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I currently serve as the Deputy CIO at a public hospital, leading a project to achieve Hospital Accreditation Information Technology (HAIT) certification. In this role, I apply nearly all the principles of the 12-step management process.
The first step is to clearly define the project for all stakeholders, highlighting its importance and specifying their roles. Organizing tasks, planning their sequence, and setting a timetable enable the team to progress efficiently. A safety margin is included for each task, although it is less than the 90% typically recommended in training. Delays are anticipated, as stakeholders have primary responsibilities in hospital operations that limit their ability to fully dedicate themselves to the project.
To address delays, we reserve “crashing” or accelerating tasks for the final phase to ensure the project meets its deadline, rather than applying it during the intermediate stages. For project monitoring, we use tools like Notion and Sheets, which function effectively as Gantt charts. Regular adjustments are made at each milestone to keep the project on track and aligned with its objectives.
Despite these efforts, we did not achieve our goal during the evaluation. However, we conducted a thorough review to identify areas for improvement and to implement lessons learned for future projects.
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Previously, I served as a leader in a medical student organization. I set an example to inspire one of my juniors to take on a project. Initially, she was hesitant because she believed it would be too challenging and feared it might end in failure. I encouraged her by highlighting her strengths and emphasizing the potential benefits the project could bring to both her personal growth and the organization. I also empowered her by granting decision-making authority and offering support whenever she needed it. Finally, I reassured her not to fear failure, reminding her that failure is a part of growth and something we can overcome.
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Recalling details is my weakest area in listening. I encounter this problem when doing my job as a doctor examining patients, though not in meetings or conferences. During history taking, I have to multitask by evaluating the patient’s detailed history, observing their expressions, performing a physical examination, and considering differential diagnoses and the next steps in management. Due to this overload of tasks, I sometimes miss small details in the history-taking process. To address this, I often paraphrase or recheck details with the patient and take brief notes in the EMR on crucial information.
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Motivation stands out as my strongest emotional intelligence skill. This aspect of EQ allows me to recognize the value of my work for both myself and others, driving me to take on ambitious challenges in both academic and professional contexts and succeed in them.
However, self-regulation is my weakest area. When I face difficult individuals or situations, I often feel stressed, making it harder to address these issues effectively. Sometimes, these challenges affect me at home as well as at work, and in certain situations, this lack of self-regulation results in poor decision-making.
To work on this weakness, I intend to accept that everyone is different and that I can’t control every situation as I might wish. In challenging moments, taking a pause and writing down my thoughts before responding are strategies I can adopt to strengthen my self-regulation.
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Hello everyone,
I am Chanapong Lertpanyawattanakul, a rehabilitation doctor at a community hospital. Currently, I also serve as the Deputy CIO at my hospital. Having gained valuable knowledge from the MAP-C program, I am eager to further expand and deepen my understanding of health informatics to enhance my career path, including academic research and the development of organizations related to health informatics.
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I would like to discuss point 15 on page 342: ‘When the same hypothesis is tested in different studies and none or a minority of the tests are statistically significant (all P > 0.05), the overall evidence supports the hypothesis.’ While individual studies may not show statistical significance, it would be incorrect to assume that this trend applies to all studies. For example, in a meta-analysis that combines various studies with no statistical significance or conflicting findings, evidence of an effect may emerge, possibly due to an increase in sample size.
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Hello everyone,
My name is Chanapong. I am currently employed as a physiatrist at Chao Phaya Abhaibhubejr Hospital. In my work, I frequently utilize statistics for analyzing medical records and conducting research. I am proficient in using MS Excel and SPSS. Additionally, I am currently enhancing my skills in data analysis by studying R and Python, which I believe will further support my work in statistics-related tasks. -
According to the Technology Acceptance Model (TAM), for successful adoption, new technology should be at least as useful as its predecessor. If the new technology is only easier to use but does not offer the same level of usefulness or functionality as the old one, users may resist adopting it. To ensure the successful adoption of new technology, it should offer at least the same level of usefulness as the previous one while also being easier to use.
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Technological Literacy:
High technological literacy facilitates the reception of new experiences with emerging technology. Individuals with high technological literacy find it easier to adapt to new technology compared to those with lower technological literacy, as they possess a stronger foundational understanding.Social Influence:
The social environment plays a crucial role in the adoption of new technology. When individuals observe others in their social circle embracing and utilizing new technology, they are more likely to follow suit. Examples of usefulness and usage patterns demonstrated by colleagues, friends, or family members influence the adoption of new technology.Socioeconomic Status:
The cost associated with newer technology tends to be higher. Individuals with lower socioeconomic status may face greater difficulty in acquiring new technology, thereby limiting their ability to perceive its ease of use or usefulness. Socioeconomic status emerges as a significant external influence in this context.Job Relevance:
The relevance of new technology to one’s job or workplace, particularly if it enhances job functions or simplifies tasks, increases its perceived usefulness and ease of use. Whether through voluntary adoption or organizational mandates driving technological transformation, the alignment of new technology with job roles fosters its adoption among users. -
To determine why bed nets were not used, conducting a qualitative study is an appropriate approach for this situation. This method can delve into the reasons and experiences behind the lack of bed net usage in this community. By applying semi-structured interviews with individuals or conducting focus group discussions, valuable insights into the perceptions of not using bed nets can be gained. Additionally, we can gather more information about alternative methods for preventing malaria transmission rather than relying solely on bed nets.
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Efficacy is the ability to produce a desired amount of the desired effect or success in achieving a given goal. In healthcare, it is the capacity for beneficial change (or therapeutic effect) of a given intervention (for example a drug, medical device, surgical procedure, or a public health intervention) under ideal or controlled conditions.
Context: Clinical trialsEffectiveness is setting the right targets to achieve an overall goal (the effect). It is the extent to which planned outcomes, goals, or objectives are achieved as a result of an activity, intervention, or initiative intended to achieve the desired effect, under ordinary circumstances. In healthcare, it is the extent to which a drug achieves its intended effect in the usual clinical setting.
Context: Pragmatic settings, observational studiesEfficiency is the ratio of the output to the inputs of any system (good input-to-output ratio). An efficient system or person achieves higher levels of performance (outcome, output) relative to the inputs (resources, time, money) consumed.
Context: Cost-effectiveness study, for example, measuring nursing hours, bed days, and days supply of drugs. -
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Age-specific mortality rate
An age-specific mortality rate is a mortality rate limited to a particular age group. It is used to compare the mortality rates without being affected by the difference in age distributions.
Calculation:
The numerator is the number of deaths in that age group.
The denominator is the number of persons in that age group in the population.Infant mortality rate
Infant mortality rate is the probability of a child born in a specific year or period dying before reaching the age of one. It reflects the health of the mother and infant during pregnancy and the year after that.Calculation:
The numerator is the number of deaths among children < 1 year of age during a given time interval.
The denominator is the number of live births during the same time interval. -
Comorbidities, such as non-communicable diseases (NCD), are more prevalent in older age and could act as confounders in this context. NCDs may restrict participation in social activities, resulting in a less active contact pattern. Conversely, younger individuals typically have fewer comorbidities, contributing to increased participation and a more active pattern, as indicated by the results.
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1. The author is interested in this study because of the increasing rate of suicide in Thailand and there was no previous study on socioeconomic factors associated with suicide in Thailand, which differs from developed countries’ studies.
2. Alcohol consumption is the risk factor that I want to discuss. Drinking alcohol leads to an inability to self-control and encourages one to commit suicide, especially with depression and a high risk of suicide. Thus, alcohol consumption leads to a higher suicide rate.
3. Statistical modeling help to analyze factor associated with suicide using regression analysis. Furthermore, it may demonstrate the extent to which certain variables affect the suicide rate. Additionally, it may be used to pinpoint the areas with greater rates than others, necessitating effective and appropriate policies for that region.
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1.One potential challenge in this situation is data availability. In Thailand, the location might receive from the 43 folders system via the reimbursement, which could not contain an actual residential area but a registered base location—leading to inaccuracy when investigating epidemiological studies. Additionally, using different approaches to obtain the location, rather than obtaining it from the registry, requires resources including budget, specialists, and technology.
Another issue is data confidentiality. Using a person’s address to pinpoint their position more precisely for epidemiologic research might reveal the owner’s sensitive information.
It is reasonable to regard spatial epidemiology as an interdisciplinary science. With the use of advanced spatial, location-based, and technologies, such as GIS and GPS, in conjunction with demographic and health data, spatial epidemiology integrates a number of scientific fields, including epidemiology and spatial science.
2.The location in which a person lives or works should be taken into account as a possible disease factor. Different regional traditional foods are linked with particular diseases. Lower incidences of hypertension can be found in Mediterranean countries with Mediterranean diets. The liver fluke, Opisthorchis viverrini, which is present in traditional uncooked freshwater fish meals, is also accountable for the higher prevalence of cholangiocarcinoma in Northeastern Thailand.
Additionally, a medical condition may be related to a different latitude. Countries with latitudes further from the equator have higher multiple sclerosis prevalence rates due to lower sun exposure.
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Thank for your attractive presentation. Early detection to prevent the spreading of the disease is crucial. I like your system that include village health volunteer to share the knowledge after reporting and analyzing data. I have some question about how to confirm the diagnosis in the system to rule out other tropical infection(its presentation can mimic leptospirosis).
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Comparing public communication regarding the COVID-19 situation from the leaders of two countries: Singapore and the USA, based on the CREC principle is described as following
1. Be first: The Singapore leader publicly communicated the COVID-19 situation after two weeks of the event. While, the US leader communicated after the situation worsen, new clusters, and WHO declared COVID-19 as a global pandemic.
2. Be right: Both leaders told the real information of the current situation.
3. Be credible: Singapore PM explained all the situation in detail and was more humble. For the US PM, he provided information in overview and accused European travelers of causing a new cluster and overexaggerating the healthcare and economics systems.
4. Express empathy: Singapore’s leader’s public communication included understanding the anxiety and reactions of people to the situation and encouraging people to solve the problem together.
5. Promote action: Both leaders provide information on how to prevent the spreading of COVID-19. But, the US provided more about the economy and financial measures to help its people.
6. Show respect: The end of Singapore PM communication mentioned paying respect to volunteers and healthcare workers. While the US did not mention or honor the frontline workers’ hardship.
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List of the disease outbreaks that have been declared as PHEIC
-2009: The Influenza A (H1N1) pandemic
-2014: poliomyelitis
-2014: outbreak of Ebola in Western Africa
-2018–2020: Ebola epidemic in the Democratic Republic of Congo
-2015–2016: Zika virus epidemic
-2020: COVID-19 pandemicThese outbreaks raise concerns because they are extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response. The situation is serious, sudden, unusual, or unexpected which carries implications for public health beyond the affected state’s national border and may require immediate international action.
Conditions that can lead to PHEIC in the future are global warming, biological terrorism, and advanced genetic engineering.
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The application of centralized helplines for COVID-19 information in Thailand is needed to improve. During the outbreak, this central helpline shows only the information of the number of the infected rate, hospitalized rate, and death rate. Essential information on how to self-management and prevent spreading to others is lacking. For example, the correct management on how to clean environment near infected cases is not reached to the community. Different methods were used which are not effective and cause harmful side effects. And there are many hotlines to call when people get an infection. They have to call each hotline to get treatment due to insufficient operators. This situation should be solved by providing a single hotline that has sufficient manpower according to the demand.
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Using inaccurate data can lead to various problems, related to the public health policy and management system for controlling and preventing the disease. In case of data overestimation, inappropriate increasing cost and resources to deal with the actual situation are encountered. On the contrary, utilizing underestimated data lead to delay detection and control of the disease, causing the disease to spread and increase morbidity and mortality. The increasing burden on time and resources to control and treatment of the disease that is out of control is really challenging when this situation occurs.
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IT can assist in outbreak investigation in various processes. During active case finding, CDSS may be one of the tools to help in the screening process. Applying IT in the data collection process helps to systematically and comprehensively record outbreak data. Exchangeable and timely visualized reporting data, like epidemic curves, help decision-making to manage the outbreak more effectively and promptly. Additionally, using GIS to specifically locate where is the hotspot of the outbreak also helps the investigator to respond and take action appropriately.
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Data visualization tools for decision support are the technology or tool that I like most. This technology is widely used during the COVID-19 pandemic by different countries and organizations. Timely and accurately collecting data are clearly visualized to the different levels of audiences, ranging from the general population to national organization, to use the information for distinct purposes. For the general population, accessing this visualized data can raise their awareness about how fast transmission or areas with a high rate of transmission, preventing their own from getting the infection. At the national level, it can use the visualized data to decide and planning policy actively responding to the COVID-19 epidemic, in terms of healthcare, economy, and society. Properly allocating healthcare resources to the needing area is easily manageable when using these tools.
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How can surveillance help to detect and control the disease?
-Surveillance helps to control the disease by detecting the confirmed case and high-risk cases along with time and place. Proper monitoring and responding to the transmission of disease by using well-planned countermeasures is one of its benefits. Suitable allocation of healthcare resources according to the trend of the outbreak can be managed easier when using surveillance.Should we conduct active or passive surveillance or both for the disease, why?
– In the case of COVID-19 disease, we should use both active and passive surveillance to early detect the spreading of the disease. If we use only a passive system, we will not detect the asymptomatic and mild severity of the case, causing further transmission and may be out of control.Which method should be best to identify cases, why?
Cases in medical facilities VS community
– To identify case needs both cases in both medical facilities and the community. Preventing transmission is essential for outbreak control. Therefore, the case in the community may be an asymptomatic or mild symptom, should be early detected. For medical facilities, the only cases with moderate-severe symptoms are detected.Sentinel VS population-based surveillance
– Population-based surveillance is more suitable for national-level management. While sentinel surveillance is more suitable for the local community that has a low infection rate.Case-based VS aggregated surveillance
-Case-based surveillance is suitable in areas with low transmission rates. On the other hand, aggregated surveillance is more preferably in high transmission areas, which can be switch to case-based surveillance when the transmission rate decreases.Syndromic VS laboratory-confirmed surveillance
-Laboratory-confirmed surveillance is more suitable in well resources countries. It can provide the rate of transmission precisely and prevent using overestimate management, which will increase the burden on expenditure.What dissemination tools will do you choose to disseminate COVID-19 surveillance information? Why do you choose/these tools?
Ongoing, real-time dissemination tools are the most suitable tools for this outbreak. We can monitor the data easily( number of confirmed cases, hospitalization rate, ICU occupying rate, death rate, and recovery rate) and plan the timely countermeasures according to the available resources. -
According to the ADKAR model, changing the systems from paper-based documents to EMR in my organization is inappropriate management as following
Awareness: Lack of communication to all officers to raise awareness about the importance to change and how to change is encountered. Moreover, opinions from the members do not reach the executive team.
Desire: Some people don’t want to change to the new system because of traditional system familiarization and lack of IT skills.
Knowledge and Ability: The training course is not properly provided to all users. Only IT officers receive hands-on training. But they give support to the user when facing system problems and time to adapt to the new system.
Reinforcement: Regular evaluation of the implemented system from all users is provided to improve and develop the better system.
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The collected data should not be given out to the research team due to the information privacy principle. Reviewing the informed consent of the collected data, which have permission only to this study or further study, is important. If the informed consent provides further use of the data, giving the data to another research team is acceptable. In contrast, the other research teams have to gain permission for their study purpose if the former inform consent does not provide further data usage.
If you want to provide data to them, you have to provide only unidentifiable data to protect the data privacy of individuals recruited in the project and have an official agreement on the purpose to use the collected data.
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As a health informatician who encounters this scenario, I cannot tell my friend about what I have known to maintain the confidentiality of patient information. Interfering other family issues about their health problem is inappropriate. My friend may or may not already know about her partner’s disease, but she did not tell me about that. Although she may have a risk of infection, I do not have the right to disclose this information. Her husband should receive advice about telling his partner when he was diagnosed with HIV infection. It depends on his autonomy more than beneficence or non-maleficence principle in this situation.
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My previous organization had implemented EMR in both outpatient and inpatient departments. But its function was not fully used in inpatient departments. In contrast, proper adaptation to the new system was accomplished in the outpatient department. The factors associated with success and failure are described following.
1. Operation
-All Officers do not receive proper training on how to use the system. Only a few officers related to the IT department received hands-on training. When problem-related to the system occur, we have to contact directly to maintenance support of the EMR company because we don’t have a position to hire an IT officer who could manage this problem.2. Design
-The system was designed to specifically use in outpatient. The inpatient system has some functions as laboratory management and medication management. Other functions like medical records or vital sign records are not included in this system. Hence, the staffs have to use both traditional paper systems along with the EMR system.
-Its GUI is not easy to use by the general staff. And its system requires the registration of redundant data causing a burden to the users. Alert fatigue is also a problem related to improper notifications.3. Cost
– Initial investment budget is not sufficient to provide EMR to both departments. Choosing the EMR that can partially operate in an inpatient department while fully function in the outpatient department is the reason for this implementation.4. People
– Some officers have their own opinion to not change to the new system. Reasons for not to change are the current system running smoothly and how difficult to adapt to the new system. Communication to the officers about the importance to change the system and how they can adapt by providing time and training is essential. -
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Thank you for sharing. This project is the first step to implement HIE in Thailand. Solving problems related to lack of health data exchange, like personal medical history, between the organizations is crucial to current Thailand’s healthcare situation. The next step is to recruit more public and private hospitals while maintaining data privacy and data security to achieve the next level of healthcare services.
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I have experienced some of CDSS in my organization
1.CPOE
-It is very helpful for its alert about drug interaction, drug allergy, and dosage calculation. But, there is some limitation about repeating notification in some patients who were exempted and confirmed to use medication that caused interaction, which is not serious.2.AI in medical imaging
– Analysis of medical imaging like chest radiograph could help to detect abnormalities, that may not be detected, and reduce misdiagnosis.The influencing factors to support CDSS are how efficient and reliable their systems are. Other points are how this system can generally be used and the perspective of the user to the CDSS.
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If the hospitals do not use ICD standards, it will cause many negative effects to the healthcare system as following
1. Transferring data from hospital to hospital or hospital to public health data center will be more difficult due to the lack of the same standard data like structure or meaning, which will cause problems related to the interpretation of exchanging data.
2. We will face obstacles in using data for health policy, disease surveillance, and healthcare resources management.
3. For reimbursement, in the case of both health insurance and hospital, it will cause improper allocation in expenditures. -
I have experienced some problems and also heard from other officers. EMR may increase workload and time for recording patient data, instead of only pay attention to the patients. But, EMR also increases data recording efficiency. Providing time to adapt when the transition from the paper-based medical record to EMR is crucial to the officers. Additionally, it should have a friendly GUI, reduced redundant data recording, proper notification or alert to avoid alert fatigue, and a system that supports the user to work more efficiently like OCR and voice recognition as Auswin suggested.
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Thanks for sharing this useful application. It is suitable in Thai society, in which people don’t have enough courage to receive psychotherapy and there is social stigmatization on receiving this treatment. It keeps personal privacy and easily accesses counseling whenever and wherever you want, instead of receiving counseling at the hospital.
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From my perspective, eHealth definition should be “using technology combined with relative knowledge to facilitate healthcare to be better in the way of patient and healthcare provider-centric approach “. Examples of knowledge that is used along with technology are business, health informatics, and public health. The purpose of the implementation of eHealth is not only benefited patients but also healthcare providers.
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An example of big data is the navigation or mapping application like Google Maps.
Volume: As crowded traffic occurs in all cities, especially in urban areas, the data that can be collected is enormous.
Velocity: Real-time process of data is required to operate the application when navigating to the destination.
Variety: Different types of data are collected. Vehicle’s location obtained by GPS, traffic cameras, satellite, and mobile phone location is the example of obtained data to be further analyzed.
Veracity: Considering the data trustworthiness of these applications is depend on how fast and volume of the data be updated and processed. There is an incident when using the mapping application navigating the user to the roadworks or incorrect destination.
Value: The collected data can suggest the shortest route and time to users when using the application. It can help reducing fuel usage and carbon production.
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I had observed on implementation of EMR instead of paper-based medical records at my former workplace. Before changing to EMR, the paper-based medical records were scan and upload to the database. We had to go through all pages to find what information we want. And some of the medical records were omitted. So, there were not completely stored combined with different handwriting, some are difficult to interpret, leading to the transition to EMR.
This project helps all medical records can be stored and easily to obtained what part we want. It can reduce the medical error from handwriting and error from drug allergy or drug interaction from its CDS. Reducing storage space and workload for scanning documents is also one of its benefits.
The challenge of this project is all officers have to learn about the system and it takes time to accustom to the new system. During the transition period, increased waiting time for hospital service is encountered combine with the personal error from using the new system. But, these challenges have been solved when providing more knowledge and practice to all officers to use this system effectively.
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Choosing a third-party file transfer service is very crucial and is the responsibility of the business. When data breaching occurs, the business and third-party vendors should take along the responsibility for the damage to their patients. To prevent breaching in third party service, regularly re-evaluate their data security and disaster plan is the top priority, not just the beginning of the contract.
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Thanks for sharing about this case. I really agree with you that the company should have preventive measures on this incident, not blaming their customers for entering their email to the search bar. Well-design data security should be implemented to prevent this reoccur and the customers should receive guidance on what to do after this incident occurred.
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Using public free WIFI named as a public or private organization, and some acquaintance people is vulnerability to your computer to be hacked. It is more secure when you use your cellular data when doing transactions or important matters.
The easily guessed passwords like “123456789” or date of birth are commonly used in present. The hackers may have to try passwords like these to unlock your computer.
Using other computers and act like the owner is possible means for the attacker to get your information. To prevent this event, having functions like automatically log out from a program or computer within setting time or requiring authentication before proceeding with the operation are suggested.
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The advantages of a cloud server are less expensive cost when comparing with a physical server, not requiring the area and maintenance for a physical server, IT personnel can work other roles, instead of monitoring and maintaining a physical server. But, the cloud server should provide trustable and strongly data security and data privacy.
What kind of cloud computing service model would be most appropriate (SaaS, PaaS, IaaS)? Why?
For the service of the cloud computing model, SaaS is the most appropriate for this situation. The IT officer doesn’t have to build the web-based application from the beginning. The SaaS can provide both the developing application and maintaining its system. The role of the IT officer can be a coordinator with the SaaS company providing information on what service and system design his hospital need, while he can play a role in fixing computers as before. -
Based 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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To design an EA of HIS among different hospitals successfully is to have the collaboration of different stakeholders as following
1. Healthcare professionals in each field. They can provide what they need in this system to manage the data properly. They can also provide about GUI that is easy to use in the point of the users.
2. Data controller/Lawyer to discuss the legal issues of the system about data privacy according to the law (PDPA).
3. IT officers (programming, data security, networks, GUI ) to build the system according to the team have planned and plan about the system maintenance.
4. Patient can give their advice about their concern to the system, such as data leakage or consent.
5. Health Informatician to collaborate with all members of the team to achieve the goal of building HIS.
6. Data scientist who could provide how to use and analyze the collecting data for further development.
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As a physician currently training in physical medicine and rehabilitation, I have to acquire more skills and knowledge to become a health informatician as following.
1. Public health knowledge (epidemiology, clinical statistics, disease surveillance) is an important part of public health informatics. I had little knowledge in this field when I was a medical student. So, I want to learn more in this field to apply and utilize the knowledge in various settings.
2. Computer sciences are another crucial part I have to learn. Programming skills, like R, Python, or SQL are useful when we analyze and utilize the data. And data visualization programs, such as Tableau or Google Data Studio, are also the part I want to learn more, to increase audiences’ perception of the presenting data.
3. Legal issues about data privacy and cybersecurity, such as PDPA, are an essential part of health informatician knowledge. We have to know about these issues to manage our organization’s data legally.
4. Organizational management skill is a skill I what to improve. Collaboration with your team member or other teams using communication and project management skill is an important skill helping the organization run smoothly and succeed in its goals.
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If I were a director of the hospital, I would change HIS to cloud, Using HIS on cloud computing can reduce costs for investment and maintenance, IT staff, and areas for computer servers and document storage. We can easily access HIS wherever and whenever we want. Backup of data in the cloud is another advantage because it automatically updates data to the time we set. Cloud computing also provides standard data privacy and security.
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I completely agree with the importance of balancing user requirements with project objectives. Since different users often have varying needs, it’s impossible to deliver a product that satisfies everyone without significantly increasing resources like time and cost. I believe that constantly readjusting the plan to accommodate every user’s demands is not an effective way to lead a project. Instead, clear communication about how the project is defined is essential. Reaching an agreement with stakeholders before starting ensures alignment and sets the foundation for a successful project.
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Thank you for your comment. I agree with you that we can collect data on who is prone to have a diabetic foot ulcer, as classified by IWGDF guidelines as low, moderate, and severe risk. We can collect data on which impairment, site of abnormal pressure (callus), and management they receive along with patients with diabetic foot ulcers.
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