1. Bangyai is one of the six districts of Nonthaburi Province Bangkok vicinity

2. Bangyai Hospital Local Health services 9 MOPH Health promotion hospital (HPH 2 Municipal Health centers 69 Primary Care Centers Total Population 124,468 / 1,296.54 per Km sq.

3. Fast growing district

4. 55,527 Household 59,847 male 64,594 Female 2011 midyear pop. Population Structure in catchment area Bangyai Hospital FemaleMale Population Pyramid Percentage

5. Service Providers in Bangyai One 400 bed private hospital + one 30 bed MOPH hospital Clients 9 Health Promotion Hospitals (HPH) 9 Health Promotion Hospitals (HPH) 69 Primary care centers Hospital(CUP) HPH 1 st care center

6. 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)

7. Bangyai Coverage UC

8. Visits by Health Insurance Schemes

9. Revenue Source by Scheme (BHT)

10. Why do we use ICT ? Tedious and repetitiveSingle entry multi output Difficult to monitor Unit cost Waiting time Workload Increase quality Drug utilization review Unit cost/case Pre visit order (reduce waiting time) – lab and xray Human Error Handwriting Coding Lost of OPD card (160,000) Continuous care data Easy to retrieve data No data loss. NHSO required electronic data for reimbursement

11. Hospital software program HOSxP 15 May 2008 PHIS October 2004 HIS 2000 Provincial Policy IPD and Legal Cases - Paperbase

12. 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 Relevant Regulations derives from …

13. 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) 2012 MOPH IT Key Indicator

14. 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

15. 1. Person 2. Service 3. Diag 4. Procedure 5. Medication 6. ANC 7. EPI 8. Family Planning 9. Mother and Child health 11. Reproductive Health 10 Post partum 13. Nutrition 14. Non communicable disease 15. Health coverage 16. Appoint 17. Surveillance 12. Death 1. Person 2. Service 3. Diag 1. Person 2. Service 4. Procedure 3. Diag 1. Person 2. Service 5. Medication 4. Procedure 3. Diag 1. Person 2. Service 6. ANC 5. Medication 4. Procedure 3. Diag 1. Person 2. Service 7. EPI 6. ANC 5. Medication 4. Procedure 3. Diag 1. Person 2. Service 8. Family Planning 7. EPI 6. ANC 5. Medication 4. Procedure 3. Diag 1. Person 2. Service 9. Mother and Child health 8. Family Planning 7. EPI 6. ANC 5. Medication 4. Procedure 3. Diag 1. Person 2. Service 10 Post partum 9. Mother and Child health 8. Family Planning 7. EPI 6. ANC 5. Medication 4. Procedure 3. Diag 1. Person 2. Service 3. Diag 11. Reproductive Health 10 Post partum 9. Mother and Child health 8. Family Planning 7. EPI 6. ANC 5. Medication 4. Procedure 1. Person 2. Service 18. Home 19. Screen for Non communicable disease 20. Chronic F/U 21. Lab F/U Thailand min. data set 2012

16. TRUE 6M/512K TOT 6M/512K Load Balance Internet Server 1. HOSxP (Master) 2. HOSxP (Slave) 3. Dental Archive Data 4. Network Monitor Floor4 Switch 1. IT Section 2. Health Insurance Section 3. Mental Health and Narcotic Section 4. Quality Development Section 5. Nursing Section Proxy Cache Core Switch Floor2 and 3 Switch Floor2 Floor3 1. Inpatient Section1. Administration Section 2. Finance Section 3. Procurement Section 4. Dental Section 5. Thai Traditional Medicine Section 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 1 st ) 8. Radiology Room 9. Family Care Room

17. Database Minimum Core Dataset Treatment by MD Clinical screening Health scheme check Validate Insurance Scheme and Pt status Regist Financia l First Screening Medication OPD Service workflow         Patient walk in

18. LAB,X-Ray Admission Observe Discharge Go home Dead Refer AE OD costing CMI RW Adj RW UC SSS CSMBS ORLRER Treatment by MD Data for Reimbursement Minimum Core Dataset Patient walk in First screening Health coverage Register Clinical Screening         Data for Reimbursement Hospital work flow 2011 CMI = 0.7 Adjust RW = 1527.66 5,140 BHT /165 USD / 128 EUR per admission BOT 23 Jan 2012

19. JHCIS - ระบบงานสถานีอนามัย และ PCU ศูนย์เทคโนโลยีสารสนเทศและการสื่อสาร สป. สธ. Application in Primary care/public private by Java Health Center Information System ( JHCIS) Examination Room Registration/ Screening Area Dental and other Clinics CHCIS Database Server Pharmacy Room JHCIS Data base

20. 20 Health promotion Hospital/PCU (HPH) ID Card Reader to acquire and record needed clients’ personal data for JHCIS Last 50 Entries Health Scheme Validation MOPH ICT ConfigureConnection PHO 12/09/58 JHCIS with Smart CardNHSO

21. PC/Notebook Provincial Health Office Administrator Download (2) Download FOP.ZIP, FPP.ZIP From PROVIS Server (3) Upload / (3) Upload / Import Import FOP.ZIP, FPP.ZIP FOP.ZIP, FPP.ZIP to REP-OP NSHO Web Site to REP-OP NSHO Web Site Server in Provincial Health Office NSHO Server Upload / Import F18, FOP, FPP (1) Upload / Import F18, FOP, FPP Export Data (F18, FOP, FPP) Hospital /PCU Export Data (F18, FOP, FPP) PROVIS – Data integration PROVIS – Data integration

22. Cup Management - OPD summary - Prevention & promotion - Dental - Diagnosis code - 21 groups - Fiscal & Activity Inter hospital activities + Budget allocation and transaction report SSS transaction report(SSN_DATA) CSMBS OPD / IPD /PP transaction report REPORTS :

23. PCU Transferring households information to Android tablet by FFC Autosync program when doing home visit. -Locating houses using GPS - Create Genogram (family tree with data on gender, age, health condition and relationship in the family Easy to use means to get real-time info to update health data for maintenance and synthesis cards. Update health maintenance and personal data into JHCISDB automatically by FFC Autosync program. HPH Village Visit our website@ www.ffc.in.th ( Free version now available in Android Market ) FFC Autosync Android Tablet Family Folder Collector System FFC Autosync

24. 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 Benefit Quality improvement Knowledge management Increase reimbursement Unit cost – cost containment

25. JHCIS Using ID smartcard for registration Read data from the chip on ID smart card to fill the registration form

26. Hos XP Using ID smartcard to record service history Read data from the chip on ID smart card to fill the form

27. 27 Checking SSO benefit

28. 28 Checking health benefit

29. Single entry for all requirements “Smart card” Future Goal

30. Framework National Health Information System : NHIS

31. Implement of 3P Integration Pilot Project