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I would like to introduce the COVID-19 dashboard from
The COVID-19 dashboard on Open Development Cambodia is a powerful tool for visualizing the pandemic’s impact in Cambodia, offering comprehensive, up-to-date information in a visually engaging format.
However, it also presents challenges related to complexity, potential information overload, and accessibility issues. Addressing these disadvantages could further enhance its usability and effectiveness for a broader audience.
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Topic Discussion Week 1 : AI and Ethics in Health
1. According to the “Responsible Research and Innovation” concept (Prof.Reidar’s lecture), would this ChatGPT be justified regarding risk-benefit VS. precaution (Better safe than sorry)?
ChatGPT is very helpful when we need information to make decisions, but it’s not supposed to make decisions instead of us. It’s like having a smart friend who gives us advice, but we still have to decide on our own.
Technology, including ChatGPT, can totally make our lives easier and less stressful. It’s like having a handy tool to rely on when we need help figuring things out. But, we shouldn’t let it take over our thinking. We still need to use our judgment.2. What are your concerns relating to the ChatGPT? The concerns can be ethics, legal, technology, data quality, public health issues (watch Prof.Reidar’s lecture on AI and Ethics & the article
– Transparency
– Privacy and security of informationAlso,
I would like to share my mind mapping on Responsible Research and Innovation and AI with ethics in health care (Pros and Cons) as the picture -
I would like to inform my opinion about point 8 “Lack of statistical significance indicates that theeffect size is small” (on page 341).
In my opinion, the objectives and setting of the study have a major impact from the proper sample size. In general, a good sample size is one that allows reliable statistical analysis as well as accurately represents the population.
I think larger sample sizes are preferable because they offer a more accurate representation of the population and smaller the possibility of sampling errors. But the larger sample sizes is also increase the effect of practical variables, such as availability of researcher, budget, and time.
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My name is Nakarin. I am working as medical laboratory manager of a private hospital in Cambodia.
My mainly work is about manage the laboratory operation works well with best quality of the result to patients.
I am familliar with Excel for some basic statistical analysis for summary or predict on my work.
I would like to use more tools of statistical analysis to help my work more successful and professional.
I believe that this kind of knowledge is never worse and can be applied to every working field.Nice to meet you all.
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In my opinion, I don’t have a specific job or position related to COVID-19 control policies, I can articulate some ethical principles and best practices that individuals in diverse roles may consider:
– Ensure transparent communication regarding the virus, preventive and policy decisions to the public.
– Strive for the fair implementation of policies, avoiding disproportionate impacts on specific populations.
– Privacy and data protection:
– Acknowledge uncertainties and open to updating policies based on new research and findings.
– Prioritize the safety and well-being of healthcare workers by ensuring adequate provision of personal protective equipment (PPE) and support.
– Prioritize public education to promote preventive measures and raise awareness.
– Provide economic and social support to individuals and businesses affected by control measures. -
I am working where there is no universal health coverage, and the Social Security Fund is the primary means of accessing healthcare for those with jobs.
However, even those with the Social Security Fund face limitations in terms of access, long waiting times, and certain treatments or medications not being covered.
For those without the Social Security Fund, they have to pay for healthcare services themselves. While paying by themselves may offer quicker service, the financial burden remains a significant issue for the majority of the population, limiting access to quality healthcare.
The situation highlights the urgent need for efficient and effective development in this country’s public health sector. -
Apart from the shortage of health informaticians in various organizations, there is also a significant challenge in investing in IT related to informatics in the area where I work. This includes limited access to education in health informatics.
Many healthcare facilities do not prioritize having health informaticians in their organizations because they can still provide patient services through paper-based management, without the need to invest in such systems. They do not see the importance of comprehensive data management.
The creation and development of health informaticians are limited due to the scarcity of resources and government policies that do not prioritize the development of medical technology. This makes it difficult to produce and develop personnel, leading to shortages.
All of these factors contribute to a lack of awareness about the importance of health informatics, and there is much room for improvement.
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As I am now working in the public hospital, the data of patient is the one of the most important thing that we need to concerns. Many consent form have been created for ask approval on sharing patient’s information or any data even sharing within the hospital.
I would say that share or not share depends on the purpose of using that data or information
1. Data sharing by patient request or relative request; this kind of requisition is very sensitive on data sharing. we have to make sure that we got approval from the owner of the data or information before sharing by getting consent from them. And, we have to beware that the shared data or information is only the approved one and approved recipient.
2. Data sharing for improving healthcare services within hospital or state. All of the patient’s information is valuable for improving hospital services or even the improving of the country’s healthcare system. This kind of data sharing can be done and might not be need consent from the owner of the data or information. But the important thing is all of patient identification or any data that can refer to the owner of the data must be blinded
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Using Electronics Medical Record (EMRs) in healthcare has its good sides and challenges.
Advantages
– Efficiency and accessibility. EMRs make keeping records way easier and quicker, helping to get and update patient info fast. Doctors and nurses can see patient records from far away, making decisions faster.
– Improved accuracy. EMRs cut down on mistakes that can happen when people write things down, making patient data more accurate.
– Enhanced coordination of care. Electronic records help different healthcare folks work together better, improving how they collaborate on a patient’s care.
– Cost savings. Using EMRs can save money by cutting down on paperwork, storage, and other administrative stuff.
– Decision support tools. EMRs can include tools that help healthcare pros with decisions, like reminders and prompts for better clinical choices.
– Patient engagement. EMRs let patients check out their health records, getting them more involved in managing their own health.Disadvantages
– Healthcare staff might need time to get used to the new systems, which could slow things down during the switching.
– EMRs from different systems might not be compatible together, making it tough for different healthcare groups to share info easily.
– Data security concerns especially if there’s a data breach or someone gets unauthorized access. -
I do agree with the information provided by this article. The information are mostly covered the issue of health big data I thought which is should be.
In my opinion, missing data is the popular issue that is found in daily work. This might come from the standardization of the record form or even from the recorders themselves. Here are some more ideas to deal with the missing data issue in our daily tasks:
– Standardized record forms by using the same record form. This way, the data information will be recorded the same way by everyone, and it lowers the chance of forgetting things.
– Continuous training and education by keep giving training sessions to the people who record data so they understand how important it is to put in the right information.
– User Acceptance Testing (UAT) by testing the recording tools often to make sure they work well for the people using them and ask them for the feedback and regularly improve the recording tools
– Quality assurance checks by Have a strong process to check the quality of recorded data.
– Clear guidelines and procedures by makin clear rules on how to record data. -
I do agree with all four recommended points that public health professionals can do to fight corruption,
1. Getting all the important people in the health system to understand corruption challenges is a big deal. It helps make specific plans and gets everyone on board to stop corruption.
2. To fight corruption, we need to figure out which actions are most important. We should pick actions based on how bad they are and how much they mess things up. Focusing on the most important areas helps use resources well and makes sure we stop corruption quickly.
3. When looking into corruption in health, it’s smart to look at the whole picture. This helps find the main reasons and big issues causing corruption. By doing this, we can come up with better and long-lasting solutions.
4. Saying clearly how the research community can help fight corruption is super important. This not only helps create strong evidence but also supports making rules and changes for the better.
However, it’s important to ensure that public health professionals fighting corruption are legally protected or have proper safeguards in place. Corruption can sometimes come from powerful individuals who might try to hinder their efforts.
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In the private sector, healthcare can be driven or elevated through the competitive advantage of private entities in terms of investment and competition in the healthcare market. The private sector is well-equipped, whether in terms of financial capabilities or investments, enabling them to attract human resources, facilities, new technologies, and advanced technologies to swiftly and satisfactorily serve healthcare recipients. Additionally, business expansion and the expansion of service facilities within the private medical sector create rapid and convenient transmission and communication of treatment or patient data.
However, due to the fundamental factors stemming from private sector investments to produce these products and services, the cost of private healthcare services is higher compared to those provided by the public sector. This higher cost limits access to the healthcare system in this category, primarily due to financial constraints. Various services are determined by these factors, restricting certain groups of people from accessing this system.
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There are 10 pages of the data visualization consist with several charts for visualize the data. The different type of chart can display us the different information.
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There are 2 page in my dashboard;
– page 1: the number of confirmed case, recovered case and death case separated by country and date.
– page 2: the number of confirmed case, death case including GDP of each country and the data were grouped by continent. -
I would like to share this dashboard; https://nssac.bii.virginia.edu/covid-19/dashboard/
This dashboard shows varieties of data which separated in global level, region level, country level and state level of USA and China. The data also visualized in the several ways; map, chart and numeric.
Like most of all about friends’ example, it has the filter function to see interesting data; active case, confirmed case, Deaths and recovery case.
One of the function that like is the Time Line Slider (which in the top of the map). This function can show us the time line of each data that we select and we can also make the map show only the data in the range of date the we need.By the way, the data of USA and China are showed in state count while others showed in country count. This thing could make readers misunderstand such as, in the map of confirmed case, it seems like The country with the highest number of people infected is Brazil, which is not correspond with the correct data.
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This CRF is one of the great CRF. that is user-friendly and not difficult to understand how to use this CRF. But in my opinion, there are something that might be improve as shown below,
– Screening ID and subject ID should not be the same number. Because not everyone who was done the screening would be enrolled. So, the subject ID will not be continuous if some of them meet the exclusion criteria.
– I think it would be more effective if we can collect all of the date, month and year of birth instead of collecting only year of birth. Because if we are not sure about their age, we can re-calculate it again while we have their birth date .
– should we have the name of investigator who complete this CRF?
– Having coding consistency will be useful for data entry person.
– Make sure that the page layout is ok before use. -
Having data standard for clinical research is one of important parts that can build public health research trust. Same objective of the research but in many different locations can support each other by sharing the data together which means they would increase the research out. But if the data is not the same quality or the same standard, which cannot share or support the outcome of other and which could not build more trust in public research.
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We are using Microsoft Access for the study I mentioned above and we found some problem like the system cannot verify the data we entered such as visit date of Day3 is before Day0. But for our next study we will use MACRO database system for our data management. Due to we have only 1 data entry person, MACRO system can help us to verify the data we entered. If the system found some queries, it will show the pop-up to remind us to re-check the data in CRF again.
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For the last study, most of procedures have been done. But the data entry program for sample log (for fill in sample’s details for example; subject ID, time point, collection date/time, storage date/time, unique aliquot ID) was not be created before the investigators meeting was held. So, the database set up, edit, check the data entry program and the data entry screen test could not be done at that time. When the completed-CRF and other related document arrived, we forget to do data entry screen test before we started performing data entry. Another issue is we have only 1 data entry person that we perform the data entering with manual check. But we do only 10 percent crosscheck in spite of this data is very important for sample analysis.
Next time we have to create the data entry program before the investigators meeting will be held. The data entering should be 100 percent for crosscheck.
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As for my current work that working in the research field, we are working with the data collection by using designed CRF from our data management team. We create the protocols for using that CRF and translate the protocol into the language that our site located in.Before the volunteer enrollment begin, we have “site initiation visit” for training our staffs at site to make sure that they can work properly.
After the site perform the volunteer enrollment for a while, we will be at the site again as “site monitoring visit” for monitor that how is their work, is there any problem with the CRF or relate file? If we found any problem, we have to revise our document or protocols at this time.
After finished enrollment of all volunteer, we will have “site closing visit” for summarize our work together and get the CRF and related document back for data entering and keep the data in our database for analysis and further use.
The problem we found is the staff at site records what they had done into their notebook not in the CRF because they don’t need to make the CRF dirty. After they finished their activity in that day, they will copy all data from their notebook to CRF which the error can occurred in this process.
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I had some experiences with the public hospital (tertiary care hospital). They have the IT department responsible for information technology and create new technology for the hospital following the director’s policy. But they cannot perform their work properly. Because they do not understand a lot of medical terms and they do not understand what the doctor need, which made the hospital can not use the information system for running their activities as much as their need. I think informaticians can help the hospital with this task and the hospital can run their activity with the IT platform as much as they need.
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If I am an in-charge of a data set in my country. Before these data will be shared, my team and I have to make sure that the data set that we have is the good quality of data within the standardized format that easy to be used for those who want to use that data. And the most important thing before sharing data is we have to respect the consent of the participants. All the data must be de-identified and all of the confidential parts of the participants should not be shared. If I and my team can make sure all of the criteria above, the data is ready to be shared
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In my opinion, the Universal Health Coverage of Thailand and the health care system in the USA are different but it makes sense.
For US citizens, they have to pay for the healthcare service as much as they can afford it, which means the quality of health service will depend on how much they pay for.
But for Thai citizens with UHC programs which the government announced which services are included in the program and which services are not included. For the quality of the medical services, I heard some of the services or some of the medicines cannot use in this program while other programs like Social Security Scheme or Government Or State Enterprise Officer are covered more. But it makes sense because UHC has to cover all of the Thai citizens and a lot of money has to spend per year. -
I have just heard about Net Pracharat. It is an interesting project that can improve the quality of living for all Thai citizens especially the people who live in remote areas. This project can help them to access essential information such as government information, health service and other things that they need to know. But I think there are many things that we have to concern about this project,
– Data phishing, due to the people in remote areas are not familiar with the internet using, data phishing can easily happen. The government should train them to have awareness about the data phishing.
– The number of wifi hotspot is not enough for the user in a village. The government should add more hotspot. -
Advantage of using EMR instead of traditional paper-based medical records
– Patient safety – The healthcare provider can spend more time with EMR for making the decision for the patient’s treatment instead of a little bit of time during the patient visit.
– Effectiveness and efficiency – Using EMR can help the healthcare provider to make the decision while they can see every information of the patient just in one page or one time that they key-in the Hospital Number. When every important information can integrate together, the treatment will be more effective and efficient.The disadvantage of using EMR instead of traditional paper-based medical records
– Increased risk of data breaches
– Using EMR can cause the patient’s uncomfortable
– EMR is not much user-friendly -
– Missing data; Using EMR can cause this problem. Some of the patients cannot answer the question on EMR form and some of the healthcare providers ignore to complete the EMR form. The leader of the organization should inform their officer about how important each information which needs to fill in the EMR form.
– Selection Bias is unavoidable, the researcher should design or find a way to adjust it and acknowledge it in the study report.
– Data Analysis and Training; The leader of the project or organization should support all staff to get trained until they can perform proper work. If they can perform their work fluently, the data that they collect will be useful.
– Privacy and Ethical Issue is one of the most important things. Healthcare providers should manage both of them to maintain both healthcare providers and patient’s privacy, confidential and ethical issues.
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It is very beneficial since the hospital information system (HIS) becomes a part of the hospital services. The program can gather important things that doctor and patient should use while they need. It helps the hospital to reduce a lot of time for managing patient’s information. Hospital staff can work easier and the errors while working will be reduced. When the hospital can manage their information systematically, the patients will be satisfy with the services. By the way, high Availablity technology in the hospital information system can be quite high of the cost as well. A hospital should carefully decide about that.
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May I share my experience with the confidentiality of the patient’s laboratory information.
I used to work in a hospital’s medical laboratory which performing the test that has to be secured, there are anti-HIV, CD4 and HIV viral load.
The hospital has their procedure for reporting the result of the above testing to the doctor and the patient with highly secured.
But in the lab, everyone in the lab can access to the anti-HIV, CD4 and HIV viral load result even the accountant of the lab. In many time, the lab’s staff who are not related to the test access to the result without permission.
I think the staff in the lab who should be allowed to access the test result is only the people who perform that test.
Now, they changed the procedure for reporting the result into more secured and only related staff allowed access to the information by setting the permission of each user for accessing the LIS system.
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