title: Effectiveness of Implementation of Electronic Malaria Information System as the National Malaria Surveillance System in Thailand.
abstract: BACKGROUND
  In moving toward malaria elimination, one strategy is to implement an active surveillance system for effective case management. Thailand has developed and implemented the electronic Malaria Information System (eMIS) capturing individualized electronic records of suspected or confirmed malaria cases.
  
  
  OBJECTIVE
  The main purpose of this study was to determine how well the eMIS improves the quality of Thailand's malaria surveillance system. In particular, the focus of the study was to evaluate the effectiveness of the eMIS in terms of the system users' perception and the system outcomes (ie, quality of data) regarding the management of malaria patients.
  
  
  METHODS
  A mixed-methods technique was used with the framework based on system effectiveness attributes: data quality, timeliness, simplicity, acceptability, flexibility, stability, and usefulness. Three methods were utilized: data records review, survey of system users, and in-depth interviews with key stakeholders. From the two highest endemic provinces, paper forms matching electronic records of 4455 noninfected and 784 malaria-infected cases were reviewed. Web-based anonymous questionnaires were distributed to all 129 eMIS data entry staff throughout Thailand, and semistructured interviews were conducted with 12 management-level officers.
  
  
  RESULTS
  The eMIS is well accepted by system users at both management and operational levels. The data quality has enabled malaria personnel to perform more effective prevention and control activities. There is evidence of practices resulting in inconsistencies and logical errors in data reporting. Critical data elements were mostly completed, except for a few related to certain dates and area classifications. Timeliness in reporting a case to the system was acceptable with a delay of 3-4 days. The evaluation of quantitative and qualitative data confirmed that the eMIS has high levels of simplicity, acceptability, stability, and flexibility.
  
  
  CONCLUSIONS
  Overall, the system implemented has achieved its objective. The results of the study suggested that the eMIS helps improve the quality of Thailand's malaria surveillance system. As the national malaria surveillance system, the eMIS's functionalities have provided the malaria staff working at the point of care with close-to-real-time case management data quality, covering case detection, case investigation, drug compliance, and follow-up visits. Such features has led to an improvement in the quality of the malaria control program; the government officials now have quicker access to both individual and aggregated data to promptly react to possible outbreak. The eMIS thus plays one of the key roles in moving toward the national goal of malaria elimination by the next decade.
authors.affiliation: Department of Tropical Hygiene (Biomedical and Health Informatics)Faculty of Tropical MedicineMahidol UniversityBangkokThailand.
authors.forename: Shaojin
authors.identifier: 0000-0003-4846-9513
authors.initials: S
authors.lastname: Ma
authors.affiliation: Department of Tropical Hygiene (Biomedical and Health Informatics)Faculty of Tropical MedicineMahidol UniversityBangkokThailand.|Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS)Faculty of Tropical MedicineMahidol UniversityBangkokThailand.
authors.forename: Saranath
authors.identifier: 0000-0001-8455-2344
authors.initials: S
authors.lastname: Lawpoolsri
authors.affiliation: Department of Tropical Hygiene (Biomedical and Health Informatics)Faculty of Tropical MedicineMahidol UniversityBangkokThailand.
authors.forename: Ngamphol
authors.identifier: 0000-0003-1031-7979
authors.initials: N
authors.lastname: Soonthornworasiri
authors.affiliation: Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS)Faculty of Tropical MedicineMahidol UniversityBangkokThailand.
authors.forename: Amnat
authors.identifier: 0000-0001-9715-6658
authors.initials: A
authors.lastname: Khamsiriwatchara
authors.affiliation: Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS)Faculty of Tropical MedicineMahidol UniversityBangkokThailand.
authors.forename: Kasemsak
authors.identifier: 0000-0003-0042-9889
authors.initials: K
authors.lastname: Jandee
authors.affiliation: Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS)Faculty of Tropical MedicineMahidol UniversityBangkokThailand.
authors.forename: Komchaluch
authors.identifier: 0000-0002-4425-1202
authors.initials: K
authors.lastname: Taweeseneepitch
authors.affiliation: Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS)Faculty of Tropical MedicineMahidol UniversityBangkokThailand.
authors.forename: Rungrawee
authors.identifier: 0000-0003-4401-8803
authors.initials: R
authors.lastname: Pawarana
authors.affiliation: Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS)Faculty of Tropical MedicineMahidol UniversityBangkokThailand.
authors.forename: Sukanya
authors.identifier: 0000-0002-3887-4462
authors.initials: S
authors.lastname: Jaiklaew
authors.affiliation: Thai Health Information Standards Development Center (THIS)Health Systems Research InstituteMinistry of Public HealthNonthaburiThailand.
authors.forename: Boonchai
authors.identifier: 0000-0001-8932-1086
authors.initials: B
authors.lastname: Kijsanayotin
authors.affiliation: Department of Tropical Hygiene (Biomedical and Health Informatics)Faculty of Tropical MedicineMahidol UniversityBangkokThailand.|Center of Excellence for Biomedical and Public Health Informatics (BIOPHICS)Faculty of Tropical MedicineMahidol UniversityBangkokThailand.
authors.forename: Jaranit
authors.identifier: 0000-0001-7916-8460
authors.initials: J
authors.lastname: Kaewkungwal
keywords: Thailand; data quality; eMIS; epidemiology; evaluation; malaria; mixed-methods; public health informatics; surveillance system