An Evaluation of the Enhanced Information System for COVID-19 Surveillance in Thailand, 2020: A Pre-Post Intervention Comparison

Abstract

With information technology, a traditional coronavirus disease (COVID-19) surveillance system was improved with five additional features including auto-verification system, laboratory reporting system, confirmed case notification system, data feedback loops, and integrated event-based surveillance system. We conducted a surveillance evaluation to compare quantitative and qualitative attributes before and after the improvement. Qualitative and quantitative studies were conducted to measure the effectiveness of enhancing the information system according to the US-CDC framework. Qualitative attributes consisting of simplicity, acceptability, accessibility, flexibility, and stability, and quantitative attributes consisting of timeliness and completeness were investigated and compared between pre-enhanced and post-enhanced information system using the chi-square test. During January to April, there were 74,565 patients under investigation reported to the surveillance system. We interviewed a total of 16 health personnel. After the improvement, we observed statistically significant increases of completeness and timeliness from 55 to 66 and 75 to 96 percent, respectively. Almost all stakeholders (15/16) reported that the system was improved significantly. All qualitative attribute scores were increased including acceptability from 57 to 73, simplicity from 43 to 77, stability from 47 to 80, flexibility from 57 to 73, and usefulness from 50 to 80. In summary, all the qualitative and quantitative attributes were improved significantly (p-value<0.01 for the chi-square test). Enhanced information system with careful understanding of the existing workflow and stakeholders could improve performance of the surveillance system in both qualitative and quantitative attributes. Surveillance evaluation process could be used to assess the improvement, gather feedback, and identify the gaps.