Prof. Dr. Nguyen Thanh Long Director, VAAC MINISTRY OF HEALTH VIET NAM ADMINISTRATION OF HIV/AIDS CONTROL

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.

OVERVIEW OF HIV/AIDS HEALTH INFORMATION MANAGEMENT SYSTEM 1. Organizational structure of HIV/AIDS information system National Institute of Hygiene & Epidemiology Pasteur Institute of Nha Trang 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 Management & Coordination Report Technical Assistance Technical groups Other Ministries International organization Feedback & Information sharing District PMCs PACs of Central coast provinces MOH (VAAC)

OVERVIEW OF HIV/AIDS HEALTH INFORMATION MANAGEMENT SYSTEM (cont.) 2. Collection, analysis of HIV/AIDS information Analysis (Conducted at district PMC, PACs, Regional institutes, VAAC) Information collection: - From service sites (VCT, ARV, Harm reduction, PMTCT, VCT….) - From special surveys Information Publications

Archive,AnalysisArchive,Analysis Dissemination Routine information collection Instruction information Special studies Information Exchange Sharing, Synthesizing Update Information Reporting forms, questionnaires Software Website, CD & printed documents OVERVIEW OF HIV/AIDS HEALTH INFORMATION MANAGEMENT SYSTEM (cont.) 3. Management and dissemination of information

6 4. Information synthesis Software Hardware Database Internet HIV/AIDS INFORMATION SYSTEM Health information system, General statistic office Integrated OVERVIEW OF HIV/AIDS HEALTH INFORMATION MANAGEMENT SYSTEM (cont.) ?

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 ing.

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. HARDWARE SYSTEM

SOFTWARES CURRENTLY BEING USED IN HIV/AIDS HIV-INFO SOFTWARE (Management of HIV/AIDS cases, deaths, sentinel surveillance data) DECISION 28/2008/MOH ONLINE REPORTING SOFTWARE METHADONE INFORMATION SOFTWARE HIV TESTING SOFTWARE VCT AND PEER EDUCATION ACTIVITIES SOFTWARE REPORT FOR GOVERNMENT Primary data Secondary data Data use CARE & TREATMENT SOFTWARE UNGASS REPORTING (CRISS) UNIVERSAL ACCESS REPORTING FORM (UNAID/WHO) ESTIMATION & PROJECTION PLANNING TOOLKIT Data export

I. HIV-INFO software 1. 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 2. Implemented since 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. 4. Input data: Demographics, risk behaviors, dates of HIV tested, AIDS, deaths...

Phần mềm quản lý người nhiễm HIV-INFO: 2.1.

Entered Data Screened Data DB Regional Institutes Template Screened Data DB province Templat Screened Data DB district Coded data Data entry Coded data Data entry Coded data OFFLINE screening OFFLINE screening OFFLINE screening Temp Sreened Data DB SERVER Send, receive data online

II. Prevent HIV software 1. Purpose: Management, analysis, monitoring, and evaluation of VCT & harm reduction activities. 2. Implemented: since Application scale: intended for PACs and more than 180 VCT sites in 53 provinces/cities. 4. Input data: demographic information, risk behaviors, harm reduction information.

Data flow VCTsOPCs VCTsOPCs HRs PMUs of J project CMUs of J project PACs VAAC PMUs of H project CMUs of H project CMUs of I project Sub-project module (PrevenHIV) Central module (PrevenHIV)

III. LIS software (Laboratory information system) 1. 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 2. Implemented: since 12/ 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).

Data flow

Networking lab machines I-OpenELIS Networking lab machines I-OpenELIS Networking laboratory machines ELISA machines CD4 count machines Heamatology testing machines Biochemistry testing machines…

IV. Methadone information software 1. Purpose: to manage electronic records on methadone treatment. Monitoring provide methadone every day. Managing the dose and treatment adherence 2. Implemented: piloted since Application scale: Methadone clinic in Hai Phong 4. Input data: Patients’ information, treatment dose, adherence…

V. ARV management software 1. Purpose: to manage electronic records on ARV treatment. Monitoring the treatment process and result of ARV treatment 2. Implemented: piloted since Application scale: intended for all ARV clinics. Currently being used in Bach Mai hospital, National Institute for Tropical diseases 4. Input data: patients’ information, treatment doses, adherence… 5. It is recommended that the software to be revised for online reporting

VI. Online reporting software 1. Purpose: to report HIV/AIDS activities based on the national and international indicators (UNGASS, Universal Access) 2. Implemented: piloted since 2010, scaled up nationally since 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 1. Purpose: to provide information on HIV/AIDS activities, official legal documents, reports. 2. Implemented: since 2005

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. LESSONS LEARNT

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. CONSTRAINTS AND ISSUES

FUTURE DIRECTION ON DEVELOPMENT OF THE INFORMATION SYSTEM,

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 HARM REDUCTION PMTCT VCTLIS HIV-INFO ARV REPORT

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.