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

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 Provincial Health Office Decision - Making Level Introduces Policy Implementation District Health Office Planning, and Performance Controling Planning and Performance Controling Level Health Centre Performance Activities Day to Day Operating Level

Sustainable e-Government Project for Health Information and Communication Technology Development Health Administration Department Office Executive Support System 71 Regional Technical Center 75 Provincial Health Offices 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 Total Front Office Back Office LAN Line Satellite System MIS & Data Warehouse e- services on Department Activities : Logistic : Health Business : Consultation : Epidemiology

Conceptual Framework for health information www.themegallery.com Database System 12 Files & 18 Files Survey data Health Data Bank Auditing & cleansing Medical record exchange Health Information Healthcare Center/ Primary Care Unit Health service Provider (Hospitals) Ministry’s departments 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 Company Logo

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

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

Background of the reporting system www.themegallery.com 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

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

Changes of reporting system www.themegallery.com 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

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

Impact of Health Insurance to reporting system (12 files dataset) www.themegallery.com 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

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

Data flow and their interconnection workflow of 18 files dataset www.themegallery.com About 200 million individual records are received annually from nearly 10,000 PCUs 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

Data cleansing and reporting of 18 files dataset www.themegallery.com 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

Data cleansing and reporting of 18 files dataset (Con.) www.themegallery.com 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

Data incentive for the data collection & consolidation of 18 files dataset www.themegallery.com 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

Data incentive for the data collection & consolidation of 18 files dataset (Con.) www.themegallery.com 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

Data quality definitions and criteria for payment of 18 files dataset www.themegallery.com There are 3 main data quality definitions criteria Basic data accuracy incentive (5baht/record) 1 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 2 3 Company Logo

Other data collection and consolidation www.themegallery.com 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

Other data collection and consolidation (Con.) www.themegallery.com 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

Future of the consolidated both 12 & 18 files dataset www.themegallery.com 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