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Nominee Information

Institutional Information
Member State Thailand
Institution Name Lampang Hospital
Institution Type Public Agency
Administrative Level Local
Name of initiative The Importance of ThaiRefer for Referral system in Thailand
Projects Operational Years 6
Website of Institution http://www.lph.go.th

Question 1: About the Initiative
Is this a public sector initiative? Yes

Question 2: Categories
Is the initiative relevant to one of the UNPSA categories? Reaching the poorest and most vulnerable through inclusive services and partnerships
UNPSACriteria
2017.1.1 Introduces an idea, policy, practice or structure that is distinctively new, innovative and unique in the context of a given country or region, for reaching the poorest and most vulnerable and ensuring that they make progress towards the SDGs
2017.1.2 Increases the access of the poorest and most vulnerable people to quality and affordable public services. This can be done notably by addressing the obstacles that hinder their access to public services such as geography, income or other social or economic factors, security issues, care burden, mobility, discrimination related to sex, gender, age, race, ethnicity and other factors depending on the country or regional context. This can also include introducing new approaches to delivering services or claiming rights and obtaining benefits, so that the poorest and most vulnerable can access those more easily.
2017.1.3 Promote partnerships to mobilize and share knowledge, skills, technologies and financial resources to support the poorest and most vulnerable
2017.1.4 Encourage and promote effective partnerships between public, private and civil society organizations to deliver public services or respond to the needs of the poorest and most vulnerable. Those can be based on experience and strategies that can empower the poorest and most vulnerable to reach the SDGs in various areas
2017.1.5 Creates mechanisms to ensure that the poorest and most vulnerable (and those who represent or assist them) can easily obtain information about public services -notably services related to the SDGs- , related decisions and approaches, as well as about their own rights and entitlements.
2017.1.6 Creates mechanisms that can help the poorest and most vulnerable (and those representing or assisting them) to hold the government accountable on the delivery of public services. This may include mechanisms allowing them to provide feedback on the relevance, quality and cost of public services; report any wrongdoing; initiate investigations; file complaints or request compensation where relevant.
2017.1.7 Introduces mechanisms that ensure that public officials are informed about the special needs of the poorest and most vulnerable, trained and equipped to meet them and held accountable when these needs are ignored or when the rights of the poorest and most vulnerable people are not protected.

Question 3: Sustainable Development Goals
Is the initiative relevant to any of the 17 SDG(s)? Yes
If you answered yes above, please specify which SDG is the most relevant to the initiative. (hold Ctrl to select multiple)
Goal 3: Good Health
Goal 5: Gender Equality
Goal 9: Industry, Innovation and Infrastructure
Goal 11: Sustainable Cities and Communities
Which target(s) within the SDGs specified above is the initiative relevant to? (hold Ctrl to select multiple)
3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents
3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
3.a Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate
3.b Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
3.d Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks
5.4 Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate
11.2 By 2030, provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, women, children, persons with disabilities and older persons
11.c Support least developed countries, including through financial and technical assistance, in building sustainable and resilient buildings utilizing local materials

Question 4: Implementation Date
Has the initiative been implemented for two or more years Yes
Please provide date of implemenation (dd/MM/yyyy) 14 Jun 2011

Question 5: Partners
Has the United Nations or any UN agencies been involved in this initiative? No
Which UN agency was involved? (hold Ctrl to select multiple)
The Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty Organization
Please provide details

Question 6: Supporting documentation
Will you be able to provide supporting documentation for your initiative? Yes

Question 7: UNPSA Awards
Has the initiative already won a UNPS Award? No

Question 8: Other Awards
Has the initiative won other Public Service Awards? Yes
If yes, please specify name, organisation and year. Public Sector Excellence Awards, Office of the Public Sector Development Commission, 2017

Question 9: How did you learn about UNPSA?
How did you learn about UNPSA? Office of the Public Sector Development Commission, OPDC, inspire our organization to improve our services and encourage us to submit this awards.

Question 10: Validation Consent
I give consent to contact relevant persons and entities to inquire about the initiative for validation purpose. No

Question 1: About the Initiative
Is this a public sector initiative? Yes

Question 2: Categories
Is the initiative relevant to one of the UNPSA categories? Reaching the poorest and most vulnerable through inclusive services and partnerships
UNPSACriteria
2017.1.1 Introduces an idea, policy, practice or structure that is distinctively new, innovative and unique in the context of a given country or region, for reaching the poorest and most vulnerable and ensuring that they make progress towards the SDGs
2017.1.2 Increases the access of the poorest and most vulnerable people to quality and affordable public services. This can be done notably by addressing the obstacles that hinder their access to public services such as geography, income or other social or economic factors, security issues, care burden, mobility, discrimination related to sex, gender, age, race, ethnicity and other factors depending on the country or regional context. This can also include introducing new approaches to delivering services or claiming rights and obtaining benefits, so that the poorest and most vulnerable can access those more easily.
2017.1.3 Promote partnerships to mobilize and share knowledge, skills, technologies and financial resources to support the poorest and most vulnerable
2017.1.4 Encourage and promote effective partnerships between public, private and civil society organizations to deliver public services or respond to the needs of the poorest and most vulnerable. Those can be based on experience and strategies that can empower the poorest and most vulnerable to reach the SDGs in various areas
2017.1.5 Creates mechanisms to ensure that the poorest and most vulnerable (and those who represent or assist them) can easily obtain information about public services -notably services related to the SDGs- , related decisions and approaches, as well as about their own rights and entitlements.
2017.1.6 Creates mechanisms that can help the poorest and most vulnerable (and those representing or assisting them) to hold the government accountable on the delivery of public services. This may include mechanisms allowing them to provide feedback on the relevance, quality and cost of public services; report any wrongdoing; initiate investigations; file complaints or request compensation where relevant.
2017.1.7 Introduces mechanisms that ensure that public officials are informed about the special needs of the poorest and most vulnerable, trained and equipped to meet them and held accountable when these needs are ignored or when the rights of the poorest and most vulnerable people are not protected.

Question 3: Sustainable Development Goals
Is the initiative relevant to any of the 17 SDG(s)? Yes
If you answered yes above, please specify which SDG is the most relevant to the initiative. (hold Ctrl to select multiple)
Goal 3: Good Health
Goal 5: Gender Equality
Goal 9: Industry, Innovation and Infrastructure
Goal 11: Sustainable Cities and Communities
Which target(s) within the SDGs specified above is the initiative relevant to? (hold Ctrl to select multiple)
3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents
3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
3.a Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate
3.b Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
3.d Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks
5.4 Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate
11.2 By 2030, provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, women, children, persons with disabilities and older persons
11.c Support least developed countries, including through financial and technical assistance, in building sustainable and resilient buildings utilizing local materials

Question 4: Implementation Date
Has the initiative been implemented for two or more years Yes
Please provide date of implemenation (dd/MM/yyyy) 14 Jun 2011

Question 5: Partners
Has the United Nations or any UN agencies been involved in this initiative? No
Which UN agency was involved? (hold Ctrl to select multiple)
The Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty Organization
Please provide details

Question 6: Supporting documentation
Will you be able to provide supporting documentation for your initiative? Yes

Question 7: UNPSA Awards
Has the initiative already won a UNPS Award? No

Question 8: Other Awards
Has the initiative won other Public Service Awards? Yes
If yes, please specify name, organisation and year. Public Sector Excellence Awards, Office of the Public Sector Development Commission, 2017

Question 9: How did you learn about UNPSA?
How did you learn about UNPSA? Office of the Public Sector Development Commission, OPDC, inspire our organization to improve our services and encourage us to submit this awards.

Question 10: Validation Consent
I give consent to contact relevant persons and entities to inquire about the initiative for validation purpose. No

Question 1: About the Initiative

Is this a public sector initiative? Yes

Question 2: Categories
Is the initiative relevant to one of the UNPSA categories? Reaching the poorest and most vulnerable through inclusive services and partnerships
UNPSACriteria
2017.1.1 Introduces an idea, policy, practice or structure that is distinctively new, innovative and unique in the context of a given country or region, for reaching the poorest and most vulnerable and ensuring that they make progress towards the SDGs
2017.1.2 Increases the access of the poorest and most vulnerable people to quality and affordable public services. This can be done notably by addressing the obstacles that hinder their access to public services such as geography, income or other social or economic factors, security issues, care burden, mobility, discrimination related to sex, gender, age, race, ethnicity and other factors depending on the country or regional context. This can also include introducing new approaches to delivering services or claiming rights and obtaining benefits, so that the poorest and most vulnerable can access those more easily.
2017.1.3 Promote partnerships to mobilize and share knowledge, skills, technologies and financial resources to support the poorest and most vulnerable
2017.1.4 Encourage and promote effective partnerships between public, private and civil society organizations to deliver public services or respond to the needs of the poorest and most vulnerable. Those can be based on experience and strategies that can empower the poorest and most vulnerable to reach the SDGs in various areas
2017.1.5 Creates mechanisms to ensure that the poorest and most vulnerable (and those who represent or assist them) can easily obtain information about public services -notably services related to the SDGs- , related decisions and approaches, as well as about their own rights and entitlements.
2017.1.6 Creates mechanisms that can help the poorest and most vulnerable (and those representing or assisting them) to hold the government accountable on the delivery of public services. This may include mechanisms allowing them to provide feedback on the relevance, quality and cost of public services; report any wrongdoing; initiate investigations; file complaints or request compensation where relevant.
2017.1.7 Introduces mechanisms that ensure that public officials are informed about the special needs of the poorest and most vulnerable, trained and equipped to meet them and held accountable when these needs are ignored or when the rights of the poorest and most vulnerable people are not protected.

Question 3: Implementation Date

Has the initiative been implemented for two or more years Yes
Please provide date of implemenation (dd/MM/yyyy) 14 Jun 2011

Question 4: Partners/Stakeholders

Has the United Nations or any UN agencies been involved in this initiative? No
Which UN agency was involved? (hold Ctrl to select multiple)
The Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty Organization
Please provide details

Question 5: Required Supplemental Documents

Will you be able to provide supporting documentation for your initiative? Yes

Question 6: UNPSA Awards

Has the initiative already won a UNPS Award? No

Question 7: Other Awards

Has the initiative won other Public Service Awards? Yes
Comments: Public Sector Excellence Awards, Office of the Public Sector Development Commission, 2017

Question 8: Sustainable Development Goals
Is the initiative relevant to any of the 17 SDG(s)? Yes
If you answered yes above, please specify which SDG is the most relevant to the initiative. (hold Ctrl to select multiple)
Goal 3: Good Health
Goal 5: Gender Equality
Goal 9: Industry, Innovation and Infrastructure
Goal 11: Sustainable Cities and Communities
Which target(s) within the SDGs specified above is the initiative relevant to? (hold Ctrl to select multiple)
3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
3.2 By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live births
3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being
3.6 By 2020, halve the number of global deaths and injuries from road traffic accidents
3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
3.9 By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination
3.a Strengthen the implementation of the World Health Organization Framework Convention on Tobacco Control in all countries, as appropriate
3.b Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
3.d Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks
5.4 Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate
11.2 By 2030, provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, women, children, persons with disabilities and older persons
11.c Support least developed countries, including through financial and technical assistance, in building sustainable and resilient buildings utilizing local materials

Question 9: Validation Consent

Do you have any objections to us inquiring about the initiative for validation purposes? No

How did you know about UNPSA?

How did you know about UNPSA? Office of the Public Sector Development Commission, OPDC, inspire our organization to improve our services and encourage us to submit this awards.

Nomination form

Questions/Answers

Question 1

Please provide a brief summary of the initiative including the problems/challenges it addressed and the solutions that the initiative introduced (300 words maximum)
“ThaiRefer” is a software program, using for emergency patient referral from a local hospital to a tertiary-care center. The developer got an idea to develop ThaiRefer from observing a flight information display system at Suvarnabhumi airport, in which a computer displays arrivals and departures flight information in real-time. Thus this system was applied to develop a referral software program. This program resolves problems occur among referral process and makes an early notification at the destination hospital to get ready to receive emergency patients. The ThaiRefer program was developed by collaboration between IT officers and emergency medical team. The ThaiRefer program has developed until it is stable and can be used effectively in Lampang. ThaiRefer has been supported by the Ministry of Public Health and has widely implemented across the country. Seamless health service network results in increasing equality of access to healthcare services. Patients receive quality, safety, and timely referral.
a. What are the overall objectives of the initiative?
Please describe the overall objectives of the initiative (200 words maximum)
1.Increasing accessibility 2.Increasing safety, timely, and quality of the referral system 3.Providing effective referral system. 4.Decreasing mortality and morbidity during refer 5.Strengthening and sustaining healthcare system
b. How does the initiative fit within the selected category?
Please describe how the initiative is linked to the criteria of the category (200 words maximum)
ThaiRefer is the innovation of the information technology for referral system. This program was developed by the emergency medical team that faces problems occurring among referral process. By installing the program in a computer hardware in a hospital, a tablet, or a smartphone and connecting the program with the internet network, the program will link patients’ health records from the database of that hospital and gives the access right of the destination hospital to only view that patient’ s health records. When the referral is initiated, the information of a referred patient is sent to the hospital of destination. Then the destination hospital can prepare for the arrival of the patient. With the GPS that links with the program, the destination hospital can estimate the arrival time of the patient and can prepare for the arrival properly. For security process, password and security log system are used. After the Thai Refer program has been implemented, the mortality rate of transferred patients in Lampang decreased from 0.32% in 2010 to 0.06% in 2017.

Question 2

The initiative should improve people’s lives, notably by enhancing the contribution of public services to the implementation of the 2030 Agenda for Sustainable Development and the realization of the SDGs
a. Please explain how the initiative improves the delivery of public services (200 words maximum)
ThaiRefer program was invented and developed by an emergency medical team, leaded by Thanin Lokeskrawee MD,PhD., and IT specialists, leaded by Teerin Ketvichit PhD. The program was started in the name of Lampang Refer Link V. The ThaiRefer project has been supported by Lampang hospitaland, Lampang provincial public health office. Patients’ health information that sends to Lampang hospital during referral process makes the referral process seamless and reduces the use of paper records. In addition, the feedback information of the patients from Lampang hospital to a community hospital which makes a referral gets a community hospital prepares for the continuity of care for that patient. Ministry of public health foresees the benefits of the program. The use of Lampang Refer Link is broadening and its name has been changed to ThaiRefer in July, 2012

Question 3

The initiative must impact positively a group or groups of the population (i.e. children, women, elderly, people with disability, etc) and address a significant issue of public service delivery within the context of a given country or region.
a. Please explain how the initiative has addressed a significant issue related to the delivery of public services (200 words maximum)
ThaiRefer was developed by collaboration between emergency medical team and IT specialists. The concept of flight information display was applied to the ThaiRefer program for referring patients from 12 community hospitals to Lampang Hospital in order to get the staffs at the destination hospital readily equipped. The implementation of ThaiRefer was supported by the Executive Board of Lampang hospital and Lampang Provincial Public Health office to reduce the losses during patient referrals. With ThaiRefer, the death rate has been successfully reduced from 0.32% in 2010 to 0.06% in 2017. During these years, ThaiRefer was continuously developed to meet the users’ requirements. Eventually, it was received a patent and was handed over to the Ministry of Public Health to broaden the usage through the whole country.
b. Please explain how the initiative has impacted positively a group or groups of the population within the context of your country or region (200 words maximum)
As soon as a referral report from a community hospital is submitted, the emergency care staffs at Lampang hospital get notified. The information received at the destination includes the patient’s name and the arrival time. The referred patients will be sorted in ascending order of the estimated arrival time. Useful information of the referred patient such as medical treatment history, severity of Illness, and initial diagnostic assessments can be found on the Telemedicine display. This allows medical staffs at the destination and the origin to cooperate in planning the treatments prior to, during, and after the transfer. This process not only helps speeding up but also maintaining the continuity of the treatments. Accordingly, the resulted seamless referral system ensures customers with a higher rate of lifesaving, fulfils the needs of service providers, and reduces costs of patient referrals.

Question 4

The initiative must present an innovative idea, a distinctively new approach, or a unique policy or approach implemented in order to realize the SDGs in the context of a given country or region.
a. Please explain in which way the initiative is innovative in the context of your country or region (200 words maximum)
Since the high death rate during referrals had been a serious nationwide problem, Ministry of public health saw the importance of broadening the use of ThaiRefer outside of Lampang. Therefore, with the help of Lampang’s development team, the program was extensively installed in 8 neighbour provinces in the North of Thailand in 2012, 14 provinces in the South in 2013-2016, and 45 provinces in the Central, East and North East, which were 67 provinces in total. After the successful installations, Lampang Hospital delivered the program to the Ministry of Public Health for the sustainable development.

Question 4b

b. Please describe if the innovation is original or if it is an adaptation from other contexts (If it is known)? (200 words maximum)
ThaiRefer was a novel program inspired by flight information screens in airports. Seeing that the concept of providing flight information to let passengers manage their time properly was useful, it could thus be adapted in a patient referral system. The Lampang Hospital program development team implemented the program to match Lampang’s public health system. Over 30 versions of the program were developed under the name “Lampang Refer Link” to achieve the maximum efficiency in information connection all over Lampang. Then, after receiving a lot of attention from medical providers throughout Thailand along with the fast developments to expand the coverage of ThaiRefer in the majority of the country, the program’s name was changed to “ThaiRefer” in July 2012. Afterwards, a patent of ThaiRefer was filed on 5th February 2014. Nowadays, the program has been used in 4,482 medical providers of 67 provinces, of all 77 provinces in Thailand. It has proved to reduce patient transfer time resulting in reducing the death and disability rates and made most providers reach the same standard of the patient referral system.

Question 4c

c. What resources (i.e. financial, human , material or other resources, etc) were used to implement the initiative? (200 words maximum)
1. Human – Multidisciplinary team including physicians, nurses, IT specialists, and a person who is responsible for referral of each hospital contribute to the online program. Their feedbacks and suggestions help developing team to go forward. 2. Budget 2.1 Private supports; True Corporation; an internet and mobile service provider in Thailand supports the high speed internet in remote areas. 2.2 Public supports; Ministry of public health, provincial public health offices, and hospitals supports IT infrastructures, IT technologies, IT equipment, and IT specialists. End users in each hospital are allowed to feedback and contact with IT specialists when problems occur. In addition, National Institute for emergency medicine develops the guideline for transfer critically ill patients. 2.3 Wisdom supports; emergency care providers collaborate with IT specialists pull their unique potential specialty to develop the program and effective referral system

Question 5

The initiative should be adaptable to other contexts (e.g. other cities, countries or regions). There may already be evidence that it has inspired similar innovations in other public-sector institutions within a given country, region or at the global level.
a. Has the initiative been transferred to other contexts?
Yes
ThaiRefer for emergency referral. The first version of ThaiRefer program had been implemented in all healthcare sectors in Lampang.After this successful implementation, ThaiRefer was referenced at healthcare conferences across the country.Public hospitals were required to participate in using the program. Lampang hospital set a team including IT specialists and ER-nurses to provide program implementation and maintenance support. For critically ill patients such as patients with STEMI, strokes, or sepsis, the add-on programs were developed. With these add-on programs, the door to needle time was reduced, complications that caused from delayed treatments were reduced, patients’ survival rate increased, and the disabilities reduced. Also the program helps the referred-back process to be smooth and seamless.

Question 6

The initiative should be able to be sustained over a significant period of time.
a. Please describe whether and how the initiative is sustainable (covering the social, economic and environmental aspects) (300 words maximum)
Sustainability of ThaiRefer ThaiRefer initiates the high quality of referral system. It increases patients’ accessibility and promotes equality to healthcare services. The evidences were shown in the increasing of bed occupancy rate to 89.14% in 2017 and the accessibility to healthcare services of in- and out- patients with low-income to 78.9% (1,826,835 patients) in 2017. This program supports the government’s policy that emphasizes on integration and resources sharing of healthcare services that are in the same areas.
b. Please describe whether and how the initiative is sustainable in terms of durability in time (300 words maximum)
Recently, Ministry of public health sets up the health data center that collects the all health data of the patients that using public healthcare services. The health data center aims to serve future public health services at any levels.

Question 7

The initiative should have gone through a formal evaluation, showing some evidence of impact on improving people’s lives.
a. Has the initiative been formally evaluated?
Yes
If yes, please describe how the initiative was evaluated? (200 words maximum)
The Public Sector Excellence Award awarded to ThaiRefer in 2017. The recipient of this award is selected by the Office of the Public section Development Commission.
b. Please describe the outcome of the evaluation of the impact of the initiative (200 words maximum)
There are the private hospitals and hospitals outside the Ministry of Public Health to joined with the Thairefer program more than 100 hospital.
c. Please describe the indicators that were used (200 words maximum)
The ThaiRefer program was proved to increase accessibility rate and increase referral quality. End-users and patients were satisfied with the program. The coverage rate of using ThaiRefer increased from 13 public healthcare sectors in Lampang in 2011 to 478 public healthcare sectors in 2013. There were 4,482 public healthcare sectors in Thailand using ThaiRefer in 2016. The accumulate number of patients using ThaiRefer program until Jan, 2018 were 1,826,835. By using the ThaiRefer program the death that occurs during emergency referral reduced from 0.32% in 2010 to 0.06% in 2017. The death rate is reduced because the referring hospital is required by the program to fill up all important information before refer. Therefore the referring hospital needs to develop the emergency assessment skills.

Question 8

The initiative must demonstrate that it has engaged various actors such as from other institutions, civil society, or the private sector, when possible.
a. The 2030 Development Agenda puts emphasis on collaboration, engagement, coordination, partnerships, and inclusion. Please describe what stakeholders were engaged in designing, implementing and evaluating the initiative. Please also highlight their roles and contributions (300 words maximum)
The success of the program depends on the collaboration between multidisciplinary health professions and 4,482 healthcare sectors. Also supports from 4,482 hospital directors and Ministry of Public Health are keys to success.

Question 9

a. Please describe the key lessons learned, and any view you have on how to further improve the initiative (200 words maximum)
1. IT is important to support future healthcare system 2. The success of the ThaiRefer came from the effective supports and collaboration among administrators, developers, and end-users 3. The sustainability of ThaiRefer program developing is based on the collaboration among multidisciplinary health professions

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