Salin Sirinam

Gaps between rural and urban health in Thailand
– Workforce imbalance: Major cities and urban areas have a higher concentration of doctors, including subspecialists, for which the ratio can be up to 10x different.

– Accessibility: Rural people rely on a three-level healthcare system where traveling to district hospitals for specialized treatment…[Read more]

Thailand is currently facing a crisis regarding its health workforce. For example:

The Problems

– Poor distribution: We produce enough doctors on paper, but they are in the wrong places. While cities are fine, some are oversaturated, but the rural border areas face low doctor vs population ratio. Other professionals, especially nurses, are even…[Read more]

The good side of using EHR and why I prefer it is that, unlike the paper-based system where retrieving record cards for old patients is time-consuming and difficult, EMR allows faster access and review of complete medical histories. Digital systems allow more consistent and detailed information, improving the coordination between health workers,…[Read more]

I would like to add some thoughts about the communication gap between the frontline collectors and the analysts regarding the main challenges in the article.

Missing Data: Data is often missing because workers are busy and sometimes don’t see the point of completing it. They should be shown how their data turns into better patient care or…[Read more]

I agree with all 4 main recommendations in the article. To solve any problem, the first step is acknowledging that the problem exists. In order to reach a consensus among different stakeholders, we must clearly define the specific issues we are trying to solve, which in this context is corruption.

However, I believe one reason it is so difficult…[Read more]

Changing of dialysis policy in Thailand

In 2022, Thailand changed its national dialysis policy from a Peritoneal Dialysis (PD) First model to Patient-Led Dialysis. This improvement aimed to allow patients to choose their preferred dialysis modality (HD or PD) based on individual clinical needs and lifestyle preferences without additional…[Read more]

If I were developing a DR plan for a 250-bed hospital, I’d include the following steps and tools:

## Phase:
1. Activation: Identify potential risks and staffs (including committee) who will be responsible for activating the processes and assessing when there is a pre-defined disaster.
2. Execution: Power, network, and EMR will be restored f…[Read more]

Benefits for patients: For example, it improves the quality of care. In case the system goes down, HA will keep clinical data flowing seamlessly. Medical information won’t get lost or delayed. Moreover, it will impact how quickly health workers can get the patient information they need. No waiting time when a patient needs immediate…[Read more]

Thank you for sharing your real case. It helped me understand the issue clearly, and your lessons learned are practical. I think your example shows the common pitfall where test systems are treated as low-risk, but attackers don’t see the difference. This is why consistent security plans and routine audits are necessary for every system, not j…[Read more]

I’d like to share an example of an incident in Thailand in 2020, when a tertiary hospital in central Thailand was attacked by ransomware (Ref: https://www.bangkokpost.com/thailand/general/1982423/ransomware-attack-on-saraburi-hospital).

In summary, Saraburi Hospital’s computer system was hit by ransomware, causing the entire system to crash. Thi…[Read more]

Hi Jenny 🙂 I have limited IT knowledge, but I think data extraction from EHRs would use SQL to structure and integrate data, Python or R to clean and automate it. Additionally, AI/NLP to extract structured information from texts like radiology reports, before entering the CKDSS.

Thank you for your insightful comment as always! I totally agree that linking evaluation results to long-term impact is also important. Especially in the CKDSS, the evaluation indicators such as data accuracy and user feedback can inform policymakers about areas needing improvement, helping early detection programs and overall CKD care.

Hi Kevin! So although the CKDSS is based on laboratory and clinical data, it can still be used for the general public, especially during the dissemination stage. After data analysis, the results provide important information on the burden of CKD in Thailand, which can be used to increase public awareness and engagement. Recently, public health…[Read more]

Thank you for your comment, Hteik 🙂

Since CKD is a slowly progressive disease, data collection will be continuous through the EHR system once abnormal values meet the pre-defined criteria, with automatic extraction from laboratory records. Additionally, data will be aggregated and reviewed monthly at the hospital level, and analyzed quarterly at…[Read more]

Hi Sirithep! Thank you for the presentation. I appreciate that you chose RSV, as it’s increasingly relevant not only in children but also in adults and the elderly. I agree with the use of sentinel and syndromic surveillance across schools and daycare centers, though it would be helpful to clarify how active surveillance will be implemented.

I a…[Read more]

Hi New! Thank you for your presentation. I like that you clearly explained the case definition, although the COVID-consistent symptoms might be too broad and could benefit from further clarification. I would suggest visualizing the data flow and showing how each stakeholder connects to make it easier to understand how the system works. I also like…[Read more]

I like that you mentioned leadership style. Sometimes it depends on the context, the nature of the country, the character of the people, or how they would like to hear from and be supported by their leaders

Based on CERC, PM Lee was a more effective communicator. His statement was delivered at the initial phase of the outbreak and stated what was already known by bringing up the scientific evidence, such as the infectivity and mortality comparison, which built the strong credibility. He also expressed empathy and showed respect for public reaction by…[Read more]

I agree with you and I think Thailand has the same issue relating trust in the government.