Sri Lanka Journal of Bio-medical Informatics最新文献

{"title":"Research Trajectory in Digital Health - A Retrospective Study on a Masters Programme in Biomedical Informatics in Sri Lanka","authors":"P. Siribaddana","doi":"10.4038/sljbmi.v11i2.8101","DOIUrl":"https://doi.org/10.4038/sljbmi.v11i2.8101","url":null,"abstract":"Introduction: In most Low- and Middle-Income Countries, research output related to digital health is not adequate. In some instances, the output from the established research programmes may not match the needs. In Sri Lanka, a masters degree programme in Biomedical Informatics (“masters”) aimed at medical doctors from the state health sector is a key contributor to the research output in digital health. The programme which is conducted by the Post Graduate Institute of Medicine has trained nearly 180 medical doctors. This study intends to understand the evolving research output of the above programme and the causalities for the evolution from 2011 to 2020. Method: The study gathered publicly available data pertaining to theses submitted by graduates of the masters from the library of the Postgraduate Institute of Medicine. It also gathered historical data through published records and from authors own recollections about the evolution of the programme until 2020 from its inception. An interpretivist approach was used in analysing the data and deriving the conclusions. Results and Analysis: The study identified 166 research titles published as dissertations by the graduates of the programme from 2011 to 2020. These research titles belong to six key areas in digital health; public health informatics, clinical informatics, policy and governance, education informatics, bioinformatics, and pharmacy informatics. Yearly research output varied depending on the number of students in the batch and due to other factors including available opportunities, changing programme priorities, funding opportunities, trainer capacity and evolving digital health landscape of the country. While the research output was dominated by ‘policy and governance’ and ‘bioinformatics’ related research at the beginning, the output is currently dominated by ‘public health informatics’ and ‘clinical informatics’ related research. Conclusion: The research output from the programme indicates a strong focus on public health and clinical informatics related research. Evolving health information systems may have contributed to the growing interest as it creates opportunities for further research.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123866249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the management of midnight data to enhance evidence-based decision making","authors":"A. P. Sandanayake, S. Wickramasinghe","doi":"10.4038/sljbmi.v11i1.8092","DOIUrl":"https://doi.org/10.4038/sljbmi.v11i1.8092","url":null,"abstract":"Introduction: Hospitals collect and store massive amounts of data. Developing better 'Information Systems' to manage these data more efficiently had been a challenge during the past decades, and automation was considered by many as the way forward. Method: An interventional project with predominantly qualitative methodology was carried out to implement and then assess a manual and computer-based intervention for management of midnight data at Base Hospital, Horana. Key Informant Interviews, Focus Group Discussions, and document reviews were the key components of the qualitative arm of the study. A satisfaction survey was subsequently conducted among the nursing staff, and selected indicator values were measured pre and post-implementation. Results: Following the pre-interventional analysis, the modified data management system was introduced to address the gaps in the system. The post-interventional analysis revealed that the modified system has better and user-friendly collecting, reporting and analysing tools, enhanced data dissemination capabilities and favourable outcome with the inbuilt system to identify data errors. Satisfaction among the nursing staff demonstrated visible improvement. Conclusion: The study recommends a gradual introduction of process modification and automation of the midnight data management system at Base Hospital Horana.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130054576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current practices in using standard clinical terminologies to record surgical procedures through electronic health information systems in state sector hospitals in Sri Lanka","authors":"K. Wijayaweera, R. Marasinghe","doi":"10.4038/sljbmi.v10i3.8068","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8068","url":null,"abstract":"Introduction: In Sri Lanka, routine health information systems lack information on surgical procedures at the institutional, regional and national levels. Electronic Health Information (HIS) systems with standard clinical terminologies are expected to address this gap. Therefore, this research was conducted to study the current practices of using electronic information systems and standard clinical terminologies to record surgical procedures in state sector hospitals in Sri Lanka. Methods: This exploratory study was conducted employing Hermeneutic Phenomenology as the research methodology. A maximum variation sampling method was employed to enrol 24 participants from seven tertiary care hospitals representing different stakeholder groups in recording and using surgical data. In-depth interviews were conducted with the consented participants to explore their lived experiences and interpretations in relation to the research objective. Interviews were audio-recorded and thematically analysed using the five-stage process proposed by Ritchie and Spencer. Results: The main themes identified grounded in data include; the purpose of recording surgical procedures, current practices, and use of electronic information systems & clinical terminologies to record surgical procedures. Different categories of health care staff were involved in recording surgical procedure data. No uniformity or a standard was followed in the process of recording surgical data, the data elements or the clinical terminologies used in this process. Three electronic health information systems (Hospital Health Information Management System (HHIMS), Hospital Information Management System (HIMS) & Electronic Indoor Morbidity & Morality Return (eIMMR)) are widely adopted in the state health sector using either International Classification of Primary Care (ICPC-2)  or International Classification of Diseases (ICD-10) as the main clinical terminology. A functioning theatre module is only available in one state hospital in the country. Moreover, private electronic databases are employed by many surgeons to record surgical procedures in addition to institutional electronic health information systems. Conclusions: Current practices of recording surgical procedures reflect a wide variation in the use of data elements, the clinical terminologies, and the process of recording surgical procedures. No standard HIS is in place to capture data on surgical procedures. However, electronic databases are used by individual surgeons to record surgical procedures they perform. Such initiatives are not adequate to reap the benefits of digital health technologies.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124257005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adequacy score for the availability of essential drugs of an institution","authors":"I. Ihalagama, C. A. D. M. N. C. Kolambage, T. U. Subasinghe, W. D. Sudasinghe","doi":"10.4038/sljbmi.v10i3.8080","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8080","url":null,"abstract":"Introduction: Sri Lanka classifies a set of essential drugs for the country in their “National List of Essential Medicines”. The drugs in the list are expected to be available in the functioning health systems at all times; in adequate amounts and in appropriate dosage forms, with assured minimum quality, at a price people can afford. However, there is hardly any mechanism to keep track of the adequacy of essential drugs. Hence, the scope of this study is to take a step forward from there, by defining an adequacy score for the adequacy of the essential drugs in a specific institution for a defined period. Methods: The drug consumption, institutional admissions and out-patient visits for the institution were analyzed. The available models also were identified and studied. A model was developed to calculate available drug volume (adjusted to a time period) against a predicted volume of the drug. The predicted volume of drugs that should be in the stock was then calculated by using a neural network applying the previous data. The adequacy of each individual drug was calculated. The percentage of the mean of adequacy score for each drug was expressed as adequacy score for the list of essential medicine. Results: This model has doubled the accuracy of a non-time adjusted model in predicting the adequacy of a drug as this includes the temporal distribution of the volume of drugs. It eliminates overestimation of the stocks at the point of reception of new stock and eliminates the underestimation in the pre-reception period. Each drug in the list was assigned a dynamic adequacy score. Conclusions: The new model has improved the accuracy against the non-time adjusted model. The generated score is dynamic and updated along the time axis, therefore has the potential to be used as a performance indicator of the institution as well. The model can be scaled-up adding more data elements in the prediction of the needed volume of drugs. However, the model may need further validation based on the practically relevant independent parameters.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"81 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125890361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health information governance: a literature review","authors":"M. Hapudeniya, V. Dissanayake, R. Hewapathirana","doi":"10.4038/sljbmi.v10i3.8073","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8073","url":null,"abstract":"Introduction: In recent years, healthcare organizations have started treating data as a valuable asset as the proper management of data and information could lead to meaningful data use, improve service delivery, reduce risk and the lower cost of healthcare. Trust on the information in the healthcare setting is crucial. Health information governance concepts have been introduced to the health sector to face the new challenges imposed by the changing stakeholder expectations, technology and socio-political environment. The objective of this study was to review the literature to understand the current implementation and practice of health information governance in different countries. Methods: Literature was searched using Google, Google Scholar and PubMed with the combination of keywords “health” and “information governance”. To make the search more comprehensive similar terms such as “medical”, “clinical”, “record” and “data” were used. The search was limited to papers or documents written in English and available free of charge. Information was collected in to five broad categories; definition, scope, principles, laws and regulations, roles and responsibilities.  Results: It was found that there is more the one definition for health information governance. It covered all the aspect of information management from information generation to destruction. Most common principles of IG were; accountability, integrity, protection, compliance, availability, retention, disposition, and transparency. It was found that there were different laws and regulations on data protection, freedom of information, computer misuse and crime, and health and social care related regulations and policies support the implementation of IG. Conclusion: There were many health information governance principles identified by different countries but not all principles were included in the IG frameworks when implementing. There were different laws and regulations support the implementation of IG. Roles and responsibilities were different form one country to another.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122798884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An electronic learning management system to train public health medical officers in maternal and child health services in Sri Lanka","authors":"H. Karunarathne, A. Jayathilake, K. Kasthuriarachchi, S. Senanayaka, S. Samarasinghe, K. Kumarasinghe, D. A. Dimal, M. Islam, J. J. Hariyaram, F. Mubarak, S. Irfaan, L. Liyanaarachchi","doi":"10.4038/sljbmi.v10i3.8076","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8076","url":null,"abstract":"Introduction: Reproductive, Maternal, New-born, Child, Adolescent and Youth Health (RMNCAYH) programme in Sri Lanka is an exemplary model in the region. Family Health Bureau (FHB) conducts numerous training programmes for different levels of public health staff involved in RMNCAYH services.  Even though these training programmes are proven a success for many years, there are numerous challenges from both FHB and trainee’s perspective due to resource limitation. The aim of this project was to assess the needs and to design & develop an electronic learning management system to train public health medical officers in maternal and child health services. Methods: The project contained two main components. The first component was a need assessment for a Learning Management System (LMS) for courses conducted by the Family Health Bureau among end-users. It was a cross-sectional descriptive study, using a self-administrated questionnaire among all Medical Officers of Health (MOH), Additional Medical Officers of Health (AMOH) and Medical Officers of Maternal and Child Health (MO-MCH) distributed in electronic format.   Email addresses were obtained from the official email database available at FHB. Associations were analysed using Kruskal-Wallis statistics - H. The second component was the designing and development of electronic LMS by customising free and open-source Moodle platform according to a custom-made development model. Pre-test conducted within the FHB among Medical Officers. Results: Responses given to the questionnaire show that participants prefer courses with a shorter duration for conventional training programmes (60.30%).   The majority preferred blended training models over conventional methods (68.84%). The preferred model (from online training, conventional, or blended training model) is significantly associated with previous participation in web-based training (Ha = 12.04, DF = 1, P = 0.001), knowledge of using internet/web surfing(Ha = 10.73, DF = 1, P = 0.001), and how often participants using computer for office work (Ha= 23.88, DF = 2, P = 0.000) respectively. LMS was developed by customising Moodle version 3.7.2, and the Theme selected was the ‘Trending’. Alternations to the system were done according to the comments received. The final product was named as eBridge since the LSM is bridging the gap between the trainers and trainees. Conclusions: Majority prefer blended training programmes in contrast to conventional programmes conducted by the FHB. Study variables related to computer and digital literacy of MOHs and AMOHs were significantly associated with the preferred method of training. The final product of the electronic learning management system to train Medical Officers of Health, Medical Officer of Maternal and Child Health was developed according to the needs.  Post-implementation assessment needed to be carried on eBridge-LMS to assess the effectiveness and cost-benefit.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128379313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel readiness assessment framework for the application of artificial intelligence in the healthcare sector","authors":"L. Jayaratne, V. Dissanayake","doi":"10.4038/sljbmi.v10i3.8071","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8071","url":null,"abstract":"Introduction: When introducing new technology, pre-implementation readiness assessment is not a new concept. Though published data on readiness assessment on electronic health records, health information technology, and eHealth are abundant, no studies have been conducted on readiness assessment on the application of artificial intelligence (AI) in healthcare institutions. Moreover, the structure and composition of the assessment tools vary with adopting technology and perspectives of the institution considered. Methods: In this study, a novel framework was developed to assess the readiness for artificial intelligence in healthcare institutions. By extending this framework, a novel employee readiness assessment tool and structural readiness assessment tool were developed to assess the institutional readiness for artificial intelligence-based ophthalmological diagnosis support systems. Both tools were tested and validated. Using these tools, institutional readiness was measured at National Eye Hospital of Sri Lanka (NEH). Results: 27% of employees of NEH were ready to accept AI-based Ophthalmological diagnosis support systems at the hospital Out-Patient Department (OPD), while there was only 8% structural readiness at the hospital. Conclusions: This study presents the first readiness assessment framework for the healthcare sector with validated tools to assess the institutional readiness for artificial intelligence-based ophthalmological diagnosis support systems. The developed framework and tools can be adapted to assess the readiness for artificial intelligence in any healthcare institution.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"38 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131354140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of electronic health information systems in the Sri Lankan state health sector: a cross sectional study","authors":"S. Wijesinghe, N. Liyanaarachchi, M. Silva, L. Siriwardena, S. D. Silva, Y. A. K. E. Samaranayake, A. Jagoda, M. Landry, M. Ortan, K. Mendis, T. Tennakoon","doi":"10.4038/sljbmi.v10i3.8086","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8086","url":null,"abstract":"Introduction: Over the past years, the state health sector witnessed the development and deployment of many intuitional based, electronic Health Information Systems (eHIS) in Sri Lanka. These eHIS have been implemented with varying degree of maturity and some show the potential to be scaled-up. However, some initiatives had been limited to pilot implementations and failed to scale up for sub-national to national level. The objectives of the evaluation were to assess the scaling up potential of the eHIS, provide recommendations to the national digital health strategy and enlist the systems in a global digital health marketplace i.e. Digital Health Atlas, for higher visibility and review. Methods: The MAPS toolkit was used as the primary evaluation tool, owing to its strong focus on digital health interventions scale-up. It was mapped with the eleven guiding principles of the National Health Information Policy strategic action plan which was assumed to be the closest available digital health strategy at the time of this evaluation, as there was no explicit digital health strategy for the country. Furthermore, the MAPS toolkit was logically mapped to the Principles for Digital Development for interpretation. The questionnaire was adopted with minor changes to suit local settings and validated by a panel of experts. The tool was administered to the managers of the currently implemented eHIS by three trained Interviewers. Data were randomly verified for quality assurance. Evaluated systems were enlisted in Digital Health Atlas, Sri Lanka country page. Results: 22 data points of 18 exclusive systems participated in the evaluation. Majority of the systems evaluated had a national scope (75%), and a very few projects had a subnational (12.5%) and institutional level scope (12.5%) but implemented at the institutional level. Nearly 60% of them had a financial contribution from the Ministry of Health while 25% had both financial as well as human resources. Nearly 91% of the systems have tested their products for usability with anticipated user groups. Further 86% of the systems had a demonstrated efficacy with 96% stating that the system has demonstrated effectiveness. Therefore, it was assumed that the slow scale-up progress was due to implementation issues rather than usability issues. Majority of the systems had a formal partnership with the Ministry of Health/Government entities. However, the formal partnerships with implementing partners, technology partners and service providers were not up to the standards. The formal partnership with marketing (communications) partner and evaluation (or research) partner was not identified by many systems. Majority of the systems have considered potential economic costs for scaling up the eHealth project. Nearly 46% (22.7% documented) have identified the total cost of ownership over the next five years, to reach their projected scale. Another 46% (18.2% documented) have identified key elements of the cost associated","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"85 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127432383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A descriptive cross-sectional study: knowledge, attitude and practice on telemedicine for healthcare among the general public in the western province of Sri Lanka","authors":"D. Jayakody","doi":"10.4038/sljbmi.v10i3.8081","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8081","url":null,"abstract":"Introduction: In the era of technology, most service fields have digitalized their systems to provide a more convenient, faster and safer service of better quality to their clients. However, Sri Lankans have not adapted to the Telemedicine field as fast. Attitudes and awareness of telemedicine applications in Sri Lanka were not assessed according to previous literature. The Objective of this study was to determine the level of knowledge, experience and attitude of the general public towards telemedicine in Western Province, Sri Lanka, in order to recommend measures to improve the effectiveness of a telehealth consultation. Methods: A descriptive cross-sectional study done in Western Province, Sri Lanka.  The study sample included the general public between the age of 18 years and 64 years, literate in English and IT, and reside in Western Province, Sri Lanka. Participants were selected using random sampling. A self-administered online questionnaire was distributed.  Results: The response rate was 12.1% (N=390). Majority of the population (n=257) had no previous experience with telemedicine. There was no significant relationship between the use of telemedicine and age (p=0.54), gender (p=0.703), and income (p=0.786). Majority of the people have a good knowledge and a positive attitude towards telemedicine. They find telemedicine is effective and efficient. There were statistically significant relationships between knowledge and perceived improvement in efficiency (p=0.001), knowledge and perceived effectiveness (p Conclusions: Age, gender, and income are not barriers to use telemedicine. Better knowledge and positive attitudes improve the perceived effectiveness and efficiency of telemedicine including teleconsultations. Based on the factors that have been tested, spreading and improving the awareness of telemedicine is one of the key measures that can help the growth of telemedicine in Sri Lanka. It is essential for telemedicine service providers to give priority to improve awareness at the same time working on implementations. This study further identifies, taking measures toward greater patient satisfaction is essential for the effective delivery of telemedicine interventions.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124259107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of an electronic system in the surveillance of adverse events following immunization (AEFI) in Sri Lanka: a pilot study","authors":"A. Wijayarathne, M. Dilan, W. M. R. R. Wickramarathne, S. Ginige","doi":"10.4038/sljbmi.v10i3.8085","DOIUrl":"https://doi.org/10.4038/sljbmi.v10i3.8085","url":null,"abstract":"Introduction: The Expanded Programme on Immunization (EPI) established in 1978`in Sri Lanka, has continued to make excellent progress over the past four decades, most notably in terms of achieving high immunization coverage and disease control. When the perception of risk associated with vaccine preventable diseases decreases, the fear of adverse effects following immunization (AEFI) tend to increase. This can reduce compliance with vaccination, allowing for the re-emergence of controlled diseases. AEFI reporting is important as it is a direct measure of the efficiency of the immunization programme in a country. In Sri Lanka, a solid system of paper-based reporting is in place. AEFI systems are aimed at providing information that allow for continuous assessment of the safety of a given vaccine in the studied population in a timely manner. The objective of this study was to analyse the requirements of AEFI system and to develop a web-based system to report data from divisional and regional areas to the Epidemiology Unit. Methods: The study was conducted in two phases. The first phase was to identify the data flow and the existing paper-based formats. In-depth interviews with relevant stakeholders were carried out as the second phase to gather requirements. The data gathered were qualitatively analysed to derive the requirements. Market research was done to identify the most suitable platform/system to cater the requirements. A system was customized using DHIS2 platform. Data sent in paper-based formats to the Epidemiology Unit for the first quarter of year 2019 were entered into the system by data entry operators as a pilot study. The system was then presented and evaluated by the AEFI experts at the Epidemiology Unit to see whether it derives the 'data for action'. Results: A set of requirements were derived as a result of qualitative analysis. The stakeholders prioritized the need to collect aggregate AEFI data island wide. Hence, DHIS2 platform was identified as suitable for the purpose and customized according to the needs of the users. the stakeholders accepted that the system derives the needed data and the data quality was better in the electronic system compared to the existing paper-based format. Conclusions: The DHIS2 based electronic system was suitable to capture AEFI. The developed system will be used countrywide at the Medical officer of Health level and regional levels to collect and report AEFI data to the provincial and national level. A future study should be done to evaluate the scalability of the system to record individual incidents at the clinic or field level.","PeriodicalId":129773,"journal":{"name":"Sri Lanka Journal of Bio-medical Informatics","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114890761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}