This participatory action research was undertaken to determine the process used to develop
the Health Information System for Project and Budget Management (HIS4PM) and to evaluate its
effectiveness. The HIS4PM was developed to support work related to the missions of the health
care organizations in the seven provinces in Southern Thailand under the 12th Regional Health
Service Center, also known as Health Service Area 12 (HSA 12). A sample of 84 HIS4PM users, 12
from each of the 7 provinces, was purposively selected into the study. Three representatives from
four different health care organizations in each province, namely the hospitals and the sub-district
health promoting hospitals, the provincial and the district public health centers, were chosen
to participate. The administrators of the hospital/healthcare center, the project planning staff,
and the budget department staff for each organization were specifically recruited. Qualitative
and quantitative data were gathered by using in-depth interviews, documentary studies and analyzing
the current health information system; assessing the HIS4PM development using questionnaire.
Results: The study found that the main concept employed to guide the development of the
HIS4PM web-based application was a relational database based on a Rapid Prototyping Design
Model (RPDM) in order to allow any involved users to be able to access the single entry system
and update their real time data information. There were three main steps used to develop the
HIS4PM including: 1) reviewing the current health information system and assessing what developments
were needed to improve the system; 2) determining the possibility of determining and
assessing risks during the HIS4PM system development process and to plan-out the project to
ensure that all aspects of performing work related to the project planning and budget monitoring
missions could be performed and were addressed; and 3) completing the development process
using the 6-phase rapid prototyping design model. These 6 phases included: 3.1) assessing the
needs and analyzing the content to gather the vital information regarding what needed to be
included in the new software program using the rapid prototype manual along with in-depth interviews; 3.2) setting objectives for the software design and development using the data flow diagram
and object-oriented design techniques; 3.3) constructing a prototype; 3.4) performing a trial run evaluation
of the prototype HIS4PM system for approximately two months (February-March 2015) to evaluate
the program and obtain feedback and suggestions for improving the system, as well as the preliminary
users’ level of satisfaction; 3.5) installation and maintenance of the completed system; and 3.6) evaluation
the new HIS4PM software program using the questionnaires during March-April 2015.
In terms of its effectiveness, the study discovered that the newly developed HIS4PM could help
support the project planning and budget monitoring by the public health organizations in HSA 12. The
HIS4PM was practical and facilitated performing work at all levels ranging from the level of regional
health administrators to the working users at operating units. Moreover, the newly developed HIS4PM
not only helps reduce the duplication of data records and allows all users to update data in real time from
their operational sites, but it is also able to link data from all operating sites together. Therefore, it can be
accessed rapidly, meets the users’ needs, helps facilitate working from different operating sites, and helps
promote an effective, focused work atmosphere.
HIS4PM user satisfaction was assessed using the questionnaires and found that the majority of the
users were highly satisfied with all aspects of the new HIS4PM, including the policy to provide the HIS4PM
program to every public health organization, the policy’s implementation strategy, as well as the applicability,
the completeness and the appropriateness of the HIS4PM program.
Recommendations: 1) When the HIS4PM is considered for use in other regions, it is important to
take into account the drive behind the administrators’ policy management, 2) the HIS4PM national development
process should take into account the interests and needs of the local areas’ main operating unit,
and 3) when the HIS4PM is considered for nationwide use, it still has to be subjected to the operational
standard framework of the information system.