Dr. Porntep Siriwanarangsun Inspector General & Chief Information Officer Ministry of Public Health, Thailand.

1. เ Effective strategy for data collection and consolidation Dr. Porntep Siriwanarangsun Inspector General & Chief Information Officer Ministry of Public Health, Thailand.

2. The Required Information at Each Level of MOPH Agency Central Administration Department/Division Determine Targets and Main Strategies Policy Level Planning, Controling, Monitoring and Resource Allocating Decision - Making Level Introduces Policy Implementation Provincial Health Office District Health Office Planning, and Performance Controling Planning and Performance Controling Level Health Centre Performance Activities Day to Day Operating Level

3. Sustainable e-Government Project for Health Information and Communication Technology Development Health Administration Department Office Executive Support System 75 Provincial Health Offices 71 Regional Technical Center Management Information System Decision Support System 94 Regional/General Hospitals Knowledge Work System and Office Automation System 726 Community Hospitals 876 Community Health Centers Transaction Processing 9791 Health Centers MIS & Data Warehouse Front Office Total Back Office LAN Line Satellite System e- serviceson Department Activities : Logistic : Health Business : Consultation :Epidemiology

4. Healthcare Center/ Primary Care Unit Ministry’s departments Database System 12 Files & 18 Files Survey data Data Auditing & Data cleansing Health Data Bank Medical record exchange Health Information Health service Provider (Hospitals) Data warehouse/Web GIS / Remote custom / High speed server& communication / HL7&CDA/ Web service / Satellite TV Hardware/Software / People ware/ KM Standard + Data Confidentiality + e Health Strategy / Vision / Budget / e Government Conceptual Framework for health information Company Logo

5. E Health • Physical Basic structure • - Network PC sets in all level health units • - High speed Network • 2. Data recording System • 3. Data Services System - 20 systems • 4. Report System - Front& Back Office • 5. HRD & Technology Transfer • Outsourcing for services and maintenance

6. Develop the supporting mechanism for Health Information System Develop and integrate the appropriate Health Information System Strategy 3 Strategy 1 Develop the standardization for data structure & coding Develop the appropriate and adequate data communication and consolidation Strategy 2 Strategy 4 Strategy for data collection & consolidation Strategy for data collection & consolidation Company Logo

7. Background of the reporting system Background of the reporting system Aggregated activity reports were prepared and sent monthly from each health service units (eg, Provincial hospitals, District hospitals, Primary Care Units) to each Provincial Health Offices (PHO), then to Health Information Unit in the Ministry of Public Health (MOPH) Company Logo

8. Activities cover birth/death, epidemiological, curative, preventive and promotive data • Aggregated data were gathered and processed into country report by electronic means Background of the reporting system(Con.) Company Logo

9. Changes of reporting system • In 1995 domestic data structure & coding standardization are developed to support the individual record data system eg, 12 files dataset (for hospital use), 18 files dataset (for PCU use), and miscellaneous code Company Logo

10. Changes of reporting system (Con.) • In 2003 international data structure & coding standardization are much improved and developed reporting system for insurance scheme. Company Logo

11. Impact of Health Insurance to reporting system (12 files dataset) • Only Inpatient UC (Universal Coverage) records are sent and processed for reimbursement, about 5 million individual records are received annually at MOPH • Report were then generated from every individual patient records, most of them were inpatient group Company Logo

12. Data collection & data consolidation of 18 files dataset • In 2007 MOPH and NHSO started the new project expanding the data processing to cover more service data from nearly 10,000PCUs. • 18 files dataset is used for monitoring the PCUs activities and possibility for future enhancement of OPD DRG convention Company Logo

13. Data flow and their interconnection workflow of 18 files dataset • About 200 million individual records are received annually from nearly 10,000PCUs via PHO • Raw data are sent weekly from each PCU to PHO via Internet or portable media, then data are imported and verified into standard provincial buffer data file Company Logo

14. Data cleansing and reporting of 18 files dataset • The first round data inspection is screened to check for coverage, timeliness and completeness • Then the second round data inspection is screened to checked for data accuracy, the important check points of data accuracy are ICD10, date of services, weight/height of kids, service codes, etc. Company Logo

15. Data cleansing and reporting of 18 files dataset(Con.) • Data reporting is for administrative and academic purpose, the report will be posted back to the website monthly so that every users can retrieve and make use of them Company Logo

16. Data incentive for the data collection & consolidation of 18 files dataset • Budget for the data incentive is from NHSO, budget will be paid to PHO following the scores that comply with the data quality definitions criteria • Anyhow some prepaid payment (50% of the estimated record number sent/year/PHO) will be paid immediately to every PHO at the beginning of year so that every PHO have budget in hand to push the work Company Logo

17. Data incentive for the data collection & consolidation of 18 files dataset (Con.) • Additional payment to PHO(50% remained) will follow when data sent to MOPH and comply with the data quality definitions. Net payment will follow after the prepayment substration Company Logo

18. 2 1 3 Data quality definitions and criteria for payment of 18 files dataset Basic data accuracy incentive (5baht/record) There are 3 main data quality definitions criteria On top additional incentive for data timeliness (5baht/record), checked for data ontime and data regularity On top additional incentive for data specialty (5baht/record), checked for some specific diseases and PP services Company Logo

19. Other data collection and consolidation • Besides the 12 & 18 files dataset system, birth & death data is another data collection and consolidation system that MOPH has been supported by the Ministry of Interrior (MOI) for more than 10 years Company Logo

20. Other data collection and consolidation(Con.) • Leased line connecting country databases of birth & death citizens from MOI can be accessed from MOPH for regular data download • Again birth & death data from both systems (PHO&MOI) can be reconciled and crosschecked with each other for their completeness Company Logo

21. Future of the consolidated both 12&18 files dataset • The findings go well with the increasing number of dead mother, that means the individual records received from both 12 files dataset (for hospital use) & MOI can be used for data reconciliation and data processing. Then Thai maternal death rate must be recalculated and it come out to be about 40/100,000 live birth. Company Logo