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1) Should you give the data out?
• I will decide not to provide the requested data because it will violate the general principle of informatics ethnic privacy of information. Their requested data is too risky and easily detected the identity of patient like home address and contact list. It is totally against the informatics ethnic without consent.2) If you want to provide the data to them , what and
how will you do it?
• If regarding to benefit of research to prevent disease. I will discuss the national lead to get approval to share with them. After getting approval, I will ensure not to violate the ethical principle of informatics and will make a plan to share without personal disaggregated information. The individual home address and contact inform will be deleted and their representative geo point will be shared for the purpose of disease mapping. I will request the commitment from research team to follow the principle of accountability and the other general principles as well. -
Based on provided scenario;
What should I do?
• As a health information professional, I haven’t right to tell my friend about his husband information according to privacy of the patient. I must keep all patient information as confidential.Can you interfere with other people or family issue?
• No, I am not allowed to disrupt patient personal issue.
But, should your friend not know about this because she might be at risk?
How will you follow the fundamental principles about right to self-determination, doing good
and doing no harm to others? Isn’t it your obligation and the right of the subject to hold the information?
• Regarding to risk of transmission and harm to others, I can advocate the patient to follow precaution and procedure not to transmit the disease. I will encourage the patient to decide the family safety and protection the risk. -
Let me share the changes in way of distribution in flood response to ensure effectives of support to the affected community. I am responsible to report the data timely and make sure the accountability corner to get the feedback directly from the beneficiaries regarding distribution. I am the new role in the team, previously they distributed the items via village leader and get the data collection forms from them. I advocate the team the pro and cons of indirect distributions. It would be difficult to control the quality of data. Village leaders do not understand the procedure of distribution and have limitation to manage effectively. Moreover, there might be fraud case and complaints regarding to the response. I suggest to manage the distribution by the staff. I conducted the data collection form training and develop standard distribution criteria with the input of the management team. At the end, we could distribute the response items with our team effectively. We also keep this practice in the next emergency response. Learning from this scenario, the following are the reflection of change in ADKAR model;
1) Awareness: The team aware the cons of indirect distribution to the community. Data quality, fraud cases, bias, complaints will be impact if we could not supervise the village leaders.
2) Desire: Management Team and Staff agree to improve the quality of work. When they conduct in-person distribution, they well understand the ground condition and take care the importance step to be effective in work.
3) Knowledge: After training, staff gained required skill and technique to manage distribution.
4) Ability: Response team members are voluntarily organized. Staff actively participate in distribution by adjusting with their normal program task. Tools, plan, transportation are also arranged and supported to be effective.
5) Reinforcement: Real time reporting, beneficiaries’ gratitude, staff participation is the key to contribute successfully. Moreover, Management team provide necessary support like stakeholder coordination, technical guidance and appreciation to the response team.
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An example of a system in your organization.
In my previous work, VRS(Volunteer reporting system) was endorsed to access the primary health care services from community health workers. The paper based reporting form was used for reporting. The project staff were trained to supervise the quality of performance. The data are entered in offline ACCESS database and export as excel database to review the summary dashboard for decision making. It was well functioning for remote and hard to reach area where geographical and limited internet. However, there were a lot of difficulties in implementation. For the data quality,
Volunteers understanding affect in recording because some of volunteer were old age and illiterate to fill correctly.
The transportation cost and operation charges to get data and manage compared to online digital platform.
The program was funded by external donor and project could not proceed when grant did not extend after agreed timeline. The system could not operate because of no fund. The HR resources were also shortage especially in community level.
The model is better to take responsibility the government and should lead with basic health staff to improve basic health care services in community. -
1) Example of Decision Support System used in the implementation
Regarding to my experiences, Project performance are based on Logical framework which are filled with target based on theory of change (desired outcome). Indicators are defined to measure the progress of project and adaption are made based on tracking the indicators. Indicators are also collected by using standardized form to measure the intended result. Evidence are generated based on data collection and use to decide the adaptive changes like project redesign, adding resources (budgets, Human resources, technical trainings).
2) Working well?
Data collection and information are essential to be reflective decision making. Without real time data, effective intervention can not be conducted by management level. Although Humans and Organization level are working well as per responsibilities, there is a constraint that is preventing to be functioning. It is technology. Lack of enough data affects in decision making.
3) Factors that influence the decision support system implementation
Lack of enough data is the critical issue for decision support. Secondly, Human resource and Organizational structure are also important vice visa. Enough HR and Good organizational management could enable to conduct enough data for correct decision making. -
Currently, most hospitals use the ICD standard to classify disease diagnosis. What would happen if the hospitals in the country do not use the ICD standard?
Without using ICD standard, Disease name will be vary based on medical officer for example, myocardial infarction and ischemic heart disease. Let assume that those are the same meaning and just different in recording disease. So, There will be two disease name in the database. It will impact in data compilation and will coded like two different diseases . And then, there will be inaccurate conclusion for clinical analysis and decision making. The consequences will be serially endless as impact of not using ICD (uniform) coding name. -
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1) What do you think about this finding?
Regarding to EHR six main causes of physician burn out, 1) EHRs’ documentation and related tasks, 2) EHRs’ poor design, 3) workload, 4) work overtime, 5) inbox alerts, and 6) alert fatigue.
2) Have you ever heard any complaints from health officers (or yourself) on using EMR?
This is also common in our implementation The main reason is poor design, interactive functions like auto filling, coding instead of filling long text, lack of trainees, continuous maintenance and system improvement.
3) Any suggestions to avoid or reduce this problem.
The resolving options are firstly EHR app design fixing upgrading to be user friendly and assisting interactive auto generated function. Then, conducting training for user and gathering feedback and continuous improvement before releasing the app. -
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In my opinion, e-Health is a set of terminology which is leading to enable health. It means set of functions based on services and data to produce effective, efficacy and efficient for using by customers. The fundamental is skeletal frame to provide health services. It should include interactive electronic data recording and generating system, health care service strategy and marketing plan to meet the desired output. There is an additional functions that is continuous monitoring and evaluation of the system to make adaption and decision making to meet the impact.
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In my opinion, Healthcare data could be considered to be fit in with seven Vs.
1) Volume: it is huge amount of data in a hospital. there might be million of pts records per year
2) Velocity: It is important to get real time data as well to use so timely updated is essential to upload.
3) Variety: There is also different type of data as pt record, lab result, stock data, financial data, logistic data with structured or unstructured data. That various type of healthcare data are needed to use in generating the impact of health care services.
4) Value: Data is precious when they use for multiple perspectives example value for money analysis, disease trending, medical research, making policy
5) Validity: It is one of core characteristic of data to record accurate data in health care. It means correct dosage of medicine, lab result, diagnosis etc.
6) Veracity: Health care data must be trustworthiness, good quality to apply in different purposes.
7) Visualization: It is also required to capture and generate the load of cases, financial growth, investment amount. Those visualized figures will help the management level to oversee the prominent points of health care setting to provide decision making for improvement. -
Have you ever observed a health informatics project in your (other) organization? Please provide a brief introduction.
I have experiences in health data management especially volunteer based report. There is a Maternal new born and child health (MNCH) project implemented with community based volunteers. The volunteers were trained MNCH basic skill and provide health services to the community. There are two type of volunteer which are Axillary Midwife (AMW) and Community Health worker (CHW). AMW provided maternal health services like Antenatal care, delivery, Post natal care and referral services if the cases are out of their manageable conditions. CHW provided child health care especially under five year diarrhea and pneumonia cases to get treatment as per protocol. They are responsible to report with specific format like AMW monthly, CHW Monthly report including drug consumption. Our project staff conduct supportive supervision to them and refill the stock monthly. Project staff collected their reports and transfer to data staff to conduct data entry. We used offline Microsoft access database with separate AMW and CHW data entry form. There are around 900 volunteers from 7 tsps. There are four data staff who conduct data entry and provide feedback to project staff if there was irrelevant facts to improve data quality. They reported the offline access database to data officer monthly. The data officer combine the tsp monthly report and conduct data analysis. Then prepared monthly reporting with formatted template. In the format, There is summary of cases like how many deliveries cases by AMW and how many under five diarrhea and pneumonia cases are treated by CHW. Moreover, We also have to monitor the stock usage to forecast the estimated consumption for upcoming quarters.How can this health informatics project help to improve the current practices?
– The data officer are responsible to monitor delivery information, case trending of diarrhea and pneumonia, drug consumption and forecasting for procurement. We can also use the health informatics like there was unusual case load in one village or surrounded villages from corresponded place. It is the alert of GE outbreak. When GE Outbreak occur, we reported to respective township health department and conducted outbreak response with basic health staff.
Are there any challenges or difficulties in implementing the project?
– There are numerous challenges while implementing the project. The first bottle necks was graphically remote area. It is difficult to reach and internet connection is not available to set online reporting. The result is delay reporting and responding. The information are known when project staff visited to their area. The second challenges is volunteer education. Since the area was hard to reach, there was scare resources to assign as a volunteer. Their literacy is primary level and they had difficulties to use registers and prepare report. It was the major impact in data quality. The project staff conducted closely supervision and coaching monthly to improve data quality. -
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Dear Bro,
Thanks for sharing this interesting case, I learned that although MFA was used to secure the system and then unauthorized request are blocked automatically. However, auto block function was not enable. It seems to double check or trail whether it does work or not as we always practice in our real work.
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As an attacker, He/she will find the vulnerability points of the system. There might be different based on structure of the system.
1) If the structure is web-based and control by user name. The first technique invading the system based on constructed web-based language. The another one will be user name and level of user privilege. If he/she gets the higher level user permission, the impact will be huge.
2) The second facts is based on assets. If asset are stolen or loss and transferred to attackers, they will try to hack or modify based on asset type.
3) IF the IT dataset is offline system, he/she might duplicate and misuses or selling the project to opponent’s company or agencies. -
1) I would rather recommend cloud server because physical server is more costly and require IT officer to maintain and fixing issue all the time. Could server is interactive and easily accessible with minimal effort. We can buy a cloud server with effective cost and can assure easily accessibility, mobility, data security and scalability. Moreover, maintenance and support that are taking responsible by service providers. We can spare our IT resource in fixing issues.
2) What kind of cloud computing service model would be most appropriate (SaaS, PaaS, IaaS)? Why?
SaaS is the most appropriate because it is software based and we can easily rely on provided services. It is more user friendly and effective ways. Cloud infrastructure are upgrading all the time based on consumers’ demands and experiences. We can make choice based on hospital requirements and can request to be user friendly model. -
Information plays vital role not only in outbreak situations but also in any emergency conditions. Immediate response or Specific information are importance to design outbreak response program. We can’t provide effective services without identifying the community needed or ground situations. In term of Flood response, We created real time data collection tools via KOBO platform to get the update data from the community. Our team conducted rapid need assessment and submitted data via link. Moreover, we also collected information from other local stakeholders to get the affected House hold list including status of safe drinking water. We could provide chlorination tablets to the affected household to prevent waterborne disease. Later on, By using the affected HH list, We also could provide latrines construction and hygiene awareness promotion as three month post-flood response project. As summary, Informatics is important to disseminate and advocate in outbreak/emergency situation.
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Regarding as a public health informatician, there are core skills that are enhancing to be a professional especially public health, IT skills, conceptual knowledge and critical thinking.
1) Public Health
I have foundation of public health knowledge because my bachelor focus on public health. I am also familiar with data collection, data processing and application in the output based projects.
2) IT skills,
I need to improve IT skills especially how dynamic database and dataset are constructed to generate the information in real time event.
3) Conceptual Knowledge and critical thinking
I also need to get the skill sets to create a road map or solution based on public health issue. I haven’t experience in resolving public health issue deeply. -
Hello Everyone, Nice to meet you. My name is Wai Phyo Aung and you can call me William as nickname. I am from Myanmar. I graduated from University of Community Health, Magway, Mayanmar. I work as a Humanitarian aid worker in an INGO and NGO especially in monitoring, evaluation and learning field. I hope this program will be effective my career development and skill in contribution of my work. Have a good day!!!
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