Post on 07-Apr-2020
Surveillance and Strategic
Thailand 4.0
อํานาจ คําศิริวชัรา
รองหวัหน้าศนูย์ความเป็นเลิศทางสารสนเทศศาสตร์ชีวเวชและสาธารณสขุ
(Center of Excellence for Biomedical and Public Health Informatics)
คณะเวชศาสตร์เขตร้อน มหาวิทยาลยัมหิดล 12 กรกฏาคม 2560
วตัถุประสงคห์ลกั
• ต้องการให้เห็นภาพในการใช้การบริหารจดัการฐานข้อมลู นัน้เป็น
องค์ประกอบสําคญัและจําเป็นในการสร้างระบบสารสนเทศยคุใหม ่
• ข้อมลูพืน้ฐานท่ีจําเป็นตอ่การแสดงผล
หวัขอ้บรรยาย
• ประสบการณ์การพฒันาระบบเฝ้าระวงัโรค ในระดบัตา่งๆ พร้อม
ตวัอยา่งระบบจริง
– ระบบเฝ้าระวงัโรคไข้มาลาเรีย
MAIN FOCUSING AREAS
• Public Health Informatics
Screening sites & Clinical Sites
Local DMU
EDIT LOGIC
DATA CLARIFICATIONS
CRF Image
Double Verification Primary
Database
DMU Study Monitoring
Reports
Provincial Center DATA CLARIFICATIONS
CRF Image
DataFax Double Verification Primary
Data Base
SAS Data Sets/ Transport Files
Study
Monitoring Reports
Data Coordinating And Analysis Center
Study Coordinating Center
Local DMU DATA CLARIFICATIONS
fax machines
Definition
• Public Health Informatics has been defined as the systematic application of information and computer science and technology to public health practice, research, and learning. It is one of the subdomains of Health informatics.
Malaria Surveillance System moving toward Malaria Elimination
Strategy
To provide effective management information system capable of coordination at operational staff to enable rapid and high quality implementation of Malaria elimination strategy of Artemisinin Resistance
Objective
Originally summarized in paper-based
GIS can be done by using pin within village map
6 core modules of malaria program within BVBD
Epidemiology module
Vector Control Module
BCC Module
Entomology Module
Partnership Towards Malaria Reduction in Migrant and Conflict-Affected Population in Thailand Donors: Global Fund Round Round 10 Partners: PR: Department of Disease Control SR: BVBD, BIOPHICS, SMRU, IOM, Raks Thai, Malaria Consortium, Kenan Institute Asia
2012-2016
System Coverage Area
The system coverage area will cover 22 provinces along Thai-Myanmar-Cambodia borders. Within year 2013, the system will link with department of disease control to cover the whole country. Data from 9 refugee camps will also merge with the system.
Work & Data Flow
Geographic Information Unit (GIU), Department of Tropical Hygiene,
EP 1
EP 3 EP 1
Not Infected
Infected
• Case investigation • Treatment
Day 0
• Drug compliance • Case follow-up
Day 1,2,3
Pf : Day 7,14,21,28,35,42
Pv: Day 7,14,21,28,60,90
• Case follow-up
• Case Detection
MIS
VIVO
EP 1 FU
Case Detection
Passive Case Detection/ Active Case Detection
Location Information
Diagnosis Result
Treatments
Malaria Information System
• Paper-based reports are transformed into electronic system capable of capturing the following data – Blood draw information (ACD,PCD) captured by web-based – Case Investigation captured by web-based – Case Follow up captured by mobile phone links to web-based
• Summary reports including details are also provided at operational level – Epidemiology reports – Monthly/Weekly infection reports – Malaria real time warning – Occupation infection reports – Demographics infection reports
• Geographic Information System – patient locations can be captured by using mobile phones, and generated real-time mapping at – Village level – Household level
• Project Goal , M&E key indicators in Objectives 1 and 2 can be automatically generated from the system
BIOPHICS incorporate with PR DDC, BVBD, The Global Fund
• Starting from fiscal year 2012, BIOPHICS has
successfully converted paper-based malaria vertical program into electronic-based from 22 endemic provinces.
• Later in fiscal year 2015, the consolidation process between malaria vertical program and 506 national surveillance system was launched. – Redundancies from 2 systems were captured – New visualization tool was introduced
14 31
45
20
42
40
19
16 17 39
38
15 36
37 34
6 32
43
24 23 22
33
35
4 5 1
3
2
8
7 9
44
28
29
30 10
25 26
27
13 11 12
Myanmar
Lao PDR
Cambodia
Malaysia
N
BOE
BVBD Thai
M1+M2
Malaria reporting systems in Thailand
• 2 overlapped reporting systems • Bureau of
Epidemiology(77provinces) • Provincial, district hospitals • District Health Promotion
hospitals • VBDU
• BVBD(Endemic Areas) • VBDC VBDU • Malaria Clinic • Malaria Post • Border Malaria Post • Hospital & Health Promotion
Hospital
PHO
ODPC
Consolidation Process between BVBD and 506 to find real malaria burden by get rid of redundancy
figures from 2 systems
Problems
• Each system tries to get the complete figures by entering data across each other.
• Both system are dispersed throughout the nation, and hardly to do perfectly key-in across 2 different units.
• Redundant figures in malaria reports can be seen in both systems. When combine, it is difficult to know what will be the actual figures of malaria case report
รว1 MP/BMP รว3 MP/BMP F/U VIVO
Ep1 Form Investigation Form
F/U VIVO
Reporting flows between two systems
Malaria Online
506 reporting
system
Consolidation and
Visualization by using BI
Fuzzy Logic • Data warehouse standard feature in Data
Quality Service (DQS)
• The Algorithm in Fuzzy Grouping will analyse entire data and create source data set to Reference record set
• The Reference record set will then match with fuzzy algorithm, and generate similarity score from any comparisons.
Source Data Set
Matching Records
Similarity Score
Results after consolidation and remove redundancy cases
3 years data
Calendar yr 2006 2007 2008 2009 2010 2011 2012 2013 2014 Grand Total
1=BOE 21,101 16,210 14,591 11,505 63,407
2=VBD 7 306 1,508 3,884 3,026 9,434 29,177 27,871 26,034 101,247
Grand Total 7 306 1,508 3,884 3,026 30,535 45,387 42,462 37,539 164,654
Fiscal yr FY2007 FY2008 FY2009 FY2010 FY2011 FY2012 FY2013 FY2014 Grand Total 1=BOE 17,384 15,817 15,808 12,727 61,736
2=VBD 24 1,104 3,262 3,502 4,125 27,694 29,598 27,255 96,564
Grand Total 24 1,104 3,262 3,502 21,509 43,511 45,406 39,982 158,300
After removing redundancies 36,869 35,726 31,443 Redundancy records 8,518 6,736 6,096 Removal Percentage 19% 16% 16%
After removing redundancies 34,844 38,363 32,872
Redundancy records 8,667 7,043 7,110
Removal Percentage 20% 16% 18%
New Data Visualization Technique called Business Intelligence (BI)
used for displaying malaria consolidation between
Malaria online V.S
506 Reporting System
Display Methodology
BOE BVBD Convert to the same format
converted
BVBD
converted
BOE
Merged
BOE + BVBD
Total Cases that redundancies
have been removed
Repeated Records
BI Web-based
Malaria GIS Online
Consolidated Business Intelligence Platform
สไลด ์การบรรยายทาง ระบาดวทิยาของ
ท่าน อาจารย ์คาํนวณ อ้ึงชูศกัด์ิ
ท่ีปรึกษากรมควบคุมโรค
กระทรวงสาธารณสุข
สอดคลอ้งกบัสาระการบรรยายจึงขอนาํมาเผยแพร่ให้
ศึกษาประกอบ
Kumnuan Ungchusak, Advisor to Department of Disease Control, MOPH
วตัถุประสงคร์ะบบเฝ้าระวงั
• เตือนภยั มกัใช้กบัทางโรคตดิเชือ้ เพราะระยะฟักตวัสัน้
– Situation analysis team ดทูกุวนั เพ่ือ alert for actions
• ปรับปรุงโปรแกรมให้ดีขึน้
– แนวโน้มลดลง
– การบริหารจดัการ
– ภาระโรค
– คําถามตา่งๆ เพ่ือการวิจยัตอ่ – วางนโยบาย และแผนปฏิบติัการ
Kumnuan Ungchusak, Advisor to Department of Disease Control, MOPH
5มิติ การเฝ้าระวงั
• ขัน้ตอนการเกิดโรค การป่วย การตาย Morbidity & Mortality • พฤตกิรรม Behaviors risk factors • Determinants ธุรกิจท่ีเก่ียวข้อง ท่ีทําให้เกิดเหต ุ
– มิดไนท์สงกรานต์ ทําให้เกิดอบุติัเหต ุหลงัเท่ียงคืน เพ่ิมขึน้อย่างมาก
• Program responses – มาตรการ
– ออกกฏหมาย
• Abnormal events – Facebook live
Kumnuan Ungchusak, Advisor to Department of Disease Control, MOPH
Different types of data collection
• Case-based surveillance (รายบคุคล) & Event-based surveillance (สนใจขา่วมากกวา่บคุคล)
• Sentinel surveillance (จดุยทุธศาสตร์ตวัแทน) VS universal surveillance (scale up)
• Syndromic (iLi) VS laboratory • Behavior
Kumnuan Ungchusak, Advisor to Department of Disease Control, MOPH
Different ways of data collection
• Passive case detection ลงทนุน้อยท่ีสดุ • Active case • Survey • Study • Census สํามะโนประชากร
Kumnuan Ungchusak, Advisor to Department of Disease Control, MOPH
Different source of information
• Hospital • Community • Government sectors • Publications • Media
Kumnuan Ungchusak, Advisor to Department of Disease Control, MOPH
Review of surveillance system • Describe how the system work? Work flow • Has the surveillance information been utilized by
program and decision makers • How is the quality of the surveillance
– Timeliness – Completeness – Validity
• Supporting – Staff – Budgeting – tecniques
Kumnuan Ungchusak, Advisor to Department of Disease Control, MOPH
Thank you
Questions