TY - JOUR AU - Dang, Huyen AU - Dao, Sang AU - Carnahan, Emily AU - Kawakyu, Nami AU - Duong, Hong AU - Nguyen, Trung AU - Nguyen, Doan AU - Nguyen, Linh AU - Rivera, Maya AU - Ngo, Tuan AU - Werner, Laurie AU - Nguyen, Nga PY - 2020 DA - 2020/9/22 TI -越南从小型试点扩大到国家电子免疫登记的决定因素:背景:数字卫生创新可以提高卫生系统的绩效，但以往的经验表明，许多创新并未超越试点阶段，无法实现规模化。越南的国家免疫信息系统(NIIS)始于一系列数字卫生试点，于2010年首次启动，并于2017年在全国范围内正式启动。国家免疫信息系统是中低收入国家在全国范围内实施电子免疫登记的少数例子之一。目的:本研究的目的是了解越南国家EIR规模扩大的决定因素。方法:本定性研究探讨了越南在全国范围内扩大环境影响评估的促进因素和障碍。定性数据收集于2019年10月至12月，通过深入的关键线人访谈和案头审查。移动健康评估和规模规划(MAPS)工具包指导了研究设计、访谈指南和分析框架的开发。map将成功的关键决定因素或“规模轴”定义为基础、伙伴关系、财务健康、技术和架构、运营以及监测和评估。结果:伙伴关系和业务轴是越南成功扩大环境影响评估的关键，而基础工作、监测和评估轴被认为是所有其他轴成功的重要贡献者。 The partnership model leveraged complementary strengths of the technical working group partners: the Ministry of Health General Department of Preventive Medicine, the National Expanded Program on Immunization, Viettel (the mobile network operator), and PATH. The operational approach to introducing the NIIS with lean, iterative, and integrated training and supervision was also a key facilitator to successful scale-up. The financial health, technology and architecture, and operations axes were identified as barriers to successful deployment and scale-up. Key barriers to scale-up included insufficient estimates of operational costs, unanticipated volume of data storage and transmission, lack of a national ID to support interoperability, and operational challenges among end users. Overall, the multiple phases of EIR deployment and scale-up from 2010 to 2017 allowed for continuous learning and improvement that strengthened all the axes and contributed to successful scale-up. Conclusions: The results highlight the importance of the measured, iterative approach that was taken to gradually expand a series of small pilots to nationwide scale. The findings from this study can be used to inform other countries considering, introducing, or in the process of scaling an EIR or other digital health innovations. SN - 1438-8871 UR - //www.mybigtv.com/2020/9/e19923/ UR - https://doi.org/10.2196/19923 UR - http://www.ncbi.nlm.nih.gov/pubmed/32960184 DO - 10.2196/19923 ID - info:doi/10.2196/19923 ER -