Presented at the UNSW ASEAN Conference, The University of New South Wales, Sydney, Australia (online) on October 10, 2020

1. 1
Digital Learning, Health, and
Literacy: A Vision from Thailand
Nawanan Theera-Ampornpunt, M.D., Ph.D.
October 10, 2020
www.SlideShare.net/Nawanan
UNSW ASEAN Conference 2020

2. 2
The “What” of
Digital Health

3. 3
Use of information and communications
technology (ICT) in health & healthcare
settings
Source: The Health Resources and Services Administration, Department of Health
and Human Service, USA
Slide adapted from: Dr. Boonchai Kijsanayotin
Health IT

4. 4
Use of information and communications
technology (ICT) for health; Including
• Treating patients
• Conducting research
• Educating the health workforce
• Tracking diseases
• Monitoring public health.
Sources: 1) WHO Global Observatory of eHealth (GOe) (www.who.int/goe)
2) World Health Assembly, 2005. Resolution WHA58.28
Slide adapted from: Mark Landry, WHO WPRO & Dr. Boonchai Kijsanayotin
eHealth

5. 5
Digital Health
Transformation

6. 6https://medium.com/@marwantarek/it-is-the-perfect-storm-ai-cloud-bots-iot-etc-4b7cbb0481bc

7. 7
http://www.ibtimes.com/google-deepminds-alphago-program-defeats-human-go-champion-first-time-ever-2283700
http://deepmind.com/ http://socialmediab2b.com
An Era of Smart Machines

8. 8
Digitizing Healthcare?
http://www.bloomberg.com/bw/stories/2005-03-27/cover-image-the-digital-hospital

9. 9
“Big data is like teenage sex:
everyone talks about it,
nobody really knows how to do it,
everyone thinks everyone else is doing it,
so everyone claims they are doing it...”
-- Dan Ariely @danariely (2013)
Substitute “Big data” with “AI”, “Blockchain”, “IoT”
of your choice.
-- Nawanan Theera-Ampornpunt (2018)

10. 10
Hype vs. Hope
Jeremy Kemp via http://en.wikipedia.org/wiki/Hype_cycle
http://www.gartner.com/technology/research/methodologies/hype-cycle.jsp

11. 11
“Smart” Machines or
Overreliance on Technology?
https://www.bbc.com/news/business-47514289
https://www.standardmedia
.co.ke/article/2001318679/e
thiopian-airlines-crash-
investigators-reach-
conclusion

12. 12
Digitization 
Digital Transformation

13. 13
To really answer the “What”
of Digital Health, we need to
understand the “Why”

14. 14
• “Don’t implement technology just for
technology’s sake.”
• “Don’t make use of excellent technology.
Make excellent use of technology.”
• “Health care IT is not a panacea for all that ails
medicine.” (Hersh, 2004)
Some “Smart” Quotes

15. 15
To treat & to care
for their patients
to their best
abilities, given
limited time &
resources
Image Source: http://en.wikipedia.org/wiki/File:Newborn_Examination_1967.jpg (Nevit Dilmen)
What Clinicians Want?

16. 16
Why Aren’t We Talk About These Words?
http://hcca-act.blogspot.com/2011/07/reflections-on-patient-centred-care.html

17. 17
The Goal of Health Care
The answer is already obvious...
“Health”
“Care”

18. 18
• Safe
• Timely
• Effective
• Patient-Centered
• Efficient
• Equitable
Institute of Medicine, Committee on Quality of Health Care in America. Crossing the quality
chasm: a new health system for the 21st century. Washington, DC: National Academy
Press; 2001. 337 p.
High Quality Care

19. 19
19
19
WHO (2009)
Components of Health Systems

20. 20
20
20
WHO (2009)
WHO Health System Framework

21. 21
(IOM, 2001)(IOM, 2000) (IOM, 2011)
Landmark Institute of Medicine Reports

22. 22
• Humans are not perfect and are bound to
make errors
• Highlight problems in U.S. health care
system that systematically contributes to
medical errors and poor quality
• Recommends reform
• Health IT plays a role in improving patient
safety & quality
Summary of These Reports

23. 23
Health IT
Health
Information
Technology
Goal
Value-Add
Means

24. 24
Areas of Health Informatics
Patients &
Consumers
Providers &
Patients
Healthcare
Managers, Policy-
Makers, Payers,
Epidemiologists,
Researchers
Copyright  Nawanan Theera-Ampornpunt (2018)
Clinical
Informatics
Public
Health
Informatics
Consumer
Health
Informatics

25. 25
Incarnations of Health IT
Clinical
Informatics
Public
Health
Informatics
Consumer
Health
Informatics
HIS/CIS
EHRs
Computerized Physician
Order Entry (CPOE)
Clinical Decision
Support Systems
(CDS) (including AI)
Closed Loop
Medication
PACS/RIS
LIS
Nursing
Apps
Disease Surveillance
(Active/Passive)
Business
Intelligence &
Dashboards
Telemedicine
Real-time Syndromic
Surveillance
mHealth for Public
Health Workers &
Volunteers
PHRs
Health Information
Exchange (HIE)
eReferral
mHealth for
Consumers
Wearable
Devices
Social
Media
Copyright  Nawanan Theera-Ampornpunt (2018)

26. 26
Where We Are Today...
Copyright  Nawanan Theera-Ampornpunt (2018)
Clinical
Informatics
Public
Health
Informatics
Consumer
Health
Informatics
Technology that
focuses on the sick,
not the healthy
Silos of data
within hospitalPoor/unstructured
data quality
Lack of health data
outside hospital
Poor data
integration across
hospitals/clinics
Poor data integration
for monitoring &
evaluation
Poor data quality (GIGO)
Finance leads
clinical outcomes
Poor IT change
management
Cybersecurity
& privacy risks
Few real examples
of precision
medicine
Little access
to own
health data
Poor patient
engagement
Poor accuracy
of wearables Lack of evidence
for health values
Health literacy
Information 
Behavioral
change
Few standards
Lack of health IT
governance

27. 27
Overview of Thailand’s National Health IT Reform
Intra-Hospital IT
• Electronic Health Records &
Health IT for Quality & Safety
• Digital Transformation
• AI, Data Analytics
• Hospital IT Quality
Improvement (HA-IT)
Inter-Hospital IT
• Health Information
Exchange (HIE)
Extra-Hospital IT
• Patients: Personal Health
Records (PHRs)
• Public Health: Disease
Surveillance & Analytics
Patient
at Home
Copyright  Nawanan Theera-Ampornpunt (2019)

28. 28
Strategic
Operational
ClinicalAdministrative
LIS
Health Information ExchangeBusiness
Intelligence
Word
Processor
Social
Media
PACS
Personal Health Records
Clinical Decision Support Systems
Computerized Physician Order Entry
Electronic Health Records
Admission-Discharge-Transfer
Master Patient Index
Enterprise Resource Planning
Vendor-Managed Inventory
Customer Relationship Management
4 Quadrants of Hospital IT
Copyright  Nawanan Theera-Ampornpunt (2013)

29. 29
Hospital A Hospital B
Clinic D
Policymakers
Patient at
Home
Hospital C
HIE Platform
Health Information Exchange (HIE)

30. 30
Healthtech Startup Ecosystem
www.facebook.com/HealthTechThailand/ No endorsements implied

31. 31WHO & ITU
Achieving Health Information Exchange (HIE)

32. 32
Toward a Smart Health Thailand

33. 33
#LessHype
#MoreHope
My Plea...

34. 34
Information Literacy
• Goes beyond skill-based computer literacy model,
by including softer skills such as:
–Evaluation of information
–Recognition of information need
Bawden D. Origins and concepts of digital literacy. In: Lankshear C, Knobel M, editors. Digital literacies: concepts, policies and practices. : Peter Lang; 2008.

35. 35
Digital Literacy
• Gilster (1997): “An ability to
understand and to use
information from a variety of
digital sources”
• Gilster: DL “is about mastering
ideas, not keystrokes”
• Bawden (2008), referring to
Gilster’s definition: “Simply
literacy in the digital age”
Gilster (1997)
Bawden D. Origins and concepts of digital literacy. In: Lankshear C, Knobel M, editors. Digital literacies: concepts, policies and practices. : Peter Lang; 2008.

36. 36
Digital Literacy (Bawden, 2008)
Bawden D. Origins and concepts of digital literacy. In: Lankshear C, Knobel M, editors. Digital literacies: concepts, policies and practices. : Peter Lang; 2008.
4 generally agreed components of DL
1. Underpinnings
• Literacy
• Computer/ICT Literacy
2. Background Knowledge
• The World of Information
• Nature of Information Resources
3. Central Competencies
• Reading & Understanding Digital &
Non-Digital Formats
• Creating & Communicating Digital
Information
• Evaluation of Information
• Knowledge Assembly
• Information Literacy
• Media Literacy
4. Attitudes & Perspectives
• Independent Learning
• Moral/Social Literacy

37. 37
Health Literacy
• “The degree to which individuals have the
capacity to obtain, process, and understand basic
health information and services needed to make
appropriate health decisions”
(Ratzan & Parker, 2000; Selden et al., 2000; HHS, 2000)

38. 38
Health Literacy
Institute of Medicine 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.

39. 39
Health Literacy
Institute of Medicine 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.

40. 40
Health Literacy
Institute of Medicine 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.

41. 41
Health Literacy
Institute of Medicine 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.

42. 42
Health Literacy
Institute of Medicine 2004. Health Literacy: A Prescription to End Confusion. Washington, DC: The National Academies Press.

43. 43
Health Literacy
http://nutrition.about.com/od/recipesmenus/ss/learnlabels.htm