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For a super tertiary hospital, the stability and security of the information system are very important. We must ensure the system runs smoothly and that patient data is protected to keep the hospital functioning. The development of a disaster recovery plan should include the following key procedures:
Risk Assessment: Identify risks to the information system, such as hardware failure, cyberattacks, or natural disasters.
Data Backup Strategy: Implement regular backups using cloud storage and on-premise servers for redundancy. Use automated backup systems to reduce errors.
Replication: Use real-time data replication to ensure minimal data loss during a disaster.
Recovery Procedures: Develop a step-by-step recovery process for bringing systems back online quickly. Schedule periodic testing of the recovery system to ensure its effectiveness.
Communication Plan: Create a communication system to notify key staff and stakeholders in case of system failure.
Staff Training: Train IT and hospital staff on emergency procedures to ensure readiness.
For technology, considering the hospital’s large scale and limited budget. A hybrid backup system combines on-premise backups with cloud solutions for cost efficiency. Use Virtualization machines for faster recovery of critical systems. UPS and generators for reliable power backup. High-Availability Clusters to ensure continuous operation of critical applications.
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For my research project on DRG, I am applying some of the 12-step project management process. First, I clearly define my goals to learn about the DRG system and Case Mix Index and to complete the research within one year. I agree on the expected results, timeline, and deliverables.
Next, I list the tasks needed for the project and organize them by assigning jobs to team members and setting due dates for each task. To make the plan easier to follow, I use a Gantt chart to show the tasks and their deadlines visually.
Finally, I hold regular meetings to monitor progress, solve problems, and make any needed adjustments. And review the results at the end of the project.
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Implementing High Availability (HA) technology in the HIS offers key benefits to both patients and the hospital, strengthens the hospital’s ability to deliver reliable, efficient, and safe healthcare services.
For Patients
– Ensures doctors and nurses can continuous access patient records and clinical data at all times for timely care.
– Safety, minimizes errors, such as missed treatments or medication delays.
– Faster processes like registration and billing improve patient trust and satisfaction.For the Hospital
– Maintains services during maintenance or failures.
– Ensures adherence to data security regulations.
– Savings cost and reduces risks of costly data recovery or repairs.
– Reliable care enhances the hospital’s image and attracts more patients. -
I have never experienced a failure in maintaining confidentiality, integrity, or availability of information systems. However, as a statistician working in a hospital and work relate patient databases. Although I am not directly responsible for data security, as a data user, I am aware of the possible risks and their consequences.
If confidentiality is compromised, unauthorized access to patient information, such as medical records, can result in privacy breaches, legal issues, and loss of patient trust.
If integrity is affected, inaccurate or altered medical records could lead to incorrect treatments, harming patient safety and damaging the hospital’s credibility.
If availability is disrupted, the healthcare team might lose access to critical data, potentially delaying care and posing a life-threatening risk to patients in emergencies.
To prevent such issues
Confidentiality: Encrypt patient data and restrict access to authorized personnel only.
Integrity: Use audit trails and data validation methods to monitor and protect data from unauthorized changes.
Availability: Regularly back up data and ensure systems are protected from cyberattacks, such as ransomware. -
Thank you for sharing your presentation on the hybrid surveillance system. The integration of surveillance methods is a strong approach for early detection. Regarding the use of a weak definition to identify suspected dengue cases, I suggest adding indicators to measure the accuracy of case detection. If the system has high accuracy and minimizes false positives, it can greatly support rapid outbreak response.
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Thank you for your malaria surveillance system presentation. I appreciate your focus on integrating passive, active, and sentinel surveillance, especially in hard-to-reach areas. Having statistical data on malaria prevalence in remote hilly and forest regions could help plan and select sentinel surveillance sites more effectively.
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Since I studied in a field unrelated to health or medicine, when I had to work with a multidisciplinary team, I had to learn a lot to understand the work. I decided to lead a research project about DRG or the Case Mix Index, which no one in my department has do before.
I invited my supervisor and long experienced staff in the department to join the project. I showed respect to everyone and honestly told them that I had no knowledge about the DRG system or coding diseases, and want to learn about it through this research. I sought their expertise by asking questions and encouraging them to share their valuable knowledge and long experience. I held some meetings to create opportunities for discussion and knowledge exchange.
Moreover, I ask support from the hospital’s senior management to act as advisors for the research project and informed all team members about this. I also let them know about the research grant provided by the hospital to encourage participation.
I believe that showing sincerity, respect, and honor to team members at all levels, good communication, appreciation , and creating an atmosphere of good collaboration can motivate the team, and thinking about the results after achieve the goal can also inspire me.
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Recalling details is a key skill I need to improve. My job requires me to communicate with medica/healthcare staff. Often, I don’t fully understand their words or points, especially during management or academic meetings. Also, when doctors or nurses request patient statistics, they tend to speak quickly and use specialized medical terms, which are already difficult for me. Because of this, I have to focus very hard. I always prepare paper and pen to write down important points and any unfamiliar terms to look up later. If the situation allows, I’ll repeat back or clarify my understanding with the speaker. Working in my current role has realize me how important listening and understanding are, so I take more notes now, sometimes I take notes even though I can’t read my own handwriting. Additionally, I’ve practicing meditation a bit daily to improve my concentration and memory.
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My strongest EQ component is motivation. I can easily motivate myself when challenges arise or I encounter obstacles or disappointment, and I am quite resilient. My motivation helps me stay committed and push through with patience, knowing that my efforts and patience contribute to a positive impact in my life.
My weakest area is social skills, especially talking skills. I struggle with starting conversations, networking, guessing people’s thoughts and minds, and finding the right way to express myself.
Action Plan:
To improve my social skills, I’ll practice active listening by really paying attention during conversations, carefully ask questions, and thinking carefully about my responses. I also practice making small talk, greeting people, and smile more often. Lastly, I plan to join more activities and meetings, and try to connect with new and diverse people in different settings. -
In reviewing the public communication about the COVID-19 situation from Singapore and the USA, both leaders PM Lee Hsien Loong and President Donald Trump communicated important information to their citizens, that have similarities and differences in their messages.
How did they apply the CDC’s six principles of CREC in their COVID-19 addresses?
1. Be First: PM Lee addressed Singaporeans early in the outbreak, providing clear updates and response measures. President Trump spoke after WHO declared a pandemic, focusing on protective measures for Americans.
2. Be Right: Both leaders offered preventive guidelines. PM Lee detailed Singapore’s preparations, explaining that the virus spreads more easily than SARS but is less deadly, references statistics with a 0.2% mortality rate, similar to seasonal flu. While President Trump though less detailed about the virus itself, he emphasized government actions like funding and economic.
3. Be Credible: Both leaders emphasized their countries’ preparedness. PM Lee noted Singapore’s enhanced readiness compared to SARS, highlighting stockpiled masks, PPE, upgraded medical facilities, and trained professionals. He also explained raising the DORSCON level to “Orange” to reflect vigilance. President Trump focused on travel restrictions, financial and funding support, government agencies fight the virus, medical supplies, and vaccine research.
4. Express Empathy: PM Lee showed empathy by acknowledging Singaporeans’ anxieties and praising healthcare workers and volunteers, building solidarity. President Trump addressed the elderly population’s vulnerability but showed less direct empathy toward those feeling fear or anxiety than PM Lee.
5. Promote Action: Both leaders encouraged their citizens to remain calm and assured manage the situation. They both advised maintaining personal hygiene, such as hand hygiene, and monitoring health to reduce public anxiety. However, PM Lee highlighted the importance of avoiding panic buying and mentioned that Singapore’s better prepared psychologically. President Trump, on the other hand, emphasized restoring order by promising financial support for workers affected by the virus, including loans for small businesses and tax policy.
6 Show Respect: PM Lee stressed unity and community support, commending healthcare workers and trusting Singaporeans to stay calm. Trump highlighted government actions, emphasizing the U.S.’s strong healthcare and economy.
In summary, both leaders are effective communicators who follow the CDC’s six principles and focus on building confidence and unity in their countries to face COVID-19. However, they have different emphases, PM Lee focuses more on public health and direct measures to handle the virus, while President Trump emphasizes economic support and managing the outbreak’s impact. In my view, PM Lee’s speech feels like dealing with the virus outbreak, while President Trump’s speech seems like dealing with the effects of the outbreak.
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Based on five themes proposed in the article, my country may need to improve in these areas to enhance preparedness for future pandemics:
1. Team: While my country has a good healthcare system, there’s still a need for better coordination between public health teams, hospitals, and local health volunteers when sharing health data and responding to emergencies.
2. Transparency and Trust: The needs to strengthen its data privacy laws and make them clearer to the public. While there is a Personal Data Protection Act (PDPA), many people still don’t fully understand how their health data is used and protected.
3. Technology: Public health technology infrastructure requires enhancement in several areas:
– Many healthcare facilities still rely on paper-based systems or outdated technology
– Integration between different healthcare systems and databases
– Real-time data sharing capabilities between hospitals
– Public health surveillance systems need modernization4. Techquity: While my country has made progress in digital technology, there remains a significant digital divide between urban and rural areas. Access to mobile phones, internet-connected devices, and the associated costs, as well as digital literacy skills, vary significantly across different geographic regions and demographic groups. Many elderly people and those in remote areas still lack access to digital health tools and services.
5. Transformation: The better standards for collecting and sharing health data across different hospitals and healthcare providers. Currently, different hospitals often use different systems that don’t work well together.
To strengthen pandemic preparedness, should prioritize the following:
1. Digital Infrastructure and Accessibility
• Expand digital infrastructure, invest in high-speed internet connectivity, especially in rural and underserved areas.
• Promote affordable technology to encourage policies that make mobile devices and internet plans more affordable for all.
• Support disadvantaged groups by implement targeted programs to bridge the digital divide for marginalized populations, including low-income individuals and older adults.
2. Digital Health Literacy and Training
• Enhance digital skills by provide comprehensive digital literacy training to healthcare workers, public health officials, and the general public.
• Develop intuitive digital health tools and applications that cater to diverse needs and abilities.
3. Modernized Health Information Systems
• Establish robust data governance frameworks to ensure data security, privacy, and ethical use, to strengthen data governance
• Upgrade health IT, invest in modernizing healthcare information systems to improve data collection, analysis, and sharing.
• Standardize data sharing by develop clear standards for data exchange between healthcare facilities to facilitate seamless information flow.
4. Collaborative Approach
• Improve coordination among government agencies, healthcare providers, and technology companies to align strategies and avoid duplication.
• Encourage collaboration between public and private healthcare sectors to leverage resources and expertise.
• Communicate more openly about how they collect and use health data, especially during health crises. This would help build more trust with the public. -
The list of outbreaks declared as PHEIC include:
– The 2009 H1N1 Pandemic
– The 2014 polio eradication
– The 2014 outbreak of Ebola in Western Africa
– The 2015-2016 Zika virus epidemic
– The 2018-19 Kivu Ebola epidemic
– The 2019-nCoV outbreak (COVID-19)These outbreaks raise concerns due to several key factors:
1. High Morbidity and Mortality Rates: Many outbreaks, such as Ebola or COVID-19, have the potential to cause a high number of illnesses and deaths, overwhelming health systems and leading to severe health and economic impacts.
2. Global Spread and Impact: Infectious diseases can spread rapidly due to international travel and trade, ma king local outbreaks a global concern.
3. Limited Resources and Capabilities: Outbreaks often exceed the normal capacity of local health systems, requiring coordinated responses that include external assistance, multi-agency efforts, and international support to manage the crisis.
4. Unpredictability: The scale, timing, and nature of outbreaks can be unpredictable.
5. Economic and Social Disruptions: Outbreaks can lead to disruptions in travel, trade, and essential services, impacting economies and societies globally.A disease or condition that may potentially lead to a PHEIC in the future
I’ve read news about global warming is causing deadly germs trapped in the Arctic permafrost to come back to life. Scientists have discovered several viruses frozen in the polar ice, and research has revealed that the world may face new epidemics from melting ice. In my opinion, a virus emerging from melting polar ice could potentially lead to a PHEIC in the future. This aligns with the WHO’s criteria for a PHEIC:
1. Serious Impact: A virus of this origin could cause a significant number of cases or even high mortality, particularly if it spreads widely among populations with no existing immunity or available treatments.
2. Unusual or Unexpected: The emergence of an ancient virus from polar ice would be unprecedented, as such viruses have been frozen for thousands of years, making them unfamiliar to modern medicine and unanticipated in current health frameworks.
3. International Spread: Given global travel, the risk of rapid, cross-border transmission would be high. If the virus were to emerge near areas with active wildlife or human populations, it could easily spread internationally.
4. Trade or travel restriction: To contain such a virus, countries might impose travel and trade restrictions, impacting international movement and economies.Given these factors, if more than two of these criteria are met, such an event might be reported as a potential PHEIC, with WHO making the final decision.
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Based on the evaluation of the Korean hepatitis B surveillance system in the report by Chung J et al., two specific gaps identified in the current surveillance system are:
Gap 1: Misreporting of Chronic Cases
The system is designed to monitor only acute hepatitis B cases, but there are instances where chronic cases are mistakenly reported as acute. This occurs due to unclear diagnostic criteria and the use of tests intended for chronic hepatitis B, leading to inaccuracies in the data collected.Addressing Gap:
• Improved Diagnostic Guidelines: Updating the surveillance system’s guidelines to include more precise diagnostic criteria for acute hepatitis B can help reduce misreporting. For example, additional tests like liver function parameters (e.g., ALT, AST, and bilirubin levels) and specific antibody tests like HBeAg and HBV-DNA levels, could be required to confirm the acute nature of the infection.
• Training and Education for Healthcare Providers: Providing regular training for healthcare professionals on distinguishing between acute and chronic hepatitis B is crucial. This training should focus on the specific diagnostic criteria and the importance of using appropriate tests (e.g., IgM anti-HBc for acute cases) to avoid confusion.
• Integration of Automated Data Checks: Implementing automated alerts within the reporting system to flag potential chronic cases based on patient history and test results can help healthcare providers double-check before submission. This can minimize errors and ensure the system only records accurate acute cases.Gap 2: Lack of Targeted Focus and Utilization
The surveillance system is not fully focused on the most important areas and is not being used to its maximum potential. It only monitors acute cases, which limits its ability to manage and monitor chronic hepatitis B, missing the opportunity to address chronic cases, which have a greater long-term impact. This gap can lead to misreporting and an incomplete understanding of the disease’s spread and severity.Addressing Gap:
• Expand Surveillance to Include Chronic Cases: The surveillance system should be expanded to include both acute and chronic hepatitis B cases, providing a fuller picture of the disease’s impact. The implementation could be done by integrating data from hospitals and clinics that manage chronic hepatitis patients. Health authorities can integrate data from existing healthcare systems, such as hospital records and insurance databases, to track chronic cases. This would require collaboration between medical institutions and public health agencies to share relevant patient data.
• Integrate Data from Other Health Services: Integrating information from other health services, such as vaccination records, treatment plans, and regular check-ups for chronic patients. Establish data-sharing agreements between public health authorities and other health services. Establishing a centralized database that links information from hospitals, clinics, and other healthcare providers. -
Information technology supports outbreak investigations by improving data collection, analysis, and communication, enabling public health agencies to respond more quickly and effectively to outbreaks.
Surveillance and Data Collection: Electronic Surveillance Systems like the National Outbreak Reporting System (NORS) enable real-time data collection and automated monitoring of health records. Event-based surveillance integrates diverse reports for early outbreak detection.
Data Management and Analysis: Database systems can be used to store, organize, and analyze large amounts of epidemiological data efficiently. GIS mapping helps visualize outbreak spread and identify sources.
Hypothesis Testing: Statistical software assists in testing relationships and hypotheses, aiding the understanding of transmission modes and risk factors.
Communication and Coordination: IT improves real-time communication among health authorities and supports Reporting and Follow-Up, and public health campaigns to promote preventive measures.
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A comprehensive Disaster Recovery Plan (DRP) is essential for maintaining organizational resilience, focusing on risk assessment, clear recovery objectives, and efficient backup strategies. Regular testing and staff training are critical to enhance readiness and minimize downtime during emergencies.
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Thank you for sharing your approach. It’s great to see how you balance flexibility and structure in project management. Using a customized chart to track tasks and progress is a smart way to stay organized and productive. Incorporating more steps from the 12-step process in the future is a good plan to improve even further. I will Incorporating its too.
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Thank you for your feedback and question. Yes, I agree that the early symptoms of diabetes can overlap with other diseases, making syndromic surveillance challenging. So I have an idea to use AI to assist in screening for diabetes by combining symptom-based data with risk assessment information. For example, in Thailand, we have the Thai Risk Score developed by the Diabetes Association of Thailand. This approach can complement areas with limited access to laboratory diagnostics, enhance the accuracy of identifying high-risk individuals , and support early detection efforts.
The symptoms I plan to include in the syndromic surveillance system are derived from the IDF Diabetes Atlas (2021) and align with the typical symptoms of diabetes, such as:
1) Excessive thirst (polydipsia)
2) Frequent urination (polyuria) or bedwetting
3) Lack of energy or fatigue
4) Constant hunger
5) Sudden weight loss
6) Blurred vision
7) Diabetic ketoacidosis -
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I completely agree that recognizing each team member’s contributions and making them feel valued is crucial for building a positive and motivated team environment. Additionally, holding team meetings fosters clear communication and ensures everyone understands the project goals, promoting better collaboration.
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Concentration is crucial for effective listening, as it helps us focus fully on what is being said. Summarizing what we hear improves our ability to recall details and understand the big picture. Additionally, I recommend trying breathing exercises or meditation; these may help maintain focus during conversations.
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Thank you for sharing your thoughts! I think this comparison highlights how different political systems shape leaders’ communication styles. PM Lee’s speech shows a transparent, unified approach, while President Trump’s focuses more on national strength and reassurance. Each leader met some CERC principles, but Lee’s message felt more grounded in specific guidance, while Trump’s leaned on economic assurances.
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Thank you for sharing your thoughts. I agree that PM Lee’s speech felt more empathetic and fact-based, backed by clear facts, which aligns well with effective crisis communication. On the other hand, President Trump’s speech seemed more focused on praising administrative efforts, which may have lacked the same level of direct public guidance and transparency.
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Thank you for sharing these challenges about digital health in Myanmar. While these are serious issues, I believe Myanmar can make progress by starting with simple mobile health solutions that work even with basic phones, focusing on areas that are ready for this change. I hope the situation will improve step by step, especially for communities that need healthcare support the most.
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Thank you for sharing your opinion. HIV has a significant impact on public health, but it’s not “unusual or unexpected” at this point. It’s been around for decades and we have a good understanding of its transmission and prevention. I’m not sure it meets all the criteria for a PHEIC. Perhaps in the future a new, highly lethal strain of HIV could trigger a PHEIC, but the current situation doesn’t seem to fit the bill.
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Thank you for clearly summarizing the gap in the system’s usefulness. I agree that making the system interactable through data sharing between the surveillance system and public health agencies is crucial. This development could lead to faster outbreak responses and better management of hepatitis B cases.
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Thanks for sharing how IT can help with outbreak investigations.
mobile Apps are great for collecting data during outbreaks. They let health workers quickly or real-time enter information about new cases right where they are. Online platforms then make it easy to share this data, helps everyone stay up-to-date and respond faster to the outbreak. -
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Using machine learning for disease surveillance can be expensive, so it’s important to carefully consider the costs and benefits before implementing it. Regarding the acceptance of reports from online sources, health authorities need to have a process in place to evaluate the credibility of the information. This may involve verifying the source of the data, assessing the accuracy of the reporting, and considering the potential biases that may be present.
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Telemedicine can be helpful for managing mild COVID-19 symptoms, can help reduce the burden on healthcare systems and prevent the spread of the virus. However, telemedicine may not be suitable for all cases. Additionally, delays in medication delivery can be a challenge, especially in remote areas or during times of high demand.
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laboratory-confirmed surveillance is the gold standard for confirming monkeypox cases, but all surveillance not end up at laboratory-confirmed surveillance, especially in areas with limited laboratory resources. In some cases, clinical features and epidemiological evidence may be sufficient to suspect a case of monkeypox.
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Yes, I agree that case-based surveillance is indeed effective for monkeypox, providing quick, detailed information for health officials. However, it’s best for severe or symptomatic cases and may overlook mild or atypical ones. Therefore, combining multiple surveillance methods becomes crucial when cases surge, ensuring a more comprehensive picture of the outbreak.
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