Global Health Risk Framework Resilient and Sustainable Health Systems to Respond to Global Infectious Disease Outbreaks: Workshop Summary (2016) / Chapter Skim
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4 Strengthening Information Management Systems
4 Strengthening Information Management Systems
Pages 57-74
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From page 57... ...
(Frankfurter, Greenough, Wilson) • National promotion of education of health care workers in using and configuring health information systems can be done through vocational training, university and higher educa tion training, and incentivized learning and use.
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From page 58... ...
The critical capacity for disease surveillance can also be augmented by both new and existing technology solutions. HEALTH INFORMATION SYSTEMS Improving Epidemic Response Using Digital Health Solutions Kate Wilson, Director of Digital Health Solutions at PATH, focused on possible options for improving epidemic response using digital health solutions.
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From page 59... ...
For technology providers, products and services become more economically sustainable and for mobile operators, digital health services can drive long-term value creation. Lessons Learned About Health Information Systems During Previous Outbreaks Regarding past instructive experiences during an outbreak, Fitter mentioned that after the Ebola virus disease (EVD)
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From page 60... ...
. "Systems that are built to be interoperable from the outset and designed to last in the long term have the advantages of enhanced flexibility and repurposing potential." -- Kate Wilson, Director of Digital Health Solutions, PATH Wilson outlined a set of characteristics that, in her opinion, should ideally apply to every digital health investment.
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From page 61... ...
The Better Immunization Datab Initiative is an example of a digital health ap proach that relies on OpenHIE's internationally recognized and tested standards, explained Biondich. Information systems are not generally designed to handle high volumes of data exchange, but OpenHIE is optimized for scale and large volumes of secure data traffic.
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From page 62... ...
TABLE 4-1 Potential Country Investments for Scaling Digital Health Interventions Near-Term Investments Longer-Term Investments Case for Action Develop rigorous total cost of Sponsor national advocacy ownership (TCO) models and and education efforts on the collect consistent health impact impact seen from digital health data on each implementation investments Leadership Require government and donor Invest in design and coordination before allocating implementation of country-led investments strategies Effective Product Direct investments toward Evaluate more rigorously each making products inter-operable project against agreed performance with existing infrastructure levels and health outcomes Viable Economic Identify the "gives" and "gets" Require that each rollout identifies Model for each product before rollout a viable long-term business model by stakeholder after catalytic financing ends Supportive Policy, Support national development Provide incentives to adopt agreed Regulation, and of eHealth architecture and standards and policy frameworks Standards implementation plans to national governments Effective Program Require new investments Capture and share best program Management to have dedicated program management practices within a management staff through country national rollout Human Capacity Sponsor greater local university Embed national informatics and entrepreneurs' participation capacity in projects versus using from the outset overseas staff SOURCE: Wilson presentation, August 6, 2015.
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From page 63... ...
Effective Program Capture and sharing of best Investment directed toward most Management practices in more digestible, effective models for implementing practical forms digital health Human Capacity Sponsor regional peer networks Develop the next cadre of eHealth and specialized capacity leaders through university-level programs targeted toward health informatics programs in practitioners emerging markets NOTE: ITU = International Telecommunication Union; NCD = noncommunicable disease; TCO = total cost of ownership; WHO = World Health Organization. SOURCE: Wilson presentation, August 6, 2015.
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From page 64... ...
A further objective offered by multiple participants would be to create a peer-learning network among countries to build a common curriculum and to govern the priorities of the content that is developed. Several other participants also suggested incentivizing and educating health care workers to use health information systems.
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From page 65... ...
Nguku and Nasidi of the Nigerian CDC characterized disease surveillance as the "backbone of disease control." Lessons from Surveillance Response to West Africa EVD Outbreak Fitter contextualized the discussion of disease surveillance systems by detailing the problems that arose in response to the West Africa EVD outbreak. The Integrated Disease Surveillance and Response (IDSR)
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From page 66... ...
At each level, there are designated surveillance "focal persons" who routinely receive and disseminate information from health facilities and community health workers, on the basis of which they carry out investigations on priority diseases and report accordingly through the health management information system. With the support of the U.S.
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From page 67... ...
Officers are provided with transportation and mobile communication support to facilitate their contact tracing work. During interoutbreak periods, the ongoing surveillance system remains in place, she said, and the task force meets on a monthly basis to review disease surveillance data and continually updates epidemic preparedness and response plans with respect to the situation on the ground.
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From page 68... ...
Key Gaps in Existing Surveillance Systems Several participants highlighted gaps and challenges in existing systems, with the view to discussing strategies for capacity building and system strengthening. Some of the gaps Fitter highlighted included
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From page 69... ...
DISEASE SURVEILLANCE SYSTEMS: HIGHLIGHTED OPPORTUNITIES Multiple participants highlighted several key areas for improvement in disease surveillance systems and sketched possible strategies for addressing them. Using Existing Technologies and/or Knowledge in Innovative Ways Wilson expressed concern about focusing too heavily on new technology innovation, calling for a shift away from thinking about existing
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From page 70... ...
Promoting Country Ownership of Institutionalized Surveillance Systems A related topic discussed was the idea of building on existing capacities to allow countries to take ownership of institutionalized surveillance systems by instilling accountability and the abilities to self-audit, self-regulate, and report. Multiple participants noted that a challenge faced by efforts to establish more country-level autonomy is the lack of adequate super ision and management for reciprocal information acquisi v tion, training, and reporting on the country and international levels.
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From page 71... ...
Engaging and Educating All Sectors in Disease Surveillance Participants including Awunyo-Akaba, Myers, Greenough, and Tomori emphasized the key role of community health workers, NGOs, and civil society, traditional rulers, and religious leaders in disease surveillance, and suggested ways to more effectively engage them in that system. Building on ideas presented in the discussion on promoting country ownership of surveillance, several participants remarked that community trust could be fostered by interdisciplinary information sharing; for example, veterinary students and medical students could collaborate and contribute to understanding manifestations of certain zoonotic diseases.
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From page 72... ...
Several participants pointed to the related topic of better and earlier training and education about public health concepts for communities, health care workers (including veterinary students and pharmacists) , NGOs, and civil societies in order to further facilitate improved and sustainable surveillance systems.
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From page 73... ...
, a national surveillance strategy should be both IDSR-based and Inter national Health Regulations–compliant, combining routine indicator- and event-based surveillance across human and animal health systems for early outbreak detection and rapid response.5 Implemented in a step-wise fashion and facilitated by routine progress monitoring, the strategy encompasses disease-specific protocols and an information communication technology infrastructure that encompasses a workforce trained in surveillance, an integrated surveillance and laboratory national health data warehouse, and data exchange that is interoperable across local, national, and international platforms. 5 See http://www.cdc.gov/globalhealth/security/actionpackages/real-time_surveillance.htm (accessed November 9, 2015)
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