Bangyai Bangyai is is one of the one of the

six districts six districts of of

Nonthaburi Nonthaburi Province Province

Bangkok vicinity

Bangyai Hospital

Local Health services

• 9 MOPH Health promotion hospital (HPH

• 2 Municipal Health centers

• 69 Primary Care Centers

Total Population 124,468 / 1,296.54 per Km sq.

Fast growing districtFast growing district

55,527 Household 55,527 Household 59,847 male 64,594 59,847 male 64,594 FemaleFemale

2011 midyear pop.

Population Structure in catchment area Bangyai Hospital

FemaleFemaleMaleMale

Population PyramidPopulation Pyramid

PercentagePercentage

Service Providers in BangyaiService Providers in Bangyai

One 400 bed private One 400 bed private hospital + one 30 bed hospital + one 30 bed

MOPH hospitalMOPH hospital

ClientsClients

9 Health Promotion 9 Health Promotion Hospitals (HPH)Hospitals (HPH)

6969Primary care centersPrimary care centers

HospitalHospital(CUP)(CUP)

HPHHPH

11stst care care centercenter

Thailand’s Health Insurance Thailand’s Health Insurance SchemesSchemes

Universal Coverage SchemeUniversal Coverage Scheme (UC)(UC)Under National Health Security Office - NHSO)

Social Security SchemeSocial Security Scheme (SSS)(SSS)Social Security Office - SSO)

Civil Servant Medical BenefitCivil Servant Medical Benefit Scheme (CSMBS)Scheme (CSMBS)(Comptroller General’s Department - CGD)

Bangyai Coverage

UC

Visits by Health Insurance SchemesVisits by Health Insurance Schemes

Revenue Source by Scheme (BHT)

Why do we use ICT ?

Tedious and repetitive Single entry multi output

Difficult to monitor•Unit cost •Waiting time•Workload

Increase quality•Drug utilization review•Unit cost/case•Pre visit order (reduce waiting time) – lab and xray

Human Error•Handwriting•Coding•Lost of OPD card (160,000)

Continuous care data

•Easy to retrieve data•No data loss.

NHSO required electronic data for reimbursement

Hospital software programHospital software program

Provincial Policy

IPD and LegalCases - Paperbase

• Thai constitution “Individual right and freedom”

• Act of Parliament Electronics 2000• Computer Related Crime Act 2007• Official Information Act 1997• Thailand National Health Act 2010• Thailand Health Insurance 2002

Relevant Regulations derives from …

1. Updated system for patients’ health which can be linked between HPH and CUP

2. Minimum increase of registration and treatment at HPH of DM and HT patients by 10% (to transfer chronic cases from CUP to HPH)

2012 MOPH IT Key 2012 MOPH IT Key IndicatorIndicator

Ex. - Thailand Standard Health Code

– Diagnosis standard - ICD10 version 2007 – Procedure standard - ICD9CM– Drug standard - 24 digit– Traditional Thai medicine standard – Individual SES standard – Health services standard

1. Person2. Service3. Diag 4. Procedure 5. Medication 6. ANC 7. EPI 8. Family Planning 9. Mother and Child health 11. Reproductive Health

10 Post partum

13. Nutrition

14. Non communicable disease

15. Health coverage

16. Appoint

17. Surveillance

12. Death

1. Person2. Service3. Diag

1. Person2. Service

4. Procedure

3. Diag

1. Person2. Service

5. Medication

4. Procedure

3. Diag

1. Person2. Service

6. ANC 5. Medication

4. Procedure

3. Diag

1. Person2. Service

7. EPI 6. ANC 5. Medication

4. Procedure

3. Diag

1. Person2. Service

8. Family Planning

7. EPI 6. ANC 5. Medication

4. Procedure

3. Diag

1. Person2. Service

9. Mother and Child health

8. Family Planning

7. EPI 6. ANC 5. Medication

4. Procedure

3. Diag

1. Person2. Service

10 Post partum

9. Mother and Child health

8. Family Planning

7. EPI 6. ANC 5. Medication

4. Procedure

3. Diag

1. Person2. Service3. Diag

11. Reproductive Health

10 Post partum

9. Mother and Child health

8. Family Planning

7. EPI 6. ANC 5. Medication

4. Procedure

1. Person2. Service

18. Home

19. Screen for Non communicable disease

20. Chronic F/U

21. Lab F/U

Thailand min. data set 2012Thailand min. data set 2012

TRUE6M/512K

TOT6M/512K

Load BalanceLoad Balance

Internet Server

1. HOSxP (Master)2. HOSxP (Slave)

3. Dental Archive Data4. Network Monitor

Floor4 Switch

1. IT Section2. Health Insurance Section

3. Mental Health and Narcotic Section

4. Quality Development Section

5. Nursing Section

Proxy CacheProxy Cache

Core SwitchCore Switch

Floor2 and 3 Switch

Floor2 Floor3

1. Inpatient Section 1. Administration Section

2. Finance Section3. Procurement

Section4. Dental Section5. Thai Traditional Medicine Section

Floor1 Switch

1. Outpatient Room 2. Accident and Emergency Room

3. Medical Record 4. Pharmacy Room 5. Delivery Room 6. Public Relation

7. Health Insurance (FL 1st) 8. Radiology Room

9. Family Care Room

Database

Minimum Core

Dataset

Treatment by MDClinical

screening

• Health scheme check• Validate Insurance Scheme and Pt status• Regist

FinancialFirst Screening

Medication

OPD Service workflow

Patient walk in

LAB,X-Ray

•Admission •Observe

Discharge• Go home• Dead• Refer

AEOD costing

CMIRW

Adj RW

UC

SSS

CSMBS

OR

LR ER

Treatment by MD

Data for Reimbursement

Minimum Core Dataset

Patient walk inFirst screening

• Health coverage• Register

Clinical Screening

Data

for

Reim

burs

em

entHospital work flow

2011 CMI = 0.7Adjust RW = 1527.66

5,140 BHT /165 USD / 128 EUR

per admissionBOT 23 Jan 2012

JHCIS - ระบบงานสถานอนามั ย และ PCU

ศู�นย�เทคโนโลยสารสนเทศูและการส��อสารสป.สธ.

Application in Primary care/public private byApplication in Primary care/public private byJava Health Center Information SystemJava Health Center Information System ((JHCIS)JHCIS)

Examinatio

n Room

Registration/ Screening Area

Dental and other Clinics

CHCISDatabase Server

Pharmacy Room

JHCIS

Data

base

20

Health promotion Hospital/PCU (HPH)

ID Card Reader to acquire ID Card Reader to acquire and record needed clients’ and record needed clients’ personal data for JHCIS personal data for JHCIS

Last Last 50 50

EntrieEntriess

Health Health Scheme Scheme

ValidationValidation

MOPH ICTMOPH ICT

Configure Configure ConnectionConnection

PHOPHO

21/04/23

JHCIS with Smart Card

NHSONHSO

PC/NotebookPC/Notebook Provincial Health Provincial Health

OfficeOffice AdministratorAdministrator

(2) DownloadDownloadFOP.ZIP, FOP.ZIP, FPP.ZIPFPP.ZIPFrom PROVIS From PROVIS ServerServer

(3) (3) Upload / Upload / ImportImport

FOP.ZIP, FPP.ZIPFOP.ZIP, FPP.ZIP to REP-OP NSHO Web to REP-OP NSHO Web

SiteSite

Server in Server in Provincial Provincial

Health Health OfficeOffice

NSHO NSHO ServerServer

(1) Upload / Upload / Import Import F18, FOP, F18, FOP, FPPFPP

Hospital /PCUExportExport Data Data

(F18, FOP, FPP)(F18, FOP, FPP)

PROVIS – Data PROVIS – Data integrationintegration

Cup ManagementCup Management- OPD summary - Prevention & promotion - Dental - Diagnosis code - 21 groups - Fiscal & Activity

Inter hospital activities +

Budget allocation and

transaction report

SSS transaction report(SSN_DAT

A)

CSMBSOPD / IPD

/PP transaction

report

REPORTS :

JHCIS DB

PCU

Transferring households information to Android tablet by FFC Autosync program when doing home visit.

-Locating houses using GPS - Create Genogram (family tree with data on gender, age, health condition and relationship in the family

Easy to use means to get real-time info to update health data for maintenance and synthesis cards.

Update health maintenance and personal data into JHCISDB automatically by FFC Autosync program.

HPH

Village

Visit our website@ www.ffc.in.th

( Free version now available in Android Market )

FFC Autosync

Android Tablet

Family Folder Collector Family Folder Collector SystemSystem

FFC Autosync

Challenges

• Security• Speed VS Quality• Data Integration

– -> Real time VS Pt right– -> IT policy among

hospitals• IT manpower career

ladder - at community hospital

• Duplicate data Reporting

Benefit

• Quality improvement

• Knowledge management

• Increase reimbursement

• Unit cost – cost containment

JHCIS

Using ID smartcard for registration

Read data from the chip on ID smart card to fill the registration form

Hos XPUsing ID smartcard to record service history

Read data from the chip on ID smart card to fill the form

27

Checking SSO benefit

28

Checking health benefit

Single entry for all requirements“Smart card”

Single entry for all requirements“Smart card”

Future Goal

Framework

National Health Information System : NHIS

Implement of 3P Integration Pilot Project