Managing COVID-19 within and across health systems: why we need performance intelligence to coordinate a global response

Abstract

Background: The COVID-19 pandemic is a complex global public health crisis presenting clinical, organisational and system-wide challenges. Different research perspectives on health are needed in order to manage and monitor this crisis. Performance intelligence is an approach that emphasises the need for different research perspectives in supporting health systems' decision-makers to determine policies based on well-informed choices. In this paper, we present the viewpoint of the Innovative Training Network for Healthcare Performance Intelligence Professionals (HealthPros) on how performance intelligence can be used during and after the COVID-19 pandemic. Discussion: A lack of standardised information, paired with limited discussion and alignment between countries contribute to uncertainty in decision-making in all countries. Consequently, a plethora of different non-data-driven and uncoordinated approaches to address the outbreak are noted worldwide. Comparative health system research is needed to help countries shape their response models in social care, public health, primary care, hospital care and long-term care through the different phases of the pandemic. There is a need in each phase to compare context-specific bundles of measures where the impact on health outcomes can be modelled using targeted data and advanced statistical methods. Performance intelligence can be pursued to compare data, construct indicators and identify optimal strategies. Embracing a system perspective will allow countries to take coordinated strategic decisions while mitigating the risk of system collapse.A framework for the development and implementation of performance intelligence has been outlined by the HealthPros Network and is of pertinence. Health systems need better and more timely data to govern through a pandemic-induced transition period where tensions between care needs, demand and capacity are exceptionally high worldwide. Health systems are challenged to ensure essential levels of healthcare towards all patients, including those who need routine assistance.

Features Constituting Actionable COVID-19 Dashboards: Descriptive Assessment and Expert Appraisal of 158 Public Web-Based COVID-19 Dashboards

“…In other words, the mere accessibility of COVID-19 dashboards does not guarantee data-informed decision-making [ 12 , 33 ]. Although communication sciences, health promotion, and the emerging field of health care performance intelligence offer insights into the effective delivery of information [ 14 , 33 - 36 ], the factors that make dashboards actionable in the context of COVID-19 have yet to be rigorously assessed.…”

Covid-19 Pandemic Impact on Maternal and Child Health Services Access in Nampula, Mozambique: A Mixed Methods Research.

“…Those preventive measures might have reduced the number of infections: Mozambique is in the 9th position in the number of cases in Africa (3651), mostly men (60%), mainly within 25 and 44 years of age (53%), 58% asymptomatic and 34% with light symptoms and 21 deaths (0.6% death rate, the 7th smallest in Africa). But they have also diminished the number of health professionals (HP) at health centres (primary care) and hospitals (secondary, tertiary and quaternary care); this pandemic collateral output, aggravated by misinformation through social media networks, 5 decreased the number of users at all health care levels. Consequences on national health programs are not well known.…”

Examining Governing Board Functions and Health Center Performances During Health System Reform: A Cross-sectional Study in 4 Regional States of Ethiopia

“…This finding was in line with Kringos et al who confer that the first step in performance management should be a comprehension of relevant indicators by the relevant decision-makers. 17 Similarly, Smith et al underpin the importance of setting measurement indicators and implementing performance management as an initial step towards ensuring the health system's continuous improvement and accountability. 23 The second step of the performance intelligence framework is the translation of healthcare data and indicators into knowledge and information which can be used for governance and management.…”

“…The investigators adapted a healthcare performance intelligence framework. [15][16][17] In order to uncover the relationship between the function of governing boards and the performance of health centers, a hierarchical structure of the performance intelligence framework best fit the process of analyzing the data. The first step deals with performance measurements that include the process of healthcare big data transformation into reliable and valid indicators.…”

“…The third step deals with utilization, upon which all stakeholders can act. [15][16][17] Sample Size and Sampling USAID Transform: Primary Healthcare initiated technical support on the implementation of ECHRIGs and capacitated the leadership and governing bodies of 83 health centers. The sampling frame used in this study was developed form the Activity's reports.…”