Text-messaging based bio-surveillance to improve health reporting system in Vietnam

The Vietnamese health care system is structured with multitude of administrative levels. Infectious disease surveillance data is collected from the lowest level (commune health centers) to the higher levels by a paper-based system leading to a large time delay. This delay in disease reporting often defers the timely collection of the most recent disease data and contributes to longer government response times. This also means there is currently no effective monitoring system to early predict and prevent a possible outbreak. The situation is critical and even worse in case of the real outbreak, which needs timely actions. Given the wide coverage of mobile phone services and the low cost of use in Vietnam, mobile phone can be a useful tool to collect timely disease data, provide real-time disease map, and enable quicker responses.

The initiative was developed and implemented in 3 phases to explore insights about the feasibility and practicalities of the utilization of the text-messaging based reporting system in health care in Vietnam. Two participating provinces are Hung Yen and Hoa Binh of Vietnam. A central data repository server, equipped with an SMS text message gateway to collect and send text messages through a designated cell phone number, was set up. The commune health center staff members were asked to text selective disease information for each patient record from the patient paper logbook in a structured but simple format to this cell phone number. Two commonly seen diseases in northern of Vietnam (diarrhea and influenza-like illness) were chosen to be reported. The data were instantly made available on a data management website built on the server, which was securely accessible through the Internet and aimed to provide a real-time disease heat map for better monitoring and control. Disease data were collected at the central level after just a second and were immediately available for different government tiers through the website and real-time disease heat map.
Phase 1 (Jul – Dec 2012): This phase was carried out in a total of 20 communes in two provinces: Hoa Binh (a mountainous province) and Hung Yen (a delta province) to examine the feasibility of reporting use of the texting system.
Phase 2 (Jul – Dec 2013): This phase was carried out in a total of 40 communes in the same two provinces to assess the feasibility and practicalities of the utilization of SMS text message-based disease-reporting system from the commune health center staff’s perspective. We applied three different structures of reporting message to find out the suitable amount of effectively collectable information.
Phase 3 (Mar – Aug 2016): This phase was carried out in the same communes of phase 2 to examine the use of bi-directional reporting message to provide a best-practice model with evidence of utilizing text-messaging in improving efficiency and quality of reporting task.

There is no available solution yet. Two provinces are piloting electronic HMIS (health management information system) province-wide, but this is not possible for most of other provinces where a lot of commune health centers are not equipped with computers and internet access. The Vietnamese Ministry of Health (MOH) is testing the web-based reporting system, but this proposed program is only applicable at district-level and up. This project is a potential complement component for the MOH testing program in order to provide a more complete solution nation-wide.