HealthCare System in Thailand:Past -
Present and Where is the Future ?
Dr. Pradit Sintavanarong
Minister of Ministry of Public Health, Thailand
ริชมอนด์ 11-10-56
- The document outlines Thailand's health system and recent reforms towards universal health coverage.
- Key aspects include establishing the National Health Security Office in 2003 to provide quality healthcare access for all Thai citizens. The Universal Coverage scheme was launched, replacing the previous 30 Baht policy.
- Community hospitals and health centers play an important role in implementing healthcare policies and providing easily accessible primary care services at the local level.
HealthCare System in Thailand:Past -
Present and Where is the Future ?
Dr. Pradit Sintavanarong
Minister of Ministry of Public Health, Thailand
ริชมอนด์ 11-10-56
- The document outlines Thailand's health system and recent reforms towards universal health coverage.
- Key aspects include establishing the National Health Security Office in 2003 to provide quality healthcare access for all Thai citizens. The Universal Coverage scheme was launched, replacing the previous 30 Baht policy.
- Community hospitals and health centers play an important role in implementing healthcare policies and providing easily accessible primary care services at the local level.
Future of Thailand's Healthcare Industry in tier 2 cities
http://www.solidiance.com/whitepaper/future-of-thailands-healthcare-industry-in-tier-2-cities.pdf
http://www.marketresearchthailand.com/thailands-tier-2-cities-strive-in-medical-tourism/
Health access for all Thailand’s.The Thai citizens gain universal access to essential health services at zero cost, and reap significant benefits as babies get healthier, workers increase productivity, and households reduce financial risk.
Presented at The Fifth National Conference on Medical Informatics and The Annual Meeting of The Thai Medical informatics Association (TMI-NCMedInfo 2017) on November 24, 2017. Copyrighted by Boonchai Kijsanayotin, reproduced and shared with permission.
An introductory lecture for 3rd year medical students, (RACM302: Community Medicine), Faculty of Medicine Ramathibodi Hospital, Mahidol Univeristy, 2017.11.29
An introductory lecture for 3rd year medical students, (RACM302: Community Medicine), Faculty of Medicine Ramathibodi Hospital, Mahidol Univeristy, 2017.11.28
Don Nutbeam | The evolving concept of health literacySax Institute
Professor Don Nutbeam, Vice Chancellor of the University of Southampton in the UK, spoke to the HARC network in April 2010 to help us consider how to improve healthcare delivery for people with low health literacy.
HARC stands for the Hospital Alliance for Research Collaboration. HARC is a collaborative network of researchers, health managers, clinicians and policy makers based in NSW, Australia managed by the Sax Institute.
HARC Forums bring members of the HARC network together to discuss the latest research and analysis about important issues facing our hospitals.
For more information visit saxinstitute.org.au.
Future of Thailand's Healthcare Industry in tier 2 cities
http://www.solidiance.com/whitepaper/future-of-thailands-healthcare-industry-in-tier-2-cities.pdf
http://www.marketresearchthailand.com/thailands-tier-2-cities-strive-in-medical-tourism/
Health access for all Thailand’s.The Thai citizens gain universal access to essential health services at zero cost, and reap significant benefits as babies get healthier, workers increase productivity, and households reduce financial risk.
Presented at The Fifth National Conference on Medical Informatics and The Annual Meeting of The Thai Medical informatics Association (TMI-NCMedInfo 2017) on November 24, 2017. Copyrighted by Boonchai Kijsanayotin, reproduced and shared with permission.
An introductory lecture for 3rd year medical students, (RACM302: Community Medicine), Faculty of Medicine Ramathibodi Hospital, Mahidol Univeristy, 2017.11.29
An introductory lecture for 3rd year medical students, (RACM302: Community Medicine), Faculty of Medicine Ramathibodi Hospital, Mahidol Univeristy, 2017.11.28
Don Nutbeam | The evolving concept of health literacySax Institute
Professor Don Nutbeam, Vice Chancellor of the University of Southampton in the UK, spoke to the HARC network in April 2010 to help us consider how to improve healthcare delivery for people with low health literacy.
HARC stands for the Hospital Alliance for Research Collaboration. HARC is a collaborative network of researchers, health managers, clinicians and policy makers based in NSW, Australia managed by the Sax Institute.
HARC Forums bring members of the HARC network together to discuss the latest research and analysis about important issues facing our hospitals.
For more information visit saxinstitute.org.au.
Presented at the RACM 302 Community Medicine Course, Doctor of Philosophy Curriculum, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on December 3, 2018
Presented at the Department of Community Medicine, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on December 4, 2017.
Presented at The Seventh National Conference on Medical Informatics and The Annual Meeting of the Thai Medical Informatics Association (TMI-NCMedInfo 2018), Bangkok, Thailand on November 23, 2018
The Future of Thai Health Systems: Healthcare Quality Management and Control ...Borwornsom Leerapan
Panel discussion on the future of Thai health systems: healthcare quality management and control according to the Statute on the National Health System B.E. 2552
สถานการณ์ระบบบริการสุขภาพและการควบคุมคุณภาพตามธรรมนูญว่าด้วยระบบสุขภาพแห่งชาติ พ.ศ. 2552", การอภิปราย “อนาคตระบบสุขภาพไทย สุขภาพคนไทยดีขึ้นหรือแย่ลง”, ประชุมวิชาการ การวิจัยระบบสาธารณสุข ครั้งที่ 3
Presented at the Life Sci. Level Up Challenge 2020, a Project to Promote and Incubate New Medical and Health Technology Researchers and Startups Promot 2020 by Thailand Center of Excellence for Life Sciences (Public Organization) (TCELS) and Srinakharinwirot University, Ministry of Higher Education, Science, Research and Innovation, Bangkok, Thailand on August 1, 2020.
Presented at the BDMS Golden Jubilee Scientific Conference 2022 "BDMS Beyond 50 years: Looking towards the centennial," Bangkok Dusit Medical Services Public Company Limited (BDMS), Bangkok, Thailand on October 19, 2022
Telemedicine provides healthcare at a distance using telecommunications technology. It has grown from focusing on increasing access to now emphasizing convenience and cost reduction. Store-and-forward and home-based telemedicine have evidence for treating chronic diseases, while office/hospital telemedicine is effective for verbal interactions in specialties like neurology and psychiatry. Current trends include expanding telemedicine to more chronic conditions and migrating services from clinical settings to homes and mobile devices. However, reimbursement remains limited and fragmented while quality of remote care compared to in-person visits requires more evidence. Proper guidelines, standards, training and balancing innovation with risk-based regulation can maximize telemedicine's benefits while minimizing harms.
This document discusses digital health transformation and the role of health information technology. It begins by exploring concepts like artificial intelligence, blockchain, cloud computing and big data. It then examines the potential for "smart" machines in healthcare while acknowledging the complexities of digitizing such a system. The document emphasizes that clinical judgment is still necessary given variations in patients. It outlines components of healthcare systems and forms of health IT both within and beyond hospitals. Finally, it discusses using health IT to support clinical decision making and reduce errors.
Presented at The Thai Medical Informatics Association Annual Conference and The National Conference on Medical Informatics (TMI-NCMedInfo) 2021, Bangkok, Thailand on November 26, 2021
The document discusses the field of health informatics and provides definitions and examples. It defines health informatics as the application of information science to healthcare and biomedical research. It describes the relationships between health informatics and other fields like computer science, engineering, and the medical sciences. The document also discusses different areas of health informatics like clinical informatics, public health informatics, and consumer health informatics. It provides examples of common health information technologies used in healthcare settings like electronic health records, computerized physician order entry, and picture archiving systems.
This document provides an introduction to research ethics and ethics for health informaticians. It begins with definitions of ethics, morals, and norms. It then discusses the role of law, professional codes of conduct, and ethics in establishing standards of acceptable behavior. Key topics in research ethics are introduced through discussions of historic cases like the Nazi human experiments, Beecher's research ethics violations, and the Tuskegee Syphilis Study. The document outlines the Belmont Report's three ethical principles of respect for persons, beneficence, and justice. Ethical issues in health informatics like alerts fatigue from clinical decision support systems and unintended consequences of health IT are also discussed.
Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...Nawanan Theera-Ampornpunt
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 10, 2021
Consumer Health Informatics, Mobile Health, and Social Media for Health: Part...Nawanan Theera-Ampornpunt
Presented at the Master of Science and Doctor of Philosophy Programs in Data Science for Healthcare and Clinical Informatics, Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand on November 10, 2021
26. • “Don’t implement technology just for
technology’s sake.”
• “Don’t make use of excellent technology.
Make excellent use of technology.”
(Tangwongsan, Supachai. Personal communication, 2005.)
• “Health care IT is not a panacea for all that ails
medicine.” (Hersh, 2004)
Some “Smart” Quotes
35. 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
37. A safe, effective care that
focus on us, the patients,
and our needs
What Patients Want
38. • Safe (ปลอดภัย)
• Timely (ทันเวลา)
• Effective (มีประสิทธิผล)
• Patient-Centered
(ยึดผู้ป่วยเป็นศูนย์กลาง)
• Efficient (มีประสิทธิภาพ)
• Equitable (เป็นธรรม)
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.
Quality of Care
42. • Safe
–Drug allergies
–Medication Reconciliation
• Timely
–Complete information at point of care
• Effective
–Better clinical decision-making
Being “Smart” in Healthcare
43. • Patient-Centered
–Empowerment & better self-care
• Efficient
–Faster care
–Time & cost savings
–Reducing unnecessary tests
• Equitable
–Access to providers & knowledge
Being “Smart” in Healthcare
45. • To Err is Human (IOM, 2000) reported that:
–44,000 to 98,000 people die in U.S. hospitals
each year as a result of preventable medical
mistakes
–Mistakes cost U.S. hospitals $17 billion to $29
billion yearly
–Individual errors are not the main problem
–Faulty systems, processes, and other conditions
lead to preventable errors
Patient Safety
46. • 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
Summary of These Reports
47. Image Source: (Left) http://docwhisperer.wordpress.com/2007/05/31/sleepy-heads/
(Right) http://graphics8.nytimes.com/images/2008/12/05/health/chen_600.jpg
To Err is Human 1: Attention
48. Image Source: Suthan Srisangkaew, Department of Pathology, Facutly of Medicine Ramathibodi Hospital
To Err is Human 2: Memory
49. • Medication Errors
–Drug Allergies
–Drug Interactions
• Ineffective or inappropriate treatment
• Redundant orders
• Failure to follow clinical practice
guidelines
Common Errors
50. External Memory
Knowledge Data
Long Term Memory
Knowledge Data
Inference
DECISION
PATIENT
Perception
Attention
Working
Memory
CLINICIAN
Elson, Faughnan & Connelly (1997)
Clinical Decision Making
51. Example of “Alerts & Reminders”
Reducing Errors through Alerts & Reminders
52. • Guideline adherence
• Better documentation
• Practitioner decision making or
process of care
• Medication safety
• Patient surveillance & monitoring
• Patient education/reminder
Documented Values of Health IT
53. Tip #3: Link IT Values to
Quality (Including Safety)
55. Hospital Information System (HIS) Computerized Physician Order Entry (CPOE)
Electronic
Health
Records
(EHRs)
Picture Archiving and
Communication System
(PACS)
Various Forms of Health IT
74. • The Large N Interfaces Problem
N = 2, Interface = 1
# Interfaces = N(N-1)/2
N = 3, Interface = 3
N = 5, Interface = 10
N = 100, Interface = 4,950
Standards: Why?
75. นวนรรน ธีระอัมพรพันธุ์. ตำนำนควำมเชื่อและข้อเท็จจริงเกี่ยวกับมำตรฐำนสำรสนเทศทำงสุขภำพ. ใน: Health
Data Standards Expo: From Reimbursement to Clinical Excellence; 2011 Aug 8-9; Bangkok,
Thailand. Bangkok (Thailand): Mahidol University, Faculty of Medicine Ramathibodi Hospital;
2011 Aug.
http://www.slideshare.net/nawanan/myths-and-truths-on-health-information-standards
Myths and Truths on Standards
76. Myths
• We don’t need standards
• Standards are IT people’s jobs
• We should exclude vendors from this
• We need the same software to share data
• We need to always adopt international standards
• We need to always use local standards
Theera-Ampornpunt (2011)
Myths and Truths on Standards
77. Tip #4: Go for Systems that
Use Standards, Not a Unified,
Conquer-the-World System
Image Source: http://www.denofgeek.com/movies/avengers/37236/why-loki-was-cut-from-avengers-age-of-ultron
78. คาถามเพื่อมุ่งสู่ Health Information 4.0
•เลิกคุยกันว่าจะใช้ app
เดียวกันได้ยังไง เสียที
Image Sources: http://im-hospital.blogspot.com/2012/01/step-1-refer-link.html https://www.youtube.com/watch?v=nR5pbWSzv1c
81. Source: Courtesy of นพ.พลวรรธน์ วิทูรกลชิต ผู้อานวยการศูนย์เทคโนโลยีสารสนเทศและการสื่อสาร
สานักงานปลัดกระทรวงสาธารณสุข
Health 4.0 as eHealth Vision
82. Source: Courtesy of นพ.พลวรรธน์ วิทูรกลชิต ผู้อานวยการศูนย์เทคโนโลยีสารสนเทศและการสื่อสาร
สานักงานปลัดกระทรวงสาธารณสุข
Health 4.0 & Digital Economy (DE) Roadmap
83. Source: Courtesy of นพ.พลวรรธน์ วิทูรกลชิต ผู้อานวยการศูนย์เทคโนโลยีสารสนเทศและการสื่อสาร
สานักงานปลัดกระทรวงสาธารณสุข
DE, MoPH’s 4 Excellence & eHealth