scholarly journals Converting the existing disease surveillance from a paper-based to an electronic-based system using District Health Information System (DHIS-2) for real-time information: The Lebanese experience

Author(s):  
dalal Ali youssef

Abstract Introduction:The Ministry of Public Health in Lebanon is in the process of converting the surveillance reporting from a cumbersome paper-based system to a web-based electronic platform (DHIS-2) to have real-time information for early detection of alerts and outbreaks and for initiating a prompt response.Objectives:This paper aimed to document the Lebanese experience in implementing DHIS-2 for the disease surveillance system. It also targets to assess the improvement of reporting rates and timeliness of the reported data and to disclose the encountered challenges and opportunities. MethodologyThis is a retrospective description of processes involved in the implementation of the DHIS-2 tool in Lebanon. Initially, it was piloted for the school-based surveillance in 2014; then its use was extended in May 2017 to cover other specific surveillance systems. This included all surveillance programs collecting aggregate data from hospitals, medical centers, dispensaries, or laboratories at the first stage. As part of the national roll-out process, the online application was developed. The customized aggregated-based datasets, organization units, user accounts, specific and generic dashboards were generated. More than 80 training sessions were conducted throughout the country targeting 1290 end-users including health officers at the national and provincial levels, focal persons working in all public and private hospitals, laboratories, and medical centers as well. Completeness and timeliness of reported data were compared before and after the implementation of DHIS-2. Challenges and lessons learned during the roll-out process are listed.ResultsFor laboratory-based surveillance, completeness of reporting increased from 70.8% in May to 89.6% in October. Timeliness has improved from 25% to 74%. For medical centers, an improvement of 8.1% for completeness and 9.4% in timeliness was recorded before and after training sessions. For zero reporting, completeness remains the same (88%) and timeliness has improved from 74% to 87%. The main challenges faced during the implementation of DHIS-2 were mainly infrastructural and system-related in addition to poor internet connectivity and limited workforce and frequent changes to DHIS-2 versions.ConclusionImplementation of DHIS-2 improved timeliness and completeness for aggregated data reporting. Continued on-site support, monitoring, and system enhancement are needed to improve the performance of DHIS-2.

2021 ◽  
Author(s):  
Dalal Youssef ◽  
Ayat Yaghi ◽  
Abbas Jouny ◽  
Linda Abou-Abbas ◽  
Houssam Chammaa ◽  
...  

Abstract Introduction:The Ministry of Public Health in Lebanon is in the process of converting the surveillance reporting from a cumbersome paper-based system to a web-based electronic platform (DHIS-2) to have real-time information for early detection of alerts and outbreaks and for initiating a prompt response.Objectives:This paper aimed to document the Lebanese experience in implementing DHIS-2 for the disease surveillance system. It also targets to assess the improvement of reporting rates and timeliness of the reported data and to disclose the encountered challenges and opportunities. MethodologyThis is a retrospective description of processes involved in the implementation of the DHIS-2 tool in Lebanon. Initially, it was piloted for the school-based surveillance in 2014; then its use was extended in May 2017 to cover other specific surveillance systems. This included all surveillance programs collecting aggregate data from hospitals, medical centers, dispensaries, or laboratories at the first stage. As part of the national roll-out process, the online application was developed. The customized aggregated-based datasets, organization units, user accounts, specific and generic dashboards were generated. More than 80 training sessions were conducted throughout the country targeting 1290 end-users including health officers at the national and provincial levels, focal persons who were working in all public and private hospitals, laboratories, and medical centers as well. Completeness and timeliness of reported data were compared before and after the implementation of DHIS-2. The unveiled challenges and the main lessons learnt during the roll-out process were discussed.ResultsFor laboratory-based surveillance, completeness of reporting increased from 70.8% in May to 89.6% in October. Timeliness has improved from 25% to 74%. For medical centers, an improvement of 8.1% for completeness and 9.4% in timeliness was recorded before and after training sessions. For zero reporting, completeness remains the same (88%) and timeliness has improved from 74% to 87%. The main challenges faced during the implementation of DHIS-2 were mainly infrastructural and system-related in addition to poor internet connectivity and limited workforce and frequent changes to DHIS-2 versions.ConclusionImplementation of DHIS-2 improved timeliness and completeness for aggregated data reporting. Continued on-site support, monitoring, and system enhancement are needed to improve the performance of DHIS-2.


Author(s):  
Yupo Chan

This paper reviews both the author’s experience with managing highway network traffic on a real-time basis and the ongoing research into harnessing the potential of telecommunications and information technology (IT). On the basis of the lessons learned, this paper speculates about how telecommunications and IT capabilities can respond to current and future developments in traffic management. Issues arising from disruptive telecommunications technologies include the ready availability of real-time information, the crowdsourcing of information, the challenges of big data, and the need for information quality. Issues arising from transportation technologies include autonomous vehicles and connected vehicles and new taxi-like car- and bikesharing. Illustrations are drawn from the following core functions of a traffic management center: ( a) detecting and resolving an incident (possibly through crowdsourcing), ( b) monitoring and forecasting traffic (possibly through connected vehicles serving as sensors), ( c) advising motorists about routing alternatives (possibly through real-time information), and ( d) configuring traffic control strategies and tactics (possibly though big data). The conclusion drawn is that agility is the key to success in an ever-evolving technological scene. The solid guiding principle remains innovative and rigorous analytical procedures that build on the state of the art in the field, including both hard and soft technologies. The biggest modeling and simulation challenge remains the unknown, including such rapidly emerging trends as the Internet of things and the smart city.


2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Pia D. MacDonald ◽  
Niamh Darcy ◽  
Rita Sembajwe ◽  
Eileen Reynolds ◽  
Henry Chidawanyika ◽  
...  

ObjectiveThe objective is to discuss two decades of international experiencein health information and disease surveillance systems strengtheningand synthesize lessons learned as applicable to implementation of theGlobal Health Security Agenda (GHSA).IntroductionRTI International has worked on enhancing health informationand disease surveillance systems in many countries, includingThe Democratic Republic of the Congo (DRC), Guinea, Indonesia,Kenya, Nepal, Philippines, Tanzania, Zambia, and Zimbabwe.Strengthening these systems is critical for all three of the Prevent,Detect and Respond domains within the Global Health SecurityAgenda.We have deep experience in this area, ranging from implementingDistrict Health Information Software (DHIS), electronic medicalrecords, health facility registries, eHealth national strategies,electronic Integrated Disease Surveillance and Response system(eIDSR), mobile real-time malaria surveillance and response, nationalweekly disease surveillance, patient referral system, and communitybased surveillance. These experiences and lessons learned can informwork being done to advance the GHSA.We will discuss several examples, including activities in Zimbabweand Tanzania. RTI has been working in Zimbabwe for over six yearsto strengthen the national health information system. This workhas included the configuration and roll-out of DHIS 2, the nationalelectronic health information system. In doing so, RTI examinedand revitalized the weekly disease surveillance system, improvingdisease reporting timeliness and completeness from 40% to 90%.Additionally, RTI has integrated mobile technology to help morerapidly communicate laboratory test results, a laboratory informationmanagement systems to manage and guide test sample processing,and various other patient level systems in support of health servicedelivery at the local level. This work has involved capacity buildingwithin the ministry of health to allow for sustainable support of healthinformation systems practices and technology and improvements todata dissemination and use practices.Similarly, RTI has worked for more than five years to helpstrengthening the National HIS in Tanzania. These activities haveincluded stakeholder coordination, developing national eHealthstrategy and enterprise architecture, harmonizing indicators,redesigning routine reporting instruments, national DHIS 2 roll-out,information technology infrastructure management and user helpdesk support, reducing the number of parallel information systems,data dissemination and use, development of district health profiles,development of the national health facility registry, and supportingroll-out of the electronic integrated disease surveillance system.MethodsWe will profile selected projects and synthesize critical lessonslearned that pertain to implementation of the GHSA in resourceconstrained countries.ResultsWe will summarize our experience and lessons learned withhealth information and disease surveillance systems strengthening.Topics such as those that relate to advancing the GHSA RealTime Surveillance and Reporting Action Package areas will bediscussed, including: indicator and event based surveillance systems;interoperable, interconnected, electronic real-time reporting system;analysis of surveillance data; syndromic surveillance systems;systems for efficient reporting to WHO, FAO and OIE; and reportingnetwork and protocols in country.ConclusionsOur experience working over the past 14 years in 9 countrieson different HIS and disease surveillance system strengtheningprojects has led to a deep understanding of the challenges aroundimplementation of these systems in limited resource settings. Theseexperiences and lessons learned can inform initiatives and programsto advance the GHSA.


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