รูปแบบการอภิบาลระบบสุขภาพดิจิทัล: ข้อเสนอสำหรับระบบสุขภาพไทย

Boonchai Kijsanayotin; Kamonporn Suwanthaweemeesuk; Anawat Ratchatorn; Tiem Ungsachon

Authors

Boonchai Kijsanayotin Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Kamonporn Suwanthaweemeesuk Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University
Anawat Ratchatorn Independent Researcher
Tiem Ungsachon Thai Health Information Standards Development Center, Health Systems Research Institute

Keywords:

digital health, digital health governance, digital health influencing factors, collaborative governance, health information system

Abstract

Background: Digital health governance was identified as an essential foundation for establishing e-health in Thailand by the Ministry of Public Health (MOPH) and World Health Organization (WHO) Thailand since 2010. Despite many health information systems and digital health developments, there is still no consensus amongst stakeholders on national digital health governance mechanism. Objective: This study aimed to identify appropriate digital health governance mechanism for Thailand health systems. Methodology: There were two parts to the study. First, we reviewed literature including digital health governance and health systems from international reports and various digital health governance documents from Malaysia, the Philippines, Australia, England, the USA, and Canada. Second, a qualitative study design was used involving a semi-structured in-depth interview method. Eleven health information technology scholars, executives, and startup entrepreneurs were interviewed face to face or online. Result: The review on digital health governance in the six countries showed the influences of political systems, culture, and health systems leading to diverse implementation models. In-depth interviews employed the governance models of the Broadband Commission 1) the health ministry mechanism, 2) a government-wide digital agency mechanism, and 3) a dedicated digital health agency mechanism. Majority of key informants agreed with the dedicated digital health agency mechanism. More than two-thirds made pertinent suggestions: 1) leaders should be decisive in their decision-making with continuity of leadership, 2) strong collaborations to reduce working in silos, and 3) proper health information standards. Conclusion: In the context of Thailand, the MOPH alone cannot govern digital health. However, the MOPH can lead governance mechanism through collaborating with other ministries and stakeholders. Good collaborative governance is the key to an effective digital health governance system, with decisive leaders and continuity of leadership. The preferred model is the dedicated digital health agency mechanism and health information standards are crucial.

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