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In my opinion, I think Vaccine reservation system is one of the problem. Because people have to fight over each other to get in to the reservation system which are always error. If the system have information system that supported from the government, it would be better. In order to allow everyone get access to the vaccine.
Thank you
Pimthong S.-
Yes, It’s right, it’s happening.
I think the problem addresses the fact that the vaccine reservation systems are unable to handle the high volume of transactional data being fed in at the same time.
In TMHG 545, you will learn some techniques how to design the system to handle a ton of transactional data.Thank you,
Pongthep -
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In regards to health, Information System can be used in data collection. One of the example is the collection of COVID-19 data. The data needs to be real-time and reliable so it can generate an accurate picture of the pandemic situation. A strong foundation of reporting system is a key part of generating high-quality data to understand the situation better. It would support the authorities to decide the next step in order to control the pandemic.
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When health information needs to be collected for disease surveillance in the post disaster situation, it can be chaotic if no protocol as a common language including disease definition, category and data format is agreed in advance and disseminated internationally, particularly in the situation where emergency medical teams with different background are coming from all around the world to support the affected country.
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I think you are talking about an interoperability and standards. If all healthcare agencies can use the same standardized data collection methods in their information system, for example HL7 which is a set of international standards for transfering health information. It is likely that this problem can be solved.
Thank you,
Pongthep -
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In my opinion, there are many health data systems implemented in different health care providers, so there are gaps between places and systems for the data to be connected and transferred. This is due to the limitation of software compatibility and internet connection from certain areas (eg. rural areas with limited cellular signal). For example, primary care units use JHCIS to store and manage health data, community hospitals use HOSxP, many tertiary hospitals or private hospitals use their own developed software. If there are standards in data and software for every health care provider, accessing health care and referring the patients might be easier.
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Although each health care whether private or under government are using different software, however as far as I know, I think that the Ministry of Public Health may have a set of standard file system like the 43 files system for supporting the data sent from the healthcare providers throughout Thailand.
Thank you,
Pongthep
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From my experiences, according to the pandemic situation that we faced with, the clear communication system are still be the problem. We need to implement the channel or the protocol that share the same definition or at least same direction to communicate with each other whether in healthcare personnel or the population. Effective collecting and sharing information system should be installed for providing the useful, real-time and reliable information to people including trustworthy public relations system.
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Health data is personal information. We have various systems in Thailand. Standardization and data government policy may have inconsistency. These two systems are the foundation of health informatics.
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Absolutely, data inconsistency could lead to inaccurate analysis and report generation. So, when we disign and implement a health information system in every level, we need a system, software, application, and database that can facilitate the data validation and cleaning in order to get a good quality of data.
Thank you,
Pongthep
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The information system has made life easier in all sectors . Both the government and private agencies are using the information system for good outcomes. In the developed countries, both agencies are using information systems in an efficient way.
In developing countries , due to the limited resources, government agencies need to do more in the implementation of information systems. As a result of this, People are lacking COVID testing, vaccination, and proper treatment. -
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Information systems are necessary, including in the health system. From my experience, it is not only about disease information systems but also health resource information systems such as logistics. health workers cannot work if logistics are not available. Logistics management records are important for knowing the remaining stock and planning for logistics procurement. Based on this we developed a comprehensive malaria information system including a logistics record system such as drugs, RDTs, LLINs, larvicides, etc.
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Same as you mentioned, in Thailand, we have a malaria information system too. It is in the project of Thailand malaria elimination program. In the applicatoin, there are many mudules, for example, patient data entering, follow-up, drug dispensing, foci, entamology, mapping, logistic management, and project budget management.
Thanks for sharing your experience,
Pongthep
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Two systems that suddenly come into my mind are Vaccine Reservation System and Medical Records System.
1. Vaccine Reservation Systems usually are built with some information systems already, but it not smoothly run right now. Causes of the struggle , from my own experience, might be the complexity of this kind of system. It should contain many features to be a perfect system, for instance, Patient Details, Doses Calculation, Payment system and some feature cannot be built perfectly with just only one team. Payment system must be relevant with bank’s IT team other than the hospital’s IT team. Another problem is time, Covid-19 pandemics is very urgent. So all developers has very short period to develop their Vaccine Reservation System and the outcome from rush process is not so good. In conclusion, Vaccine Reservation Systems are built with IS already but with proper IS it can be a lot better.
2. Recording medical records always done by healthcare providers everyday. It’s essential and necessary to improve both treatment outcome and process of caring. Nowadays, most doctor and other healthcare providers record their task by just writing. Hand-written documents have many disadvantages such as difficulty to analyze, difficulty to read and difficulty to store. If IS was implemented in this task, it would made a lot data to be more useful.
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Nice post. Your opinion is comprehensive. In terms of paper-based system, sometimes it is hard and takes time to transform the paper-based work flow to a digital information system, howerver if we dont’ want to change the way what doctors and nurses are doing by writting on papers. From my experience, we can use a tool called “OCR-Optical Character Recognition” to transform hand-written data to a database in an information system. Anyway, we need to design a set of standard forms for the OCR software.
Thank you,
Pongthep -
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Health information exchange is the main problem in my opinion. In Thailand, communication between healthcare professionals from different hospitals uses paper with handwriting, which can be misinterpreted from poor handwriting, or use the Thai Refer program, which is difficult to use and does not provide enough essential information. When the doctor from different hospitals requests for previous medical history, the patients have to go to the previous hospital to obtain it. I think it might be better if EMR can be implemented in all hospitals, which can provide electronic data instead of handwriting and can easily collect all information to exchange between the healthcare sectors and transfer to MOPH for health policy. However, it may require a standard exchange system because different hospitals use different HIS.
Another problem is lack of the personal medical records. I think that all should have individual electronic personal medical records that can only be accessible on their own, and provide information like vaccination history, perinatal history, or developmental history. For example, I have encountered the problem when patients were bitten by a dog and go to the hospital to receive rabies and tetanus vaccination. Almost all patients cannot remember their previous vaccination. From this point, it affects the management and increases the cost to provide vaccination as they never have before. Therefore, I think this electronic personal medical record could help to solve this problem.
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Your post is very interesting ! Thanks for sharing this.
Personal health record, in my opinion, is the must thing to be happened in the near future.
It will improve quality of healthcare by providing all necessary data needed lead to better diagnosis and treatment. It’s also provide more privacy because everyone control their own data, no one can access to their data without their permission.
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From my perspective, I would like to change the computer system at my workplace. Currently, I have my desktop computer in my room, which contain data files or programs that are specific to my work; however, when I am going to use another computer at another station at my workplaces such as OPD or operating room, I cannot connect to my data files or program that I use. Would it be better if I log in to my data file or specific program no matter where I am? For example, when I log in to the computer at OPD, that computer becomes my desktop (consist of my data files) instead of OPD desktop.
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Well, I think you should talk to your IT guys to implement a technology we called “Active Directory” in your organization. Typcially, an active directory is installed on a LAN server. It controls user login, permission, email, file servers, printers, and etc. With active directory implemented, you can login on any workstation to access your files or data which stored on a file server in your workplace’s LAN. The IT guys can set access control on your data just for only you.
Thank you,
Pongthep
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Base on my own experiences, the Electronic Medical Record (EMR) system could be troublesome when it came to research, especially multicenter research. The HosXP program, which was EMR, was not allowed to directly draw the data from it, hence I manually screened through the computer screen and exacted the particular data which was time-consuming and ineffective. In addition, EMR database was not linked to other hospitals, which made multicenter studies harder to conduct. These perhaps hindered the research studies in Thailand to such an extent.
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For my real-life as the general physician in the government hospital, the commom problem is the medical record system. Thailand’s medical record system, espicially in public hopspital is the unique, hand-wirtting, poor-accessible system. Firstly, handwrittin medical record can solve via using electronic doctor order’s system which is online, up-to-date, and solve the understanding problems on Doctor’s hand writting. Secondly, interhospital medical record connection is important for flowing of medical data and continuty of medical care. In conclusion, Electronic doctor order’s system is the good representation of information technology implemention in the real life.
Taksin U.
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