Forum Replies Created
-
Posts
-
-
The purpose of this dashboard is designed to provide stakeholders with insights for planning and preventing the spread of malaria. However, this dashboard may not be suitable for the general public as it contains a large number of adjustable parameters that may be difficult to comprehend.
This dashboard presents the main information:
1. Total number of Malaria infections in Thailand
2. Line graph showing the number of infections per month
3. Bar graph displaying the number of infections by age group
4. Map showing the infection levels by province
5. Map showing the infection levels by district
6. Table displaying the number of infections by province.Certainly, this dashboard is an interactive dashboard with functions that allow you to adjust various parameters to view detailed information. The following are the available actions:
1. Select the year for displaying the results.
2. Choose the occupation of the interested infected individuals.
3. Select the gender of the interested infected individuals.
4. Choose the age range of the interested infected individuals.
5. Select the province of interest.
6. Reset filter button.
7. the download report button.I would be glad to receive your suggestions. Please feel free to comment on this dashboard.
-
-
-
https://ddc.moph.go.th/covid19-dashboard/?dashboard=province
The dashboard above provides updated information on the weekly COVID-19 status in Thailand, with the latest update as of June 11, 2023. First of all, I apologize for the data being in Thai.
From this dashboard, I found several aspects that I like:
• The use of color tones that are not too harsh on the eyes, with clear meanings. For example, red represents the number of new infections, black represents the number of deaths, and blue represents the number of vaccinated individuals.
• The dashboard also includes a bar chart that shows the provinces with the highest number of infections, with colors graded according to the intensity of the infection rate. This makes it easy to distinguish which provinces have a high number of infections. Additionally, there is a total number of infections displayed at the end of each bar, allowing for easy comparison even among closely ranked provinces.
• The dashboard also features a map of Thailand, color-graded according to the number of infections in each province, which corresponds to the bar chart. This enables users to have a better overall view of the spread of the pandemic in each region.
• It is an interactive dashboard where users can scroll to view the infection rates in each province, and they can hover their mouse over the map to see the number of infections in each province.What I dislike about this dashboard:
• There are line charts that attempt to show the trend of infection and death rates, but it lacks labels on both the x and y axes, which may result in unclear interpretation.
• The text and numbers feel cramped together, causing eye strain, such as in the blue frame displaying the number of vaccinated individuals. -
-
-
-
This week, I learned about three important things.
1. Artificial intelligence is advancing quickly, especially in healthcare, but there are concerns about how it may violate people’s rights and privacy or create inequality and job insecurity.
2. Responsible Research and Innovation (RRI) is a method to make sure scientific research and new technology are developed in a way that is ethical, sustainable, and takes into account society’s needs and values. This approach encourages openness, transparency, and engaging with society in the research process.
3.Precautionary principle: “Better safe than sorry”
this principle means that if something could be harmful to people or the environment, it’s better to be careful and not take the risk, even if we don’t know for sure. This principle reminds us to be responsible and avoid doing things that could cause harm, especially when we don’t have enough information to be sure. -
point No.20 page 344
An effect size outside the 95 % confidence interval has been refuted (or excluded) by the dataThe point is saying that the 95% confidence interval is not enough evidence to completely reject or exclude an effect size. The confidence interval is based on certain assumptions, and if those assumptions are not met, the interval may not accurately represent the true effect size. So, we need to consider other factors along with the confidence interval before we can confidently say that an effect size has been refuted or excluded. Basically, we need to be careful and not jump to conclusions based solely on confidence intervals.
-
It’s shocking that when I think about it, identifying someone based on non-identifiable information isn’t as difficult as I thought. In today’s world where information is abundant on the internet. Example for me
Education: MD from Phramongkutklao College of Medicine
Current education: MSc, BHI
Age: 28Just these three pieces of information can be used to easily identify my name and surname. Just search on the internet to see who graduated from Phramongkutklao Medical College and match it with a list of those who are currently studying in this course.
-
For me, I would first conduct a thorough search for any existing research in the same area. Ideally, I would uncover previously studied information that would save time and resources. However, if I am unable to find suitable research, I may need to conduct additional qualitative studies.
I think, prioritizing between the depth of information required and the time it takes is crucial. In cases where the information is highly sensitive and requires in-depth analysis, conducting an in-depth interview is necessary. However, when it comes to data on the use of bednets, which is not highly sensitive, I will begin by launching an open-ended questionnaire to comprehend why most people choose not to use bednets. Subsequently, I will categorize the reasons and conduct focus group studies to discuss them in each group.
-
In the context of replacing an old technology with a new one that is easier to use, the TAM would suggest that the new technology is likely to be perceived as more useful and easier to use by the users. I think there are many perspectives to explain perceived usefulness. I think the new technology should cover the following areas.
– Having a short learning curve
– Improving work efficiency
– Increasing safety for customers and users
– Increasing the speed of data transmission or communication faster
– Making it easier for users to see the big picture and focus on the details. -
There are various external factors that can affect an individual’s perceived usefulness or ease of use of a new technology.
Previous technology experience: Those who have previous experience with similar technology may find it easier to use and more useful compared to those who have no prior experience.
Social influence: An individual’s perception of a technology can be influenced by their social circle’s opinions and experiences, including friends, family, or colleagues.
Training and support: The level of training and support provided by the technology provider or organization can significantly impact an individual’s perceived ease of use and usefulness. Sufficient training and support can help users overcome obstacles and boost their confidence in using the technology.
Compatibility with existing systems and processes: If a new technology is compatible with existing systems and processes, users may find it more useful and easier to use. Conversely, if it requires significant changes to current workflows or processes, users may perceive it as less useful and more challenging to use.
Availability and accessibility: The availability and accessibility of a technology can also affect an individual’s perception of its usefulness. If a technology is easily accessible and readily available, users may perceive it as more useful and be more likely to adopt it.
-
Efficacy
Efficacy refers to the ability of an intervention to produce a beneficial effect in a highly controlled environment, such as a clinical trial. Essentially, it measures the intervention’s performance under ideal conditions.Effectiveness
it is equally important to assess the intervention’s effectiveness in real-world settings, where conditions are not as controlled as in a clinical trial. Effectiveness measures the ability of an intervention to produce a beneficial effect in practical circumstances.Efficiency
This refers to the cost-effectiveness of the intervention or the extent to which its benefits outweigh its costs. In other words, it measures the intervention’s value for money and is important when deciding whether to implement a particular intervention. -
Travel patterns could be a confounding factor in the association between age and contact patterns in this study. Young adults may be more likely to travel than older adults, and travel could increase the opportunities for contact with others.
For example, young adults in Thailand may be more likely to take domestic or international trips for leisure, work, or study purposes. They may travel by plane, train, or bus, and stay in hotels or hostels where they may have more opportunities to interact with other travelers or local residents.
On the other hand, older adults may be less likely to travel or may take shorter trips closer to home. They may prefer to stay in more private accommodations such as vacation homes or relatives’ houses, where they may have fewer opportunities for contact with others.
-
Neonatal mortality rate
Definition:
Number of deaths during the first 28 completed days of life per 1000 live births in a given year or other period.Calculation:
To calculate neonatal mortality rate, the number of deaths in the first 28 days of life is divided by the number of live births in the same time period. The result is then multiplied by 1,000 to obtain the rate per 1,000 live births.Usefullness:
The neonatal mortality rate is a key indicator of the overall health and well-being of newborns. It provides important information on the quality of healthcare services and can be used to identify areas for improvement. Neonatal mortality rate is also used to monitor progress towards achieving national and international health goals, such as the United Nations Sustainable Development Goals, which aim to reduce neonatal mortality rates in countries around the world. In addition, the neonatal mortality rate is a valuable tool for policymakers, health professionals, and researchers who are working to improve the health and well-being of newborns and their families. -
I forgot that if I didn’t answer Ajarn question, I probably wouldn’t get a point. So let’s answer once again.
As I work on the frontline, I may not be able to play a main role in COVID-19 containment. But I do my job in providing appropriate treatment and advice to COVID-19 patients.
I treat patients based on updated COVID-19 guidelines, not inventing treatment guidelines by myself for maximum benefit to patients and also not harm to patients.
I recommend pros and cons and let patients make their own treatment choices. (Even sometimes I convince patients to select the best choice for themself.)
And finally, I honestly write the information in the COVID-19 reimbursement form to be fair to both insurance companies and patients.
-
Thank you to all my friends for sharing their interesting perspectives on working ethically.
As a physician, we are guided by four core ethics in our practice – Beneficence (doing good), Non-maleficence (to do no harm), Autonomy (giving the patient the freedom to choose freely), and Justice (ensuring fairness). However, the COVID-19 pandemic has presented a new set of challenges that test our belief in these principles.
One of the biggest ethical dilemmas faced by healthcare workers during the pandemic is triage and allocation of scarce resources. With limited hospital beds, ventilators, and personal protective equipment (PPE), healthcare workers must make difficult decisions on who will receive life-saving treatments and who will not. This raises questions of fairness and justice. and maybe it puts healthcare workers in a moral bind.
The distribution of vaccines has presented another ethical dilemma during the pandemic. The question arises as to who should receive the vaccine first and which vaccine should be given priority. While the government has mandated vaccination, recipients may still not have enough information and/or affect their work if they do not agree to the vaccination as required. This raises questions about patient autonomy and also highlights the need for clear and transparent communication with patients.
In conclusion, the COVID-19 pandemic has challenged us to balance the four core ethics of beneficence, non-maleficence, autonomy, and justice. It is important for healthcare workers, policymakers, and the general public to work together to ensure that ethical values are intact, even in the most challenging of circumstances.
-
In general, Universal Health Coverage (UHC) scheme aims to ensure that all people have access to quality health services without financial problems. UHC in Thailand entitles everyone to receive free medical services at a government hospital close to the household registered area.
For me, what needs to be done to make this system truly accessible to everyone is a matter of public relations as there are still so many people who don’t understand that they have the right to free treatment or they are afraid to have to pay a lot of money for medical services, resulting in not receiving treatment even though the illness is very serious.
Sometimes people misunderstand that they have to pay 30 baht for treatment, but in reality, everything is completely free. However, sometimes the name of the “30 baht rights” makes some people afraid and not go for treatment as well.
From my experience as a volunteer doctor in a rural area, I found that some areas in Thailand are very far away from health facilities, even if they have the right to receive treatment for free, they are not able to travel to the nearest hospital (40km+ without a car or a motorcycle) or can’t even take a day off from work because their family won’t have enough food to eat.
Therefore, in order for everyone to be able to enjoy equal free treatment rights, more hospitals in the rural vicinity and public relations with the community are required.
In summary, the strengths of this UHC schema are huge, such as promoting equality in society and allowing immediate treatment in case of emergency in every hospital. However, there are challenges as well such as people who live far from medical facilities or those who do not know or do not understand that they have rights.
-
From my perceived experience, I sense that many hospital administrators are beginning to know buzz words like “big data” or “AI” and feel that their data can be immensely useful, but they still do not know where to find the right person to be a manager in this field. Therefore, many potential hospitals are trying to send their personnel to learn about health informatics. For example, in this class, there are many people who are sent by an organization to bring knowledge back to develop their businesses. However, I think that’s just what I’ve learned personally, which can’t properly answer the overall situation of the country.
I have read the paper of Ajarn Nawanan. That paper was published in 2011 on the topic of Thai hospitals’ adoption of information technology: a theory development and nationwide survey (THAIS). Ajarn concluded that “Basic IT adoption in Thai hospitals appears to have passed the tipping point. Focus should be on adoption of more advanced technologies (such as comprehensive EHRs and clinical decision support systems) and ensuring that adoption translates into
better processes and outcomes, as well as addressing barriers to health information
exchange.”After that, I searched for information on the topic of health informatics in Google Trends for the past 10 years in Thailand. It has been found to have been searching for this term regularly over the past 10 years, but its popularity tends to be moderate to low. the searched provinces are quite a few, most of which are large provinces such as Nakhon Pathom, Songkhla, Khon Kaen, Chiang Mai and Bangkok (pictured below).
As for the challenging topics, I think are the following.
– People still don’t know what health is health informatics.
– Unclear boundary between pure IT and informatics
– Lack of knowledge about the career path of health informatician
– Lack of widespread training on basic knowledge of health information.
-
if I am the administrator of a large national database, my primary goal is to ensure that information is accessible to all citizens. In particular, government information that does not pose a security risk should be made available to the public for verification and honest criticism.
In the business aspect, data is often referred to as the “new oil.” Sharing of data in the business sector should be based on demand and supply, with access restricted to those with sufficient funds. However, if state leaders believe that certain information would promote free competition and benefit the country, it may be necessary to use government resources to acquire it. This can also be achieved through laws that require businesses to disclose certain information to the public.
In Thailand, efforts are being made to develop open government databases that are accessible to all citizens. For example, the website https://data.go.th/ has a robust management system in place to ensure the quality and safety of information before it is published.
In conclusion, I believe that information sharing is vital for promoting the development of research and for maintaining transparency. However, to share information safely and effectively, it is crucial to educate those who share data and to implement proper auditing procedures.
-
From my point of view, I think the way to deal with each challenging topic is as follows.
Missing data
Finding missing data is an unavoidable aspect of working with data, and it is important to have a plan in place to systematically handle it. While this may be manageable for smaller scale surveys, it can become a significant challenge when dealing with large datasets or data from electronic health record systems. To effectively address this issue, it is crucial for informaticians to be educated on the various methods for coping with lost data. In addition, Data validation and quality checking at the data entry stage will help reduce the amount of missing data.Selection bias
Despite the potential for selection bias, observational research can be a valuable starting point for exploring new possibilities and understanding complex phenomena. It can provide important insights and serve as a foundation for more in-depth studies using methods such as randomized controlled trials or molecular experiments. Additionally, observational research is often more cost-effective and less time-consuming than other types of studies, making it a useful tool for researchers to utilize in the early stages of their research. So I think the way to deal with selection bias is important to be aware of this bias and understand it in order to accurately interpret and make decisions based on the data.Data analysis and training
With the constant emergence of new data analysis methods, it is important to be familiar with multiple approaches. No single method is suitable for all types of data, and each has its own strengths and weaknesses. Having a diverse knowledge of analytical methods increases the chances of successful data analysis.Privacy and ethical issues
In order to cope with this problem, I think that it is crucial for the government to establish clear and comprehensible laws and to provide researchers with the necessary training in information security. This will ensure that research can continue in a safe and secure manner. -
As a physician with experience working in a hospital that uses both paper and electronic medical record (EMR) systems, I have found that there are both advantages and disadvantages to using an EMR system. Here, I will outline some of the key strengths and weaknesses of EMR systems in a hospital setting.
Strengths:
-Improved efficiency in browsing patient history: With EMR systems, accessing a patient’s past medical history is much faster and more efficient than searching through paper records. This is especially beneficial for critically ill patients who require immediate access to their previous medical history in order to receive appropriate treatment.
-Reduced communication errors: EMR systems eliminate the problem of reading errors due to poor handwriting, which is a common issue with paper records.
-Better notifications and statistical reports: EMR systems can provide notifications for potential drug interactions or allergies, as well as summaries of important statistical results, such as the average blood glucose level over the course of treatment.
-Increased completeness of the information: EMR systems provide a more secure and complete way of storing patient information, as compared to paper records which can be lost or damaged.
Weaknesses:
-EMR systems require a learning curve: It takes some time to master the use of an EMR system, and trained assistance is often required for first-time users.
-Transitioning to EMR systems can be difficult: Hospitals that are switching from paper records to EMR systems may face challenges in dealing with both old and new data, which can put a burden on users.
-Network crashes and power outages can disrupt access to EMR systems: These types of issues can cause problems with database access and interrupt the overall operation.
-Increased risk of information leakage: EMR systems may present a higher risk of information leakage compared to paper records.
-Cost implication: Implementing an EMR system can be costly as it requires significant investment in hardware, software, and training.
-
I partially agree with all four recommendations. If I am an optimist, I think these four steps will lead to success in dealing with corruption. However, since my friends’ opinions are pretty much the same, I’m going to look at it from different angles to add some variation. I’m going to be pessimistic with the assumption that corrupt people are smart, powerful, and have large-scale networking.
I think the first step is not should be convening stakeholders, but to find a way to identify which stakeholders are really honest before planning together to combat corruption. Because if the team leader is a great corruptor then this team will only find small corruption against the leader’s interests. Moreover, there will be no person who dares to report suspected corruption.
In the second step, I agree that prioritization is necessary in order to make the best use of limited resources. I also agree that it will be very important to understand the reasons why
corrupt practices thrive. However, if the priorities were made by corrupt leaders, then the results would certainly not be realistic.Third, I strongly agree with encouraging research about corruption and disseminating information to everyone, and I also think that there should be courses on anti-corruption methods included in fundamental education in Thailand.
fourth, I think that in Thailand there should be an independent organization that mainly conducts studies on corruption and disseminates this information freely, with the researcher being protected and researchers’ information being concealed from the authorities. (working independently with National Anti-Corruption Commission).
Finally, I sincerely hope that we can overcome all of this corruption.
-
Nowadays, our society is gradually becoming an aging society. The problem of falling among the elderly is the second leading cause of death from unintentional injuries, especially among empty-nesters and elderly living alone. However, as technology improves, developers have tried to create solutions to this problem, producing cameras and AI systems that detect falls and send alerts to caregivers.
As far as I know, some hospitals, nursing homes, and personal users are starting to adopt these technologies. I think barriers to getting this technology into the health system are as follows.
– It is a new technology that is not well known yet.
– The accuracy is not very high, sometimes there are false alarms.
– Users need to have some level of technical knowledge to be able to understand and use the system.
– The problem of infringement of privacy rights
– It is a technology that is still expensive and has a high installation cost.
– Concerned about the security of the data because if outsiders access the stored images, the user may be compromised. -
As for a regional hospital in Thailand, a disaster recovery plan (DRP) for an information system is extremely important. If I am going to develop a DRP for this hospital, I would follow these steps as follows.
1. Identification and Analysis of Disaster Risks/Threats
Naturally, in regional hospitals, all departments are fully operational on weekdays, while on holidays only specific departments such as the emergency room or in-patient unit are open. In addition to the above information, risk attributes such as impact, predictability, and advance warning are also an important part of disaster risk and impact analysis. The risk factors that are likely to be found in Thailand that will affect the hospital system include the high flood or fires that cause information system damage, attacks by computer viruses, physical attacks on server rooms, power outages, communication network failure, etc.2. Classification of Risks Based on Relative Weights
After identifying various risk factors, they were categorized into different classes to accurately prioritize them. For example, facility risks (power outages, fires), External risks (floods, viruses, physical attacks), data system risks, departmental risks, and desk-level risks.3. Building the Risk Assessment
After categorization, each risk is scored by using likelihood, impact, and restoration time. In order to be able to correctly prioritize which factors are of high priority so that planning can be made in the first place.4. Determining the Effects of Disasters.
In order to properly plan the restoration, the affected areas of the disaster must be clearly defined. Each disaster may affect many sectors, for example, a fire may cause damage to communication networks, data storage systems, computer desks, or even a power outage. Moreover, it should also determine the cost of downtime, downtime tolerance limits, and interdependencies.5. Evaluation of disaster recovery mechanisms
After listing affected entities, The selection of a recovery mechanism is at this stage. for the case of information systems, there are much technology that aids the recovery process. For example, DR-Site (cold, warm, hot), tape backup, and replication. From my point of view, for regional hospitals, patient information is essential and very important in making treatment decisions, so even with a relatively high budget, choosing a warm DR-site or a hot DR-site is also a good choice.6. Disaster recovery committee
Finally, representatives from all stakeholders were set up to supervise the DRP and practice continuously for maximum efficiency jointly. -
From my point of view, if my hospital has implemented High Availability technology in the hospital information system, it would help all parties to operate more smoothly.
Firstly, Patients will receive services without delays caused by hospital computer system problems.
Healthcare workers are not frustrated by system problems resulting in taking care of patients with more peace of mind. The patient’s medical history is not lost even though it has been examined for a long time.On the other hand, The hospital will be favored by both patients (customers) and employees. The hospital was able to operate at full capacity due to a few system downtimes. Moreover, hospitals are ready to handle unexpected events such as power outages or ransomware attacks.
-
If I had been working in the government healthcare sector during the peak of the COVID-19 pandemic, I would have looked at STEEP factors as the following topics:
Social:
– Frontline workers are afraid of contracting COVID-19, resulting in fewer human resources.
– Lack of confidence in the public health system that will be able to cope with this problem.Technologies:
– The use of telemedicine reduces the risk of infection for both healthcare workers and uninfected patients.
– Vaccine development technology helps stop the spread and severity of the disease.Environment:
– There has been increased strictness in treating infectious waste to prevent the spread of infection.
– The terms and conditions for using the operating room have been improved to be safer during a pandemic.Economic:
– Shortages of masks and hand sanitizers have led to higher prices and shortages in hospitals.
– Shortages of antiviral drugs and improper distribution have led to a shortage of medicines in many hospitals.Political:
– Ambiguity in policies and directions for controlling COVID-19, causing inappropriate medical resource management planning.
– The government focuses on financial support to stimulate the economy rather than supporting public health. -
I haven’t had any experience with system administration. However, as a user, I saw a gap in the system of the hospital where I worked. The hospital’s Picture Archiving and Communication System (PACS) uses extremely easy-to-guess passwords such as 1, 1234, or 0000. This increases the risk of the patient’s personal information being leaked because everyone in the hospital can easily guess the password to enter and retrieve information from the PACS.
In order to prevent the risk of breaching the information confidentiality. I think hospitals should improve access restrictions by setting up strong passwords and educating users on computer security literacy.
-
It’s a concise presentation and the diagram is easy to understand.
I have an idea of the type of surveillance system as disease surveillance, which I understand it needs accuracy, but if adjusted to mixed with syndromic surveillance it may be faster to control the outbreak.
All in all, the system is very interesting and would like to be implemented in order to reduce the mortality rate of RSV infection.Best!
-
It’s an excellent presentation.
I like the idea of using AI to help predict before the outbreak. So it would be able to prevent outbreaks quickly.
I think adding the user satisfaction evaluation would also be awesome.
in order to bring user recommendations to improve the system to be able to last longer.Thank you
-
This is the Gantt chart I used when I was working on a project as a student.
https://drive.google.com/file/d/16HnDyJ-tRV8rq30tJPCwehrEgLMw5bsH/view?usp=sharing
-
After listening intently and analyzing the matter of the six principals of CREC,
PM Lee Hsien Loong,
1) Be first: the video was released two weeks after the outbreak and a day after the DORSCON was raised to orange.
2) Be right: the prime minister described information on SARS and influenza was cited. Both diseases are clearly and easily compared to the severity of COVID-19.
3) Be credible: he had excellent both verbal and non-verbal communication. Including citing scientific information that listeners can easily understand and follow. All of these promoted the credibility of speaking.
4) Express Empathy: he showed that he understood the people who hoarded food and facemasks out of fear. He did not blame the people and explained why there was no need to fear shortages of goods.
5) Promote action: He explains how to help prevent disease by washing hands, not touching their faces and eyes. For those who start to get sick, go to the doctor immediately and do not go to a crowded place.
6) Show respect: he pays homage to those who work hard to keep the country moving even in times of crisis, such as healthcare workers, business federations, public transport workers.President Trump
1) Be first: the time to communicate with the people was too late.
2) Be right: he didn’t give enough information about what was known and what was unknown.
3) Be credible: he said like the cause of the COVID-19 outbreak came from other countries, but did not clearly compare the number of outbreaks from within the country or abroad.
4) Express Empathy: he did not show understanding and empathy with the US people in both verbal and non-verbal communication.
5) Promote action: I listened to it and felt that he put a little emphasis on hand washing and self-quarantine. On the other hand, he focused on what he had done, whether he was allocating grants or banning countries.
6) Show respect: I feel like he’s trying to show the greatness of himself and his country rather than respect. -
My story is about something that happened in my house recently. Everyone knows exercise is good for both mental and physical health. So I planned to get my mom and dad to exercise. Of course, it’s easy to tell someone to exercise, but the results often don’t go as expected. First of all, I chose a method of exercise that we could work out at home, so there was no excuse for not exercising even on a rainy day. To reduce their excuses for lack of equipment and wasted time traveling to the gym, I selected the T-30 workout that uses only a training mat. I started exercising where they could see me every day. Moreover, I frequently invited them to exercise with me. After I did that for seven days, my mother began to exercise. However, my father still refused to exercise. So I put a whiteboard in front of the fridge and recorded the number of exercises that my mom and I did as a score to show progress every day. Finally, after half a month, my dad came to exercise together. Currently, my family’s exercise continues almost every day for 4 months in a row.
-
From my point of view, Thailand did well in the mid to late stages of the epidemic, and there was still a lot of improvement in the early stages. In the early stages of the outbreak, each stakeholder does their own work to deliver outcomes. He made dozens of applications that worked separately, inconsistently adding to the burden on the people. This problem can be solved by planning from visionary leaders and managing each unit to work together at the beginning.
The early data on the number of infections was not reliable and not transparent, leading many people to think that the reporting was controlled by someone with hidden interests. Moreover, data stored by the state is frequently hacked, indicating untrustworthy security that should be urgently corrected.
Finally, in the aftermath of the coronavirus outbreak, the government came to take care of unity which was considered a good solution. However, it remains to be questioned whether in the next outbreak “Will we be ready and skilled enough to deal properly from the beginning?”.
-
WHO has declared the Public Health Emergency of International Concern (PHEIC) a total of 7 announcements. In each announcement, there were the following reasons:
1. 2009, H1N1 influenza
-Serious? Yes (highly transmission, CFR 0.02%, vaccine unavailable at that time)
-Unusual/Unexpected? Yes (new emerging pathogen)
-International spread? Yes
-Trade/travel restriction? Yes2. 2014, Polio
-Serious? Yes (CFR 2-5% among children/ CFR 15-30% among adolescents and adults)
-Unusual/Unexpected? No
-International spread? Yes (WHO aims to eradicate for preventing a global resurgence of the disease)
-Trade/travel restriction? NO3. 2014, Ebola in Western Africa
-Serious? Yes (CFR 40-50%)
-Unusual/Unexpected? Yes (re-emerging pathogen)
-International spread? Yes
-Trade/travel restriction? Yes (WHO does not recommend general bans on travel or trade, or general quarantine of travelers arriving from Ebola-affected countries. However, 30 countries have instituted restrictions on travel from the three West African countries most affected by Ebola)4. 2015, Zika virus
-Serious? Yes (4-6% of pregnant people infected with the Zika virus have children with microencephaly )
-Unusual/Unexpected? Yes (new emerging disease)
-International spread? Yes (vector-borne disease)
-Trade/travel restriction? NO (If you are pregnant, you should NOT travel to areas with Zika outbreaks.)5. 2018, Ebola epidemic in Kivu region
-Serious? Yes (CFR 67%)
-Unusual/Unexpected? Yes (re-emerging pathogen)
-International spread? Yes
-Trade/travel restriction? Yes6. 2019, COVID-19
-Serious? Maybe Yes (CFR 3% [2017], available vaccine but limited)
-Unusual/Unexpected? Yes (new emerging pathogen)
-International spread? Yes (zoonotic and human-to-human transmission)
-Trade/travel restriction? Yes7. 2022, Monkeypox
-Serious? No (IFR 1.4%, highly spreading)
-Unusual/Unexpected? Yes (re-emerging pathogen)
-International spread? Yes
-Trade/travel restriction? NoIn the future, I really hope that the war between Ukraine and Russia will not use dirty bombs or nuclear weapons. However, if it would be used, it will cause public health emergency of international concern because radioactive substances not only cause serious disease, they can spread far into the air and contaminate water that can reach neighboring countries or go beyond that.
Feel free to correct me, If I’m wrong.
-
From my point of view, this SORMAS project is awesome, it can be deployed in only 14 days. they conducted qualitative interviews with the NCDC incident managers about the timeliness, usefulness, and workload of the conventional system compared with SORMAS. Moreover, qualitative evaluation for completeness was also done. If I can add indicators, I would like to add indicators as follows:
1. Data consistency: Since the conventional system used a lot of people and mediums(post and Excel) to send data at each stage, I think there would be a higher error in the data than SORMAS. Verification should be done by checking the NCDC data against the log data from the source to check for errors or duplications.
2. User experience and service quality: Since there are only two days of training for staff who use the SORMAS, it is likely to encounter problems during work. There should be indicators that will be used to improve the system even further such as user satisfaction questionnaires, and a summary of user reports regarding problems of the system.
-
From my point of view, there are many ways to apply information technology in the outbreak investigation process.
1) Verification & Preparation: In the process of confirming the diagnosis, if we could automatically link data from hospital databases to surveillance centers using ICD-10 of the disease being monitored, it would speed up the response time.
2) Describe the Outbreak: We can use well-developed web applications to increase the efficiency of work instead of the traditional epidemiological data collection model such as OpenClinica, REDCap, Epicollect5, etc.
3) Hypothesis & Testing: If we could aggregate high-quality data and store ready-to-use data in a secure cloud database, we will be able to provide opportunities for talented researchers across the country to access data for maximum efficiency. For example, Data Archival for Maximum Utilization System (DAMUS) is a project that allows researchers access to Thailand’s diabetes and hypertension care database to develop research that benefits the country.
4) Response & Action: We can respond more quickly and communicate more easily through real-time dashboard visualization such as Tableau, Power BI, Looker studio, etc.
-
I would like to tell you about telemedicine apps in Thailand. Telemedicine has greatly improved during the coronavirus pandemic. Patients with ATK for covid-19 positive do not need to go to the hospital. Patients can consult a doctor online and the medicine can be delivered to their homes within 3 hours (in Bangkok and provinces around Bangkok). This app reduces the spread of infection due to patients do not need to travel, reducing the risk of spreading the infection in public areas.
Nowadays, after coronavirus has become endemic, people still use telemedicine to treat common illnesses such as flu, diarrhea, AGE, etc. In the future, there will even be a blood test or an X-ray at home, which would help reduce the congestion in the hospital.
-
1. How can surveillance help to detect and control the disease?
•Surveillance helps to explain the current epidemiology of disease, changing trends and identifying new outbreaks. All of these are important information for planning to detect and prevent disease outbreaks.2. Should we conduct active or passive surveillance or both for the disease, why?
•We should conduct both methods. We conduct active surveillance on people who come from high-risk countries and surveillance in areas where the index case has been found in order to limit the spread of monkeypox and urgently treat infected people.3. Which method should be best to identify cases, why?
3.1 Cases in medical facilities VS community
•In not infected area, surveillance should be initiated from detecting cases in medical facilities first as it saves more resources, but after identifying an index case, we must go to the area to investigate people with mild symptoms or high-risk groups to prevent the spread in the community.3.2 Sentinel VS population-based surveillance
•To answer this question. I think, we should weigh between the severity and contagiousness of monkeypox versus cost to surveillance. From my point of view, I think doing just sentinel surveillance is enough for this disease.3.3 Case-based VS aggregated surveillance
•Emerging diseases should use the case-based method in order to collect detailed information and clearly identify the epidemic area.3.4 Syndromic VS laboratory-confirmed surveillance
•Monkeypox disease has flu-like symptoms. This makes syndromic surveillance less sensitivity. If using this method, it would waste a lot of resources. So, I think I’ll go with the laboratory-confirmed surveillance as my primary method until the situation changes.4. What dissemination tools will you choose to disseminate monkeypox surveillance information? Why do you choose this/these tools?
•Ongoing, Real-Time Dissemination Tools are my selected method because, if the infrastructure is ready, adding a disease to surveillance is less time consuming and inexpensive. This will result in excellent tracking of the new emerging disease. -
I think that requests for individual information should not be traceable to the identity of the owner of that information. If there is a violation of this section, it is not only unethical, but it is also illegal.
To prevent unlawful and ethical reasons, I would require applicants to reduce their need for too much personal information. Directly identifiable information such as contact information or addresses must be concealed. indirectly identifiable information must be broad enough that it cannot be traced to an individual for instance geolocation must be defined as region-wide enough to not be able to identify a particular home and narrow enough to be useful for research purposes.
I think there must be a contract for what purpose the information will be used. Including explaining how to keep the data safe, when the data will be destroyed after a period of time, And the signing of a non-disclosure agreement.
-
I think that the EMR check process should mask the name of the examinee to prevent bias and I agree with Mr.Preut that accession to highly sensitive information should be limited to a patient and physicians who the patient has given permission to access the information.
To answer the above question I think good workers should be able to distinguish between work and personal matters appropriately. Job secrets must not be shared with outsiders, even if they are family or close friends. if I were a health information professional, I wouldn’t have the right to talk directly to patients about this information. I think that If this information is leaked, it would hurt the owner of the data, so I will keep this a secret. Finally, everyone has the right to make their own decisions based on the principles of Autonomy. Therefore, patients have the right to decide whether or not to disclose their information.
-
From the previous topic, I’ve been talking about the online test result notification system for COVID-19. If analyzing that topic according to the ADKAR model, it will be found as follows.
Awareness: Everyone who works in the field, who comes in contact with COVID-19 patients every day, wants to reduce the amount of time they meet with the patient as much as possible to reduce the chances of getting infected. For the patients themselves who do not know whether they are infected or not, they would like to reduce the time spent in close contact with the people who come to wait for testing as well. Therefore, awareness among stakeholders is clear and easy to understand.
Desire: When everyone realizes, they want to reduce the amount of time they have to spend together. However, the problem is not easily solved. Both frontline workers and patients are unable to fulfill their wishes on their own.
Knowledge: I’m not sure in detail whether the solution came from listening to the voices of the frontline workers or from some other way. Finally, the solution came from the hospital administrators who had the idea to change the conventional lab report format to the online format.
Ability: The executives have to arrange a half-day training session to teach on-site personnel to use the system. Moreover, the system is designed to be easy for patients to use.
Reinforcement: In this process, there was no apparent reinforcement. But it’s successful because everyone is aware and wants to make this system happen in order to reduce the workload.
-
I would like to mention the online test result notification system for COVID-19 that my hospital has done and it has been very successful.
The factors that make it successful are as follows.
Data – There are examples of successful projects in several hospitals and published in medical journals. This provided reliable references that the project would be successful as well.
Cost – This project was developed by in-house personnel as the IT department has programming and web-dev capabilities, Therefore, it saves the budget from having to hire outsourcing.
Operation – At the start, the executive staff explained the advantages of the system and set a date for the system to be implemented in Town Hall. After that, there is a process of training for operational staff. Then test the system with real patients. Finally, evaluate and feedback on the results for continuous system development.
Design – Due to the system having a slight workflow change in the process of referring patients from the next day’s appointment at the hospital to waiting for the results online at home. Moreover, this system can significantly reduce the workload of staff and patients who must travel to receive the results again the next day.
People – As this system reduced the burden on all stakeholders and significantly increased patient satisfaction. Therefore, everyone was willing to cooperate and accept this change.
-
When I was a first-year intern I found it really difficult to choose the right diabetes medication for my patient because there are many different diabetes medications, contraindications, and the need to adjust the dosage according to GFR (kidney function value). For this reason, I consulted a nephrologist and created a mini-CDSS program for me and my friends (intern-1 doctors) to use. I coded my own program in Python. Just filling in the GFR and related medical conditions, the program will calculate the appropriate dosage and does not recommend drugs that are contraindicated ( Picture ).
My evaluation for this CDSS is as follows:
Human
-System Use: This program is used by just graduated physicians to reduce mistakes in prescribing diabetes medications. Experts or experienced doctors do not need to use this program.
-User Satisfaction: People who use this program are very satisfied because it is easy to use compared to other dosage calculator programs.Organization – This program is not run by my hospital. This makes disadvantages of the program not being updated and maintained after I had moved out from this hospital.
Technology – This program works easily and fast. It can be improved or bug fixed by myself. But there is a challenge in data validity as new research comes out every day so the accuracy of the program also changes over time.
Net Benefits – Since there is no concrete evaluation of outcomes, I think patients receive more accurate treatment and increase patient safety.
-
I think without interoperability standards, each hospital would have a hard time transmitting information to each other. Data must be converted to suit each organization and hospital, which would waste a lot of human resources and time to convert the data. Due to a large amount of data preparation time required, a fast response to the rapid rise in incidence is difficult. Consequently, the surveillance system would work inefficiently.
-
Thank you for sharing
It is a user-friendly, visually appealing dashboard with clear visibility and easy-to-understand graphics. Additionally, it includes another page for viewing geographic distribution. Moreover, it allows for customization of time ranges, nationality, occupation, or age groups to display specific and detailed results. One possible development point could be to add descriptive labels to the pie charts, such as gender or malaria type, to enhance readability for the users.
-
-
I agree with you, FARKHAN. Thank you for sharing.
From this dashboard, I like:
– The interactive map feature that allows users to click and explore detailed information for each area.
– The color scheme used, which is not overly diverse.However, there are a few areas where I believe this dashboard could be improved, such as:
– The font size, which is extremely small.
– Some data that is unclear. For example, the mortality rate; I’m not sure if it represents data for a specific time interval or the overall data.
– The line chart uses the X-axis as an area. it might be better represented as a bar chart to enhance clarity.
– The size of the numbers on the right side varies, which does not seem to correspond to the magnitude of the numbers. I think, the font size followed the number of digits, where larger numbers of digits would have smaller font sizes. -
-
