Published on 06-Dec-2010
Validated on 05 Mar 2013
"Our new Lotus Domino reporting system has reduced the time for compiling nationwide data from a week to one or two hours, putting us in a better position to take action against disease outbreaks." - Aidas Spiečius, ULAC IT specialist
Lithuanian Ministry of Health
IBM Business Partner:
As a wake-up call to the world’s governments, the World Health Organization (WHO) issued a warning in 2007 that “new infectious diseases are emerging at an unprecedented rate around the world—and spreading faster than ever.” WHO issued this dictum: “Every country has a global responsibility when it comes to stopping the spread of infectious diseases.” Against this backdrop, the Lithuanian Ministry of Health has taken steps to strengthen its capacity for protecting the health of its citizens.
Lithuania’s tiered public health infrastructure needed faster, more efficient epidemiological reporting to better protect the public against spread of communicable diseases
An electronic reporting system built on IBM® Lotus Notes® and IBM Lotus® Domino® streamlines provision of information on communicable diseases for public health surveillance, disease prevention and control
Increased data accuracy and speed at which nationwide information is compiled, analyzed and made actionable enables fast, preventive response to head off nascent epidemics, which helps save lives
As a wake-up call to the world’s governments, the World Health Organization (WHO) issued a warning in 20071 that “new infectious diseases are emerging at an unprecedented rate around the world—and spreading faster than ever.” Citing multiple causal factors, WHO issued this dictum: “Every country has a global responsibility when it comes to stopping the spread of infectious diseases.”
Against this backdrop, the Lithuanian Ministry of Health has taken steps to strengthen its capacity for protecting the health of its citizens. Its organizational infrastructure for monitoring, preventing and controlling the spread of infectious disease involves several tiers and relies on a data gathering and reporting hierarchy. Forty-eight territorial Public Healthcare institutions (PHIs) regularly gather case data on instances of disease reported by doctors, hospitals and labs. The data on individual cases is reported first to 10 Public Health Centers (PHCs) at the county level, then to the Lithuanian Centre for Communicable Disease and AIDS (ULAC) where it is aggregated and reviewed by analysts.
ULAC tracks and analyzes the epidemiological data nationwide, and implements disease prevention, management policies and protective services. It also works closely with the government’s ministry of health, which collaborates with communicable surveillance networks, WHO, authorities of the European Union (EU) and foreign countries. In addition to developing public health programs, the ministry provides information on communicable diseases and preventive measures to the institutions concerned, the media and the public.
Alternative to paper-based communication needed
For many years, the reporting process spanning this hierarchy depended on paper-based communications. Monthly reporting was communicated up the chain via hand delivery, fax or the postal service. Email was introduced seven years ago, which helped, but there were still barriers to efficiency because ULAC, using manual tabulation, aggregated information only once a month about confirmed cases. Frequent errors required phone conversations to correct. Faxes sometimes too dim to read were also inaccessible to more than a few people. Data in wayward emails would have to be re-sent.
With all these delays, the process for aggregating and moving data from case-level reporting all the way to where nationwide data could be analyzed to identify patterns and dangers was too slow. To improve the efficiency and accuracy of its disease control surveillance, ULAC wanted to accelerate data gathering and reporting by streamlining communications among the people involved, consolidating the data in one place, and making it transparent and accessible.
Electronic reporting transforms surveillance
With help from IBM Business Partner COMPIDEA, the PHCs developed an integrated electronic reporting system based on IBM Lotus Notes and Domino software. Workstations are installed in the territory and county PHCs, the offices of SPHS and ULAC. The reporting platform, named ULISAS, accesses Lotus Domino databases containing patient and staff activity records, notifications and all the data reported by doctors, hospitals and laboratories. The data entry interface offers up to 54 input fields with defined values, data quality is assured by validation against a set of rules, and notes on patients or investigations can also be entered.
Online reporting brings huge advantages in speed, accuracy, efficiency and transparency. Data is exchanged every hour between territorial and county PHCs via Lotus replication, and SPHS receives information about any patient who has fallen ill from contagious disease every day. Data duplication has been eliminated, and any errors can easily be corrected online. For example, if a lab’s test results disconfirm a preliminary diagnosis or indicate another, this new information can immediately be made known.
Since system functionality spans collecting, aggregating, storing and analyzing data end-to-end, all the data is in one place and processes are handled consistently within the single shared environment. An internal portal based on IBM WebSphere® Portal provides data access to all and enables disease status tracking in real time.
In the event of a dangerous outbreak, getting information fast is critical to public health so immediate action can be taken to block the spread. As Aidas Spiečius, IT specialist at ULAC observes, “When you have a flu epidemic to combat or anything like it, you need the information from yesterday, not from last week. Our new Lotus Domino reporting system has reduced the time for compiling nationwide data from a week to one or two hours, putting us in a better position to take action against disease outbreaks.” Moreover, individuals’ records in ULISAS can now be linked over time, revealing disease risk factors, and SPSS, the computer program for statistical analysis, is embedded in the system. These improvements support deeper analysis of causal factors and preventive measures.
Faster response increases protection of public health
Linking timely, continuous tracking of communicable disease occurrences to risk factors and sources of infection can enable faster medical response, portending a significant impact on public health. While it is difficult to quantify this benefit, the speed with which information can be compiled and made actionable undoubtedly helps to stop the spread of disease, protecting people’s health and lives.
Products and services used
© Copyright IBM Corporation 2010 IBM Software Group Route 100 Somers, NY 10589 Produced in the United States October 2010 All Rights Reserved IBM, the IBM logo, ibm.com, Domino, Lotus, Lotus Notes and WebSphere are trademarks of International Business Machines Corporation in the United States, other countries or both. Other company, product and service names may be trademarks or service marks of others. References in this publication to IBM products or services do not imply that IBM intends to make them available in all countries in which IBM operates. 1 “WHO Warns of Accelerating Spread of Infectious Diseases,” August 23, 2007 http://www.rferl.org/content/article/1078312.html