Bangyai is one of the six districts of Nonthaburi Province Bangkok vicinity Total Population 124,468 / 1,296.54 per Km sq. Local Health services • 9 MOPH Health promotion hospital (HPH • 2 Municipal Health centers • 69 Primary Care Centers Bangyai Hospital Fast growing district Population Structure in catchment area Bangyai Hospital Population Pyramid Male Female Percentage 2011 midyear pop. 55,527 Household 59,847 male 64,594 Female Service Providers in Bangyai Hospital (CUP) One 400 bed private hospital + one 30 bed MOPH hospital HPH 9 Health Promotion Hospitals (HPH) 1st care center 69 Primary care centers Clients Thailand’s Health Insurance Schemes Universal Coverage Scheme (UC) Under National Health Security Office - NHSO) Social Security Scheme (SSS) Social Security Office - SSO) Civil Servant Medical Benefit Scheme (CSMBS) (Comptroller General’s Department - CGD) Bangyai Coverage UC Visits by Health Insurance Schemes Revenue Source by Scheme (BHT) Why do we use ICT ? Tedious and repetitive Difficult to monitor •Unit cost •Waiting time •Workload Human Error •Handwriting •Coding •Lost of OPD card (160,000) Single entry multi output Increase quality •Drug utilization review •Unit cost/case •Pre visit order (reduce waiting time) – lab and xray Continuous care data •Easy to retrieve data •No data loss. NHSO required electronic data for reimbursement Hospital software program HIS 2000 PHIS October 2004 Provincial Policy IPD and Legal Cases - Paperbase HOSxP 15 May 2008 Relevant Regulations derives from … • Thai constitution “Individual right and freedom” • Act of Parliament Electronics 2000 • Computer Related Crime Act 2007 • Official Information Act 1997 • Thailand National Health Act 2010 • Thailand Health Insurance 2002 2012 MOPH IT Key Indicator 1. Updated system for patients’ health which can be linked between HPH and CUP 2. Minimum increase of registration and treatment at HPH of DM and HT patients by 10% (to transfer chronic cases from CUP to HPH) Ex. - Thailand Standard Health Code – – – – – – Diagnosis standard - ICD10 version 2007 Procedure standard - ICD9CM Drug standard - 24 digit Traditional Thai medicine standard Individual SES standard Health services standard Thailand min. data set 2012 1. Person 13. Nutrition 2. Service 14. Non communicable disease 3. Diag 15. Health coverage 4. Procedure 5. Medication 16. Appoint 6. ANC 17. Surveillance 7. EPI 18. Home 8. Family Planning 19. Screen for Non 9. Mother and Child health communicable 10 Post partum disease 11. Reproductive Health 20. Chronic F/U 12. Death 21. Lab F/U TRUE 6M/512K Internet Server TOT 6M/512K Load Balance 1. HOSxP (Master) 2. HOSxP (Slave) 3. Dental Archive Data 4. Network Monitor Proxy Cache Floor4 Switch 1. IT Section 2. Health Insurance Section 3. Mental Health and Narcotic Section 4. Quality Development Section 5. Nursing Section Core Switch Floor1 Switch 1. Outpatient Room 2. Accident and Emergency Room 3. Medical Record 4. Pharmacy Room 5. Delivery Room 6. Public Relation 7. Health Insurance (FL 1st) 8. Radiology Room 9. Family Care Room Floor2 and 3 Switch Floor2 Floor3 1. Inpatient Section 1. Administration Section 2. Finance Section 3. Procurement Section 4. Dental Section 5. Thai Traditional Medicine Section OPD Service workflow • Health scheme check • Validate Insurance Scheme and Pt status • Regist Clinical screening Treatment by MD Medication Minimum Core Dataset Financial First Screening Database Patient walk in LAB,X-Ray Clinical Screening Discharge • Go home • Dead • Refer AE OD costing CMI RW • Health coverage • Register UC Treatment by MD Minimum Core Dataset •Admission •Observe Adj RW OR Data for Reimbursement Hospital work flow SSS CSMBS LR Data for Reimbursement ER 2011 CMI = 0.7 Adjust RW = 1527.66 First screening Patient walk in 5,140 BHT /165 USD / 128 EUR per admission BOT 23 Jan 2012 Application in Primary care/public private by Java Health Center Information System (JHCIS) Registration/ Screening Area CHCIS Database Server JHCIS Data base Examination Room Dental and other Clinics Pharmacy Room JHCIS - ระบบงานสถานีอนามัย และ PCU ศูนยเทคโนโลยี สารสนเทศและการสื่ อสาร ์ สป.สธ. JHCIS with Smart Card MOPH ICT NHSO PHO Health Scheme Validation Configure Connection Health promotion Hospital/PCU (HPH) Last 50 Entries ID Card Reader to acquire and record needed clients’ personal data for JHCIS 20 13/04/58 PROVIS – Data integration (1) Upload / Import F18, FOP, FPP Server in Provincial Health Office (2) Download FOP.ZIP, FPP.ZIP From PROVIS Server Hospital /PCU Export Data (F18, FOP, FPP) NSHO Server (3) Upload / Import FOP.ZIP, FPP.ZIP to REP-OP NSHO Web Site PC/Notebook Provincial Health Office Administrator Cup Management REPORTS : - OPD summary - Prevention & promotion - Dental - Diagnosis code - 21 groups - Fiscal & Activity OPD / IPD /PP transaction report Inter hospital activities + Budget allocation and transaction report CSMBS SSS transaction report(SSN_DATA) ( Free version now available in Android Market ) Family Folder Collector System FFC Autosync HPH Update health maintenance and personal data into JHCISDB automatically by FFC Autosync program. PCU Easy to use means to get real-time info to update health data for maintenance and synthesis cards. JHCIS DB Transferring households information to Android tablet by FFC Autosync program when doing home visit. FFC Autosync Android Tablet -Locating houses using GPS - Create Genogram (family tree with data on gender, age, health condition and relationship in the family Village Visit our website@ www.ffc.in.th Benefit • Quality improvement • Knowledge management • Increase reimbursement • Unit cost – cost containment Challenges • Security • Speed VS Quality • Data Integration – -> Real time VS Pt right – -> IT policy among hospitals • IT manpower career ladder - at community hospital • Duplicate data Reporting JHCIS Using ID smartcard for registration Read data from the chip on ID smart card to fill the registration form Hos XP Using ID smartcard to record service history Read data from the chip on ID smart card to fill the form Checking SSO benefit 27 Checking health benefit 28 Future Goal Single entry for all requirements “Smart card” National Health Information System : NHIS Framework Implement of 3P Integration Pilot Project