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Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health
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Efficient Investment in Health Information System for a Cost Effectiveness Agenda for One Health

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GRF One Health Summit 2012, Davos: Presentation by Prof. Syed Mohamed Aljunid - Professor of Health Economics and Consultant Public Health Medicine - United Nations University

GRF One Health Summit 2012, Davos: Presentation by Prof. Syed Mohamed Aljunid - Professor of Health Economics and Consultant Public Health Medicine - United Nations University

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  • 1. Efficient Investment in Health Information System for Cost Effectiveness Agenda for One Health Syed Aljunid Professor of Health Economics and Senior Research Fellow UNU-International Institute For Global Health Kuala Lumpur UNU- International Institute For Global Health (UNU-IIGH)
  • 2. Outline
    • Multiple Stakeholders in in One Health
    • Role Information System in One Health
    • Control of Nipah and SARS Epidemic
    • Control of Infuenze Pandemic
    • Development of Electronic Health Information
    • Open Source vs Proprietary System
    • Why Invest in Open Source System?
    • Conclusions
  • 3. One Health: Integrative Approach
  • 4. Role of Information in One Health
    • Sharing of information
      • Before Outbreaks
        • Surveillance System
        • Preventive Activities
      • During Outbreaks
        • Control Measures
        • Screening
      • Post-Outbreaks
        • Effectiveness of Interventions
  • 5.  
  • 6. Source of Information
    • Data Availability
      • Regular or Adhoc
      • National/Subnational level
    • Type of Data
      • Incidence/Prevalence of diseases
      • Risk factors
        • Vector density
        • Environment: e.g. Rain fall
      • Data linked to enforcement
  • 7. HMIS Scenario in Developing Countries
    • Health Information System
      • Weak and uncoordinated
        • Data of poor quality
        • Limited Coverage
      • “ Most crucial data were not collected, if these data were collected, most were not analysed. If analysed, information was not used for decision making”
  • 8. 1996 - Cholera 1997 - HFMD 1998 - Dengue 1999 – Nipah Virus Encephalitis 2001 – Anthrax scare 2003 – SARS 2004 – Avian Flu ARE WE PREPARED?
  • 9.  
  • 10. CONTROL SARS EXPERIENCE IN MALAYSIA AND SINGAPORE 2003
  • 11. Control of SARS Epidemic
    • Department of Health
    • Department of Immigration
    • Department of Transport
    • Hospitals
    • Police
    • Airlines
  • 12. SEVERE ACUTE RESPIRATORY SYNDROME-SINGAPORE, 2003 A total of 201 probable cases of SARS and 722 suspect cases have been reported in Singapore.
  • 13. Severe Acute Respiratory Syndrome (SARS) in Singapore: Clinical Features of Index Patient and Initial Contacts
  • 14. SARS SCREENING FOR ARRIVALS THROUGH THE ENTRY POINTS IN JOHOR (1)
  • 15. Traffic Lanes at Causeway Johor Bahru
  • 16.  
  • 17. SARS Transmissions….
  • 18. Influenza A (H1N1) Pandemic: The Health System Response
  • 19. Timeline of Emergence Influenza A Viruses in Humans 1918 1957 1968 1977 1997 1998/9 2003 H1 H1 H3 H2 H7 H5 H5 H9 Spanish Influenza H1N1 Asian Influenza H2N2 Russian Influenza Avian Influenza Hong Kong Influenza H3N2 2009 H1 Reassorted Influenza virus (Swine Flu) 1976 Swine Flu Outbreak, Ft. Dix
  • 20. Swine Influenza A(H1N1) Global Response
    • The WHO raises the alert level to Phase 6
      • WHO ’s alert system was revised after Avian influenza began to spread in 2004 – Alert Level raised to Phase 3
      • In Late April 2009 WHO announced the emergence of a novel influenza A virus
      • April 27, 2009: Alert Level raised to Phase 4
      • April 29, 2009: Alert Level raised to Phase 5
      • June 11, 2009: Alert Level raised to Phase 6
    Source: WHO
  • 21. Global: Case and Fatalities As of 18 th October 2009 WHO Regions Nos. of Cases Deaths Case Fatality AFRO 13,297 75 0.56 AMRO 160,129 3,539 2.21 EMRO 14,739 96 0.65 EURO >63,000 >261 > 0.41 SEARO 41,513 573 1.38 WPRO 122,267 455 0.37 Total >414,945 >4,999 > 1.20
  • 22.  
  • 23. The Stakeholders in H1NI Control
    • Public Sector
      • Ministry of Health
      • Ministry of Education
      • Ministry of Labour
      • Public Schools
      • Hospitals
      • Universities
    • Private Sector
      • Private Practitioners
      • Private Hospitals
      • Transport System
      • Pharmaceutical Industry
      • Business Enterprises
    • Others
      • Civil Societies
      • Professional Organisations
      • High Risk Groups
      • Members of Public
  • 24. Malaysia Influenza Surveillance System (MISS)
    • Clinical Surveillance
    • ILI
    • Influenza
    • pneumonia
    Laboratory-based Surveillance Animal Surveillance Rumours Surveillance Syndromic Surveillance Early Warning Surveillance RESPONSE Inter-pandemic surveillance Pandemic surveillance
  • 25. Which Intervention is Cost-Effective?
  • 26. The Impact….
    • Economic Impact
    • US Economy
      • Direct Cost
        • Hospital Admissions: US 3 Million per year
        • Other Direct Medical Costs: US 10.4 billion per year
      • Indirect Cost
          • US 16.3 billion per year
          • Loss of productivity and life
  • 27. The Impact….
    • Oxford Economics – UK Economy
      • Loss of GDP of 5% first 6 months of pandemic
      • Recovery with 3-4 years
      • Assumptions
        • 30% of population infected
        • 0.4% mortality rate
  • 28. The Impact….
    • World Bank
      • Predictions based on
        • SARS Outbreak 2006
        • Hong Kong Flu 1968-69
        • Spanish Flu 1918-19
      • Global GDP loss
        • 0.7% to 4.8%
        • 70% due to absenteeism and efforts to avoid infections
  • 29. Source of Information
    • Quality of Data
      • Sharing of data limited if poor quality
      • Trained personnel collect the data
      • Methods of data collection valid
      • Quality Control Mechanism
      • Resources to ensure data quality
      • Regular Analysis
      • Reports published
  • 30. Data Sharing: Bureaucracy
    • Data confidentiality
      • Patient level information
      • Process to make data anonymous
      • Ethical Clearance
    • Approval process
      • Who decide to release the data?
      • How fast can data be released?
    • Political Intervention
      • Exploitation for political gain
      • Cover-up for corruption
  • 31. Data Sharing: Technology
    • Format of Data Storage
      • Paper-based
      • Electronic Records
    • Retrieval process
    • Linking of data
      • Within health sector
      • Outside health sector
    • Data usage
      • Decision making process
  • 32. Information Technology In Health Sector
    • 1970’s
      • IT used as administrative for billing and accounting
    • 1980’s
      • Financial Records, Insurance Claims, Payroll, other backoffice functions
    • 1990’s
      • Clinical Applications of IT
        • Radiology, Laboratory, Pharmacy
        • Medical Records
    • 2000’s
      • Decision Support System
      • Artificial Intelligent System
  • 33. Mongolia
  • 34. IT Innovation: Apollo Hospitals Group, India
  • 35. Cost Effective Investment for One Health
    • Health Information System
    • Electronic Information System
      • 114 Countries Worldwide
    • Value of Electronic Health Records
      • USD 60 billion annually
    • Which kind of system to invest?
      • Proprietary vs Open Source System
  • 36. Why Electronic Health Information System Fails?
    • Failure to take into account the social and professional cultures of healthcare organisations
    • Lack of attention given to education of users and computer staff is an essential precursor
    • Underestimation of the complexity of routine clinical and managerial processes
    • Dissonance between the expectations of the commissioner, the producer, and the users of the system
    • Implementation of systems is often a long process in a sector where managerial change and corporate memory is short
    • “ My baby” syndrome
    • Failure of developers to look for and learn lessons from past projects
  • 37. The New Generation Hospitals H Putrajaya Lobby H Ampang H Selayang
  • 38. What is Free Open Source Software?
    • Software whose users have the right (“freedoms”) to use, study, change, and improve its design through the availability of its source code and the right to distribute the changed program.
    • These rights are usually granted through a copyright license.
  • 39. Why Open Source Software is attractive?
    • Low cost
      • Not necessarily free
    • Flexible
      • Opportunity to Innovate
      • Source code can be viewed and modified
    • Vendor Neutral
      • Not proprietary
    • Public domain
      • Can be downloaded from Website
  • 40. Growth of FOSS Market
    • Availability of high quality software
    • Low cost and low barrier to entry
    • Availability of customization and local support service
    • Vendor independence and flexibility
  • 41. Use of specific FOSS applications in government (% shares).
  • 42. Cost Comparison of OSS versus Comparable Closed Solutions for BH - Phasev1
  • 43. Cost Comparison of OSS versus Closed Solutions for BH – Phase 2
  • 44. Challenges in Implementing FOSS in Developing Countries
    • No clear policy to promote FOSS
    • Lack of trained human resource to develop and support FOSS
    • Locked-in by Non-FOSS Vendors
    • Unclear business model for FOSS
    • Corruptions in IT Procurement
  • 45.  
  • 46. Conclusion
    • One Health involves multiple stakeholders at various local, national and international level
    • One Health Initiatives called for integrative approach in all interventions
    • Managing epidemics and pandemics collectively are important aspects of One Health
    • Sharing of Information between sectors is one of the most challenging aspect of One Health
    • Investment in Open Source Technology can be one of the cost effective venture in One Health.
  • 47. Added Value to One Health
    • Mobilising various sectors to work together in One Health is a logical move
    • Good quality, accessible and timely generated information is crucial to support decision making in One Health approach.
    • Low cost, FOSS can improve access to data for One Health
  • 48. THANK YOU [email_address] [email_address]

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