New approaches to facilitate reporting of dengue cases in Taiwan

Abstract

Purpose: Early detection and timely reporting of dengue cases are important strategies for the dengue prevention and control.To shorten the time between case reports submitted from medical institutions and received at public health authorities (PHA), Taiwan has established an electronic notification disease surveillance system (NDSS) since 2002. However, paper-based reporting is still preferred by most clinics. This may cause delays in implementing dengue control measures and increase the data entry workload for PHA. Frontline interviews indicated that complicated NDSS account application procedure and the lengthy reporting form are major reasons hindering clinics to use NDSS. To encourage clinics using NDSS, we proposed two approaches by providing convenient NDSS login and a data exchange API. Methods & Materials: We developed two reporting applications based on the existing NDSS system architecture, the widely-available clinic information systems(CIS), and the virtual private network (VPN) of the National Health Insurance (NHI) program. The first application allows doctors to enter NDSS accountlessly by having their RSA cards verified inside the NHI VPN. The second application allows clinics to use their CIS to report dengue cases to NDSS through a secure data exchange API and a shortened report form.To evaluate the effectiveness of the two applications, we analyzed the NDSS system logs and performed questionnaire surveys among clinics. Results: We found that doctors are more willing to use NDSS by accountless login, which saves login time and reduces login failures. Clinics without their own internet connections are more willing to report cases by NDSS via NHI VPN. Meanwhile, the direct API connection of the CIS with NDSS could reduce at least 70% of data entry workload. Conclusion: The study showed that these two new approaches effectively solved the NDSS login issue and significantly reduced time spent on data entry in clinics. The clinics’ willingness to report dengue via NDSS was improved. With decreasing paper-based reports, PHA staffs also benefited from less time spent and fewer entry errors while entering data into the NDSS. More time could be saved for dengue prevention and control measures.