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In planning phase,
1.Disaster/Risk identification and analysis procedure will be run as first step. Risk register will be opened to record the probable risks (both external and internal) and will be share on drive.
2.Notification and communication procedure will be developed for mitigation and response activities. Data backup (google drive and physical hard disk) and security protocol for data management will be included. Authorized access will be granted for responsible staff
3.Training and testing procedure for raising awareness about disaster among the staff
In the execution phase,
4.Restoration procedure: network and power to recover from backup, bringing up HMIS and verify the data integrity
In recovery/aftermath phase,
5.Damage assessment and documentation procedure (data backup is the most suitable method for my organization)
6.Restoration procedure (reinstalling of programs, HMIS server and cloud server such as google drive) -
The most significant health challenge is emerging and re-emerging of infectious diseases. Due to fast communication around the world, the infections are more likelito spread and imported from many gates.
Concurrenly with infectious diseases burden, antimicrobial resistance (AMR) is also warning sign for all healthcare professionals.
A few philosophical thoughts and cultural norms also hinder in receiving the preventive meaures (like vaccination), and it can cause serious health outcomes for children and vulnerable population.
Not all countries can use standard codes for data interoperability for sharing, this is also challenge in developing new drugs, vaccine and management research and educational processes.
So, WHO is alarming to run the EWARs (Early Warning Alert and Response)/ Surveillance System for common infectious diseases in every countries (e.g for Myanmar, 13 diseases are included in MS EWARs).
They also advocate about AMR and countries also published law to act in preventing antimicrobial resistance.
Many LMIC countries also took technical supports from professional to run digital Health Information System to upgrade from paper-based system to ePHI. -
For patients,
– Can monitor the patient’s health in real time matter
– Diagnosis and investigation procedures take less time to prescribe and record
– Mobilize the community partnership through the system
– Link and provide care to patient even in hard-to-reach situationFor hospital,
– Inform, educate and empower the staff using the HIS
– Can help to develop policies and enforce the public health laws
– HIS can assure competence workforce in the hospital
– Can upgrade the governance and system management
– By using the data in system, further research and evaluation will impact for continued medical education -
Our organization is working with many partners in different projects. So, the donor requirements are different for seperate ones, we have to give the data with their pre-determined formats/databases/reports and it took time and increase workload on staff. The requested variables are also multiple and not identical ones, it confuse the staff in understandig about data collection and entry.
So, I would like to set up an own data system and server with interoperability standards. The collected data must be aligned with standards ad can be analyzed as real time data for decision making. For each partner, we can extract the data from server and share with them without impacting data integrity.
For this change, I am developing megadatabase for the organization and trying to make standard forms and formats to use. I am advocating the team leaders about the data driven decision making and user friendliness of data visualization and management process. As the system development is new to our organization and it is not our highest prioritized plan in current situation, most of the team leaders are still reluctant. Aiming to start this change, I am taking this health informatics course for my organization. -
Yes, we are working with partner organization and share the same platform to use data checking and reporting. We practice authorized access to the platform but the system maintenance is not regularly updated and some functions have to be put manually. So, if I need urgent data reporting, the system cannot give the updated one immediately. There is gap between data entry and data analysis stages. I have to contact the focal person of that platform to give me the data. It takes time and cause some delay in decision making, and availability of system is not quite well. And one staff accidently delete the database from the platform and it makes alarm to all of us about maintaining integrity of information. To prevent it, we discussed among the users and review the software, how to combine data entry and analysis steps, assign the duties to regularly check the system performance, update the access control protocol and prepare the cloud backup if the platform is down.
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To be an effective communication, both the sender and receiver must have a clear understanding of the message being exchanged. To ensure this, I believe that we need to practice two-way communication, where feedbacks are continuously exchanged between parties.
To practice two-way communications, the participants should be approachable, humble and listen to each other. The person at higher level must do rapport building with their supervisees to get honest and important messages.
Within my team, I consistently apply two-way communication to achieve mutual understanding. To apply this practice, all team members are instructed to respond to messages received from me to confirm receipt and comprehension.
When I receive a message, I carefully interpret it, contact the sender if clarification is needed, and provide an acknowledgment to mark their message is well received. Similarly, when I send messages, I always verify that the recipients have received and understood the content correctly. If any misunderstanding is present, we discuss it together. Even in both local and English language, I encourage for myself and my team members to use polite office language to avoid personal emotions on messages. -
As NCD is one of the burden on healthcare, the CKDSS is very impressive to learn, Salin. Congratulations for your presentation! I would like to ask one question as this is differnet from infectious one. How often will you collect the data and analyze at the regional or national office? Do the physician or laboratory technician involve in that? Thank you
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Congratulations for your presentation about HFMD, Jen. In our country, HFMD incidences are increasing and is still micmicing other fever with rash infections. I like your system structure to implement and connected to national surveillance unit. I would like to know more about event reporting and evaluation indicator, stability. Could you please share whether the schools will report i system if there is event among the students? Thank you Jen
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Congratulations for your presentation, Ama Wah. Malaria is still challenging for our regions and require the comprehensive system for the control and prevention of infection.
I have learnt many points from you and I am curious to ask the questions.
Could you please explain about the village health volunteers, whether they will be trained for the surveillance system or they are already health workers from the community.
For usability and adaptability indicators evaluation, how would you suggest for collecting frequency, biannually or annually? Thanks ama. -
PM Lee communicate with the public as early as possible 2 weeks after the new situation while President Trump shared the information only after declaration of Pandemic by WHO.
PM Lee clearly mentioned who was taking leading role for handling the Covid 19 situation and relieved the public not to be panic by comparing the past experience.
President Trump directly talked about the serious health threat in modern history, not considering about the feelings of public. PM Lee mentioned the practical detail points to care about corona virus but President Trump only focused to do personal protective measures.
In doing the right way, PM Lee clearly show authoritative leadership type and communicate with Singaporeans to gain sense of ownership. President Trump relieved the working citizens not to worry about their wages if they have to take leave due to virus and repeatedly talked about the economy rather than the infection. He also guaranteed to find solutions not to suffer financial hardship due to medical bills.
PM Lee did not confine the movement in the country because the mortality was not high in that situation and President Trump took immediate action for travel and trad restriction from Europe and China to reduce the imported cases. So, both of them are credible to be good communicators in emergency risk communication while the empathy can be easily felt in PM Lee’s speech compared to President Trump.
Both leaders promoted the action to follow by citizens but President Trump used some technical terms and sense of showing paternalistic form. PM Lee encouraged to show empathy and share responsibilities for vulnerable groups and medical professionals when the infection became serious.
Both PM Lee and President Trump made the cooperation with community and did rapport building about mentioning their preparedness on investigation, treatment and prevention strategies to fight the novel corona virus. -
For me, leadership is an art which has to be flexible and strong at the same time. Because it relates with human beings, the leadership should not be infected with rigid rules all the time. The presence of mutual respect and belief between a leader and members is critical for getting team success.
Previous year, I became a team manager for new team at my office. I have 4 supervisees, each of them has unique characters and skills. At first, I was not familiar with them, I used commanding style to understand their capabilities. After understanding their range, I started to change pacesetting leadership for getting results in short term projects. In applying this style, some supervicees felt stress and burden so I adapted the style with affiliative one. This one is working for me to lead my team, they even more comforatable to communicate with me.
Now, I am scheduling to lead them with delegating on-job trainings, referring the professional trainings and encourage them to take both authority and responsibilities with my back up supervision (from coaching style), aiming to have democratic leadership style. This is my self-understanding of leadership from experience -
Team: For this theme, our country needs improvement in joint planning and action among different stakeholders. Due to underreporting and difficulty in rapport building among sectors, we must put many efforts to collaborate under same goal.
For transparency and trust, as mentioned above, there is still dilemma to give health data is safe or not when there is political consideration among decision makers. We, health professionals are trying to reduce this barrier in establishing digital health in our country.
For our country, the technology is under improving condition but there is still lack of techquity theme. We have various professionals for applying technology and supports from international organizations in implementing digital health system. But investment in technological infrastructures is very low especially in grass root level and many restrictions to use in some regions of country.
Our country is trying to implement digital health transformation, starting from the ministry of health. But the community still lack capacities and digital literacy to use the digital tools for their health. After facing COVID 19 pandemic, most urban population get awareness about telehealth and mhealth. -
Could you list the disease outbreaks that have been declared as the Public Health Emergency of International Concern (PHEIC)?
1. H1N1 Pandemic: The infection started from North America in April and WHO declared a pandemic in June 2009, a total of 74 countries and territories had reported laboratory confirmed infections
2. Ebola:It started in Guinea then quickly spread to neighbouring countries Sierra Leone and Liberia. In August 2014, WHO declared the outbreak a Public Health Emergency of International Concern.
3. Zika: The infection was started in Brazil since 2015. After getting the transmitted reports from 86 countries, in 2016, WHO declared that the mosquito transmitted Zika infection as Public Health Emergency of International Concern
4. COVID 19: The novel coronavirus, known as COVID-19, has spread from the People’s Republic of China to 20 other countries in 2019
On 30 January 2020 following the recommendations of the Emergency Committee, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern (PHEIC).
In May 2023, COVID is defined as no longer PHEIC and WHO stated that the virus will stay with us for many years.5. MPox: The upsurge of MPox infection in Demographic Republic of Congo and nearby countries was declared as PHEIC in August 2024.
Why do these outbreaks raise such concerns?
1. All these outbreaks caused high morbidity and mortalities for the population. The consequences of those infections are still under research and caused high DALYs.
2. The pathogen is highly transmissible and required external helps to control and preventive measures.
3. Some pathogens are new strain and some are emerging diseases, so the investigation and treatment methods are not ready. This cause panic situation among the community.
4. Due to globalization nature, the infection can easily be imported between countries. This led to pandemic and affected for travels and trades, impacting the countries’ economics and development.In your opinion, is there a disease or condition that may potentially lead to PHEIC in the future? Why?
From my opinion, the cholera may potentially lead to PHEIC in the future.
According to WHO, in 2024, there are 60 countries that reported cholera cases. The burden of the disease increased when compared to 2023 and 98% of all reported cases are from Africa, the Middle East, and Asia.
[Cholera upsurge https://share.google/EyZpXjb5pz19a2Ydo%5D
Due to unexpected occutof natural and man-made disasters, the basic sanitation infrastructures are damaging and will be difficult to access clean water. Increasing poverty, climate change, conflicts and misuse of antimicrobial drugs are also risk factors.
Not all countries have no adequate vaccines and cholera tools for measures and this is one of the disease to be monitored in resource poor regions. -
Which single design limitation most threatens valid estimates of sensitivity and representativeness? How would you address it within six weeks?
In this AEFI surveillance system, there is parallel different reporting systems. These two have no interoperability, usability and used different tools for data management.
For addressing this issue, I will start the re-designing of surveillance system reporting flow. To initiate I will do advocacy meeting with M&E team and Disease Surveillance Unit for the health staff’s awareness of the need for change, targeting to raise their desire to use acceptability interoperable data and data collecting tools (single one). Then, after getting consensus to use single management system, I will prepare the electronic data reporting system for AEFI cases from health facility to common server as immediate reporting. For zero reporting cases, there will be defined specific date (every Tuesday) to report to server. For stability strengthening, I will recruit new staff for surveillance data reporting, prepare the report formats as simple and flexible ones. After this, the AEFI surveillance training will be given to all RI providers, LIO, RIO, DSNO and M&E Officers, emphasizing the importance of data to report and giving constructive feedbacks and required logistics supplies to surveillance site.2.) Using the CDC surveillance attributes, propose one low-cost intervention to increase sensitivity. State the expected trade-offs, and list 2–3 indicators to detect impact from the intervention.
In this case, under-reporting and incomplete data decrease the sensitivity of system. So, I will initiate the direct electronic reporting system to central server (KoBo application can be used freely). All LIO, RIO, DSNO and M&E Officer will be grouped as surveillance team and monitor the reported data as their assigned duty. The reporting format will be prepared to collect the most required data (date, health facility name, village/ward, age, received vaccine, symptoms). After confirmation of the case, the case investigation process will be proceeded by surveillance team to reported health facility.
Expected trade-offs:
(1) Required training to use KoBo application and create KoBo server
(2) Responsiveness from the surveillance team will be faster and start investigation or feedback to health facility
(3) Knowledge and perceptions of RI providers to collect AEFI data will be raised due to proper training.
(4) Their workload can reduce compared to previous system.
(5) Data security and privacy must be applied for the system.
Indicators
(1) Timeliness and completeness of surveillance data on weekly basis
(2) Random data quality assessment reports between primary data source and electronic system reporting
(3) Feedbacks evaluation from RI providers for using electronic reporting system3.) For a newly introduced vaccine, should the AEFI case definition be temporarily broadened to maximize early signal detection?
– If yes, what trigger would you use to revert to the prior definition?
– If no, why should this change not be implemented?
Yes, AEFI case definition should be temporarily broadened to get many positive case as much as. Because we have no adequate capacity in giving information about vaccine safety, no reported AEFI data means that the system is not competent to provide vaccine safety consideration.
To revert the prior definition, I will request for ad-hoc NEC meeting, reporting the system’s pitfalls to consider vaccine safety and modify the AEFI case definition for new vaccine to AEFI National Expert Committee (NEC). -
Verification and Preparation Stage, there are 3 following steps to do.
1. Establish the existence of an outbreak
2. Verify the diagnosis
3. Prepare for field work
To verify the outbreak, the field team can report the data within short time and the response team can check whether it is over alert line or not by comparing the former database. The collected data in the central server will provide epidemiological information and can be used in authorization to mobilize the rapid response team. In preparation of field work, the documentation for knowledge and laboratory data can easily be extracted by information technology.
In describing an outbreak stage,
4. Construct a working case definition
5. Find case systematically and record information
6. Perform descriptive epidemiology
For case finding and line listing, the health information system will provide the fast and valid data to analyze by using GIS technology and can present by data visualization technology to monitor the distribution of the diseases. This can support the response team to start the prevention and control measures. Information technology can also provide the working case definitions and epidemiological analysis in real time.
Hypothesis and testing stage require data to perform the interview for population.
7. Develop hypothesis
8. Analytical studies to test hypotheses
9. Special study (environmental study, laboratory study)
If information technology has database of population and geographical area, it can support whether to do environmental study or laboratory study. We can create heatmap for the outbreak area and can-do contact tracing and find point of source for infection. If the information system has interoperability with other systems, we can detect the causal agent (emerging or re-emerging) and alert others to prevent the pandemic spread.
Response and action stage:
10. Implementation of control measures and follow up
11. Communication – including outbreak report
By using information technology, we can use dissemination tools for control measures such as text messaging and chatbots, wearable devices for contact tracing and follow up. For public awareness and stakeholder advocacy, we can announce the risk communication measures through dashboards and mass media with data visualization techniques. -
I like the data visualization tools for decision support in COVID 19 surveillance and response. In COVID 19 pandemic period, enormous big data were collected through nationwide surveillance sites. If the public health professionals cannot use the information technology for presenting the result of those data analysis, the responses for prevention will be delayed. To make an important decision for public health intervention, the decision makers must clearly see the epidemiological trend of infection. In COVID-19 dashboards, time-series charts and geographic maps were focused to display and it helped to understand the region-level statistics to case-level coordinate data. After that, the policymakers and public gave much attention to watch the data dashboard in real-time. Some dashboard can show contact tracing, status of patients and social distancing directives. Those dashboard data are streaming through mass media like TV channels as daily practice to raise the community awareness. Data is just data if we cannot extract information form it. And it is not information hierarchy if we cannot share the knowledge from the information. So, data sharing through visualization works to inform and educate the public by effective communication way.
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1. How can surveillance help to detect and control the disease?
Surveillance is the ongoing, systematic collection, analysis and interpretation of health data. So, healthcare professional can timely detect the abnormal dengue cases distribution pattern through ongoing data collection and careful monitoring of its trend, it can help to respond the dengue infection before their epidemic peak level in the community.
2. Should we conduct active or passive surveillance or both for the disease, why?
For routine dengue surveillance system, we conduct passive surveillance focusing on data completeness and reliability of the reported cases, e.g. dengue is one of the notifiable diseases surveillances
As dengue is highly infectious vector borne diseases, active surveillance must do because public health staff engage actively in the system and can take prompt action for the detected cases in the community level, e.g. Hess test for every fever patient
If there is potential outbreak signal from passive surveillance, active surveillance must follow in the system to find the symptomatic patients and their contact tracing to prevent public health emergency, e.g. preventive measures for population and vector control activities
3. Which method should be best to identify cases, why?
1) Cases in medical facilities VS community
To identify cases, indicator-based surveillance is more specific to detect the signs and symptoms of dengue. After setting case definition, laboratory confirmation is required. So, cases in medical facilities should be the best compared to community.
2) Sentinel VS population-based surveillance
Sentinel should be the best to identify the cases. After getting data from medical facilities, we can start sentinel surveillance by doing line listing from the patients and start contact tracing. As dengue is vector borne diseases, the infection will be spread according to the vector’s habitat.
3) Case-based VS aggregated surveillance
Case-based surveillance is the best because it can detect the age cohort, it can get detail information of patient and line listing. But it is not suitable for large spreading condition.
4) Syndromic VS laboratory-confirmed surveillance
Laboratory-confirmed surveillance should be the best, because dengue needs to be confirmed from other fever with rash cases. The reliable antigen detection are now feasible and we can start vaccination for prevention.4. What dissemination tools will you choose to disseminate monkeypox surveillance information? Why do you choose this/these tools?
I will choose ongoing real-time dissemination tool to disseminate the current monkeypox surveillance information in epidemic regions. Because monkeypox infection requires rapid public health intervention. We can detect geographical distribution and caseloads in timely manner and develop alerts immediately to the public.
For worldwide, I will choose periodic dissemination tool to do advance research and innovation for vaccines and treatment intention. -
No, I should not give the data out even though the research will generate the good prevention and control benefits.
Because their request involve sensitive personal identifiable information which violate the information privacy and disposition. It is not timely condition to violate principle of openess. I will share the data with appropriate fashion not disposing the patients’ identity. Access and security of patient data should be carefully determined to share with other teams. I have to maintain the accountability of maintaining the patients’ data in sych condition.
So, I will prepare the foillowing steps to share the data with research team:
(a) remove all personal identifiable information from data set, data minimization
(b) check whether the consents were taken from patients to use their data
(c) only share to the most responsible person of research team to handle data, limit authorization and identification (by using authentification factors)
(d) upgrade the data security measures in sharing the data between teams
(e) make agreement with research team indicating data sharing is purposed only for educational purpose and have duty to prevent the misuse of data. -
As a health information professional, I must mmaintain the ethics and principles in performing my duties. I have to keep secure this data and try not to manipulate without voluntary consent of patient. This is my accountability.
I cannot tell my friend event though I am sure that she does not know this fact. It is patient’s privacy and I must give respect. According to the given information, I am not in condition to interfere the other people because I assume that they are not currently in emergency life threatening condition. I am also not incharge doctor for this patient’s treatment process.
So, for right to self determination, I have accountability to maintain the patient’s information and he has the right to maintain his autonomy.
For doing good and no harm to others, my actions must not harm to both patient and his family.
It is my obligation to keep the patient’s data secure as a professional -
As mentioned in Topic 1 discussion, our organization is starting to use web based application for data reporting.
For this initiation,
Awareness: the project team did advocacy meeting with senior management team about the sysytem and its usefulness for the project and organization’s values. After getting approval, the project team did consultation meeting with field team and HIS team about the objective and course of system.
Desire, Knowledge and ability: Our partner organization helps as sponsor to start the project and give training to staff frequently. They support the internet charges, laptop and continously feedbacks on any compliant by the staff. They always update the system to be user friendly. The only barrier to continue the system is ongoing cost and this will be weakness in our ability for change.
Reinforcement: The partner offers they can continue their technical support for using system and currently paln to give data management sequential trainings. -
Currently, our organization uses the web base application for electronic medical recording/reporting with the support of partner organization.
Data: it is more systematic and reliable by using the server. Less human error when compare to excel data entry. We can visualize the data more conevniently and analyze quickly.
Cost: Ongoing expenditure to use the server is high. We also have to hire the data asssistant staff for data etry. If the project is close out, we cannot use that price to continue.
Operation: As the data are EMR, we need to train the data assistants about server usage and common medical terms. A supervisor always checks whether the data are correct order or not. It is still burden on continuing the system.
Design: The user interface is simple but it needs internet stability. The data can be missing out when data entry but we cannot directly check due to limitation of access.
People: All staff are now acceptable to the system and they began to change their data entry practice into elctronic format. -
In our organization, decision support system (DSS) is not fully developed yet. But I think the followings are the practices implementing as part of DSS.
As we have funding restriction, we are always tryting to priortizie the resource/medicine/trainings/IECs allocation to field teams. For this occations, we always check with HIs team for their monthly and yearly caseload reports, discuss with operation team and program teams, distributing the quantities in relatable with their workload and caseloads.
For the training opportunities, we exercise the HRHIs and assign to attend the suitable trainings.Unskilled and lack of familiarity with new system, increased workload on meetings and data analysis for distribution are the factors influencing to use DSS in organization.
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i. No standardized case definitions for the diseases among hospitals and different level of medical professionals, data reduntancy
ii. Face challenges in big data analysis for comparing of data, comprehensive management and research purposes, unable to monitor and EWAR system
iii. The above facts will impact on interoperability among institutes and country level ehealth system, increaded workload on data cleansing and verification
iv. If the hospital cannot use ICD standard, it is diffficult in calculating service package purchasing for case defining, management (logistics, financial and insurance)and implementing health economic. -
According to the article, physicians are not familiar with EHR and related IT tasks so they feld burden on EHR’s documenntation and workload burden. As they are working for human beings especially unhealthy cohorts, they will have unconsiciously concerns on inbox alerts and feel fatigue on dealing them.
The collegues working with EHR system in my country also felt above symptoms. Some are still reluctant to do documentation, some requests to assign data assistant for data entry etc.
Suggestions to reduce these:
i. prepare the EMR design to be user friendly setting
ii. train medical professionals about the system and advocate about the importance and benefits of eHealth
iii. use AI technology in implementing EMR and reducing workload burden on medical professionals -
Thanks for your presentation on Seha virtual hospital, Saya.
I see that this ehealth has greatly raised the healthcare practice of community who have been suffering from continous medical care for their chronic diseases.
They also have strategic service plan for speclialized consultation and it will be a help in reducing DALYs of patients.
The most impressive one is that their interoperabilty between 130 hospitals across the Kingdom. -
Thanks for shring the project, Ama Wah. I think this project enhance the citizens to make initiative in reaching of preventive services from health centers. This is a sign of community involvement in public health practice. From this project, health professionals can montior the ground situation and real time data analysis helps in reducing morbidity and mortality.
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eHealth makes the consumers to take ownership of their health and management process. eHealth help to overcome the barriers such as delay in decision making, delay in reaching services and delay in service providing. As they have big data in the system, eHealth can make real time decision for both prevention and treatment ranging from individual to community.
So eHealth is a data driven system making the treatment and prevention measures on real time basic. -
I think that EPI data is big data and it fit the 7 Vs as follow:
1. Volume is very large in EPI data because it collects the millions of under five children in country
2. EPI data have structured and unstructured data such as frequency of dosage, regular or catch up vaccination and AEFI incidence.
3. Velocity is also important one in EPI data, because if there is outbreak, the urgent rapid assessment of immunization status is necessary for PEP response.
4. For veracity, we have to check immunization history if the children are presented with vaccine preventable disease. EPI data is collected by the health staff by using the hospital records so it is accurate and reliable.
5. We can present the decision makers with visualization from EPI data. It will help to monitor vaccine coverage and diseases elimination programs.
6. Value: EPI data help to trace the children who are not receiving the full vaccine dosage.
7. It is vulnerable data because all confidential information of children are recorded. -
We are trying to develop Health Information System according to our organizational strategic plan. As part of this system, we have initiated the surveillance system of infectious diseases in our coverage area. The aim is to supplement the service and system gap in conflict areas to prevent the public health threats. The project started with syndromic surveillance as facility-based practice.
During first year, we have no experience in system set up project and have faced many difficulties in implementation. We collected data as weekly practice for immediately notifiable diseases and took as monthly report for other infectious diseases. This caused the front-line clinic staff to confuse and burden of data entry. As our project area has no internet connection and they had to go nearby township to submit report. So, the data timeliness and completeness were not met to target. As information is not reachable to HIS officer in time, the disease monitoring, case investigation and contact tracing are also late. The front-line clinic staff felt that the surveillance system become burden for them and gave feedbacks and complaints.
Therefore, HIS team met up with program and partner teams to develop electronic reporting system using health informatics in the first quarter of 2025. Due to many constraints and difficulties, we chose to use KOBO mobile application to collect the data and Power BI to monitor the disease trend in real time. The reporting timeline was set up as weekly basic and supported the clinic staffs with mobile tablets and Wi-Fi signal boosters. The surveillance diseases are re-selected and clinic staff are trained to use the KOBO application effectively.
After deploying KOBO to use in the surveillance system, the timeliness of reports is greatly changed and all reports reach the server in time. This is the amazing superior outcome within the project timeline. The staff did not need to go nearby township, not required report logbooks and it is cost saving for the project. The staff are satisfying to use the application; the HIS officer can analyze the data and interact with field team very quickly. The program team can monitor the incidence and trends of disease via dashboard. So, the response and medical supplies can be transported as soon as possible.
Although the reporting and monitoring of diseases is feasible with KOBO App, we cannot use electronic medical records and case investigation/symptom tracking tools.
Not all staff are familiar with technology and reluctance to use.
The data redundancy is still there because other medical recording is using paper-based system.
Due to organization nature, human resources are not enough for HIS team.
The internet stability and ability of mobile devices are still challenging in our project area so the systems are fragmented. -
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The case is interesting and get aware about the phishing mail. I would like to add some suggestions to prevent this attack. The system should be protect with defense in depth at network, application and endpoints. This can delay the exfiltration of data in short time.
Not only on raising the awareness of cybersecuirty, all staff must sit compliance examination of security as routine basic. -
Your case study is interesting and discussion points are clear. I think it will be the common accidents for many organizations, Ama Wah Wah.
I would like to discuss some points from my point of view.
YNHHS faced network hacking, so they should consider their cloud service model and types to prevent the attack.
EMRs and payment system are not affected so their topology is great and should update not to affect the confidential data server.
Regular accessing of staff’s compliance on the data security practice. -
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Thanks for your insightful discussion, Ama. As the communication pattern of dengue is changing, the population-based surveillance can produce attack rate among the patients and suitable for nationwide surevillance. The community has awareness about the dengue, like you mentioned above, the community can activitely participate in case findings.
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Thanks for sharing of your experience. Health informatics is very effective to analyze the data not only for treatment but also for research purpose in medical field. Case standardization is also challenging factor in my context. As you mention, we also face interoperability challenges between projects and different clinics.
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