is found, the faster the patient is to be taken to doctor which can be lowering severity and mortality.
3. Are there any challenges or difficulties in implementing the project?
The most challenges are precision of medical sensor, data collecting and transmission and interpretation of collected data. Oversensitivity of the sensor can flood alert system while under-responsivity means life.
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2019-10-26 at 2:20 am #15188SaranathKeymaster
Ameen, having wearable device to help alert health event in elders is a good idea. As you mentioned, we have to make sure that the device has a good precision and accuracy. We don’t want too many false alarms…as it will lead to alert fatigue and people will no longer pay attention to the alerts. Importantly, we also do not want the system to have less sensitivity that could not detect the health event.
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2019-10-26 at 4:27 pm #15195Pyae Phyo AungParticipant
Hi, I don’t have any experience on wearable medical-alerts devices. But sound good. Hope I can learn some experience form you about the devices.
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2019-10-29 at 2:22 pm #15278tullaya.sitaParticipant
The wearable medical devices sound good, It should help carer a lot about alarm for harmful event. As you mentioned Thailand is in Aging society and our populations are reduced. This device will have a lot of impact in the near future. The precision is the heart of the devices, user don’t need too much false alarm neither high threshold to alarm (because it may be too late). Furthermore, the devices should also be connected to the mobile device of carer in order to help elderly right away.
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2019-10-25 at 9:40 am #15129supawat.chtParticipant
1. Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
Our hospital try to move forward to health informatics but support only electronic drug ordering. For the medical record is still on the paper-based system. However, medical records are scanned for later reviews on the hospital computers.
2. Do you think that this health informatics project can help to improve the current practices, how?
Drug ordering can facilitate the workflow and reduce human error in the process. Since our system is still not fully electronic, therefore, paper-based medical records may make some difficulty.
3. Are there any challenges or difficulty in implementing the project?
I don’t know the real reason why we can’t fully transform to health informatics. So I think the software may not support some function at the first place. Therefore, the EA should design to serve all requirements and be able to change or modify during implementing process. If the designed system is so rigid, when a problem occurs then transformation can’t be fully developed.-
2019-10-26 at 2:23 am #15189SaranathKeymaster
Dear Supawat, fully transform from paper-based to a full EMR is such a challenge, both technical and people. In many hospitals, doctors are the main group who resist to the change. We have to have a proper change management in the organization.
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2019-10-29 at 2:27 pm #15281tullaya.sitaParticipant
I totally agree with you Dr Saranart. As I mentioned in my response, the first HIS project in my hospital still use only some part. However, originally they want to launch HIS project in OPD setting after IPD setting. After a lot of resistant occured, the HIS project for OPD is withdrawn and we use only a paper-based scanning and storage system.
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2019-10-25 at 10:02 am #15132w.thanacholParticipant
There is a project called Detection and rapid response on the respiratory threat (DARRT) in Chiangmai province. It is the web-based application that able to retrieve the electronic health records from public hospitals in Chiangmai. Patients with the ICD-10 diagnosis-related of influenza-like illness which represent influenza-like syndrome will be collected and sent to the central server. The algorithm also analyses to detect the cluster of patients in the community based on the patient’s address which we could verify the outbreak earlier and respond rapidly.
The project aims to detect the outbreak faster because in the national-notifiable disease surveillance has rather less sensitive criteria and could detect the patient who was only diagnosed as influenza. The limitation is influenza has various degree of symptoms, mild to severe, hence influenza is rarely diagnosed. This project will generate a signal to detect the cluster of a mild type of influenza which would be diagnosed as a common cold who come from the same village.
The difficulty of this project is it has less specificity, and create false positive signals. The next step of the project should focus on evaluation and how to create a more reliable signal.
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2019-10-25 at 11:39 am #15170THONGCHAIParticipant
1.Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
In my public health office have many health information projects.I have a health information project about TB. That can analyze and report Data from NTIP every months.NTIP is National tuberculosis information program.I download register patient file data from NTIP and upload to my software by FTP. It’s web application software can report data from NTIP to summary data and chart , this program is change TB database to TB health MIS information.
2.Do you think that this health informatics project can help to improve the current practices, how?
I think this health information is very usefull and easy to used.
– improve quality of work.
– Save cost and time.
– Can forecasts data to the future to planning.3. Are there any challenges or difficulty in implementing the project?
I can make web base application to report but data extract from NTIP is not easy , it have a lot of time because NTIP system is not design for easy to download , I cannot download all patient register data by one click , when I try to download all patient register data from NTIP it take a long time and show error.
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2019-10-26 at 2:29 am #15191SaranathKeymaster
Dear Thongchai, it is interesting! Accessibility to the data in the system is quite important for local public health operation.
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2019-10-26 at 8:41 pm #15200THONGCHAIParticipant
You can see it at this link.
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2019-10-26 at 4:16 pm #15193Pyae Phyo AungParticipant
Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
Yes, I have been observing health informatics projects in our organization. Those projects are OpenMRS(Open Medical Record System), LIMS (Lab information management system) and GeneAlert.
OpenMRS is for HIV,TB and Hepatitis C program.
LIMS is to record HIV viral load testing data of all State/Region in a single database.
GeneAlert system use in TB program and alert immediately is drug resistant strain is found. GeneAlert system automatically send SMS to health care provider including information about patient ID and result of Gene X pert (Rifampicin Resistant).
2. Do you think that this health informatics project can help to improve the current practices, how?
Yes, OpenMRS can health patient management and data recording and reporting system. It reduce the workload of health care provider.
LIMS help creating national level dashboard which can monitor the every detail and help management level for better decision making and action taking.
GeneAlert help sending SMS to health care provider and provider can appoint the patient fast and provide treatment early.
3. Are there any challenges or difficulty in implementing the project?
Challenges in OpenMRS, as It is individual patient recording system, health care providers need certain extend of computer literacy. Infrastructure, internet connection and user attitudes are challenging points.
In LIMS, data are not directly import from viral load testing machine. Lab technicians enter the data into LIMS manually therefore there might be chance of human errors.
In GeneAlert, good internet is required and health care providers SIM card status.
As mobile phone and SIM are getting cheaper, people frequently change their SIM in our country. If a SIM registered in GeneAlert system is changed or not working properly, the alert will not reach to health care providers and there will be delay in services delivery. -
2019-10-26 at 7:49 pm #15198NakarinParticipant
1. Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
I have experienced a work-related to informatics. Remote-site recorded all the data of volunteers in the paper which we designed for them (we call “Sample Log”). Then, they have to send us that sample logs along with the samples collected from volunteers to Bangkok. And we have to enter the data from the sample log into our database before using that data for our study.2. Do you think that this health informatics project can help to improve the current practices, how?
I think it would be better if we can let the staff at remote-site enter the data of volunteers into the database directly from the site instead of sending that sample log to Bangkok. It could help us to reduce cost, workload and save time.3. Are there any challenges or difficulties in implementing the project?
The challenging of my opinion in question #2 is the readiness of the remote-site. It is not about the site’s staff but it is the public utility of that country which our site located in. some site does not have internet. Some site has a limit of using electricity.-
2019-10-30 at 8:43 am #15306SaranathKeymaster
Akkarin, having electronic data entry at field site is a challenge, both IT and people sides. Before implementation, we have to prepare well to make sure that the implementation will go smoothly. Otherwise, people may have bad impression with the system and then against to use it.
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2019-10-27 at 2:39 pm #15206anothailand (OHN)Participant
1. Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
Yes, I observed the 2 of PHI projects, both were run by public health ministry. First was HDC dash board, It help to summarize the overall area-based situation of CD, NCD, occupational diseases,and etc. Second was NEHIS or National Environmental Health Information System, It used GIS to localized the environmental hazard in each area, and support the surveillance system for population impact of environmental health hazards. This both PHI were developed to assist in control of occupational and environmental diseases.2. Do you think that this health informatics project can help to improve the current practices, how?
Yes, I do. PHI can help to build more reliable,fast-responsive, and confidentiality-proof surveillance system for population health, both in the industry sector and community sector.3. Are there any challenges or difficulty in implementing the project?
Main challenges of implementation is the complexity of diagnosis and confirmation of diseases caused by work environment or environmental factors. So the report always underestimated, and there are also some legal aspects that requirement to notify the diseases doesn’t seem to have strong penalty and feedback system. Moreover, informatics system need to integrate various data from many organization such as ministry of health, ministry of labor, and ministry of environment. This is a huge project to come.- This reply was modified 4 years, 5 months ago by anothailand (OHN).
- This reply was modified 4 years, 5 months ago by anothailand (OHN).
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2019-10-30 at 8:47 am #15307SaranathKeymaster
Anothai, quality of data input into the system is an important issue for developing a system, otherwise it would be difficult to make use of the data. This is why attempt should be made to integrate existing data from different sources to reduce data input workload.
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2019-10-27 at 10:22 pm #15225weerawan.hatParticipant
1. Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
Health Information System. This will integrate all data of inpatients and outpatients. There are both structured and non-structured data. Doctors and nurses can access OPD cards, labs results, x-ray, patient visits, and treatment.
2. Do you think that this health informatics project can help to improve the current practices, how?Yes. This project can help reduce data fragmentation and duplication, reduce time, workload and cost. Decision making can be done in timely manner.
3. Are there any challenges or difficulty in implementing the project?
Yes, such as users’ limited technological abilities, resistance to change. The challenges are concerns about confidentiality and privacy.
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2019-10-29 at 11:11 am #15271Penpitcha ThawongParticipant
1. Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
Generally, my organization roles are related to promote individual health; however, I had chance to create the information system named “iMoji: Integrative Molecular Outbreaks and Joint Investigation” that aims to integrate genomic data and GIS of MTB clinical isolates. This system is capable for visualizing the molecular based outbreak of MDR-TB and identify hotspot area in endemic area of MDR-TB. So, if our programe is complete, we will be able to use the information to guide particular intervention for MDR-TB control.
2. Do you think that this health informatics project can help to improve the current practices, how?
I am really believe that the iMoji system will help us to investigate TB patients and the genotype of MTB, the incident area for controlling and preventing TB patients aspecially MDR-TB.3. Are there any challenges or difficulty in implementing the project?
The implementation of iMoji relates to many institutes including TB laboratories in Thailand for transporting a MTB sample from the patient to test: MIRU-VNTR, spoligotyping, next-generation sequencing, at the Department of Medical Science. Therefore this step is the most challenging; we need to ask for collaboration. Then, when we have got the result we need to confirm that each health care applies the information to enhance TB control. -
2019-11-16 at 8:23 pm #15609Dr.Watcharee ArunsodsaiParticipant
1. Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
I have ever used the GIS.BIOPHICS.org for malaria surveillance report for my research work. The GIS map will report the malaria positive cases passively after the patient visited the malaria clinic or the hospitals. The data will be classified as sex, age, nationality, and map of the case distribution by area and time.2. Do you think that this health informatics project can help to improve the current practices, how?
This project can help to inform the current situation of malaria cases and set countermeasure appropriately in time. Thailand envisions the elimination of malaria by 2024 and sets out to target malaria elimination in more than 95% of districts by 2021, and all districts will be malaria-free by 2024.
This health informatics project is setting real time and can alert the awareness of the clinical practice.3. Are there any challenges or difficulty in implementing the project?
The project is disrupted as I could not access it anymore. The challenges may be the infrastructure problems, funds, passive surveillance taking some time to report. -
2019-11-23 at 4:22 pm #15797imktd8Participant
1. Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
In my company, there is no a health informatics project but I have just known that PTT has just joined with Sa Kaeo Crown Prince Hospital Foundation to delivery a health service named “Smart Preventive Healthcare” in the 5 PTT gas station. This project includes of the online booking system, receive medicine system,vending machine medicine, smart locker and telemedicine clinic which provide health sevice to local community and increase the medical opportunitied for people who may stay far away from the hospital.2. Do you think that this health informatics project can help to improve the current practices, how?
In my opinion, our country has a problem about lack of doctors and medical opportunities. The ratio of a doctor per patient is not enough. Then the “Smart Preventive Healthcare” project helps to improve the medical opportunities. When you are sick, it’s hard to go to the hospital sometimes by several reasons, for example, on working, no time, distance from home/office to hospital etc. “Smart Preventive Healthcare” is a greate choice to help people to get a medical diagnosis or treament on time.3. Are there any challenges or difficulty in implementing the project?
Due to I am not join with this project, so will not know for more detail. Form my experience in SAP project implrementation or new IT technology system. There are a lot of problem,obstacles and challenges, for example, risk in project planning, lack of knowledge or people, suitability of the model, technical term and infrastructure problems.
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