The NHSO’s five measures to reduce medical staff workload
 
Dr Jadej Thammatacharee
Secretary-General of National Health Security Office (NHSO)
 
Recently, the National Health Security Office Board (NHSB) approved five measures designed to alleviate the workload of medical personnel within the national health securirty system.
 
These measures result discussions among our team, health providers, and health staff to relieve their burdens.
 
As many are aware, medical personnel worldwide, including in  Thailand, have been overworked due to multiple factors — including health personnel shortages and the accumulation of patients’ waiting lists since the COVID-19 outbreak.
 
World Health Organization set a standard of having one physician per 1,000 population. But Thailand has between 0.5 and 0.8 doctor per 1,000 people, according to Thailand Development Research Institute. The medical staff shortage is more severe in public hospitals due to inadequate resources.
 
Many doctors and nurses at the frontline of the pandemic have spoken out about their exhaustion and burnout syndrome because of highly workload. Many must cope with long-term mental health problems and lack support.
 
Over the past few months, many young doctors have taken to social media to urge the government to address overwork and stress among medical staff. 
 
Pushing the governments to invest more in health personnel can be the long-term solution.
But quick and short-term measures are also urgently needed to prevent the high turnover rate in the health industry, eventually leading to declining quality of care and the delay of health service deliveries.
 
As a fund manager of the Universal Coverage Scheme (UCS), a healthcare scheme that covers 47 million people, the NHSO is responsible for tackling overwork among the medical personnel as they are the central piece of the healthcare scheme.
 
The NHSO board member Assoc Prof Dr Prasobsri Ungthavorn, and chairwoman of the NHSB’s sub-committee, has led the conversations among our team and stakeholders to find ways to relieve the burden of health staff — resulting in the issue of five measures to address the challenge.
 
First, the NHSO will develop a standard data set for reimbursement that speed up the data-filling process in the NHSO’s electronic claim system, one of the most tedious and time-consuming tasks.
 
The new data set standard will allow information relating to patients and services to be sent in a single transmission using a single program.
 
Health staff can also use information in Health Information Systems (HIS) for reimbursement without the need for additional data entry.
 
This could reduce data entry and transmission workloads by up to seven times.
 
Second, we will implement an Application Programming Interface (API), a software intermediary allowing two applications to connect and share data across the organizations, especially between the NHSO and Ministry of Public Health.
 
The software implementation will require health staff to fill in data in the system once, instead of repeating the data insertion in multiple platforms run by different organizations.
 
This measure will be piloted in general hospitals and reduce the data entry workload.
Third, we have set up a working group to promote self-care among the public.
The group members include representatives from the NHSO, Ministry of Public Health, Thai Health Promotion Foundation, National Health Commission Office, Healthcare Accreditation Institute, and Health Systems Research Institute.
 
We will collaborate to encourage self-care in various forms, including community care, self-testing, and health intervention that reduce unnecessary hospital visits.
 
Fourth, we will establish a collaborative mechanism with health staff before expanding the UCS benefits, which may create more workloads for health providers.
 
Consulting with them before announcing the new health benefits will likely reduce the pressure and open opportunities for us and them to co-design new service management plans while minimizing the impacts on health staff.
 
In this case, our consultations will associate with the Ministry of Public Health, medical associations, healthcare service providers, and relevant stakeholders.
 
Finally, we are working on maximizing the role of our 1330 contact center in bed placement coordination and patient referrals.
 
We aim to assist hospital staff in finding available beds for patients if their workplaces are short of beds and facilitating patient inter-hospital transfers.
We have recently signed agreements with 17 private hospitals to add 582 beds to the national health securirty system.
 
In the near future, we aim to introduce even more effective measures to reduce medical staff workload.
 
In the meantime, we have also introduced incentives for medical personnel to continue their roles in the health system.
 
Those include extra payment for providing health services to specific population groups, including cataract surgery in elderly and HVP vaccination in student groups.
 
We have accelerated health promotion and disease prevention services to improve the health of people and reduce their chances of chronic diseases, burdening the medical personnel and the health system.
 
If we can take part in improving the well-being of medical personnel, they will enhance the quality of care — which also means the stronger health of UCS beneficiaries.