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Development and Implementation of SMS Disease Surveillance System

in Mukdahan, Thailand and Savannakhet, Lao PDR
Dr. Prapas Weerapol, Mukdahan
MBDS Associate Province Coordinator,
Mukdahan Health Office, Thailand
Rational
- Mudahan - Savarnnakhet is an
important area of Mekong Basin Disease
Surveillance.
- Mukdahan is one of cross border point
be connected to Laos, Vietnam
- Mukdahan - Savarnnakhat have been
developed ICT schema for Bio-
Surviellance
Objectives
1.! To improve the effectiveness in epidemiology report
2.! To build a network of local health officials in using disease surveillance
system to help control the epidemiology locally and internationally.
Implementation process
Public Health Office in Mukdahan province, the ICT for Development Program of
the Thai Health Promotion Foundation and InSTEDD organization has initiated the use
of SMS for disease surveillance system in Mukdahan – Savannakhet, Lao PDR under
the Mekong Basin Disease Surveillance project (MBDS) project.
Implementation Process
1. Build a network of public health officials in Lao PDR and Thailand who will be
using the Geo Chat system.
Group Communication in GeoChat system
when group member send a message
i.e. “Field visit at Nong Sung Vill.today”
Everyone in group will get message
“Field visit at Nong Sung Vill.today”
The message “Field visit at Nong Sung
Vill.today” will be added to group’s
page in Geochat
Mr.Somsak
Mr.Samarn
Ms.Sumang Mr.Somjai
Mr.Samran
“Field visit at Nong
Sung Vill. today”
The Geochat’s web display
The group’s
messages
The geographical
position in online
mapping
Geochat Training
Report type under SMS disease surveillance system
There are 2 alternatives to send the report including SMS and GeoChat website (http://gechat.instedd.org)
Mukdahan Province
Didtrict
Muang 23
Members
CS
S
S
S
Didtrict
Nikom
15
CS
S
S
S
Didtrict
Dontan
13
CS
S
S
S
Didtrict
Donglung
15
CS
S
S
S
Didtrict
Nongsung
10
CS
S
S
S
Didtrict
Kumchi-e
15
CS
S
S
S
Didtrict
Wanyai
10
CS
S
S
S
Mukdahan STTR Group Administration
07/08/09
!"#Chat
at Mukdahan - Case Study
$%&'()(*
Mukdahan
Thailand
Head of District sends
announcements and
alerts to health
centers in the district.
Head of District sends
announcements and
alerts to health
centers in the district.
PHD sends messages to
Heads of Districts
Head of District
sends messages
to the province
level and report
important or
summarized
cases
Health centers reports cases and
discuss issues with colleagues.
Messages are received by all
members of the district and by the
Head of District .
Provincial Group
Messages can be
sent through SMS ,
Web or Email .
Operational District
Group
www.opendream.co.th
HeaIth Center
Each health center worker belongs to a group
created for his district. Ìn that group he can
send messages to the rest of his colleagues in
the district and to the Head of District
District LeveI
The Head of District belongs to two groups.
The first group corresponds to his district
where he can discuss issues and receive
reports from the Health Centers. The second
is the Provincial Level group where he can
report to the PHD and discuss issues with
other Head of District.
ProvinciaI LeveI
The PHD belongs to a group that contains
all the Heads of District. Ìn that group, the PHD
not only receives reports from the Operational
Districts, but can also send alerts or information
that ODs then distribute to their respective Districts
24
21
18
15
12
9
6
3
0
Befor GeoChat With GeoChat
120
105
90
75
60
45
30
15
0
Befor GeoChat With GeoChat
Timeliness for report among SRRT in Mukdahan provice
Geochat can reduce time for report (paper form base) among SRRT in Mukdahan provice at 96 persent Geochat can reduce transetion calls among SRRT in Mukdahan provice at 93 persent
Transection calls 120 SRRT member in Mukdahan province
12
ILI Case Reporting from Subdistrict
Subdistrict
Every Friday…
5..10 subdistricts…
District
District SRRT Member
iLi 3
Number of ILI cases
• Per district: chatroom group (e.g. “muk02”) with
 All heads of subdistrict HC
 District SRRT members
Head of
subdistrict
health center
13
ILI Case Reporting to Province
District Hospital
SRRT Member
Every Monday and Thursday…
7 districts…
Mukdahan
Provincial PH Office
Ms.Punchawee
Muk iLi 34
Number of ILI cases
• For Mukdahan: chatroom group (“muk”) with
 All heads of District SRRT
 Suyai, Punchawee & Boonchok
14
H1N1 Suspect Case
District Hospital
SRRT Member
After doctor diagnoses H1N1…
Muk06 Found suspect case H1N1!
H1N1 suspect warning
All subdistricts
Formal Confirmation (paper)
+ SMS notification
Lab
Provincial PH Office
Ms.Punchawee
Formal Alert SMS (today call)
Muk we have suspect Confirmation of H1N1
Notify that response
team will be sent to
investigate
2
1
3
4
5
Muk Sending response team to Wanyai
15
Reportable Diseases
If case comes from same district
District A Hospital
SRRT Member
When doctor confirms disease…
5..10 subdistricts…
Muk06 found 2 dengue
fever at xxxx
Notify subdistricts
Provincial PH Office
Ms.Punchawee
Muk found 2 dengue
fever at wanyai
16
Reportable Diseases
If case comes from different district
Wanyai Hospital
SRRT Member
When doctor confirms disease from district
B…
5..10 subdistricts of Wanyai
Notify subdistricts
Provincial PH Office
Ms.Punchawee
Nikom Hospital
Muk06 found 2 dengue
fever at Wanyai from
Nikom
Notify that response team will
be sent to investigate
Muk found 2 dengue
fever at Wanyai from
Nikom
Muk we are sending
response team to
Nikom tomorrow
17
18
19
The current status of the project
Number of SMS sent categorized by types of report
33%
31%
36%
ILI case and ILI screening reports
Outbreak, disease screening and control notifications
General notifications and invitations
Summary
Members in the network see the necessity and value of the system. Their feedbacks
are as followings:
1. They found that they could spread out health report to everyone in such speedy yet effective method. Diseases
under surveillance that have been found and reported include H1N1 and dengue fever.
2. This cost-effective real-time report system informs the location of where the disease is found. The program and
the structure are user-friendly. And the analysis gives a collective data to Public Health Department officials and
allows them to have a better decision making for disease control.
3. Members in the network receive real-time report and notifications from either top-down or bottom-up levels. The
system has proved to have high satisfaction rate from user members.
4. Members are able to analyze data and then send the report to the public health headquarter as soon as the
disease is found. The system definitely contributes to the increase in effectiveness of disease outbreak control of
the SRRT team.
5. The system help stimulate and facilitate real-time report.
6. Public health executives are able to keep tracked of the outbreak as well as to see the big picture of the
situation.
Suggestions
1. Members from the pilot group agreed that the SMS disease surveillance system
should also be implemented in other remote areas not only for health-related report but
also any social security issue such as illegal drug, environment or dangerous areas.
Volunteers from local communities, Local Live Stock Department officials and/or people
with high potential to be infected are to be involved.
! 2. The Thai Health Promotion Foundation and InSTEED are working together to
develop the program to be able to analyze the data using computer programs so that
the report can be submitted to the public health executives as speedy as possible.
! 3. The program should be implemented in other local communities as well as in the
international level.