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MINISTRY OF HEALTH VIET NAM ADMINISTRATION OF HIV/AIDS CONTROL. APPLICATION OF INFORMATIC TECHNOLOGIES IN HIV/AIDS HEALTH INFORMATION MANAGEMENT. Prof. Dr. Nguyen Thanh Long Director, VAAC. CONTENTS. 1. Overview of HIV/AIDS health information systems.
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MINISTRY OF HEALTH VIET NAM ADMINISTRATION OF HIV/AIDS CONTROL APPLICATION OF INFORMATIC TECHNOLOGIES IN HIV/AIDS HEALTH INFORMATION MANAGEMENT Prof. Dr. Nguyen Thanh Long Director, VAAC
CONTENTS 1. Overview of HIV/AIDS health information systems. 2. Application of informatic technologies in health information managment systems. 3. Lessons learnt. 4. Constraints and issues. 5. Future direction of HIV/AIDS health information systems. 6. Recommendations.
Technical groups Other Ministries MOH (VAAC) International organization National Institute of Hygiene & Epidemiology Pasteur Institute of NhaTrang Pasteur Institute of HCM city Tay Nguyen Institute of Hygiene & Epidemiology PACs of Southern provinces M&E Units of Highland provinces M&E Units of Northern provinces PACs of Central coast provinces District PMCs District PMCs District PMCs District PMCs Management & Coordination Report Feedback & Information sharing Technical Assistance OVERVIEW OF HIV/AIDS HEALTH INFORMATION MANAGEMENT SYSTEM 1. Organizational structure of HIV/AIDS information system
OVERVIEW OF HIV/AIDS HEALTH INFORMATION MANAGEMENT SYSTEM (cont.) 2. Collection, analysis of HIV/AIDS information Information Publications Information collection: - From service sites (VCT, ARV, Harm reduction, PMTCT, VCT….) - From special surveys Analysis (Conducted at district PMC, PACs, Regional institutes, VAAC)
Website, CD & printed documents Reporting forms, questionnaires Software OVERVIEW OF HIV/AIDS HEALTH INFORMATION MANAGEMENT SYSTEM (cont.) Archive, Analysis Routine information collection Update Information 3. Management and dissemination of information Dissemination Information Exchange Instruction information Sharing, Synthesizing Special studies
OVERVIEW OF HIV/AIDS HEALTH INFORMATION MANAGEMENT SYSTEM (cont.) 4. Information synthesis Hardware Integrated ? Database Software Health information system, General statistic office Internet HIV/AIDS INFORMATION SYSTEM
APPLICATION OF INFORMATION TECHNOLOGIES IN DEVELOPMENT OF HIV/AIDS INFORMATION SYSTEMS
HARDWARES • VAAC’s network operates on Client/Server model using 2 LAN servers, specialized softwares on data management, sharing and internet access. • Develop and use an AIDSL for data management, reporting, searching and emailing.
HARDWARE SYSTEM Invested to 100% provincial M&E units on computors and network to ensure accessibility to central database system. Invested to a proportion of district M&E units to expand utilization of professional softwares.
SOFTWARES CURRENTLY BEING USED IN HIV/AIDS Data export HIV-INFO SOFTWARE (Management of HIV/AIDS cases, deaths, sentinel surveillance data) REPORT FOR GOVERNMENT DECISION 28/2008/MOH ONLINE REPORTING SOFTWARE UNGASS REPORTING (CRISS) VCT AND PEER EDUCATION ACTIVITIES SOFTWARE UNIVERSAL ACCESS REPORTING FORM (UNAID/WHO) METHADONE INFORMATION SOFTWARE CARE & TREATMENT SOFTWARE ESTIMATION & PROJECTION HIV TESTING SOFTWARE PLANNING TOOLKIT Secondary data Primary data Data use
I. HIV-INFO software • Purpose: to manage list of HIV infected, AIDS and death cases since 1990; to screen for duplicative cases; to provide information on distribution and trends of HIV/AIDS • Implemented since 2003 • Application scale: intended for all agencies that are authorized to manage HIV/AIDS cases. Currently being used by VAAC, 4 regional institutes, 63 provinces/cities, 50% districts. • Input data: Demographics, risk behaviors, dates of HIV tested, AIDS, deaths...
Coded data DB Regional Institutes Data entry Entered Data Screened Data DB province Template Screened Data Data entry DB district Screened Data Templat DB SERVER Temp Sreened Data OFFLINE screening Send, receive data online Send, receive data online Coded data OFFLINE screening Coded data Send, receive data online Data entry OFFLINE screening Promoting advantages of HIV – INFO 3.0
II. Prevent HIV software • Purpose: Management, analysis, monitoring, and evaluation of VCT & harm reduction activities. • Implemented: since 2004 • Application scale: intended for PACs and more than 180 VCT sites in 53 provinces/cities. • Input data: demographic information, risk behaviors, harm reduction information.
Data flow VCTs OPCs OPCs VCTs OPCs HRs OPCs PMUs of H project PACs PMUs of J project CMUs of H project CMUs of I project CMUs of J project Sub-project module (PrevenHIV) VAAC Central module (PrevenHIV)
III. LIS software (Laboratory information system) • Purpose: to monitor laboratory testing quality before, during and after test, to manage specimen data and test results. Change paper’s management, save time for healt workers • Implemented: since 12/2007 • Application scale: Intended for HIV labs. Currently being used in 6 sites in HCMC (Pham Ngoc Thach & Pediatric 2 hospitals, PAC HCMC) and Hanoi (PAC Hanoi).
Networking laboratory machines Networking lab machines I-OpenELIS ELISA machines CD4 count machines Heamatology testing machines Biochemistry testing machines…
IV. Methadone information software • Purpose: to manage electronic records on methadone treatment. Monitoring provide methadone every day. Managing the dose and treatment adherence • Implemented: piloted since 2010 • Application scale: Methadone clinic in Hai Phong • Input data: Patients’ information, treatment dose, adherence…
V. ARV management software • Purpose: to manage electronic records on ARV treatment. Monitoring the treatment process and result of ARV treatment • Implemented: piloted since 2010 • Application scale: intended for all ARV clinics. Currently being used in Bach Mai hospital, National Institute for Tropical diseases • Input data: patients’ information, treatment doses, adherence… • It is recommended that the software to be revised for online reporting
VI. Online reporting software • Purpose: to report HIV/AIDS activities based on the national and international indicators (UNGASS, Universal Access) • Implemented: piloted since 2010, scaled up nationally since 2011 • Application scale: intended for all HIV/AIDS centers, projects, regional institutes and VAAC, all health care facilities implementing HIV/AIDS activities.
VII. HIV/AIDS Website • Purpose: to provide information on HIV/AIDS activities, official legal documents, reports. • Implemented: since 2005
LESSONS LEARNT • Attracted leaders’ attention and support at all levels on increasing the application of informatics technology on HIV/AIDS. • Mobilized donors’ support on investment & technical assistance on specialized software development. • Collaboration among technical experts and software developers, especially during development of system specification requirements. • Strengthened timely trainings and technical assistance to software using agencies.
CONSTRAINTS AND ISSUES • Lack of common standards on health informatics technologies, hence difficulties in data management and sharing among different databases. • Limited connection and streamlining among current application software. • High cost of software development • Limited internet speed affected utilization of online software. • Human resource on informatics technologies lacks of quantity, quality and does not meet the demand of data management.
FUTURE DIRECTION ON DEVELOPMENT OF THE INFORMATION SYSTEM, 2011-2015
Tasks To ensure sustainable development and effective use of investment, strategies and plans on HIV/AIDS informatic technology development are for optimum responses to Viet Nam’s needs with attention to local technology infrastructure.
Purposes • To monitor, manage and share information on prevention, care & treatment (at all health care facilities nationally): • Meet requirements of national and international network HIV/AIDS activities • Connection services and activities on HIV / AIDS • Ensure system integrity, accuracy • Ensure the updating and use data most effectively.
MODULE FOR INTEGRATED INFORMATION SYSTEM ON HIV/AIDS VCT LIS ARV REPORT HARM REDUCTION PMTCT HIV-INFO
Some directions on exchanging patients information in the systems: - Code for Patient identifying information using UIC method. - Use of bare code in testing and patient referral. - Use of fingerprint - Use of Electronic ID card for patients. - Standardization of HIV/AIDS activity categories.
RECOMMENDATIONS • Development of standard code of administrative units nationally, synthesis of geographical information system (GIS). • MOH to establish Center for health data synthesis, to develop standards for health informatic technologies and methods for data exchange among health information systems • Support VAAC to develop codes for HIV/AIDS activities.