Yin Moe Khaing

[Yin Moe Khaing]

There is a clear gap between rural and urban healthcare in both access and quality of care in Myanmar. Urban cities have more medical professionals available, better healthcare equipment, diagnostic machines, in both private and public hospitals while many rural communities have limited health facilities, shortages of health workers, and long travel distances to reach even basic care. Some does not even go to hospitals or community clinics, and they just treated with traditional medicines. Moreover, as we discussed in Topic discussion 1, there are also healthcare professionals’ shortages occur due to many reasons.
To further close the gap, one effective idea would be to establish community-based telehealth hubs in rural villages. These hubs could be run by trained community health workers using simple digital tools to consult urban doctors, provide basic screening, and deliver health education in local languages. This approach combines technology with local trust and could significantly improve access and quality of care for rural populations. In addition, coordination with NGOs and international NGOs has played an important role in reaching hard-to-reach rural communities. These organizations often provide outreach services, mobile clinics, health education, disease prevention programmes, and support for essential services where government capacity is limited. Training local young people as community health assistants could help in terms of building trust, local employment, and improve sustainability.

[Yin Moe Khaing]

The health workforce situation in my country, Myanmar, is a serious concern. Even before recent political events, Myanmar already had a shortage of health workers, especially doctors, nurses, and midwives. Many rural and remote areas were underserved, with limited access to trained health professionals.

Since 2021, the situation has become much worse. A large number of health workers left the public health system due to safety concerns, low pay, and political situations. Many public hospitals and clinics are now understaffed or unable to provide regular services. Health workers who continue to work often face unsafe conditions, high workloads, and emotional stress. This has directly affected essential services such as maternal and child health care, immunization programs, and emergency services, especially in rural and conflict-affected areas.

To improve the situation, I believe several practical steps can be taken. First, the safety and protection of health workers must be prioritized, and medical neutrality should be respected even in conflict situation. Second, better incentives such as fair salaries, allowances, and psychosocial support are needed to retain health workers. Third, strengthening training opportunities and continuous professional development can help motivate and upskill the existing workforce. In the short term, task-shifting and stronger support for community health workers can help maintain basic health services where there are not enough doctors or nurses. Moreover, strengthening telehealth such as “Telekyanmar” (a specialized telehealth platform which provides free medical consultations to the people of Myanmar) would provide benefits for the patients, healthcare professionals, and the health system. Finally, collaboration with NGOs and international organizations is important to support health workers and sustain essential services during this crisis.

Overall, the health workforce crisis in Myanmar reflects both long-standing system weaknesses and the impact of ongoing instability. Addressing these issues is essential for rebuilding trust in the health system and ensuring that people can access basic health care.

[Yin Moe Khaing]

I would like to answer using my experience as a physiotherapist working in humanitarian setting. Using an Electronic Medical Record (EMR) system has several advantages. EMR helps keep client information organized and easy to access, which is very important for long-term rehabilitation care. It supports continuity of care even when staff change and improves communication among different professionals such as doctors, nurses, and therapists. EMR also helps the organization collect accurate data for reports, donor requirements, and program evaluation.

However, there are also challenges in using EMR in this setting. Limited electricity and unstable internet can interrupt daily work, especially if the system is fully online. The cost of computers, software, and maintenance can be difficult for NGOs with limited budgets. In addition, some staff may not be confident using digital systems, which can increase workload and cause resistance at the beginning. Data privacy and security are also concerns if proper policies are not in place.

Overall, EMR can be very useful in my setting if it is introduced carefully. A simple and low-cost system, proper staff training, and gradual implementation can reduce many of the challenges. When adapted to local resources and needs, EMR can improve quality of care and support better health service planning.

[Yin Moe Khaing]

Big health data offers major opportunities to improve healthcare and research, but it also presents several challenges, especially in low-resource settings. To effectively cope with these challenges, practical and context-appropriate strategies are required.
First, start with simple data standardization such as using basic, nationally agreed disease definitions and reporting formats to reduce inconsistency across hospitals and NGOs. Secondly, improving data quality and managing missing data through routine checks and simple validation processes can increase the reliability of analyses. Thirdly, strengthening data linkage and coordination between hospitals, NGOs, and national systems helps reduce fragmentation and duplication of data.
In addition, capacity building of health professionals is crucial. Training clinicians and public health workers in basic data management and interpretation ensures that data is correctly collected and used. Furthermore, ethical and privacy safeguards must be implemented through clear guidelines to protect patient confidentiality and maintain public trust.

[Yin Moe Khaing]

The article suggests four main actions for public health professionals to fight corruption: talking openly about corruption, clearly defining and measuring it, prioritizing actions that are feasible, and using a holistic, multidisciplinary approach.

I generally agree with these points. First, openly discussing corruption is very important because ignoring it allows the problem to continue. When public health professionals talk about corruption honestly, it helps us see it as a system problem, not just individual wrongdoing. Second, defining and measuring corruption is necessary for action, but it should be done carefully because some practices exist due to weak health systems. Third, prioritizing actions based on impact and feasibility is practical, especially in low-resource settings where everything cannot be fixed at once. Finally, a multidisciplinary approach is essential since corruption is influenced by political, social, and economic factors.

In my setting, these actions would work better if there were stronger protection for health workers, better working conditions, and more involvement from communities to improve accountability.

[Yin Moe Khaing]

I would like to consider that an example of a health system improvement could be the integration of rehabilitation services into the primary health care (PHC) system at township and community levels.
Rather than delivering rehabilitation only through NGO or hospital clinics, rehabilitation—including physiotherapy, basic functional assessments, early intervention, caregiver education, and provision of simple assistive devices—would be embedded into routine primary health care services. This means training primary health care workers and community volunteers to deliver basic rehabilitation support, detect developmental delays early, and refer children with complex needs to higher levels of care. Integrating rehabilitation into PHC brings services closer to families, reduces travel cost and delays, and improves equitable access for children in rural or underserved areas. This approach reflects WHO’s guidance that rehabilitation should be part of universal health coverage and included at primary care level to reduce cost and improve timeliness and equity of service delivery.
However, there could be possible barriers in this process. First, there may be insufficient training programs or ongoing supervision for primary healthcare staffs. Without a strong, well-trained workforce, integration can be ineffective or inconsistent. Second, integrating rehabilitation requires funds for training, basic equipment, supervision, and assistive devices. In resource-limited settings like many parts of Myanmar, health budgets may prioritize acute care and infectious diseases, leaving rehabilitation underfunded. Third, leadership and governance, clear policies and leadership at national and local levels are needed to support integration. Moreover, health information and monitoring systems are also needed. Routine health information systems often do not capture rehabilitation data, making it difficult to monitor coverage, quality, or outcomes. Without clear indicators, planning and advocacy are weakened. Last but not least, stigma and lack of awareness about disability can limit caregiver engagement with rehabilitation services.
Reference: https://www.who.int/activities/integrating-rehabilitation-into-health-systems
https://www.who.int/publications/i/item/9789241515986

[Yin Moe Khaing]

I would like to share some health challenges facing in the world and how people try to solve
1. Infectious diseases and global health security: The COVID‐19 pandemic showed the devastating impact infectious diseases can have and highlighted the need for strong global health security measures, such as disease surveillance and robust healthcare systems. Countries are strengthening disease surveillance systems, improving early detection, and sharing data more transparently to prepare for outbreaks.
2. Non‐communicable diseases and health disparities: Non‐communicable diseases (NCDs) like heart disease and cancer continue to be a leading cause of death worldwide, particularly in low‐ and middle‐income countries. Health disparities exacerbate this issue by creating barriers to prevention and treatment for certain populations. Efforts to reduce health disparities include expanding affordable healthcare access and improving medical services in underserved areas.
3. Climate crisis and sustainability in environmental action: Climate change poses an imminent threat to human health and well‐being, with vulnerable populations and regions like small island nations facing disproportionate risks. Addressing the climate crisis requires a focus on environmental sustainability and climate justice to mitigate the health impacts. Nations are adopting renewable energy, reducing emissions, and creating policies to protect ecosystems in order to curb climate-related health risks.
4. Mental health in the modern age: Mental health disorders, such as depression and anxiety, are increasingly prevalent globally. The COVID‐19 pandemic has further highlighted the importance of addressing mental health, as rates of loneliness and emotional distress have risen. Many countries are integrating mental-health services into primary healthcare and expanding access through teletherapy and online counseling. Public campaigns and community programs also work to reduce stigma and encourage people to seek help early.
5. Food safety and malnutrition: Global food security is threatened by a confluence of factors, including conflict, climate change, and economic instability. These issues can lead to food shortages, price spikes, and malnutrition, particularly in vulnerable populations. Humanitarian organizations provide nutritional assistance, while long-term strategies focus on strengthening local food production.
Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC12039348/

[Yin Moe Khaing]

Benefits for Patients
1. No delays in care: With HA, the HIS rarely goes down. This means doctors and nurses can always access patient records, lab results, allergy information, and medication history, so patients receive faster and safer treatment.
2. Faster registration and appointment processing: Patients don’t have to wait long due to system down issues.
Shorter queues and smoother patient experience.
3. Better emergency care: In emergencies, every second matters. HA ensures that life-saving information is instantly available.
Benefits for the Hospital
1. Continuous operation (no downtime losses): System outages can stop billing, admissions, lab services, pharmacy operations, and more. HA prevents service interruptions and revenue loss.
2. Stronger data protection: HA often includes backup systems and redundancy. This protects against data loss from hardware failure or power outages.
3. Improved staff productivity: Doctors, nurses, and admin staff don’t waste time waiting for the system to come back online. Higher efficiency and smoother workflow.
4. Better reputation and patient trust: A hospital that runs smoothly without “IT problems” looks more reliable and professional. This can increase patient satisfaction and trust in the hospital.

[Yin Moe Khaing]

One change I wanted to introduce in my team was improving the accuracy and consistency of our data and record-keeping for children’s therapy progress. Previously, some records were handwritten, some were kept on personal devices, and others were shared and discussed verbally. This made it difficult to track progress over time, identify patterns, or provide clear updates to supervisors and parents. I wanted to move toward a more organized and reliable digital system where all therapy notes, attendance, milestones, and follow-up plans were stored in one shared place.
To make this change, I used a democratic and coaching approach. I first discussed with my team what type of record system would be easiest for everyone to use, and I listened to their concerns about time, workload, and technical skills. Then I demonstrated simple steps for entering data, and updating records consistently. At first, the transition felt a bit slow because everyone had different levels of knowledge with using digital tools. But over time, the system became easier, and the benefits became clear—less missing information, better monitoring of each child’s progress, and faster reporting when our supervisors requested updates. This experience showed me that even small improvements in data management can create big changes in efficiency and service quality.

[Yin Moe Khaing]

Effective communication is essential in my team, especially because we work closely with children with disabilities and need to stay coordinated in our roles. I focus on creating a safe environment where everyone feels comfortable sharing their ideas, concerns, and feedback. Active listening is a key part of my approach—I make sure to listen fully before responding so I can understand the situation clearly. I also communicate expectations in a clear and organized way, whether it’s about therapy plans, scheduling, or event preparation, so team members know exactly what needs to be done.
At the same time, I believe in giving feedback with kindness and respect. When mistakes occur, I address them directly but gently, focusing on improvement rather than blame. Regular check-ins help the team stay aligned and provide opportunities for clarification and support. These practices help me build open, honest, and respectful communication within the team, which leads to smoother teamwork and better outcomes for the children we serve.

[Yin Moe Khaing]

In my professional journey as a physiotherapist working with children with disabilities, I have learned that effective leadership requires flexibility, empathy, and the ability to match the right approach to the right moment. One leadership style alone cannot meet the diverse needs of my team or the beneficiaries we serve, so I intentionally use different styles depending on the situation. Each style brings strengths, but I also stay mindful of its challenges.
Most of the time, I rely on the visionary style because I want my team to understand our goals clearly—why certain therapy plans matter, how our work supports children’s development, and the long-term impact of each session. The downside is that team members can sometimes get lost in the big picture, so I make sure to break larger goals into smaller, achievable steps.
During busy or stressful periods, I shift to an affiliative approach to maintain harmony and reduce burnout. Working in disability services can be emotionally demanding, so creating a positive and supportive atmosphere is essential. Still, being too friendly can make it difficult to address mistakes, so I practice staying kind but firm when giving corrective feedback.
When we do other types of activities such as creating parent-meeting activities or designing service materials—I use a democratic style. Involving my team in decision-making increases ownership, but it can also slow down the process. Even so, the collaborative outcome is usually worth the time.
Finally, in urgent or time-sensitive situations—such as unexpected schedule changes or last-minute requirements from supervisors—I use a commanding style. Giving clear and direct instructions helps us meet deadlines efficiently.
Overall, these experiences have taught me that adaptive leadership fits me best. I adjust my approach based on the needs of the moment, the emotional state of my team, and the goals we aim to achieve. This flexibility helps me create a supportive, effective, and purpose-driven working environment.

[Yin Moe Khaing]

What happened?
In my workplace, our cloud-based reporting system suddenly became inaccessible for several hours due to a server outage. Later, we also found that some data entries submitted right before the outage were incomplete or corrupted, affecting data integrity.
How did it affect the system or users?
Staffs were unable to log in or submit reports. Users who needed urgent information could not access the system, affecting productivity. Team members were stressed because they could not perform some important tasks on time.
How to prevent it?
Improve Availability: Implement system redundancy, regular server maintenance, and backup hosting to minimize downtime. Having a failover server ensures users can still access the system if one server fails.
Strengthen Confidentiality: Although not affected this time, using encryption, access control, and strong authentication helps protect sensitive data in general.

[Yin Moe Khaing]

Information technology plays a crucial role in assisting the outbreak investigation process by enhancing data collection, analysis, communication, and decision-making at each stage. During the initial step of establishing the existence of an outbreak, electronic surveillance systems are used to monitor disease trends and detect abnormal increases in cases. These systems allow for real-time data collection and automated alerts, which help identify outbreaks quickly.
In the step of verifying the diagnosis, information technology supports laboratory confirmation through Laboratory Information Management Systems that record, track, and share laboratory test results efficiently. Electronic medical records (EMRs) also enable healthcare professionals to verify diagnoses remotely and ensure data accuracy.
When defining and identifying cases, electronic case reporting systems and mobile data collection tools such as KoBoToolbox assists field investigators in capturing standardized data directly from health facilities or communities. These tools improve the accuracy and timeliness of case finding, even in remote areas.
In descriptive epidemiology, IT applications such as Epi Info, Excel, and Geographic Information Systems (GIS) are used to analyze data according to time, place, and person. GIS helps to map cases geographically and visualize clusters, providing insights into the spatial distribution of diseases. Similarly, analytic and visualization software such as Tableau or Power BI helps to identify patterns and generate hypotheses about the possible sources and transmission routes.
During hypothesis testing and evaluation, statistical software support the analysis of relationships between exposures and disease outcomes.
When implementing control and prevention measures, information technology enables effective communication through mobile applications, SMS alerts, and social media platforms. Decision-support systems also provide real-time recommendations for interventions based on current data trends. Finally, during the step of communicating findings, digital dashboards, online reporting tools, and interactive data visualizations allow health authorities to present results clearly to policymakers, healthcare providers, and the public.
In conclusion, the application of information technology in outbreak investigations enhances the efficiency and accuracy of public health responses. It enables rapid data collection, real-time communication, and evidence-based decision-making, which are all essential for timely control of disease outbreaks.

[Yin Moe Khaing]

I have selected Digital Contact Tracing Apps as the technology that I find most compelling due to its direct role in interrupting community transmission at scale. Digital contact tracing automates the process of identifying individuals who have been in contact with a confirmed case, offering scale and speed that is difficult to replicate using traditional methods.
How it works:
1. These smartphone applications typically leverage low-power Bluetooth technology to operate.
2. When User A and User B come into contact, their phones exchange an anonymous identifier key via Bluetooth, recording this as a contact event. These detected keys, recording contact events, are usually saved on the device for a limited time.
3. If User A tests positive for COVID-19, they update their status in the app.
4. Depending on the architecture, either User A’s contact records are sent to a central server (centralized system) or only User A’s anonymous key is sent (decentralized system).
5. User B’s app receives this information and, if a match is found with their on-phone contact records, User B is alerted of contact with a confirmed case and advised to quarantine and/or get tested.
This digital approach helps to reduce reliance on human recall, which is particularly beneficial in densely populated areas with mobile populations.
The primary importance of digital contact tracing is its role in interrupting community transmission. Following the identification and isolation of a case, rapid tracing and quarantining of contacts is crucial to prevent the further spread of the virus.
However, the effectiveness of these apps is heavily dependent on widespread adoption by the population, requiring a large proportion of users to download and comply with the advice for the strategy to be effective in reducing the effective reproduction number (R) to less than 1. Furthermore, while offering significant benefits, digital tracing apps raise considerable challenges, especially regarding legal, ethical, and privacy barriers, and require careful implementation to build public trust. Several international frameworks have emerged to address privacy concerns, advocating for decentralized systems over centralized ones, for instance.

[Yin Moe Khaing]

Infectious disease surveillance serves three critical goals for managing public health threats like dengue, a disease listed as nationally notifiable in the United States. The surveillance system aims to describe the current burden and epidemiology (including seasonality and age distribution) to justify interventions, monitor disease trends (including the impact of control measures), and identify outbreaks and new pathogens. For an outbreak-prone disease like dengue, ongoing surveillance facilitates the early detection of an outbreak, enabling a rapid public health response. While passive surveillance, where medical professionals report cases, is commonly implemented because it requires fewer resources, it is prone to missing cases. Therefore, for a complete and responsive system, passive surveillance should be complemented by active surveillance during an outbreak, where public health staff actively engage in searching the community to find symptomatic patients and conduct contact tracing.

To achieve comprehensive case identification, various methods must be employed. Identifying cases in medical facilities captures severe cases requiring hospital treatment; however, community-based surveillance is essential to capture the full burden of disease, including milder cases or those who do not seek health care. Furthermore, population-based surveillance is preferred over sentinel surveillance if the goal is to produce generalizable rates of disease (incidence and mortality rates) across a defined geographic area. To ensure detailed information for investigation and targeted control efforts, case-based surveillance, which collects individual-level data on person, place, and time, is recommended over aggregated surveillance, although systems may temporarily transition to aggregated data if the case volume becomes overwhelming. Finally, an effective case definition strategy should use syndromic surveillance (monitoring clinical symptoms without laboratory confirmation) as a sensitive alert system for suspect cases, followed by laboratory-confirmed surveillance to provide the necessary specificity and definitive identification of the etiologic agent.

For diseases requiring rapid response, such as monkeypox (Mpox), surveillance information must be disseminated quickly as surveillance is an action-oriented public health tool. I would choose real-time and online tools to facilitate rapid intervention. The Health Alert Network (HAN) is vital for quickly disseminating confirmed disease reports and information (including required actions) to medical and public health professionals at a national level. Similarly, the Program for Monitoring Emerging Diseases (ProMED) acts as an important early warning of outbreaks by consolidating and verifying reports from media and observers, disseminating this free information rapidly via email and the Internet. These rapid tools are complemented by periodic dissemination tools (such as surveillance bulletins or the MMWR/ WER), which provide formal, regular summaries of disease trends and case counts to stakeholders. Additionally, online platforms like HealthMap provide an innovative way to display collected data geographically on an interactive interface, enhancing real-time situational awareness.

[Yin Moe Khaing]

• Should you give the data out?
No, I should not give out the individual-level malaria data that include personal identifiers such as home address, geolocation, and contact number.
• How do you not violate any of the General Principles of Informatics Ethics?
Sharing such identifiable information would violate data privacy, confidentiality, and the ethical principles of informatics, particularly autonomy, privacy, confidentiality, security, and justice. To avoid violating these principles, I would seek approval first and only after proper review and authorization could data sharing be considered.
If you want to provide the data to them , what and how will you do it?
If I decide to provide the data, I would ensure that it is properly anonymized or de-identified—removing all personal identifiers and replacing them with coded numbers so that individuals cannot be traced. I would also prepare a data-sharing agreement (DSA) outlining the scope of use, data security measures, and obligations of the research team to prevent misuse or re-identification. By following these steps, I can support valuable research that benefits public health while still protecting individual rights, ensuring confidentiality, and maintaining ethical and legal standards in data management.

[Yin Moe Khaing]

As a health information professional, I have an ethical and professional obligation to maintain patient confidentiality.
I am not allowed to disclose the information to anyone without the patient’s consent. Revealing it would be a serious breach of confidentiality, violating both professional ethics and legal standards such as patient privacy laws.
I also cannot interfere with family or personal matters related to the patient. My duty is to manage and protect health information—not to make personal judgments or decisions about how the patient handles their condition. While I may feel concerned for my friend’s health and safety, I must act within my professional boundaries.
In terms of ethical principles:
Right to self-determination: The patient has the right to control who knows about his medical condition.
Doing good (beneficence) and doing no harm (non-maleficence): My role is to protect the patient’s rights and trust in the health system. Breaching confidentiality could cause emotional and social harm to both the patient and my friend.
Justice and professional integrity: All patients deserve equal respect for their privacy, regardless of personal relationships.
Although the situation presents a moral dilemma, the correct action is to respect confidentiality. If I am deeply concerned about the possible risk to my friend, I could encourage the patient (through proper channels) to disclose his condition to his spouse or seek counseling services, but I must never disclose it myself. Upholding confidentiality protects the integrity of the health profession and ensures trust in the healthcare system.

[Yin Moe Khaing]

My organization implemented a Case Analysis System to track the therapy progress and goals of children with disabilities. The system aimed to improve documentation, rehabilitation goal-setting, and communication among therapists. However, it was partially unsuccessful due to challenges in user adaptation and system design.

According to the ADKAR model (Awareness, Desire, Knowledge, Ability, and Reinforcement), the organization did not fully manage the change process effectively. While there was Awareness about the importance of digital record-keeping, many staff members lacked strong Desire to change from paper-based methods. Training sessions were limited, which meant insufficient Knowledge and Ability to use the new system confidently. In addition, there was little Reinforcement after implementation—no continuous follow-up or recognition for those who used the system properly.

As a result, some therapists continued using manual reports, and data in the system remained incomplete. To improve future system adoption, the organization should strengthen staff engagement, provide regular hands-on training, and establish ongoing monitoring and feedback mechanisms.

[Yin Moe Khaing]

My organization implemented a Case Analysis System designed to track therapy progress and goals for children with disabilities. However, the system was partially unsuccessful due to several factors. In terms of data, records were not updated regularly and lacked consistency. The cost of the system was low, but limited budget meant fewer features and poor technical support. From an operational point of view, the system helped organize client information, but slow performance and occasional errors affected efficiency. The design was not user-friendly, and it was frequently changed by the organization, which discouraged some staff from using it. Finally, the people factor played a major role—some staff were not well trained or motivated to use the new system. Overall, the system showed potential to improve service delivery but failed to achieve full success because of design, data management, and user engagement issues.

[Yin Moe Khaing]

During my work experience at hospital, one example of a Decision Support System is the electronic medical record (EMR) system that helps collect and organize patient data such as assessment findings, progress notes, therapy schedules, and outcomes. It supports clinical decision-making.
Overall, the system works reasonably well, especially for maintaining accurate client records and ensuring continuity of care among multidisciplinary team members (physiotherapists, lab technologists, pharmacists, nurses, and doctors). But sometimes the internet connectivity and staff digital skills also affect how effectively the system is used.
Factors that might influence the Decision Support System implementation could be technical infrastructure: which is reliable internet, sufficient computers, and stable power supply are necessary for smooth operation. Another one is staff training and digital literacy because some staff may not be familiar with using electronic systems, so ongoing training is essential. Besides, management support is also important because implementation works better when leaders encourage and allocate time for proper data entry and use. Last one is data quality – The accuracy and completeness of patient data entered into the system directly affect the quality of decision-making.

[Yin Moe Khaing]

One of the key purposes of ICD is interoperability. Without it, exchanging EMR/EHR data between hospitals would become inconsistent so difficulty in health information exchange occurs. Another one is clinical communication problem such as a diagnosis written in free text or using local codes may cause misinterpretation, especially when patients move between hospitals which could lead to errors in treatment, duplication of tests, and poor continuity of care. Many insurance systems use ICD codes for claims, reimbursement, and fraud detection. Without it, billing would be inconsistent and inefficient for both hospitals and insurance providers.

[Yin Moe Khaing]

I agree with the study’s conclusion. EMRs were designed to improve efficiency, accuracy, and interoperability, but in practice, they often introduce heavy documentation tasks, complex interfaces, constant alerts, and increased administrative workload. These factors can overwhelm physicians and reduce the time they spend on actual patient care, which is a key source of professional satisfaction.
I have heard many concerns from healthcare professionals that they feel they spend more time typing, documenting things than interacting with patients. User friendly interface is important as this can make simpler and easier for users.
Some solutions could be:
1. Improve system usability: We can simplify EMR interfaces, reduce unnecessary clicks, and make workflows more intuitive and using speech-to-text and natural language processing to reduce manual typing.
2.Delegate non-clinical tasks: We can employ assistants to handle routine documentation as Sir. Zam suggests. Automate repetitive tasks like prescription refills and test result notifications.
3. Training and support: We can provide continuous training so staff can use EMRs more efficiently. Involve physicians in EMR design feedback loops to ensure real-world usability.
4. Policy and organizational support: Allow protected time for documentation within working hours instead of after hours.

[Yin Moe Khaing]

Hi Jenny! Thank you for sharing this interesting project. I believe patients in remote or disadvantaged areas who often struggle with limited access to doctors, diagnostic tools, and timely interventions can receive essential health services closer to home, reducing the need for long and costly travel.

[Yin Moe Khaing]

Hi Nang!
Thanks for the knowledge. I believe this project can significantly improve current health practices. When patients receive timely and well-coordinated interventions from providers who have a full picture of their medical history, they feel more confident and cared for. This transparency and continuity of care builds trust between patients and the healthcare system.

[Yin Moe Khaing]

eHealth is the use of digital technologies to support and enhance health, health care delivery, communication, and data-driven decision-making.

[Yin Moe Khaing]

My opinion for an example of Big Data in healthcare is the Electronic Health Records (EHRs) combined with real-time patient monitoring data. For instance, hospitals now collect huge volumes of information such as laboratory test results, imaging files, medical reports, prescriptions, wearable device data (like heart rate, oxygen level, or physical activity), and patient histories. When combined, this creates a massive dataset that can be analyzed to improve diagnosis, predict disease outbreaks, and personalize treatments. This can be helpful in reducing patients’ unnecessary visit to the clinics.
Characteristics of this data according to 5Vs could be:
1)Volume: Healthcare systems generate large amount of data daily from EMRs, medical imaging, lab tests, wearable devices, and from billing systems. There is certainly large variety of data coming from different sources, in different formats.
2)Velocity: Data is generated rapidly in real-time—for example, continuous heart rate and oxygen saturation monitoring from ICU patients, and new wearable sensors helping track patient’s health trends that can be monitored by the doctors.
3)Variety: Data comes in multiple forms such as structured (lab results, demographics), semi-structured (sensor logs, prescriptions), and unstructured (doctor’s notes, CT scan images).
4)Veracity: Data quality can vary; some records may have errors, duplicates, or incomplete entries that require validation.
5)Value: When analyzed, the data can provide insights for better patient care, early diagnosis, and public health decisions.

[Yin Moe Khaing]

Brief Introduction
I have observed the implementation of an Electronic Medical Record (EMR) system in the hospital where I worked. This system was used to digitally store and manage patient health information, replacing most of the traditional paper-based documentation. The EMR allowed doctors, nurses, and other healthcare professionals to access patient records more efficiently and provide timely care.

How it can help improve current practices
The use of EMRs helped improve healthcare practices in several ways:
Efficiency: Reduced the time spent on paperwork and allowed quick retrieval of patient history, lab results, and treatment plans.
Accuracy: Minimized errors caused by illegible handwriting or misplaced files.
Continuity of care: Enabled better coordination between different healthcare providers, as all relevant information was stored in one system.
Decision support: Some systems had built-in alerts for drug interactions or abnormal lab results, improving patient safety.
Patient satisfaction: Faster and more accurate services improved overall patient experience.

Challenges or difficulties
Despite these benefits, there were several challenges in implementing and using the EMR:
Training requirements: Staff needed time and training to adapt to the new digital system.
Technical issues: Power outages or system downtime sometimes disrupted access to records.
Resistance to change: Some staff were reluctant to move away from familiar paper-based methods.
Data privacy and security: Ensuring that patient records remained confidential and secure from unauthorized access was also a major concern.

[Yin Moe Khaing]

I would consider moving the hospital’s information system to cloud computing using a hybrid cloud approach. This allows the hospital to store sensitive data on-premises while using the cloud for less critical data, which is suitable given Myanmar’s current infrastructure and connectivity. Cloud computing provides access to resources and improves mobility, allowing staff to access data from anywhere. It also offers scalability, ensures data security, provides cost savings, and includes maintenance and support handled by the cloud provider.

[Yin Moe Khaing]

Yes, my computer was once infected by a cyber threat. It happened when I inserted a USB stick into my computer without checking it for potential malware. The cause was a malware infection from the USB stick. After the infection, my computer started to slow down significantly, and some files were affected or became inaccessible. To prevent this from happening again, I will:

Always scan USB drives with antivirus software before opening any files.

Keep my antivirus and system software updated.

Avoid using unknown or untrusted USB drives.

Regularly back up important files to reduce the risk of data loss.

[Yin Moe Khaing]

I would like to build an app focused on patient care coordination and communication between doctors and patients. It would handle appointment scheduling, medical record access, telemedicine, and medication management. This ensures timely interventions, reduces miscommunication, and helps patients stay engaged in their health. The app would be a mobile app for patients with a web-based portal for doctors, supported by a cloud backend. Mobile access allows patients to receive reminders, track their health, and attend virtual consultations, while doctors can review detailed records and monitor multiple patients efficiently. By improving communication, adherence, and access to real-time data, the app helps prevent errors, enables early intervention, and keeps patients actively involved in their care. For example, abnormal lab results could trigger alerts to doctors, allowing quick adjustments to treatment and reducing the risk of complications.

[Yin Moe Khaing]

In my workplace, the patient management and therapy tracking system for people with disabilities still faces many challenges. Much of the patient information, including therapy plans, progress notes, and medical history, is recorded manually or across multiple unintegrated platforms. This leads to inefficiency, delayed access to information, time consuming, and difficulty monitoring the progress of each patient effectively.

Several components of the system contribute to these problems. Hardware is limited for real-time data entry. Software is fragmented, lacking an integrated system to track therapy, appointments, and outcomes. Data is often incomplete or inconsistent, and processes such as logging therapy sessions and generating reports are time-consuming and easy for errors. Additionally, people—including therapists and administrative staff—may be resistant to adopting digital systems or may lack proper training.

To improve the system, the clinic could implement an integrated rehabilitation information system. Providing portable devices or tablets would enable real-time data entry, while a unified software platform would streamline therapy tracking, scheduling, and reporting. Standardizing data entry, redesigning workflows, and offering staff training would further enhance efficiency. Overall, these improvements would reduce errors, save time, and enable better data-driven decisions for individualized patient care.

[Yin Moe Khaing]

Thanks for identifying the key issues, such as the incomplete implementation of multi-factor authentication (MFA) and the lack of a proactive security strategy. I would like to add The Zero Trust architecture could further enhance the system’s security posture. In this model, no user or device is trusted by default, and strict identity verification, authorization, and least-privilege access principles are enforced at every layer of the network. This would make it significantly more difficult for attackers to move laterally once they’ve gained access through a compromised account.

[Yin Moe Khaing]

Thanks for your comprehensive and and clear analysis of the SingHealth data breach. I would like to tell my opinion on some additional preventive measures that could help in mitigating similar attacks in the future. Beyond phishing awareness, it would be beneficial for organizations like SingHealth to implement Endpoint Detection and Response (EDR) tools. These tools provide real-time monitoring, automated threat detection, and the ability to respond to suspicious activity at the endpoint level. By detecting unusual activity on the front-end workstation early in the attack, the EDR system could have potentially stopped the malware from escalating further.

[Yin Moe Khaing]

Hi Nang!
The preventive measures you’ve outlined are also comprehensive, but I think there are a few more steps that could be emphasized or elaborated on to enhance data protection in similar situations. In this case, PHI was inadvertently shared with Google Ads. Anonymizing or pseudonymizing data before sharing with third parties (like Google Analytics or Ads) could reduce the risks of sensitive information exposure. Only data that is essential for the analysis or targeted ads should be shared, and all personally identifiable information (PII) should be anonymized wherever possible. Thanks for this case study. Data privacy and security measures should continuously evolve in response to new threats and vulnerabilities, especially when dealing with sensitive health information.

[Yin Moe Khaing]

Some possible means an attacker could use to conduct a security attack could be:
-Phishing mails are very popular and remain one of the most common methods of cyberattack worldwide. Attackers may send fake emails pretending to be someone or some organization or company name to trick the user into revealing login credentials or downloading malicious files.
-Exploiting weak passwords- weak or reused passwords can be targeted allowing attackers unauthorized access to electronic health records, for example.
-Network-based attacks- for example, Dos/DDoS by overwhelming systems with traffic to make them unavailable. Another one is MitM by intercepting communication between two parties.
-Malware-based attacks such as viruses, worms, trojans- attacker may use malicious software that damages systems or steal data, and ransomware which encrypts data and ask for payment.

[Yin Moe Khaing]

That’s a great example of how innovative data sources can strengthen public health surveillance, especially during emergencies like COVID-19. Using anonymized mobile phone location data was an effective and ethical way to understand population mobility without compromising individual privacy.

[Yin Moe Khaing]

I completely agree that social media platforms have become powerful tools for disease surveillance and public health communication, especially during COVID-19. They allow rapid information sharing between health authorities and the public, helping people understand symptoms, prevention, and vaccination updates in real time.

[Yin Moe Khaing]

I agree that continuous data collection and monitoring are essential for early detection and timely response before the disease reaches epidemic levels. Using both passive and active surveillance is a smart approach—passive for routine monitoring of notifiable cases and active for rapid community-level intervention when there are outbreak signals. Thanks for your discussion, Ma Hteik Htar!

[Yin Moe Khaing]

Combining medical facility data with community-based surveillance ensures that both severe and mild or unreported cases are captured. Sentinel surveillance is useful for monitoring trends and virus types, while population-based data provide the true disease burden. Thanks for discussion Myo!

[Yin Moe Khaing]

Thank you for sharing this detailed example. It’s great to see how your organization applied the ADKAR model in managing the transition to a web-based data reporting system. I agree that the ongoing cost can be a significant challenge.

[Yin Moe Khaing]

I also believe strengthening data systems and human resource capacity would definitely enhance the effectiveness of your Decision Support System.

[Yin Moe Khaing]

Hi Ama,
Thanks for sharing your opinion about EPI data. Your mention of Variety and Veracity shows the complexity of EPI data, since it includes both structured (dosage, coverage rates) and unstructured information (adverse events following immunization), and is collected by trained staff using verified hospital records. This helps ensure reliability for disease monitoring. It is good to know this process.

[Yin Moe Khaing]

Hi Sayar!
Thank you for sharing your experience with the Community-Based Health App (CBHA) project. Digital literacy and limited internet connectivity are common barriers in community-based health informatics projects. It’s encouraging that practical solutions, such as offline data collection and uploading when connectivity is available, were implemented to overcome these issues.

[Yin Moe Khaing]

Thank you for sharing your experience with the EMR project in Yangon. It’s impressive to see how you implemented a comprehensive digital solution across three clinics, involving a multi-disciplinary team of developers. Technical issues, resistance to change, interdisciplinary communication gaps, and interoperability are common challenges in health informatics projects. It’s encouraging that you addressed these proactively through standby developer support, frequent training sessions, and regular check-ins between healthcare providers and developers. These strategies demonstrate thoughtful planning and collaboration, which are crucial for successful implementation.

[Yin Moe Khaing]

Your plan to implement a hybrid cloud model for the hospital’s information system is very well considered, especially given Myanmar’s challenges with electricity and internet connectivity. Storing sensitive patient data locally while using the cloud for less critical information strikes a good balance between security and accessibility. I also agree that cloud computing can significantly improve coordination among departments, streamline EMR access, and support faster decision-making during emergencies. Your emphasis on backup power systems, offline storage, and staff training is crucial to ensure continuity and smooth operations despite infrastructure challenges. I think this approach thoughtfully combines technology benefits with practical considerations for the local context. Thanks for sharing.

[Yin Moe Khaing]

Thanks for sharing your experience.

[Yin Moe Khaing]

That sounds like a very practical and patient-centered approach. A mobile app for scheduling and symptom tracking would empower patients to take an active role in their own care, improving both awareness and adherence to treatment plans. Including a self-evaluation tool or scoring system is an excellent idea. Thanks for sharing.

[Yin Moe Khaing]

I think your proposed improvements are practical and well-targeted. Implementing interoperable EHRs, streamlining workflows, and providing comprehensive training would go a long way toward addressing both technical and human challenges. I would also add that ongoing monitoring and feedback from staff using the system can help identify new issues early and ensure continuous improvement.

[Yin Moe Khaing]

Thanks for sharing your experience. This is a reminder for me who is less aware on security matter.

[Yin Moe Khaing]

There are so many benefits of cloud server and it reduces the IT workload. I also think PaaS will be more flexible than SaaS.

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