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The article provides a roadmap for the implementation of digital health policy by stakeholders to prepare for and address current and future pandemics. Based on the themes proposed in the article, which theme(s) do you think that your country still lacks or needs improvement to strengthen the preparedness in your country.
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Taking the opportunity from post-pandemic momentum, to date, I believe that my Indonesia country is strong in making stakeholder collaboration, preserving information transparency and trust, creating and sharing health intelligence, and embarking the digital transformation. This year we are organizing the G20 presidency forum in which at this time two of three critical points are being fostered such as maximizing global health architecture and embodying an inclusive digital transformation.
As an archipelago country that serves hundreds-million inhabitants throughout thousands of islands, a challenge that hampers the accomplishment of these two points is about securing internet equity. It is true to mention that techquity issue (with a particular focus on technological equity) poses a digital gap that decreases support of internet connectivity for those residing in frontier, outermost, and less developed regions. While Global Health Security entrusts all countries to possess the ability to detect, prevent, and respond to emerging pandemic threats by reaching digital maturity, there is a need to invest in technology and infrastructure to adopt low-cost satellite connectivity and subsidized mobile phone plans for those marginalized societies.
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Thanks for sharing your experience! Since the internet has been one of the infrastructures of IT systems, having well-covered and high-speed internet that could catch up with the evolving disease situation is a pre-requisite for the system to work properly. I wonder if there is any national development plan underway for this obstacle and if there is any strategy we can adopt from other countries that share similar landscape issues.
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Of course, we had. The Mid-term National Development Plan (2020-2024) exhibits that one of the goals to achieve a digital nation is to secure information technology infrastructure. It can be inferred that the distribution of internet supplies throughout my country ought to reach an equal allocation by 2024. Although its performance was influenced by an unprecedented pandemic that led to mobility restrictions, what we had done so far seems shocking because distribution was mostly centralized on a populous island called Java. To illustrate, more than fifty percent of all BTS (based transceiver stations) are located in Java while other regions that have remote rural landscapes accounted for only 4-7%. That is what I mean by the huge disparity in techquity issue.
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From my point of view, Thailand has good performance to develop digital health policy and implement it to prepare for the next pandemics, However, there are some rooms of improvement. According to the provided article, Thailand still needs to improve some aspects in following themes. First of all, we need to improve some issues of our teamwork skill. The data generated from each point must be integrated to the center and analyze as the whole information. Moreover, this information should be linked among stakeholders, for instance, clinician, citizen, policy makers, etc. Second, inequality to access to the information is still a problem in Thailand. Some people do not use smart phone that enables them to send and receive information by the application.
These are major gaps that I think there is an opportunity to make some improvement.
Thank you.
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As from the article given, there are 5 themes listed including Team, Transparency and Trust, Technology, Techquity, Transformation.
I think Thailand still have gap in development for all of them. However, I think the most important one is Transparency and Trust. During the peak of COVID-19 outbreak in Thailand. Both government and private section implemented many policies including the travel restriction, contact tracing mobile application, vaccination records mobile application or even the mobile application to use the 50% off support from government fund for foods/supplies. (“คนละครึ่ง”) you would like to buy to support the wellbeing of Thais.
In my opinion, Thai people especially who lives in Bangkok, or the big cities are quite familiar with the technology and open for adoption. However, due to the trust issue between the people and some departments. It led to delay in implementation and the failure in implementation over the period. People tends to try the implementation at first, if there is no significant benefit/change they realize from that, they would stop doing that.Digital health policy is like other policy. The trust and action from the citizen are the most crucial one. In my opinion, even the most sophisticated health technology is useless without the user and well-planned implementation
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From my point of view, Thailand did well in the mid to late stages of the epidemic, and there was still a lot of improvement in the early stages. In the early stages of the outbreak, each stakeholder does their own work to deliver outcomes. He made dozens of applications that worked separately, inconsistently adding to the burden on the people. This problem can be solved by planning from visionary leaders and managing each unit to work together at the beginning.
The early data on the number of infections was not reliable and not transparent, leading many people to think that the reporting was controlled by someone with hidden interests. Moreover, data stored by the state is frequently hacked, indicating untrustworthy security that should be urgently corrected.
Finally, in the aftermath of the coronavirus outbreak, the government came to take care of unity which was considered a good solution. However, it remains to be questioned whether in the next outbreak “Will we be ready and skilled enough to deal properly from the beginning?”.
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Thanks for sharing your idea. It’s interesting that your analysis goes beyond the scope of IT to the governance issues at the national level as well. This is also crucial to the overall trust and management during the pandemic. I would say that Thailand has many opportunities for development in both areas!
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From the perspective of Myanmar,
Theme 1: Team Collaboration between stakeholders in health teams during pandemics to promote the flow of data must be prioritized.
I have to say before and after the military coup, the situation is totally different. Before the coup, coordination and collaboration between ethnic arms group and the central government is good but after the coup zero data is shared across the teams in different region.Theme 2: Transparency and Trust
Same as Theme 1, totally different situations before and after the coup. Before the coup, MoH report near real-time data to the pubic weekly and majority trust the government but after the coup, the majority of the public doesn’t trust the military governmentTheme 3: Technology
As Myanmar is an LMIC, our investments in digital technology is relatively lower compare to ASEAN country already but before the coup, weekly updated dashboard with accurate information up-to township level can be viewed by the public but after the coup, no one trust that dashboard anymore. So, before the coup, although compare to ASEAN countries, our investment in digital technology is less, we manage to leverage use of IT but after the coup all the systems collapsed.Theme 4: Techquity
In Myanmar, inequity exist in every aspect not only digital technology. There is a vast difference in rural vs urban and delta vs ethnic areas. In short, digital inclusion is not embraced.Theme 5: Transformation
Before the coup, although not enough, there are planned investments to transform the health systems using digital technology (e.g., developing health insurance systems using Health ID) but after the coup, all of those plan investments are scrapped in the 2022 mini-budget issued by the military government.Myanmar lack in all the thematic areas and we have to restart the health system from scratch. Unfortunately everything fall under the political umbrella and we are hopeful that in a short future we can rebuild the health system soon.
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Thank you for sharing! I believe that Myanmar has its own uniqueness in diverse ethnic groups which could be utilized in favor or against any activity. Your answer did a great job of showing us the impact of the coup on the healthcare and IT system which might take years to recover.
Hope that Myanmar will soon recover from the impact of this political disturbance and relaunch its healthcare system
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I would like to address Transparency and Trust as one of themes which needs to be improved. From the previous pandemic COVID-19, I was working in healthcare units where I was the health care user of digital health. I could see the possibility of data leakage at the end user site.
Because the digital implementation had to be widespread across the whole country as quick as possible, most technology training focused on application implementation and reimbursement, and did not concern privacy and confidentiality issues. For example, the Online ATK certificate from Moh Prompt application could be verified and generated by many healthcare providers involved such as Hospitals, Medical clinics and Pharmacy stores which means there were many healthcare and general staff from both public and private organizations who could get into personal information such as ID card, telephone number and other personal contacts. Particularly when there was a crowd of patients, many staffs had to take turn to do the task. This has created high chances of information leakages which might impact the reliability of healthcare organizations.
Moreover, there has been many personal information leakages news from staff in the organization who revealed data for personal profit. These have shown the fragility of data security at the user organization.
For further development, preparation on authorized users and privacy and confidentiality concerns could be acknowledged to raise awareness and tighten data protection from the end user site.-
Thanks for sharing this insight! This is an important loophole that could result in mistrust among related parties. Data privacy has become more critical than ever with the implementation of the Personal Data Privacy Act (PDPA). Hope that we will have a better and more practical safeguard against this sort of data leakage coming up in time!
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From my point of view, I think Thailand is doing good at start implementing digital health policy and handling with this COVID-19 pandemic. However, based on the themes proposed, including Team, Transparency and Trust, Technology, Techquity, Transformation. I personally think Thailand still need to improve all of them.
Team – there were so many applications launched by many stakeholders and government sectors.
Transparency and Trust – because of the current government, it makes Thais aware of their own personal data inputting into the system, regarding the security and confidentiality.
Technology – since there were more than one government application launched out. It seems like there were no interoperability between the system in sharing data. It caused redundancy data inputting between applications.
Techquity – superficially, it seems to be no techquity in Thais but in reality, it is not. There are still gaps between generations which cause inequalities of utilizing digital health services. Nowadays, the information technology world is moving very fast. Some of old generation or even new generation cannot keep up with new developers and trends. In addition, the cost of accessibility to use services and devices are still high when compare with the standard labor cost. This issue needs a policy to work in order to enhance access to digital health services.
Transformation – as I mentioned earlier, the applications required data input redundantly. It seems like there is no data sharing standards between each platform.
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Thanks for sharing your idea. The lack of techequity is very true and probably is true not only in Thailand. During the early COVID-19 mass vaccination campaign in LA, we did have to ask for volunteers to help the elderly fill in their electronic vaccination records. I think we might see more adaptation of IT services or platforms to meet this need.
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Like other Thai classmates, I do agree that we’ve done a good job on IT implementation in mid and late pandemic. However, I believe there’s a room for improvement all of five themes. I would like to mention “team” and “techquity” which I think
we could do better if we face the next outbreak.In terms of collaboration between stakeholders, it needs to be done at the very beginning or probably earlier than that happened this time. There were many non-government stakeholders that try to support but not linked in the main system. The data flow and information were very limited only in the center, no effective communication with the public and citizens which probably are the largest stakeholders.
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Ever since the COVID-19 pandemic, Thailand has shown its potential towards a digital health transformation. Many projects and applications have been launched from the government with cooperation from private sectors. All of them have shown promising results. So I think in a theme of
Team, my country is doing incredibly well.Like many classmates from Thailand have stated that our country needs to improve in the theme of “Transparency and Trust” and “Techquity”. Some of the platforms provided by government sector have utilised our personal data for their primary goal, yes, but provided that the political situation and citizen’s perception of the government transparency have become questionable that they might abuse the data.
For “Techquity” theme, even though most people nowadays have been using smartphones, it is an undeniable fact that there are still some places especially in rural areas where technology is still hard to access. The cause is mainly from a different in socioeconomic status, lack of government support and education.
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From my point of view, it is good that Thailand started to implement health technology during the COVID-19 pandemic. However, there are still some fields per the article of Al Knawy B., et al. that need to be improved.
Team: I can see that there are many teams in our country trying to create a digital health platform such as telemedicine, and health consultant applications from various public and private sectors. I believe that if we could combine digital health platforms into one central system policy, the health data would flow smoothly and be utilized as much as possible.
Techquity: It is still a weak point that Thailand could not support an internet connection in some rural areas. Even though we have a useful digital health policy, not all people reach the technology.
Transformation: There is still a lack of digital technologies in the healthcare systems such as EHRs and CDSS in some community hospitals. It is difficult to utilize standard data and data-sharing between different locations. This digital transformation would support interoperability in public health management.
Regardless, this is just my opinion. Please feel free to correct me if I misunderstood in any aspect. Thank you.
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