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My apologies for the belated attempt in this week’s discussion.
1. Why was the author interested in investigating the suicide problem in Thailand during the time?
The researcher would like to identify the significant factors influencing the suicide rates in Thailand. It was based on the fact that the number of suicide cases had been rising, with the figure ranging between 3,600 and 4,000 cases annually from 2005 to 2014. The average suicide rate was higher than 6 cases per 100,000 population, particularly after 2011. A considerable number of studies had been conducted in developed countries to address the increasing trend of suicide. Thus, to explore the factors influencing the suicide rate in the Thailand context, the research was conducted as a cross-sectional study on how cultural, social and economic impacts have an influence over the population in different areas of the country.
2. Each of the students picks one potential risk factor mentioned in the paper and explains how the variable can contribute to the suicide rate.
I would rather choose alcohol as one of the highly significant factors that contribute to the increasing suicide rate. In the study, suicide rates were significantly related to alcohol consumption in Thailand.
It was also highlighted that alcohol consumption in both groups aged 20 and above and aged 15-19 were compared in two models to find out how alcohol abuse in both groups affected suicide.Alcohol intake in teenagers and grown-up populations was lower in the high economic status group, and it is believed that those groups belonged to higher education levels and seemed to follow the regulations on alcohol. In the given two models, suicide cases were significantly related to alcohol drinking in adults over 20 years old group and adolescent groups between 15 and 19 years old, respectively. Model-1 has shown that one unit of increasing adult population alcohol intake could result in higher suicide rates by 0.086, while one unit of the rising population aged 15-19 drinking explained 0.01 unit of increasing suicide rate in model-2. R2 values were 0.6 in model-1 and 0.59 in model-2, representing that around 60% of the total variations in suicide rates were explained by independent variables in the models. There was not much difference in the values of the two models.
The relation between the growing number of suicides and alcohol was probably due to a loss of self-control under the alcohol, which provoked uncontrolled and aggressive behaviour, and those could be rooted in chronic depression that the person might not disclose to others.
3. How statistical modeling can contribute to investigate the epidemiology and spatial aspects of Thai suicide problem?
Multiple linear regression statistic test was applied for both models in the paper to investigate the underlying risks of suicide. Provincial data were collated from different sectors to explore social and economic factors over dependent variables. Regression models scientifically demonstrated how social factors such as occupation, alcohol consumption, female as a head of household, divorce rate, and economic factors including income, debt and unemployment, were significantly related to the suicide rate in specific parts of the country and type of relation between. The prediction model estimated the suicide rate depending on changes in risk factors and it can alarm the public health authorities to address health issues timely. Appropriate intervention programs and regulation on negative factors can be established after prioritizing the significant factors from the model.
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• What are possible reasons locations in epidemiological research have not been incorporated as much as other components in epidemiological research? How can spatial epidemiology be considered as an interdisciplinary science?
Locations and area studies are not considered at the same level as other determinants in epidemiology. There were several constraints in the past, such as the availability of high-quality data and confidentiality issues explained in the paper. We have still found a lack of proper records regarding specific disease mortality data in some developing countries, which hinders the summarization of environmental health problems. Poor data quality has been experienced in disease diagnosis and registration, including the patient’s location, even in developed countries. Thus, exposure and duration to certain health events in a specific location are quite challenging to be inferred to relate to the occurrence of the disease. Similarly, before the HIPAA Act in 1996, secondary use of epidemiology data was limited for the purpose of healthcare analysis because several data were gathered for different reasons, leading to the restriction in the usage of spatial data.
Spatial epidemiology can be regarded as an interdisciplinary science, particularly in healthcare, because concepts and knowledge from several disciplines are applied in spatial epidemiology to allow us to understand the correlation between exposure in a certain area and disease outcome. Disease distribution, mapping, intervention and response, population migration, social status, etc, are integrated into this study to deal with health challenges and overcome health problems.• Explain why it is widely recognized that the place where an individual lives or works should be considered as a potential disease determinant and give some examples.
Estimating the degree of exposure to specific risks in an area is an essential element in predicting certain health outcomes. When someone lives close to a polluted river or ocean, his/her health might be severely affected by the source of waste or toxins. Depending on the pollution level, people close to the polluted water will likely suffer from respiratory diseases, skin infections and waterborne diseases. Contaminated water sources bring neighbouring pollution, not only acute infectious diseases but also causative agents/risks for chronic diseases. -
1. How can the decision tree model be integrated into clinical practice to assist surgeons in preoperative planning and decision-making?
We can apply the model in a clinical decision-support system to assist surgeons in planning and decision-making. After collection appropriate patient informations, the potential risks and complications will be estimated and rendered by the model. Thus, those alerts will warn surgeons so that they are informed with the proper information and are more likely to have chances to prepare and manage the possible complications for better outcomes.2. What are the potential benefits and limitations of using this model in a real-world clinical setting?
There are several benefits of using the decision tree model in real-world practice to assist surgeons. Patient outcomes would be estimated more accurately, and surgeons might have opportunities to prepare appropriate measures when a poor outcome is predicted. An individual surgical plan could be planned and performed to respond to the model estimation result. There will be minimal unexpected complications during or after operations as healthcare providers might have anticipated possible case scenarios and potential risks.
The limitations of the model are the requirement for vast amounts of patient data to predict patient outcomes more accurately. There might be a rejection of the reliability of the model by the healthcare providers or due to the overburden of the recording of additional patient information. Patient data privacy is another consideration to imply the model in a real world practice. -
1. What additional factors should be considered to identify barriers and unmet needs in health information seeking among youth for HIV/STI and RH than in the paper?
I will consider effective communication channels to reach the target group, such as social media and technology platforms, to identify the gaps in delivering health information to youth. Most of the group is familiar with digital devices and social websites. Delivering information from those platforms will have a significant impact on young adulthood. A reliable Facebook page or website/peer group platform to disseminate healthcare information and gather information on barriers and gaps in healthcare access could be an appropriate solution among young adults and KAPs.2. Which types of vulnerable people in your community are missing or left behind in receiving necessary health information, and why? How can we best reach these individuals and measure the real impact of health information on their health-seeking behaviors to ensure its effectiveness?
People living in remote areas of my country are another vulnerable and marginalized group in Myanmar because many of them have limitations in accessing healthcare services and health information. Again, I also believe technology is one way to receive appropriate health information with less resource use than any other means. It could be possible to monitor the number of people from those areas who use social media and request feedback or perform surveys online relating to their healthcare knowledge and behaviours. -
Please find my Covid-19 dashboard for the final assignment in the below link. There were three menu tabs on the main dashboard representing the three pages. On the first page, the general trend of confirmed cases, recovered cases and mortality cases were described. Different charts such as bar chart, bubble chart, area chart, etc. were applied along with vector icons to enhance visualization and to promote user’s interface. Each country’s respective figures can be chosen for the detail information on the second page. Final page showed the cumulative data of specific period.
https://lookerstudio.google.com/reporting/555b30bc-fe76-461b-8004-479e6ad35aa4
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I explored a WHO SEAR COVID-19 data visualisation dashboard representing 11 countries (India, Indonesia, Thailand, Bangladesh, Nepal, Sri Lanka, Myanmar, Maldives, Bhutan, Timor Leste, and the Democratic People’s Republic of Korea). The dashboard can be found in the link below.
https://experience.arcgis.com/experience/56d2642cb379485ebf78371e744b8c6a
The dashboard displays a wide range of data on a single area, which includes caseloads, deaths, new cases, epi curve, recent trends, vaccination and public health & social measures (PHSM) index in each country. Except for DPRK, each country’s data is updated regularly, either daily or weekly, depending on the data accessibility. Total cases and deaths were described in numbers and illustrated with trend charts for cumulative data on the right side of the dashboard. The most interesting figure on the dashboard was an epi curve in the middle comparing the new cases of each country from the beginning of the Covid era until the present. Each colour in an epi curve represents a single country, and it is customisable to include or exclude the countries in a chart to compare caseloads. The period on the graph is also adjustable to examine the number of cases in a specific timeframe.
The incidence and mortality rates of each country can be found in another tab of the dashboard. The PHSM index was compared with daily cases in the PHSM tab of the dashboard so that we could learn what measures had been implemented to tackle the disease outbreak in the community. Vaccination information in each country was clearly mentioned in a separate tab and can be compared with current population data.The dashboard’s limitation is that it uses different colours to indicate the new cases in each country. This could be quite confusing for first-time users, especially the general public, when it is first introduced. However, I believe using separate colours is meaningful in this dashboard because if the monochromatic colour is applied in the histogram, it can lead the audience to disorganised figures as the chart has to present ten different nations. The second point I mention is that it is appropriate to include the option to choose a certain timeframe from the calendar or by typing instead of the slider bar to be more precise.
Overall, the dashboard is simple and comprehensive for users and provides detailed information about COVID-19 in one area. The dashboard used appropriate graphs and tables with proper colours to deliver the information with better visualisation.
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This is my assignment infographic, which reflects on the personal health information that I learned in the course.
https://snipboard.io/4ZEhjN.jpg -
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The image below is what I learned in the AI and ethics course this week.
https://snipboard.io/T2YlLp.jpg -
I elaborated on the statement, “One should always use two-sided P values”, which is presented in No. 14 on page 342.
Whereas two-sided P values are commonly used in practice, the advantage of using one-sided P values is that there are fewer subjects and resources to underpin significance. Two-tailed P values divide the significance level and it contributes to both sides. Thus, each side of a two-tailed is only half as strong as those of a one-tailed test, which supports all the significance in one aspect. Although one-tailed tests enable more Type I errors, there are many situations in which a one-tailed test could validate the data while a researcher is fully aware of the drawbacks. When there is a very strong reason to validate that one variable is superior to the other, a one-sided test would be applied.
However, a one-sided test will not measure the hypothesis in the opposite direction, so variation can’t be concluded in that direction. In general, two-tailed P values verify the evidence that the control and variation are not the same, while one-sided P values prove that a variation is stronger than the control.
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I’m Phyo, and my most recent position was as a clinical manager in the non-governmental sector. In this role, I verified weekly and monthly clinic data, analyzed health status trends, and identified challenges within the project area. The health databases in my previous organization utilized Microsoft Access. The data could be extracted into either auto-generated or customizable Excel template reports. Thus, I have some knowledge in the area related to data analysis. Although I have taken a few courses about probability and statistics in the past, I did not have a chance to complete the entire course.
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Efficacy is the capacity of a given intervention to achieve the desired result under ideal or controlled conditions. A medication, for example, would improve a patient’s condition in an ideal environment where they are closely monitored and supervised for the expected outcome.
Effectiveness is the ability of an intervention to have a meaningful effect on patients in routine clinical conditions. Despite the treatment demonstrating efficacy with a noticeable improvement in an ideal situation, its intervention performance has to be tested under real-world conditions. Effectiveness trials show how well a treatment works in real situations.
Efficiency is doing things in the most economical way in terms of time, energy, and money. Once an effective intervention is found, it has to be improved by making it more efficient, or two identical effective interventions will be tested to find the most efficient one. In other words, efficiency is comparing an input to its output.
To sum up, when outcome measures are considered in a specific order, the particular intervention will be ensured first to achieve the desired effect/solution, even if its efficacy requires an ideal environment. Secondly, the intervention will be tested in real-life situations. Lastly, if it is effective, a more economical and efficient solution will eventually be developed.
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To analyze the respondents’ denying using bednets, I would consider a qualitative study, which can find out the concerns and negative behaviours behind the denial and why they are not using it in practice. A researcher can apply in-depth interviews and focus group discussions to identify the reasons and concerns in the study group. Learning about the respondents by observation is one approach to understanding attitudes and practices towards bednets. There will be the chance to learn from real-life situations to discover misinformation and barriers to using bednets.
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Various external variables influence a new technology’s perceived ease of use and usefulness. I think past experience, workplace relevance, and social influence could be significant distribution factors for a person’s attitude and behaviour.
Individuals with past experience in IT and digital proficiency will not limit their ability to apply new technology even when they experience complex features and additional functions in the early phase of launching a new tool. Moreover, if someone thoroughly understands new technology promoting performance on the job, it somehow impacts positively the perception of usefulness. Lastly, recommendations and encouragement from colleagues and close friends can boost the person’s interest and attention to using innovations due to social influence.
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TAM highlights that a new technology should be as useful as the replacing one to promote users’ acceptance and adoption. If the new technology brings functional improvements, enhanced design and competence with current tools, users will likely accept it as it improves their performance at work. If the new tech is easier to use, there can be a positive influence on user attitude and alleviate unnecessary concerns related to issues. Despite the ease of use contributing to users’ acceptance, usefulness should be deemed the most critical factor for users’ acceptability.
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I think the following non-identifiable data would narrow down the possibilities among others in a database. Those information are:
Sex – Male
Marital status – married
Year born – 1985
Education – MD
Current occupation – BHI student
Employment history – INGO staff
Place of residence – Thailand
Place of citizenship – Myanmar -
Infant mortality rate
Infant mortality rate is the rate of deaths among infants under one year old population.
Infant Mortality Rate = Number of deaths among under ones / Total number of live births * 1000
Infant mortality rate represents a child’s viability, which describes healthcare support, socioeconomic status and environmental situation in the child’s area.Neonatal mortality rate
Neonatal mortality rate is the rate of deaths among newborns within the first 28 days of life.
Neonatal Mortality Rate = Total number of deaths of newborns less than 28 days of life / total number of live births * 1000
Neonatal mortality rate is useful for monitoring maternal and newborn neonatal healthcare status and informing health authorities about intervention plans for desired health outcomes. -
From my perspective, young adults tend to live in an urban area than other age groups because of study or work. It contributes to the usage of contact tracing apps through public awareness. Secondly, it probably finding more contacts in young adults in urbanized areas for contracting infection due to population density. “Urbanization” is associated with the exposure we have studied, and it is not an intermediate step in the causal path between exposure and outcome. It is also a risk of having more contacts in the study. Thus, I think Urbanization is one of the confounders, which is a causal relationship with contact patterns.
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I remember the time when I worked in a refugee setting during the Covid pandemic. The most significant ethical principals was the decision-making concerning isolation and quarantine measures for infected cases and their contacts. As you may be aware, refugee environments are often densely populated, with shelters situated closely together, posing a high risk of rapid infection spread within a camp setting. In such circumstances, implementing isolation and quarantine measures was essential to curb the outbreak. However, a major concern developed when considering the impact on families, as restricting their movement during isolation or quarantine meant there would be no one available to assist care for basic needs, such as food and income. Thus, we collaborated with other partner agencies and local community leaders to support fresh food and ration supply during the isolation/quarantine period.
Local public health authorities strongly advocated for our organization to enforce isolation and quarantine for positive cases in the camps as a preventive measure against the spread of COVID-19. Meanwhile, we attempted to build trust and confidence within the community, actively engaging them in collaboration with our organization for isolation/quarantine activities. This involved effectively communicating the risks and providing crucial information transparently, with integrity and in a timely manner. Transparent, integral, and timely communication proved to be crucial in fostering community engagement and disseminating information regarding isolation and quarantine. The majority of individuals were more likely to accept and adhere to such decisions when the benefits of isolation/quarantine outweighed the drawbacks.
Secondly, the ethical principle is about when the Covid-19 vaccine started to roll out in the camp setting. As justice is one of the ethical principals in population health maximization, there must be fairness in the distribution of healthcare resources to mitigate disparities. Our responsibility was also to guarantee that every individual received the appropriate type and dosage of the vaccine without discrimination based on personal characteristics. We consistently conducted health education programs, disseminating information about vaccine benefits and potential side effects. This approach aimed to empower individuals to make informed decisions and willingly participate in vaccination campaigns. In such a way, we achieved a certain number of targets in the Covid vaccination program.
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Myanmar underwent political reform in 2016 and is committed to reach Universal Health Coverage (UHC) by 2030. The Ministry of Health and Sports (MOHS) has developed a National Health Plan (2017-2021) to strengthen the health system and support the implementation of UHC.
To ensure a comprehensive approach, MOHS brought inputs from both government and non-government stakeholders. Prior to the military coup in 2021, there were consistent positive efforts and improvements in promoting the health status of the population, including significant achievements in combating communicable diseases such as malaria, tuberculosis, and HIV/AIDS through increased budget investment in public health.Despite these efforts, Myanmar’s health system still faces several challenges, as the country is classified as a low- and middle-income country in the region. Life expectancy is the lowest among ASEAN countries, and there are significant geographic, ethnic, and socioeconomic inequalities that lead to disparities in accessing health services and financial risk protection. The Myanmar health budget contributes a very low percentage of the total budget, which results in households having to pay out-of-pocket for healthcare services. This drives the population into poverty and makes it difficult for people to obtain necessary healthcare services.
Additionally, the health system struggles with challenges in the availability and distribution of health assets, as well as failures in maintaining certain important functions. Limited oversight and leadership, as well as accountability, also pose challenges. Human resources are another critical issue in the health system, with shortages of trained personnel, inequitable distribution of healthcare workers, and difficulties in workforce distribution in rural areas. The lack of clear recruitment and deployment policies, along with unclarified roles and responsibilities of trained healthcare workers at all levels of the system, has led to extra workload and burnout.
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We have a shortage of qualified health informatics professionals in our country. There needs to be proper academic programs or universities offering health informatics graduate education to healthcare professionals. A strong partnership between the Myanmar health ministry and international academic programs is needed to provide online education to the existing government-sector workforce, particularly in remote areas. While some non-governmental organizations have attempted to develop health information systems to record patient information and share it among clinics, poor internet connectivity and error-prone processes make it challenging to maintain sustainability, negatively impacting the workforce. Lastly, the high initial cost of implementing eHealth or Electronic Medical Records (EMR) systems is a significant challenge for small organizations, who must balance their budgets to hire qualified health informatics professionals and invest in IT resources.
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If I were in charge of a dataset in my country, I would definitely consider sharing it with appropriate researchers and institutions. Nowadays, the healthcare industry generates a substantial amount of patient data and information as electronic health records (EHRs), which can be utilized not only for healthcare supervision but also for medical research. These pools of data and information can provide evidence-based clinical decisions, transformative clinical research, clinical guidelines and treatments, and several benefits to the public and stakeholders. However, we must find a balance so as not to compromise the privacy and confidentiality of patients in scientific research. Laws and regulations must be enacted to safeguard patient information regarding to sharing information in research.
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Electronic medical records can offer several benefits over traditional paper-based medical records, but they also have some drawbacks. The following are the key advantages and disadvantages of using EMR in our clinical setting.
Benefits: It allows users to access patient information in real time so that the efficiency of healthcare providers is improved significantly by receiving and updating patient information with less downtime. By using EMR, hard files of patient registrations and records can be replaced as those used to take up huge physical space and have to be protected to safeguard privacy. It minimises handwriting errors and missing data records by alerting users of incomplete data.
Drawbacks: Initiating an EMR system at the beginning can be costly in terms of investment in software, hardware, training, and maintenance expenses. Staff are required to undergo comprehensive training before initiating the project which would hinder the existing workflow and cause extra workload. After a few months, well-trained staff could be a shortage in the organisation due to the high staff turnover rate. The last one concerns the confidentiality issue that was raised by the patients when the electronic system recorded their health information. Some patients are concerned that their identifications and health information can be breached and shared with other organisations without proper notice.
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After learning about the research, we have seen several opportunities in big health data. On the other hand, it has brought quite challenging issues that still need to be tackled to improve patient outcomes. Some top challenging issues describing the paper are missing data, selection bias, data analysis and training, and privacy issues.
Missing data: Those seriously impact analysis and give invalid results depending on the number of missing data. Several factors have contributed to generating missingness in the databases. Imputation techniques are one of the models that can correct missing data recommended in the paper. Another suggestion is to provide regular refresher training to staff for data validation so that a certain number of missing data can be reduced at each level.
Selection Bias: The risk of selection bias due to the inclusion of subjects from different geographic, insurance and medical history profiles were compared in this large-scale EHR analysis. Recording sampling methods and being transparent in reporting for selection bias in the analysis is recommended.
Data analysis and Training: EHR usually entails a large dataset to analyse multiple times to hypothesise an event’s significance eventually. It applies algorithms several times to handle the complexity. The government has to invest more in the sector to develop skilled staff in order to support the industry and provide regular training and workshops to widen the knowledge and skills of the staff in the statistical area.
Privacy and ethical issue: People who share their health data have the right to protect their privacy. Cybercrimes target private information to hack for several reasons and advantages. Setting up a robust security system is one of the solutions to defend hackers from unauthorised access to big health data. Sensitive information should be encrypted before it is shared with designated research.
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I believe that all four recommended points are highly acceptable to tackle corruption in the health sector. The initial step involves mobilizing key actors within the health system to identify the extent and character of corruption which is followed by protecting groups who are about to uncover corruption. Secondly, it highlights sorting the main actions to tackle corruption after summarizing the problems in the first step. A pragmatic problem-solving approach can be initiated by learning the driving factors in current practices. Thirdly, comprehensive involvement from various sectors is essential to handle corruption effectively. Lastly, it emphasizes the critical importance of further research on corruption in the health sector as essential work to prevent serious impacts and consequences for patients.
I have learned some anti-corruption approaches to transparency interventions in development projects using scorecards from community-led accountability programs established in Tanzania and Indonesia. The programs enabled communities to tackle some specific challenges and take appropriate actions to take accountability. (1) Another promising anti-corruption tool is regular audits to detect irregular practices in the health sector. It has been proved that there is a connection between corruption and the function of internal audit in Ghana after strengthening the internal audit agency. The extent and independence of the role of the internal audit team were directly related to the effectiveness of corruption reduction. It can be concluded that full implementation and assurance of the independence of the internal audit capacity can assist in combating administrative corruption. (2)Reference
1. Ash Center for Democratic Governance and Innovation. Citizen voices, community solutions: designing better transparency and accountability approaches to improve health. Cambridge (MA): Harvard Kennedy School; 2017.
2. Asiedu KF, Deffor EW. Fighting corruption by means of effective internal audit function: evidence from the Ghanaian public sector. Int J Auditing. 2017;21:82–99. -
Throughout my professional career, I have seen some initiatives for health system improvement in the southeastern region of Myanmar, through local community empowerment by non-government organizations. One of the well-known projects in the area is the ACE project (Advancing Community Empowerment project) funded by USAID. The primary goal of the project is to reduce community vulnerabilities not only in the health sector but also in the sectors of WASH, DRM, and livelihoods. The outcomes are to increase participation and leadership in the planning and delivery of services and other initiatives such as improving skills, knowledge, and strengthening engagement between service providers and communities. ACE’s health development model gave communities leadership roles in planning and delivering health services. It encourages community members to identify and address their health development needs, establish Village Health Committees (VHCs), and train community health volunteers.
However, following the Myanmar military coup in Feb 2021, several projects are required to rapidly adapt to emergency response measures while addressing the increasing basic needs, particularly in the health sector in the southeast region of Myanmar. Project adaptation in the context is needed with a high degree of flexibility in operational processes and procedures to reduce administrative constraints and more responsive mechanisms. Safety and security become significant concerns for staff in the area and alternative measures for monitoring are necessary to be considered. Due to feasibility issues for field-level staff, training from remote or virtual platforms is being used increasingly for training instead of in-person sessions. Banking and fund transfer challenges are recurrent and unpredictable in the region.
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I am currently learning an R-introductory course in the BHI program. I take it as a personal project in this scenario and 12-step project management benefits me in several ways in learning the course.
Define the project: I commit myself to learning additional R-course to have an in-depth understanding of the R-programming within a 3-month period.
Detail tasks: I blocked my time 4-5 hours a day on Sat and Sun every weekend in order to accomplish the course. If I am occupied with my other priorities on weekends, I will find my time on weekdays to catch up on the course.
Plan the running order and consider contingency: I arrange the order of the content and priorities in the course which needed to be completed in the provided timeframe. Add extra time to revision or spare time for myself in some months for contingency.
Gantt Chatt: A Gantt chart is developed for each topic I have to tackle each week/month and I will follow the plan as per the schedule.
Monitor progress & readjust the plan: I regularly review my progress in the Gantt chart and make adjustments if required to make sure I will complete the course in my committed timeframe.
Review the project: After completing the project, I will review the whole project to learn the strengths and the areas I need to develop so that I apply these experiences in my future personal development.
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I want to improve my evaluative listening skills, as emphasized in the Effective Listening Course on LinkedIn Learning. I find this challenging because effective listening involves simultaneously attentive listening and evaluating the content of the argument. As we progress in our careers, the ability to assess presentations from supervisees, vendors, and others becomes vital. To improve this skill, I plan to implement strategies such as minimizing distractions, refining mental filters, adopting effective note-taking methods, actively listening to the speaker, concentrating on content, and seeking clarification from presenters during discussions.
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As a team supervisor, I actively listen to the feedback and suggestions team members provide. Suppose I find that a suggestion would be appropriate in particular circumstances. In that case, I am willing to replace the planned schedule/activities with the suggested ones to support the active participation of team members. I believe that incorporating their suggestions fosters excitement and motivation within the team, as the ideas originate from the team members rather than senior-level staff. The team members also have a sense of ownership and accountability to contribute to the outcome and achievement.
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A disaster recovery plan for my organization’s information system will be included below. That plan entails procedures and technologies appropriate for non-government organizations I have served in my career.
Risk Assessment: Evaluating the impact and chance of risks covering threats to information systems is quite critical to sorting out the highest risks which requires taking action and minimizing risks.
Data backup and replication: Regular backup plans can be considered in cloud-based technology which is time and cost-efficient. Data backup schedules with offsite backup storage should be in place to resolve crisis scenarios and reduce further harm. Data replication for critical systems enhanced the availability of the data.
Communication plan: Maintaining business continuity requires a communication plan no matter what crisis occurs. There should be clear responsibilities to specific staff. If there is an unexpected event, it should be a security supervisor’s duty to alert the team in charge who will then send messages to staff members. Similarly, a communication plan should also include necessary communications as well as public relations to reassure stakeholders and clients about security measures.
Testing and evaluating plan: Conducting an exercise simulating a natural disaster will be a great way to learn and evaluate how the staff follows the plan and their response when they encounter barriers in the scenario. The staff’s capacity is also enhanced with feedback. Gaps in the recovery plan can be learned and more stages are added depending on the need to strengthen the plan.
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Introducing high-availability technology in the hospital information system brings several benefits to patients and healthcare providers.
Advantages to patients
Lesser system downtime offers users and patients convenient services as there is no time-lapse or gap in using hospital services. It leads to improving users’ satisfaction and reliability towards the system which also attracts more users to utilize the system. Network issues such as part of the server’s crashes or outages could be bypassed with high availability technology, seamless connection would be created between the users and the providers with efficient delivery of services.
Advantages of the hospital
It is manageable to control the overload of servers due to several requests simultaneously. System redundancy can also be applied to support main servers if those are out of function. Retrieving backup information is possible even if it faces a serious challenging situation like a disaster. -
I haven’t experienced any security breach of data maintenance which involves CIA triad. I want to share the scamming of Twitter users in 2020.
What happened?
Hackers had access to private and corporate Twitter accounts of around a million followers each. They in turn exploited a few of these accounts to promote a Bitcoin scam. The list of hacked accounts included those of social influencers such as Elon Musk, Bill Gates, Jeff Bezos, Barack Obama, etc, and even tech giants such as Apple, and Uber.
Effect on the system/users
Some Twitter users transferred around $180,000 in Bitcoin to scam accounts. After the incident, Twitter’s stock price fell by 4%. Twitter employees became victims of a chain of spear phishing attacks. Hackers collected information on company employees working from home, contacted them, introduced themselves as Twitter IT administrators, and asked for user credentials. Using compromised employee accounts, the intruders gained access to administrator tools, and they reset the accounts of celebrity Twitter users, changed their credentials, and tweeted scam messages.
Preventive measures
The following preventive measures could be considered in the scenario.
Regular update passwords: Changing the passwords regularly reduces the risk of unauthorized access by someone and promotes the security of the system.
Software update: Antivirus and antimalware updates detect and prevent phishing attacks on the system.
Training: Providing cybersecurity training to the team to promote the knowledge and awareness of phishing attacks, scam emails, and the authenticity of accounts.
Beware of impersonation and report to an organization if any suspect: To be aware of any contact or visit from the specific company or organization claiming that they were sent from it. If there is any suspicion or doubt, it should be confirmed with that company whether they have sent it or not. -
You highlighted the most important facts and information about LTBI in PLHIV. The presentation is good and I am highly impressed that you included in detail how you will measure the indicators in the surveillance system. I just want to recommend more time allocation on the presentation part of the data flow. I hope that you might convince a person at your higher level about your surveillance system to implement if he/she has clear insight about the data flow. Overall is a really interesting surveillance system!
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You have good presentation skills describing clearly all the contents related to the disease. The disease surveillance plan focuses on the most vulnerable groups of the population and provides control strategies and policies on preventive measures for the targeted population. My feedback on this assignment is to consider gathering parents’ informed consent and their strong commitment to participate in the surveillance. From my perspective, I want to collect as many throat swabs as possible to detect whether is there any circulating wild enterovirus (EV-A71) in the target population. In addition, informed consent is also required for acknowledging parents or guardians to share their children’s data although it is safeguarded.
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My strengths in emotional intelligence are motivation and empathy. Even when I face challenging situations or significant changes in life, I stay motivated to overcome obstacles with energy and a positive mindset. I firmly believe that anyone having consistent effort and the right attitude will gain success eventually. I consider myself empathetic, having deep connections with my collogues and close friends within my social circle, understanding their personal matters and emotions, and offering support to alleviate their strong feelings. However, I recognize there are areas for improvement in my emotional intelligence, particularly in self-awareness and self-regulation.
Self-awareness: During my career as a mid-level manager with the former organization, I had to struggle to recognize my emotions and surroundings while juggling multiple tasks within tight deadlines. This lack of awareness sometimes resulted in unintentional erratic behavior towards both colleagues and close friends due to focusing only on the outcome of the work. My intense focus on completing tasks on time created a tunnel vision, limiting the awareness of the broader work perspectives and ignoring the work-life balance as well.
Self-regulation: Not meeting deadlines triggered feelings of anxiety and frustration, making it difficult for me to control my emotions. It had a serious impact on teamwork when I held a leadership role. Although I acknowledge the certain extent that we can’t always control the situations, I found myself overwhelmed and emotionally reactive in such situations. This emotional disturbance affected my ability to concentrate on my work when our team’s outcomes did not align with the planned objectives and targets.Action plans to develop to improve the weakness
Self-awareness: Whenever I sense that I am rushing through tasks, I take a moment to reflect on my actions and acknowledge the emotions associated with that sense of urgency. When I interact with others, I try to be mindful of my emotional connection with people. Maintaining a work-life balance is crucial, and I share quality time with my family after work, preventing work-related stress and pressures from becoming overwhelming. Regular exercise, including breathing exercises, enhances the connection between mind and body, encouraging increased self-awareness.
Self-regulation: I recognize the importance of focusing on achievable goals within my control. Situations beyond my control may hinder certain achievements, and in such instances, I have to accept that limitations. When I find serious stress or tension with uncontrollable situations, I find value in taking short breaks or vacations and coming back with better plans and ideas. Before reacting emotionally, I make it a practice to note down the underlying causes, finding this approach to be a useful solution in various scenarios. -
The integration of electronic information management systems has a positive impact on user’s acceptability and system’s flexibility, which in turn offers an advantage for the performance of surveillance systems.
Acceptability: Electronic data recording systems remove the unnecessary burden of the time-consuming paper-based registration and allow real-time reporting to the surveillance system. User satisfaction with electronic management systems, as compared to traditional management systems, is likely to be higher due to user-friendly interface design and streamlined workflow, reducing barriers within organizations. In the event of an error or bug in the system, users can promptly request assistance to address the issue. The complex data collection method using manual registers at sentinel site can be abandoned, thus improving data accuracy, and reducing delays in surveillance activities. Responsible staff benefit from the support and advantages offered by the utilization of electronic management systems, resulting in smooth, efficient, and effective workflow.
Flexibility: Electronic information management system has the adaptive property to modify new data structure or functions to add up in the existing system. The system is flexible to adapt to the need of the program. Health information standard can be applied in the existing system to integrate into another reporting system.
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Information technology can be applied to assist the outbreak investigation process in several ways.
Verification and Preparation: With the development of online communication platforms, preparation for field work can be efficiently managed involving multiple stakeholders within a short timeframe. This approach allows a large number of staff members to understand their tasks and actively participate in the response.
Health facilities and health centers nowadays have utilized electronic health records for patients, enabling the extracting of outbreak related data in real-time. This data can be promptly reported to the respective response team for further investigation. Thus, not only verification of diagnosis but also outbreak data collection will be processed with a number of valuable information when there is an alert of an outbreak in the system.Outbreak description: Active case detection in the community can be facilitated through electronic data recording system either with tablets or laptops and it makes sure that accurate and timely information are collected. GIS started to use in some areas to locate the cases and prevent the further spread of infection.
Hypothesis generation and testing: Statistical software has been utilized to analyze the data and generate hypotheses about the origin and transmission of the outbreak.
Response and action: Data visualization dashboard has been created to support for real-time decision-making for both stakeholders and public. Those tools gather data from outbreak areas and disseminate information with visualized charts, maps, and patterns. This empowers public health decision makers to allocate resources effectively, raise awareness and implement preventive measures in the community.
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The technology I prefer most in the article is the data visualization tools for decision support for COVID-19. Those were widely used during the pandemic period to collect real-time health data, not only representing the confirmed cases but also deaths, hospitalization rates, testing numbers, and even vaccination data. Each country has developed its own dashboard to capture the disease pattern in the region and respond with the appropriate intervention, applying the figures. The WHO Covid-19 dashboard is a good example of a data visualization tool for Covid-19. To establish Data visualization tools, raw data related to Covid 19 has to be collected from all hospitals and healthcare services. Then, it has to be assigned which data are visualized with the type of charts, maps, or patterns in the tool.
Data visualization tools are important for healthcare providers, analysts, and the public. COVID-19 dashboards typically focus on time-lapse charts and geographic maps ranging from region-level statistics to case-level coordinate data. It helps to keep the informed public with the right information and supports policymakers in refining interventions. Public health officers decide on resource allocation, promoting community awareness, preventive measures in the community, etc. in the red zone area. The general public stays informed about the pandemic proximity in the area and it is also updated number of contacts in the district.
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Although I see a great opportunity and advantage in the research, it also carries a huge risk that would pose a threat to health informatics as well as patients. I tend to share the data with the research team, but it would breach a certain number of ethics that I have to abide by such as the principle of information privacy & disposition, the principle of legitimate infringement, etc. However, I will consult with ethical boards and the legal assistant team in my organization to broaden my knowledge of the ethics of sharing data and to comply laws and regulations of the host country. Following that, the final decision will be adjusted on whether I should share data with the research team.
A huge barrier in the project is that individual data has been requested by the research team. We have collected this data with a specific purpose and if we are about to share it with another organization, consent of participant have to be considered for data privacy. Instead, individual information should be de-identified before transferring to the team. In addition, the research team has to take accountability to safeguard the data privacy and confidentiality when the data is used. Regular assessments should be done for the research team on the handling of data to comply with the initial agreement.
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If I were a health information professional, maintaining medical records and noticing a close friend’s husband’s HIV status, I would not interfere with my friend’s family matters by using confidential information of hospital data. It is obviously in breach of confidentiality of private data which a health information professional has to uphold. It will have a negative impact on the patient’s family and social life if it isn’t managed well the situation and I am not also certain about my friend’s status at this stage.
All patients have the right to self-determination and should be treated with equality and justice. Health information professional has to follow the principle of information privacy for users. The patient could visit the hospital due to a reason of healthcare management and services. It is the obligation of clinicians and healthcare workers to deliver to appropriate services and information to patients and family members.
As long as I believe in the healthcare services and system of the hospital, I am doing good and doing no harm to others by maintaining confidential patient information while upholding the principle of autonomy and integrity. However, if I feel that the delivery of healthcare services or health system is not right or I have doubt that it could solve the situation of my friend’s risk, I should discuss, inform, or report to my supervisor/respective authority to take appropriate steps and actions. -
Regarding the vaccination reporting system that I mentioned in the previous topic discussion, I think our organization had appropriately managed the change for the most part when dealing with staff. The following are comparison with the ADKAR model score that I learned.
Awareness: Most of the staff were aware of the need for change in the organization. However few had experienced only paper-based registration and reporting, and they didn’t understand the impact of a new system, especially frontline health workers. Although mid-level users understood the change, there were communication gaps among users of frontline health workers because the organization couldn’t highlight the need for a new system to cover all users and it was due to project duration constraints.
Desire: Health workers had the desire to learn new skills, especially electronic reporting although they encountered several errors and bugs at the earlier of the project. Senior midwives were invited to the design phase of the project. Mid-level managers introduced and explained frontline health workers during field visits and monitoring visits.
Training: Training and required equipment were provided to several levels of users in the system. Consultants provided training to midlevel users and senior midwives in the first batch and the training was rolled out at each project site with hands-on training and practical exercises.
Ability: Regular site visits by supervisors and provide technical supervision by designated officers to solve errors and bugs in the system. It was to make sure that users were using properly the reporting system and feedback had been gathered and reported to the system focal person.
Reinforcement: We had regular meetings to overcome challenges and to collaborate among focal persons. Regular monitoring internally and externally was established to streamline the function and process of reporting.
Although we have a few communication gaps between mid-level and frontline workers, the organization tried to narrow it down by providing necessary support within the project timeframe and budget limit. -
I want to describe an electronic immunization registration and reporting system developed by my former organization. The purpose of the system was to replace paper-based records with electronic records related to immunization in the project areas.
Design: Users participated at the beginning of the project. Thus, it was designed by easy to record and track the immunization data of day-by-day activities. When we established the project, the required IT equipment was supplied to the project areas.
Operation: The training had been rolled out before launching the product to the front-line midwives. We have the huge support of senior-level management to implement the project. Good communication has been established at the beginning of the project. There was an assigned technician available at the central office and IT issues or other technical issues were solved by an operational team.
Cost: It was fortunate that we had special funding to upgrade electronic records in the project. Thus, we had a chance to hire a consultant to develop databases for immunization and other registration tools during that fiscal year. In the following year, we found some challenges in fixing bugs and errors in the system because hiring a consultant burdened the organization.
People: Users were satisfied with the electronic registration system which they weren’t required to use any longer for paper-based registration and reports. They had some inconveniences in earlier the system establishment, but the workflow became efficient and effective as things were moving on. High staff turnover had a negative impact on system workflow in later years and regular training had been limited due to constraints of the budget.
Data: There were standard indicator definitions and local vaccination guidelines to take reference for registration and reporting. Accurate and complete data could be updated in real time with the development of the new system. However, some vaccination schedule was slightly different from one area to another, completeness of certain vaccine was quite hard to standardize among project areas. -
I have experienced chronic patient record tools in the former organization. It included a clinical decision support system for users with treatment plans and alerts/reminders when consulting and recording chronic patient information. Our organization was implementing the project as an emergency operation, and the chronic drugs we used were not the long-listed as a standard hospital has. When the healthcare worker selected the diagnosis in the record, the specific treatment option related to the disease would appear in the medication session so that the healthcare worker could make the selection from the checkbox. For example, if a new DM patient came to visit the hospital and took treatment, the treatment option would be:
[ ] Injection soluble insulin Or
[ ] Oral insulin
( ) Metformin
( ) Glibenclamide
( ) Glipizide
There are other features related to decision support such as tracking of patient blood pressure, sugar level, vital signs, etc.The factors that influence the decisions support system implementation in my organization
o User-friendliness and training: Although it was designed and created to streamline the workflow smoothly and effectively, the users were reluctant to use the full function due to the lack of proper training. So, Users were encouraged to be aware of the proper function and registration that were included in the system.
o Resources: Human resources as well as IT equipment were necessary to successfully implement a clinical decision support system in the organization.
o Software designed to integrate into local project and context: In the past, our organization has brought up several software and tools that had been implemented as a pilot project in the project area, but it was failed to meet the expectations of local context and requirements of the project. It was quite hard to integrate into an existing project and it was also challenging to be accepted by the existing workforce.
o Leadership: The last but not the least factor that influences the system. The senior role in the organization who could see the quality of the decision support system and really support enthusiastically by leading and collaborating with fellow colleagues will surely establish a new system. -
ICD terminology is designed to represent standardized terms of medical diseases and problems consistently and accurately among clinicians, public health researchers, epidemiologists, etc. concerning health records. Thus, it serves as a standardized tool for healthcare workers to register, report, interpret, and analyze healthcare data and information. If a hospital does not use the ICD standard, there could be a serious impact on communication, data flow, and interoperability not only within the hospital but also with other hospitals. In addition, there could be overlapping services in community healthcare due to misinterpretation of health problems and communication gaps with duplication of healthcare assistance.
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Your final assignment project/dashboard is quite informative and valuable for users. What I like about your dashboard is that it comprises several visualization charts, such as scorecards, bubble charts, bar charts, line charts, etc., to display the respective figures regarding COVID-19 information. Appropriate use of a control button to select a specific time, continent, and country is also convenient for users, as it allows them to extract the desired information with just a touch of a button. Personally, I think it would seem best if you use the icons instead of photos to represent the scorecard data of confirmed, recovered and deaths. I feel that it is a distraction for users to use two/three photos, although those are miniature ones.
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I have noticed that you consistently show your motivation by participating in class activities and actively engaging in discussion. Even though you see tough challenges and unpleasant situations around you, we can sense that you find a way to handle the situations well, get outside of your comfort zone, and make yourself better. It is inspirational. Keep up your great job, bro!
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It is a good screening system for newborns in Myanmar. Parents can take necessary action if the newborn has certain disorders in the early stages of life. I have learned that the system is very similar to the system in Siriraj Hospital presented by Khun Weerapat. I think cost and resources are the greatest barriers to implementing of decision support system in the organization.
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