Mapping European research networks providing health data: results from the InfAct Joint Action on health information

Background Research networks offer multidisciplinary expertise and promote information exchange between researchers across Europe. They are essential for the European Union’s (EU) health information system as providers of health information and data. The aim of this mapping exercise was to identify and analyze EU research networks in terms of health data collection methods, quality assessment, availability and accessibility procedures. Methods A web-based search was performed to identify EU research networks that are not part of international organizations (e.g., WHO-Europe, OECD) and are involved in collection of data for health monitoring or health system performance assessment. General characteristics of the research networks (e.g., data sources, representativeness), quality assessment procedures, availability and accessibility of health data were collected through an ad hoc extraction form. Results Fifty-seven research networks, representative at national, international or regional level, were identified. In these networks, data are mainly collected through administrative sources, health surveys and cohort studies. Over 70% of networks provide information on quality assessment of their data collection procedures. Most networks share macrodata through articles and reports, while microdata are available from ten networks. A request for data access is required by 14 networks, of which three apply a financial charge. Few networks share data with other research networks (8/49) or specify the metadata-reporting standards used for data description (9/49). Conclusions Improving health information and availability of high quality data is a priority in Europe. Research networks could play a major role in tackling health data and information inequalities by enhancing quality, availability, and accessibility of health data and data sharing across European networks.

First study of the RuPatient health information system with optical character recognition of medical records based on machine learning

RuPatient health information system (HIS) is a computer program consisting of a doctor-patient web user interface, which includes algorithms for recognizing medical record text and entering it into the corresponding fields of the system.Aim. To evaluate the effectiveness of RuPatient HIS in actual clinical practice.Material and methods. The study involved 10 cardiologists and intensivists of the department of cardiology and сardiovascular intensive care unit of the L. A. Vorokhobov City Clinical Hospital 67 We analyzed images (scanned copies, photos) of discharge reports from patients admitted to the relevant departments in 2021. The following fields of medical documentation was recognized: Name, Complaints, Anamnesis of life and illness, Examination, Recommendations. The correctness and accuracy of recognition of entered information were analyzed. We compared the recognition quality of RuPatient HIS and a popular optical character recognition application (FineReader for Mac).Results. The study included 77 pages of discharge reports of patients from various hospitals in Russia from 50 patients (men, 52%). The mean age of patients was 57,7±7,9 years. The number of reports with correctly recognized fields in various categories using the program algorithms was distributed as follows: Name — 14 (28%), Diagnosis — 13 (26%), Complaints — 40 (80%), Anamnesis — 14 (28%), Examination — 24 (48%), Recommendations — 46 (92%). Data that was not included in the category was also recognized and entered in the comments field. The number of recognized words was 549±174,9 vs 522,4±215,6 (p=0,5), critical errors in words — 2,1±1,6 vs 4,4±2,8 (p<0,001), non-critical errors — 10,3±4,3 vs 5,6±3,3 (p<0,001) for RuPatient HIS and optical character recognition application for a personal computer, respectively.Conclusion. The developed RuPatient HIS, which includes a module for recognizing medical records and entering data into the corresponding fields, significantly increases the document management efficiency with high quality of optical character recognition based on neural network technologies and the automation of filling process.

Drug Utilization Evaluation of Colistin: A Retrospective Study

Background: Colistin, is used as the last treatment line for infections concluded from multiple drug-resistant gram-negative microorganisms. Increased consumption of colistin leads to resistance to this antibiotic in many countries. This study investigated the usage pattern of colistin administration in a selected hospital in Iran. Methods: This study was conducted in a selected hospital in Ahvaz. Inclusion criteria were all patients who received colistin during this time according to the health information system. Patients who were received less than three doses of colistin were excluded from the study. Prescription of colistin in all patients was evaluated according to the protocol extracted from the last version of Lexicomp written by Wolters Kluwer. The descriptive and analytical statistics were carried out by the R software. Results: Among 27 patients who received colistin, pneumonia (30%) was the main diagnoses. Colistin administration was based on the microbiological culture data in 70% of cases. Considering the involved microorganism, most cases were Acinetobacter spp., followed by Klebsiella spp. Loading dose was prescribed for seven (26%) patients. In only five (19%) cases, colistin dosing, including loading dose, maintenance dose, and the interval of colistin administration, was appropriate during the study time. Increasing in serum creatinine was seen in two (7.4%) patients. In 29.4% of patients, the combination of colistin and carbapenems was observed. Conclusion: Given the lack of appropriate dose adjustment of colistin that may lead to incidence of resistance and adverse effect, applying of the specialist clinical pharmacist will be suggested.

A data quality assessment of the first four years of malaria reporting in the Senegal DHIS2, 2014–2017

Background As the global burden of malaria decreases, routine health information systems (RHIS) have become invaluable for monitoring progress towards elimination. The District Health Information System, version 2 (DHIS2) has been widely adopted across countries and is expected to increase the quality of reporting of RHIS. In this study, we evaluated the quality of reporting of key indicators of childhood malaria from January 2014 through December 2017, the first 4 years of DHIS2 implementation in Senegal. Methods Monthly data on the number of confirmed and suspected malaria cases as well as tests done were extracted from the Senegal DHIS2. Reporting completeness was measured as the number of monthly reports received divided by the expected number of reports in a given year. Completeness of indicator data was measured as the percentage of non-missing indicator values. We used a quasi-Poisson model with natural cubic spline terms of month of reporting to impute values missing at the facility level. We used the imputed values to take into account the percentage of malaria cases that were missed due to lack of reporting. Consistency was measured as the absence of moderate and extreme outliers, internal consistency between related indicators, and consistency of indicators over time. Results In contrast to public facilities of which 92.7% reported data in the DHIS2 system during the study period, only 15.3% of the private facilities used the reporting system. At the national level, completeness of facility reporting increased from 84.5% in 2014 to 97.5% in 2017. The percentage of expected malaria cases reported increased from 76.5% in 2014 to 94.7% in 2017. Over the study period, the percentage of malaria cases reported across all districts was on average 7.5% higher (P < 0.01) during the rainy season relative to the dry season. Reporting completeness rates were lower among hospitals compared to health centers and health posts. The incidence of moderate and extreme outlier values was 5.2 and 2.3%, respectively. The number of confirmed malaria cases increased by 15% whereas the numbers of suspected cases and tests conducted more than doubled from 2014 to 2017 likely due to a policy shift towards universal testing of pediatric febrile cases. Conclusions The quality of reporting for malaria indicators in the Senegal DHIS2 has improved over time and the data are suitable for use to monitor progress in malaria programs, with an understanding of their limitations. Senegalese health authorities should maintain the focus on broader adoption of DHIS2 reporting by private facilities, the sustainability of district-level data quality reviews, facility-level supervision and feedback mechanisms at all levels of the health system.

Digital Healthcare Strategy

This goal of this chapter is to introduce digital strategies for healthcare. The chapter begins with an analysis of key indicators of public health and the healthcare sector. Next, the chapter presents key principles for healthcare, focusing on the constitution of the national health system. A case study focusing on Poland is then presented. After this, the chapter puts forth a digital strategy for the national health system. This is followed by an analysis of several health systems: the patient information system, the clinic information system, the pharmacy information, and the hospital information system. Next, the use of big data for healthcare is considered. The chapter concludes by putting forth a model for the national health information system and by discussing important trends in the development of digital health.

Analysis of Policy, Infrastructure Facilities and Human Resources in Preparation for Re-Accreditation

Accreditation is an acknowledgment of the public health center agency, by an independent accreditation agency set by the Minister of Health after meeting the first level health facility service standards to improve the quality of services on an ongoing basis. Puskesmas Bagansiapapi is a middle-accredited puskesmas that will go through a re-accreditation process scheduled for 2020 and is planned to be a pilot health center in Rokan Hilir district. Based on the results of initial interview with Head and Staff of Public Health center, there are some recommendations from surveyors for 2020’s re-accreditation preparation such as policies, infrastructure and human resources. Downstream 2020.This type of research is qualitative descriptive exploratory research with in-depth interviews, observation and document review with the respondents of the quality head, an admin’s leader, an UKM’s Leader, the head of UKP, the Head of Public Health Center and the Internal Health Staff. The results showed that the preparatory policies for accreditation had been implemented well. The facilities and infrastructure in preparation for accreditation have not met Permenkes 43 of 2019 and have not met the needs of the community. Judging from the adequacy of human resources has not met the standard Permenkes No. 43 of 2019 in the form of environmental sanitation workers, health information system personnel, financial administration staff, administrative staff and those needed by medical record health centers and information technology workers.Preparation for Puskesmas Bagansiapiapi accreditation in policy has been well implemented, infrastructure and human resources do not meet standards.

“Impact on Family Planning Services in Primary Healthcare Facilities in Rural Sindh – Secondary Data Analysis of Pre- and on-going COVID-19 Crisis Period”

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.

“Impact on Family Planning Services in Primary Healthcare Facilities in Rural Sindh – Secondary Data Analysis of Pre- and on-going COVID-19 Crisis Period”

The current COVID-19 pandemic has devastated the improvements in family planning services during the past years. This study assessed the impact of the global pandemic that compromised the provision of family planning services in primary healthcare facilities in Sindh – Pakistan. A retrospective data from District Health Information System (DHIS) before Covid-19 (January – February 2020) and during Covid-19 (March – June 2020) was extracted on the provision of family planning services in primary healthcare facilities in Sindh. The study was conducted to understand the impact of service provision through time-series trend analysis by comparing two health facilities i.e., BHUs and BHU plus facilities on monthly average visits (Jan-Feb average) and differences in percentage change over time on the uptake of short and long-acting family planning methods. The findings suggested that due to lockdown and restrictive mobility, the family planning services have fallen drastically in terms of clients visit the health facility from the onset of the COVID-19 outbreak in the month of March 2020 and remain stagnant till June 2020 as compare to before COVID-19 period. The overall analysis revealed the largest decay in the uptake of family planning methods specifically, pills with 31% and 26% during April 2020 in BHU and BHU plus facilities. On the contrary, uptake of Implants showed 25% and 23% decline in the month of June and May in BHU and BHU plus facilities respectively, compared to the average percentage of the pre-COVID Period. The COVID-19 pandemic has adversely affected the provision of family planning services and steeply decreased the uptake of Pills and Implants in primary healthcare facilities in Sindh. On the contrary, the disruption and decrease in services have provided an opportunity to undertake further research exploration to develop future strategies and policies to combat health challenging situations in such pandemics.

SILACAK: Bagaimana Penggunaan Aplikasi Pelacakan Kasus Kontak Erat COVID-19 di Indonesia

COVID-19started outbreaks in Indonesia from March 2020, with a large spread rate making not only Indonesia, but all exposed countries in the world find the difficulties to deal with it. The advance of technology has been used to overcome the COVID-19 cases. The Ministry of Health supported by Health Information System Programme (HISP) Indonesia adopted the DHIS2 platform in the development of a contact tracing application called SILACAK. In this study, we will discuss the development of the SILACAK application which is used as a COVID-19contact tracing application in Indonesia. The method in this study is a qualitative method with an action research approach. The use of SILACAK starts from the primary healthcare level by utilizing health workers and collaboration with volunteers and The Indonesian National Military and The Indonesia National Police. The use of SILACAK was used in stages and in July 2020 it was used by 34 provinces. Currently SILACAK is used as a tool for tracking and monitoring close contact, in which close contact tracing (at least 80%) and the ratio of close contact to confirmation cases are used as a national reference (1:15). However, for some regions there are those that cannot exceed this provision because tacthe number of close contacts does not exceed the specified limit. So that, another assessment was also carried out to see the performance of contact tracing, which consisted of: close contacts who conducted entry and exit tests, close contacts who were monitored and completed the monitoring.Keyword: SILACAK, DHIS2, COVID-19, contact tracing applicationAbstrakCOVID-19 memasuki Indonesia di bulan Maret 2020, dengan laju penyebaran yang besar membuat tidak hanya Indonesia tapi seluruh negara yang terpapar di dunia merasa kesulitan dalam menghadapinya. Kecanggihan teknologi dimanfaatkan untuk menanggulangi COVID-19. Kementerian Kesehatan didukung oleh Health Information System Programme (HISP) Indonesia mengadopsi platform DHIS2 dalam pengembangan aplikasi Pelacakan Kasus Kontak COVID-19 yang disebut SILACAK. Dalam penelitian ini akan membahas perkembangan aplikasi SILACAK yang digunakan sebagai aplikasi pelacakan kontak COVID-19 di Indonesia. Metode dalam penelitian ini dengan metode kualitatif dengan pendekatan action research. Pemanfaatan SILACAK dimulai dari level puskesmas dengan memanfaatkan tenaga Kesehatan dan berkolaborasi dengan relawan serta TNI dan POLRI. Penggunaan SILACAK digunakan secara bertahap dan di bulan Juli 2020 dimanfaatkan oleh 34 provinsi. Saat ini SILACAK dijadikan sebagai alat untuk pelacakan dan pemantauan kontak erat, yang mana pelacakan kontak erat (minimal 80%) dan rasio kontak erat dengan kasus konfirmasi yang dijadikan sebagai acuan Nasional (1:15). Namun beberapa daerah belum bisa memenuhi angka tersebut di karena kan angka dari jumlah kontak eratnya tidak memenuhi sampai angka tersebut. Sehingga dalam menilai suatu kinerja dari keberhasilan pelacakan kontak suatu daerah juga dapat mempertimbangkan dari kontak erat yang dilakukan entry tes dan exit tes, kontak erat yang dilakukan pemantauan dan menyelesaikan pemantauannya.Kata Kunci: SILACAK, DHIS2, COVID-19, aplikasi pelacakan kontak

Russian healthcare system digitalization: Opportunities and contradictions

The article is devoted to the opportunities and key contradictions of the Russian state healthcare system digitalization project implementation. The authors analyze various aspects of the system digitalization algorithms in light of the federal project “Creation of the Single Digital Circuit in Healthcare based on the Unified State Health Information System”. The aim of the article was to identify problems within goal-setting, documentation development, and practical implementation of the healthcare system digitalization project, as well as to come up with proposals for eliminating these issues. The analysis showed the inefficiency of the expensive healthcare system digitalization project, which has both objective and subjective reasons for its low effectiveness. The authors come to the conclusion that it is necessary to eliminate a number of contradictions and barriers in the framework of the project implementation in order to increase the efficiency of both the healthcare system itself and the high budget federal project of the economy digitalization as a whole. The practical significance of the article consists in the applicability of proposed approach to making the necessary amendments to the current federal project documentation, which will ensure a focus on real needs within the framework of the initiative implementation. The work may be of interest to civil servants, initiators of projects on the healthcare system digital transformation, governmental bodies, healthcare organizations managers, students, and practitioners.