 Hello, everyone. Thank you for joining us today on the DHS to Digital Academy for Track to Use webinar day one. We welcome you all on behalf of the University of Oslo and his groups in the Asia region, his India history, Lanka and his Vietnam. Today, the webinar will focus upon the tracker use cases which are being implemented in different parts of the Asia region. We have three distinguished speakers today who would be presenting their experiences on their tracker implementations. First, we have Dr. Keshav Deva representing Save the Children and National Center for AIDS and Esthetic Control, Nepal. He would be presenting his experiences on the HIV Care and ART tracker implementation in Nepal. Then we have Dr. Pamu Damarakul representing his Sri Lanka. He will be presenting his experience on implementing the COVID surveillance and vaccination platform in Sri Lanka. And last we have Dr. John Lewis, who is representing University of Oslo and also leading his Vietnam team. He will be presenting the TB Information System implementation in Laos. The structure of the webinar would be the speakers would be presenting their presentations for 15 to 20 minutes. The participants are requested to put the questions in the chat box. And at the end of the presentation for each speaker, we'll take up the questions and we'll have around 10 minutes of Q&A and then we'll proceed to our next presentation. So without any further delay, I request Dr. Keshav to please share his screen and start with the presentation. Thank you, Saurabh. Is my screen visible? Yes, Keshav. Please go ahead. Okay. Hello, everyone. I'm Keshav Deva and I'm working as a senior strategic informer and specialist at National Center for AIDS and Esthetic Control in Nepal. And today I'm going to present about our experiences, lesson learned of using DHS to track a national HIV program in Nepal. Why it's not moving slide? Okay. So this is my presentation outline. So I will share like briefly why we build DHS to track a based information system and what issues we want to solve to improve strategic information of HIV program in Nepal. And then we'll briefly present about the features of the developed system, what we developed and different components we integrated with the DHS to tracker. And in third topic will be our experiences, our piloting rollout experiences at the national level and the key lesson learned while implementing these developed information system at the national level. And the last topic would be our ongoing efforts and the plan to strengthen like information system of national HIV program using DHS to tracker. So this is about background. Why we used tracker in HIV program because we are facing lots of issues and challenges. First one is to like, when someone like any individual gets infected with HIV, see where he has to enroll in treatment for So recording up treatment details and analyzing or reporting its outcome using paper based registers is not feasible because if someone is let's say is on treatment for 10 years and taking drugs for 10 years we need to record ease follow visit data that patient or client. So if health centers or any health workers want to analyze any outcomes of the treatment, then it will be really, really not feasible to doing analysis or reporting using paper based registers. The second major issue we faced was like the that time the system was unable to track duplications of cases across like between sites or between districts, and due to lack of unique identifier system. And this also further affected by a reporting of monthly aggregated data to the national system. What happens is like if someone is on treatment if he or she moves from one district to another districts. And there is a chance like that person is counted as a new one treatment, or if some new person identified recently diagnosed with HIV infection. He or she can go to multiple sites to confirm their HIV infections. Then there is also chance that the same individuals can be reported to the national system from multiple sites. That would like overestimate out like HIV treatment coverage, or double reporting of same patient client from multiple sites to the national system. This was second major challenges and then because we invest a lot of resources and we implement lots of like programs interventions to improve the life expectancies of people living with HIV. So like just by recording the provided information and paper based registers and reporting aggregated key indicators would not like like provide any evidence for us at the national system or at different levels so we didn't know in real time what interventions are working or what's not because there was no ability of individual level information of client or patient were enrolled in our HIV care so we didn't know exactly like if detail information is the key characteristics or reasons of poor performance of clients in HIV care if we want to know like if certain percentage of patient with poor adherence or poor retention if there are lots of treatment failure, if you want to further dig down to know the core reasons. It was not possible due to like monthly aggregated data reported into the national system. Another major issues was like, even if you want to know like how many people living with HIV or client or patients are on treatment till yesterday, just to get that information it took us to us like two to three months. So it's like really difficult to know in real time like how many of them are on treatment how many of them are lost to follow up how many of them died, even just to get this information like it took us months at the national level. So to address this issue we designed the concept and this is the figure and based on this system like this idea concept what happens is DSS to to here is there was like a system existing in Nepal where sites can monthly report their data to the client's national system using DSS to a key indicators. That's aggregated information so to address these issues we tried we wanted to solve the existing problem by using DSS to tracker at the site to record individual level information and the client's they also have to like take this medicine for whole life we also want to use this mobile health into within the tracker so that we can send SMS to the mobile of PLS IV to improve retention and treatment. And we also decided to link the biometric system with tracker so that the health system can easily identify the client's movement or also keep track of their medical records. So to translate this concept into the practice. So we collaborated with partnered with his India so that we can develop system and to to use this system in all his every treatment centers of Nepal in reality. So first what we did was why I can move this slide. Yeah. So, so that it would help us to get individual level information. And then these are the like features of develop system. First what we did with technical support from his India to integrate like link mobile health within DSS to tracker for that we like develop third party SMS gateway within DSS to for sending SMS to the enrolled client we have given consent for being part of the mobile health program. And then custom scripts like a schedule based on the schedule. We filter the messages and type of messages for the city of the SMS, like what type of messages should be sent to which group of clients. So based on these we link DSS to ML within DSS to tracker. Second is the biggest challenge was to link like use biometric system within DSS to tracker. So these are the informations how we integrate biometric system within DSS to tracker I've also provided link for biometric code for your further information. And then these are the like system features in the left side it's like DSS to be a wave link we can use like it's ideas dot juby dot NP where MLT is also integrated within this system. The health workers working at the site they can register and record information of provided services we're using this HIV care and I to tracking system. And here in the right side is biometric system is Java based applications and developed by is India. Here, we can like the health workers can log in the same login provided to them for this as a tracker. And they have to log in into the both information system to record the information of patient and how to identify the existing patient or client is already on the system or not. So, this is the biometric device figure of biometric device, which help us to identify whether the someone is already on the treatment or not. If someone is already on the treatment then it helps us to access medical history of the patient or client. And then if someone is the new, then it also help us to register that new patient into the system with the biometric system also help us to link to add patients details in DSS to try to capture. And another third like key activities, the biometric system support is to if someone is already like diagnosed as I be positive from as I testing and counseling sites. If they refer to the HIV treatment centers, then that means the sites can already record the patient information in DSS to tracker, they can electronically send those from to the HIV treatment sites, and then health workers working at the treatment sites can also update fingerprints to the patient already registered at STC sites. And this is the DSS to tracker app, which allow us to for the following functionality we can like register in role, declined in the HIV program we can also refer the from as I testing size to treatment sites and from treatment sites one treatment site to another treatment sites if some patient wants to take medicines from other sites or in another districts. So within that tracker system we have like written multiple stages. If someone comes for HIV testing we also record their information. If someone found is diagnosed HIV positive, then we also record their medical history. And if they come for frequent follow up and then we also record their follow up. If the HIV positive is woman if she became pregnant then we also record their pregnancy delivery details if baby is born then we also record their HIV positive status their treatment status. If someone is like death or lost a follow up missing we also record such information of client or patient in the system. Okay, ML like, why we included it is because there are like evidences. If you send frequent like the SMS reminder SMS to the client or patient that improve the returns are in treatment among the, those are clients. So what we did is we created two types of messages one is appointment reminder. This is general awareness messages appointment reminder said sent for like field pick up city for test viral load test. And then general awareness messages are sent to the client of PLS clients or patient about the importance of regular health checkup or positive prevention so all these messages are developed in Nepali. So I'm going to present about our some of our implementation experiences and the lesson loud what we did is we first, the first identified the sides for piloting of our develop system we did piloting in the capital city. In large as a treatment centers of Nepal. And before doing that we also develop user manuals to guide health workers to use the system, both in Nepali and English language, and we are before that we also side by side also make sure that all the necessary infrastructure like server biometric device CDC were ready and installed. And there was also team like central team at the center also with technical backup from East India, ready to support or address any issues that occurred during the piloting. So successful piloting and addressing the feedback from the health workers, working at the piloting sites. We rolled out these develop system in additional as a treatment sites of Nepal by using methods of one site coaching the center team visited the, the roll out sites and we guided them and we provided them all the resources, even guidelines that required to use the system on a day to day basis for piloting his finger also visited Nepal and they also guided us for successful implementation of piloting we also like a plan in beforehand, the additional resources that require such as we need to like we have we conducted several batches of trainings to train the health workers working at the sites or the province level. So we, we allocated resources financial human resource, and any other sort of resources that required before and we plan for it. And immediately these are the like lesson on what we like learned immediately after roll out of our systems, especially after rolling out to the system to additional sites, some of the sites complain us about the double recording they also have to like record the information in paper based registers also in tracker they also complain it increased their workload. And they were like interrupted internet supply or slow internet speed at spew sites and what happened is like the treatment services started in 2004 and five in Nepal, but we piloted the system in 2017. And they were like use back data data, especially in the other sites having high client load because when we started they were like first to 17,000 PLS IV on treatment. So it takes around like 50 to 60 minutes to enter back data data in track of one client who is on a journey for eight to 10 years, they also complain about it, and to address this issues we have to like higher additional human resource to enter data into back data data to use as to tracker. And they were looking for like incomplete information in paper based registers so we didn't have any source to record a major information into tracker. And there was another issues in the beginning we solve it later because we use a Nepali data which called become some but but here there was dates AD so most of the in paper based register they use Nepali data again, this also increased their workload to convert this Nepali data to these AD. So but later we address this issue. This also like was big headache for the health workers working at the sites. So mobile health that is like in briefly like getting SMS, despite we haven't used PLS IV, HIV related terms we use no more neutral terms so that even someone else read the SMS of mobile or PLS IV or our client, no one would understand what is related to but despite that, some of the PLS IV denied providing mobile number to fear about disclosure of their HIV status. And some of the PLS IV complain about the frequency of text messages delivered through the system but we also based on the recommendations will reduce the frequency of the text messages. Another like biometric system in the beginning we thought that most of the clients or patient would refuse to provide thereby like fingerprint, but none of the sites luckily or none of the sites reported like PLS IV refused to provide fingerprint. So the clients or patient easily accepted it after briefing the purpose and the process of the biometric system. HR related human resource related and not enough time because to enter data in the DHR to tracker because the health workers working at HIV treatment centers are overburdened due to other responsibilities in emergency ward. And another major challenge was like height on over of the staff at the site so we need to provide like frequent trainings to them. Then we like develop system we rolled out and throughout the process is when they were supporting us and we were so excited and like okay we are now this is very good system. So we are going to get this very important disaggregated data so that we can monitor progress of national HIV program, but in reality what happens like after a few months of roll out is that there was like sites where like not like up taking the develop systems. There was like various very slow progress in data recording in tracker. And when we call sites to query about slow progress in using system. Most of the health workers even don't remember where we're willing for tracker capture. And in summary like immediately like few after few months of our roll out what we came to know like not all sites excited and happy to use these as to tracker based information system, at least not much excited as us working at this center. So after that we had like several meetings for how to like why resistance to use information system by health workers at the health centers. So what we the key answer we came to know is like we because we never care to answer their main questions during roll out of system that is why do they use this new information system and provide additional time considering their existing overworld like workload. We never cared about their this care to answer this question. So during roll out we mostly focused on our advantages just advantages at the center or federal level such as user individual level data to monitor treatment outcomes at national level. So ARB resume and info to help us to provide information for procurement and generate real time information appeal as having country we do just care about our advantages during roll out but that would not encourage health workers to use our information system because they have to face a lot of like activities implement a lot of activities of the health centers. So immediately after that we like to motivate site we started to focus on answering key questions like there are like different reasons why site must use this information system, which will ultimately reduce their workload. And we have used like several strategies to convince health workers sites that information system was developed to reduce their workload and support their day to day operations of services. Now like we also prioritize like that I use planet size, not just like recording in data into the system. But we also prioritize how can they use these recorded data to support their day to day operations of services. Now these are like few examples what we did is immediately after what we communicate with scientists like they can generate monthly report with one click and upload it to national system so that they can be able to prepare report in SMIS recommended format manually, which greatly saved their time which also was like great interest for them. Another example was like, we also provided like develops side level dance board with several indicators, so that the site can monitor both aggregated indicator and individual level data patient for their planning their response. For example, they can easily show the list of clients who need attention based on the parameters of retention. Let's say some they can easily download from tracker like details of lost a fellow client, so that they can download and print it to the, and they give it to the different teams who are providing community home based and care services. So that they can contact those clients and then improve the retention. At least they can also adapt their dispensing practices, they can easily identify the biological surface patient or those who are coming to on time will pick up so that they can target those patient or reduce their frequency visit to the sites. And we also organize several capacity development activities so that they can, their capacity can be improved and they can so interest into the system. And especially in the case of this COVID-19 situations we also develop YouTube videos to learn more about the information system. These, these like different activities, motivated them to use the system and the star slowly slowly. They started using this information system now currently like we have more than 33,000 PLS I've ever in moment treatment with the data recording to the system. This is the one example of this right figure like the national level or site level they can monitor this aggregated dashboard. Red means they require attention. Green means okay. And by this they can know their site status. And this is the figure like one of the trainings we organize to capacity site level and province level health workers. And after this now currently we have like the world of this information system in all it's a treatment centers of Nepal where they can record it's a testing and treatment services. And what happens in it's a program is not only we talk about it's a testing treatment where separation related services, there are other services like implemented by government and other partners like prevention services that means they are these are the activities which are implemented to prevent as I've been from getting a cyber infection, like distributing condoms lubricants, community testing or providing prep. There are like lots of services which is also implemented in Nepal they're also different as I've given support services to improve survival of clients or patient. So what our plan is to generate desegregated data for this whole HIV care continuum using DSR to track that means this prevents an intervention testing enrollment in his IV care if someone is enrolled in his IV treatment. And then whether how many of them are still on the treatment and these whole continuum information we're planning to generate from the DSR to track. So that it would be like help us to like get generated real time data at different levels site local level province level or federal level for informed response against HIV epidemic in the country. So what we'll do is we'll generate DSR to track data record data in DSR to tracker. And then we'll also integrate those data recorded in tracker to the next message. So it would help us to standardize the recording and reporting system as a program in order to also help us to ensure that our consistency and that availability at all levels. So for this and to ensure him like successfully implement this plan activities is when the eyes closely supporting us. And this is the conclusion, like, there are lots of advantages of DSR to track based recording reporting. But these are the few, like I provided here is a tracker based information system provide real time data evidence to different levels. So that the site within support a like, like plan the responses or allocate resources to close gaps in his IV treatment delivery. And the sites can also performance or monitor the targets were already reached or not. So that they can or the center of province can design public health actions to improve quality of HIV treatment. And it's the especially the dashboard also alerts health workers that's every treatment center so site about specific areas, which require attention and supports overall optimization of patient care, which is like almost impossible by using people based registers because if they are like 2000 or 3000 PLS I've been one year dissenters so it's not possible to immediately identify like poor performing patient by the health workers. And so this is the resources that if you want to know more about our information system we have like YouTube channel for this as a tracker and then we also have like user manuals of our develop system if you want to contact me I have also provided my email here. Thank you. Thank you Dr Keshav for the insightful presentation so think this system is a perfect example of the fact that it's easier to build systems, technically but it takes a lot for effort in implementing those systems and increasing the adoption of the system at the end user level because that's where the whole challenge lies of making develop system into a success story, which has been in the case of Nepal. So it has taken it on four years of effort from the country team and the technical agencies supporting the system in country to kind of take it up a level where the centers have adopted the system now and have started using the advantages, the system offers as part of its functionalities. So, in terms of the questions, we have one question from Ibrahim and AC. Dr Keshav, the question is regarding the internet availability. Is the internet available at the AIRT sites at the consistent level, or else if it's not available do we have another ways of reporting or sending the data? Yes, few sites are still especially in remote hills and mountain areas. They are like facing like slow internet issues. Now to address that issue, like we have developed this mobile based app so that they can enter the data, record data during offline and then they can go to any like offices which have like good internet access within the hospital premises or in primary health care centers. We developed it with support from Miss India and a few of the sites are using it, but they are like still like facing to use like challenges to use this mobile based app because they complain like it takes a lot of time to install and use these sites which we will address like in coming days. Thank you. Thank you for the response. So, are there any more questions for Dr Keshav? You guys can also unmute yourself and ask questions if you want to ask questions through your machines or you can add questions on the chat box. We can take up the questions at the end of the sessions as well. So thank you Dr Keshav for the presentation. We can move to the next presentation now. Dr John, if you can share your screen and present the TB information system in law please. Are you seeing my screen? Yes, if you could just put it into presentation mode if possible. Yeah. Yeah, great. Are you seeing my presentation on the screen, right? Yeah. Yes, yes, please go ahead. Hi, my name is John Lewis from University of Australia and Hispy FM based in Ho Chi Minh City. I've been looking after DHRs to implementation in Southeast Asia, focusing mainly on law and other countries in Southeast Asia and Pacific Islands. So today what I'm going to present is about use cases, DHRs, tracker use cases in in law, focusing on TB and place how what are the different effort has been gone in the region to link the the TB data across different countries and how do we address that one. So to begin with, law is a landlocked country. The DHRs to started in 2014, the initial demo and the piloting and then it was rolled out in 2000 end of 2014 to national wide on aggregate based system. In 2017 it was recognized officially by Ministry of Health with and also had a degree that like DHRs to will be a national integrated platform where all the health data will be stored. So there are thousands of people have been trained. It's a small country with the population of 7.7.1 million. Most of the health data has been used. I've been used DHRs to for the training. DHRs is managed and maintained by Department of Planning and Corporation under Ministry of Health. So they are the one who are leading the DHRs to implementation across all the programs. So they provide the service with the support office Vietnam and University of Oslo. We've been guiding the DPC in managing and maintaining the DHRs to. So they are the custodians of DHRs to implementation in law Ministry of Health. So they that means they are the people who are actually maintaining the DHRs to ordinate their hierarchy and all things and rest of the different program. They can have their own form and other things to be installed and used at their for their own program. Just to give you a bit of idea on what are the different programs which has been used. So the foundation of DHRs to in law is we had a lots of meeting with all the different program people to integrate and agree on a common hierarchy. That like we have national and then we have province district and under district we have all the health facilities. So all the different departments there was like agreement saying that like we call the province as PHO, provincial health office and district health office because each and every program they had a different name. Like malaria they call the province as province anti malaria unit, HIV had their own terminologies, TB had their own terminologies at the province level of the district level. So we just say we are like whatever we just call we call this province health office that includes all the different programs and everything in that particular place. So that's where you get from and then wherever it is like it's a provincial health of a provincial hospital and under provincial hospital that can be multiple programs to deal with. So the first agreement was done organization unit hierarchy, and if there is any hospitals or anything to be added, they will contact the DPC, and they will manage the health SAP list and providing the code and everything. So that was one thing what we constantly agreed on. And then based on that, we since when we started we started only with aggregate data, and then slowly we moved to events and then to travel. So if we just see some of the places you have aggregate and even for example, MCH and the API. And when it comes to for BB it was aggregate and the tracker, when you come to HIV it was aggregate tracker and the events. So based on the needs so there were been different things has been used. In now what we've been working on is also like a interoperable thing so if a system has been already been rolled out like example M supply which is basically logistic management information system rolled out in many places so we integrated the aggregate data from M supply to be a chance to so that the health worker can actually health worker and health administrator can actually just see the data and analyze the data from the world supply change and as well as the the the program. Thanks. So based on that one. So when we try to implement all these things there. There also been lots of innovations happen. Yeah, so we extended especially for the code with there been lots of planning and innovations are happening at the different level. So one thing was the data entry load was quite heavy at the health worker side so they could not really cope with in doing all the data entry. So what we did was is to give them public the access where they can actually register for their own information that means they entered the first name last name. Answer all the questions so the health worker can actually do the review when they come for the vaccination. So that really helped the health worker introducing the data entry burden. And they just like update the vaccination details and few other screening test. So this was actually helpful for the health worker side and for the public side it also helped on so that they don't really have to wait for longer queue so they can select the vaccination site and also the time. So when they want to visit and based on that one they can actually come to the lines. They're getting the vaccination for the COVID really helped on the second one which was is to have this green car or the yellow car on their mobile phone. So this is so they can install. The Android Play Store or the App Store which is still under development and testing phase, so they've been going to release this one soon so the citizen can actually download the data and the data is coming from DHRs too. If the person has been fully vaccinated they will get as a green card if the person is not fully vaccinated they get as a part of their mobile phone. So these are the different services and things what we've been trying to use in in law. So now coming back to the focus to on the TV TV like since like we had the agreement in 2017 TV was started using the aggregate data entry where we collected aggregate data from province district and central level hospital for every quarter TV is a quarterly based system and especially on the aggregate side. So they started with that one and they're rolled out in in all the TV units and the the provincial facilities. So that went on quite well and then they wanted to move around to the tracker so what we did was in 2018. We started in one particular province and we adopted the WHO TV package and customize it for law of needs and plus also included TV tracker contact tracing also because in the WHO package that particular time we didn't really have the TV. Contact tracing what we had TV case surveillance and we included the contract tracing of the TV and then we rolled out in Lumpabang province to see like how it was working. So there were quite a lot of challenges, things like just on the people first time they would try to use the tracker, the concept of like writing from the patient level at the paper base to online. And then like it's a one particular system so where you register a particular person one time and then you can follow it up for the entire treatment so there was quite a lot of training involved. So that also went on quite well. And after the pilot there was a review and after the review in 2019 it was scaled on to all the other TV units for reporting all the things. Plus right now we have been also working with one of the NGOs where we are trying to create the present to TV because right now. What health system gets is only the people who been confirmed as a TV positive case that's only when they get into treatment. But there have been lots of other issues on there are many people they've been just like suspected and they are negative those informations are not been stored only aggregated has been stored. So with help of this NGO, so where they can actually do the data entry that's also something which we've been working on. Just to give him a bit of things so aggregate data is stored in a different server where we just say. HMI score or twice basically for the aggregate server that means not only depending on the TV but also for all the other programs. This is the where like we store all the data and for patient level, the DPC department of planning and cooperation created a new server where all the patient level data has been stored. Irrespective of whether it is TV malaria HIV things say everything is in this server so the differentiation was when we have a patient based server so it's good you should have more authority more security and also that's why like it was created as a separate server. And so where we store the patient level data. Initially when we started like there been lots of desegregation, especially when you look at the TV form is broken up by present to keep cases then the age break up and all. So they have been collecting all the things so when we move to the tracker, it really helped the people in adopting that. The first things like when we started also there have been lots of negotiation on with TV HIV malaria department on getting the patient attributes right. So we didn't really want one attributes for TV one attributes for for HIV, for example on the occupation on the sex so we should all agree on the same attribute so it required a bit of negotiation and talking around so that like we use if it is an occupation education ethnicity to be included and also you I see in law we don't really have national ID for all the people. So what we did was is to create a UIC which is used not only for TV but also for malaria and also for for HIV, which includes first name last name date of birth sex and the birth problems. One additional field which we included in all the programs was the current address where people have to just select where the which province and which district and which village, but village is not is an optional but the province and districts are need to be required, plus the birth problems. So you I see usually use that one and it is shared across other places so that means, if a person is already been registered in one particular place let's just say malaria program TV can actually access that particular person and enroll and give their own TV ID that's okay. So then they don't really have to register other person again. So this requires tracker DHS to tracker is a when you register a particular person can be enrolled into multiple program. So only the authorized person can have a look into TV and malaria. So this also the again, sorry, TV and HIV. So this again then there've been lots of discussion on how best we can, and who should be able to have the access. So that's also the other things what we've been working with them DPC and the program head on interoperability and sharing of the data. And we use the WHO TV package so these are all different fields which they've been already been configured so we took that one and we included few local technologies and other things so that like we can try to use at the So these are the few outputs where people can actually just see where they're coming from in law what we did was each and every village is linked to coordinate. So when users are like where they are from so health worker can actually just see where they are getting the treatment and where they're actually coming from. So this also helped us in doing the analysis on looking at them, the area wise, the TV cases, and also their contact tracing. So that also really helped on other things. Apart from that one what we did was also is to collect the nationality of the TPP patient, most of them are from law but like we also just saw there from other countries like China, Vietnam, Thailand and Myanmar they've been also so getting them the data and we could aggregate the data based on our prior things to include it before we only had law and others, but like as we evolve like we just say like we need to agree on the nationality, and we had the two nationality one is full list and one is smallest, a full list was also should be agreed by all the different program people what to include a full list requires list of all the things based on, for example, COVID and other things we use the full list and for the TV and other things we use that the simple list which is basically a subset of the country so it's easy for people to just select those options and based on that one we can try to just see how many people have been cured from this particular country or transferred or lost to follow up. Maybe they have returned back to their own country, we could not try to find those details. That's basically it about from the law. There have been lots of lessons to be learned. What we also with the University of Oslo and Global Fund and this regional PB program, which is supported by Global Fund and implemented across the five GMS country which is Thailand, Myanmar, Cambodia, Vietnam. So this is a greater Macong sub region area. So where there are lots of cross broader migrant TB cases are happening, especially in Thailand moving to Myanmar or Thailand to allow and Vietnam to Cambodia. So there was a no way of finding out like how people are how do we get this information. And for in that one like this project started in late 2019. But then like COVID happened so there have been lots of pickups and like we could not travel and all. So the initial idea was each country can share their data to a regional data warehouse, especially for the people who been in the cases who been like treated from one country to other country and how best the information can be shared. So we wanted to study each and every country how things are only now is using the HS to and Myanmar, only the aggregate but therefore their own TV tracker they're using complete defense system, Thailand is using complete defense system, their own in house built same thing with Cambodia and Vietnam. So it was a challenge to how best we can try to integrate and for the regional data warehouse the HS to was selected as their warehouse or where the different countries later can be stored across. There are two steps one is for aggregate data and other one is on the patient level data, only for the international transfer that data can be stored and shared across and only authorized person can able to see this project is still undergoing and like they've been working together and lots of different lessons has been learned how to how do we best implement a tracker solution, not only in a country but across the country where the data can be shared. There have been already been lots of small scale project happening between two hospitals, they've been using line WhatsApp Facebook to send the data from one particular hospital to other other hospitals where they can actually share and re enter the same system across. So this been happening between law and in Thailand. Same thing also in law and in Vietnam in one particular place. Same thing with the Myanmar and Thailand, where they have different things and lots of NGOs and CSOs are been helping in dealing with that. For people who are familiarized with them TV information system, like when a person is transferred within the country they usually have TV 09 form which is a transfer form where they enter the patient details and the classification. And then there is a part B where the people just like to say, so these are the referring unit where they're going to send. And the third part is the, if the people have been accepted so they get an acknowledgement receipt. So that's how it works down and this has been implemented this form was implemented in Myanmar and Thailand broader where people can actually share their data across and that person who's been treated in one place the place can continue treatment in other country. So something which we have been working with the challenges where it's also like in Southeast Asia, every country speak very different languages and they have different script. So we can't even guess like what this one is until unless a person knows all the different languages. So this so then like we just say like we need to have a common level of agreement on when we do the data sharing. It's not only about your host just like even the hospital name was complicated to understand. Then again like we need to have all the organics and everything to be translated in local language and in English as the common denominator, plus the name of the particular person will be transferred in each and every country, all their name, even though they are from different countries where been stored locally in local language like if a person from Thai comes to to allow the person will enter his name in law language, not in in English. So this has been the challenge so we work around and we just say, we will keep one local language and one translated language, especially for the people who've been translated across. We did a few changes in the WHO global package where we had all the treatment details but we didn't really have the referral and the outcome. So what happens is like when a person is transferred out from one particular country to other country. SMS, I'm sorry, email is sent to the national NTP that like this particular person is going to come to your place and you might visit this particular province. Once it has been there, so like they will the receiving country can actually just say whenever they come around. Okay, this particular person is admitted in this particular hospital or continually strictly this particular hospital and that once they accepted a message is sent back to them to receiving country just saying this, this is the person and this new ID which has been accepted on and this is the treatment detail. And once they finish them the outcome and SMS also send back or sorry email is sent back as a notification saying this particular person is either cured or lost a follow up or relapse. So these are the different things which we've been trying to work on the other main key issue which we've been working with is also on the documentation documentation type, especially when we come with the migrant workers. They don't really have an actual documentation, especially in the poorest area. So they might have any driving license or temporary passport or health insurance or border pass. So we've been collecting this stuff all the document types, and so that we can try to include those people. We can try to follow it up and this has been a joint effort between University of Oslo, IOM, all the TB people from all the different countries, University of Oslo, Global Fund on trying to just see how best we can try to use all the things. So these were the few of the example where the notification is sent from one particular place to other area. This is something, a new innovation which we've been trying to work with lesson from COVID vaccine certificate. During the COVID vaccine certificate what we learned was there is no global database of a particular person who've been vaccinated. So usually the other data is stored in a QR code. And if a country wants to be accepted, so only the public key has been shared across the neighboring countries, so that they can read this QR code. And this particular person has already had this vaccination and it can be allowed. So we took that concept and we've been trying to implement that one in for the TB and cross border migrant places where sharing the data for one particular country and other countries is always challenging, especially with the patient data and all. So we is also one of the alternative solutions where data can be either printed or a person can have a smartphone and have the QR code. Other country or the hospital can read it and authenticated that this is a person and these are the different details. We've been also been trying to think how this data can be pulled back into the system so that like people don't really have to do the data and react. So these are different concepts and the things which has been under development. There's been lots of lessons been learned and also challenging. So tracker, it's always has to be it's a evolving system, which is nothing, which we just like put in as a stone. Like for example in the law PB we just let you create first name and last name after dealing with the migrant issue we just say okay we should also have first name in English last name in English, so that like it can be useful across when the people are traveling to the countries, plus also the document the country list was also the something which was included based on the discussion and all so we always need to think through on adopting and changing the tracker when we always implement. There are new things will come around a new process and also based on that one, both the implementation and technical solution should go and in hand in the changing of the requirement it is not only the technical solution, but it's also on how best we, how we can implement in our own country based on country local settings. Basically that's a way what we've been trying to deal with, and the referral referred in who has the access, who can change the demographic details. So those are the few working securities or the SOPs, what we've been like working across with all the five countries in If you have any question, please let me know I'm happy to answer. Thank you. Thank you John for the insightful presentation, which the use cases are certainly very interesting to understand cross border dynamics and how the information can be managed better when the patient moves from one country to another and of course handle the immigrant population data is always a challenge. There was one question in the chat. If you could just give a little more background on the use of QR codes in the COVID vaccination project in now and in general how we have used QR codes, and if the community can take some benefits from the developments that you've done. And then the QR code is from UNICEF Oslo and his Vietnam joint team working closely with, with EU green card pass. So that's the, the schema what is where what we have been used to generate that one. It's similar to WHO standards, but like double the standards used fire. There have been multiple COVID schema. One is EU, one is common pass, one is other things, but the idea is the simple. We are taking the data from DHRs to and converting it into a common terminologies which can be accepted across all the places. For example, the vaccination manufacturing portal is has a global key, and that is what has to be recorded. None of the DHRs to people like we store those keys. We just like store only the vaccination name and the manufacturing things but not all the different details. So that's the one thing which we, which we try to deal with. And it's this QR code things I can give you all the, the links in the chat where you already have a public facing a GitHub where you can track it on board all the things. Same thing with with the same thing with the UNICEF Oslo and DHRs to team. We also have created a public GitHub place where people developers can actually use this code and can customize it for their own needs. Thank you, John. So, once you share the resources in the chat we can share with the participants through to the Academy Slack channel. Thank you. If you have any more questions, please feel free to add to the chat box. We can take up at the end of the session. So thank you John for your precious time and I guess we can move ahead with Dr. Thank you so much, Saurabh. So good morning, good afternoon. Good evening to all of you. So, a lot of familiar faces and it's so nice to see you all again. We have had two presentations on how the DHS to tracker is used in different contexts, both from two different Asian countries in Asia. So what I'm going to do next is to take a use case from Sri Lanka, and also try to figure out like when you are at DHS to implement it. Probably you are holding a technical or administrative precision in the Ministry of Health. How we are going to decide whether we can use the tracker, because most of the time it's going to be a very challenging decision where a lot of variables are at play. And so I will try to explain that using how we adopted DHS to tracker for COVID-19 surveillance in Sri Lanka. So what the other thing that I want to highlight in this presentation that I'm going to do is to show you how you can take the DHS to tracker forward than the default DHS to tracker that comes bundled in the DHS to package. Joan has already shown you a lot of potential of DHS to so, but you have to keep in mind how DHS to aggregate tracker is different from aggregate is that you always have potential to expand it further. I mean, based on your country's potential teams potential as well as your imagination to ultimately provide better healthcare beyond country. So let me share my presentation. Right. So this work actually happened. We started of course with COVID-19 about one and a half years or even more than that in Sri Lanka. And I'm going to kind of mention you like how we devolved over time first and then specifically targeting on what are the different components of tracker that we are using in DHS to and I mean, how we have been, I mean, what are the challenges we have been, we have encountered and how we have been able to address them. So, a little bit of history. Now Sri Lanka got its first case of COVID-19 in 27 January that is just one month after the world got to know that we'd exist. And we had one discussion with the Ministry of Health on 20 January to decide what is the software platform we were going to use for COVID-19 surveillance. So these are some requirements that came from the Ministry. I highlighted them, these factors for you to get an idea like what would be the challenges you as an implementer who has a technical or administrative head in the Ministry of Health or NGO might encounter when you get a project. So here some requirements that we had was you have to enable multi-sector collaboration and sharing of data and the system, the tracker based implementation has to be developed within few days as opposed to like what you usually get like a couple of months. And then of course, because it was kind of the beginning of a pandemic, it was an outbreak in most of the countries, you can't follow the norm procurement processes, it has to be rapid. And of course, you may need to start with few health facilities as a pilot, and then you may need to rapidly scale it up the entire country. And of course, the requirements were not initially identified. I mean, this is the case in most of the implementations around new health issues. So for example, COVID was very new at that time, so everyone was not here like what would be the final set of requirements. So a specific requirements document was not there. And of course, you have to attend to the needs of diverse stakeholders. You will have to think of how to train them. I think both the presentations before it was highlighted like training is a mandatory thing. But of course, because even though it's mandatory, it's going to be a challenge when you're trying to implement a tracker based system. And of course, you might also require mobile data capture and integrate with the existing systems which are already there. So, what we did was we selected DHS to platform, mainly because we had the capacity and we had the confidence within ourselves like our team. And I think that we could do it in DHS as a tracker. So, one thing I want to mention here is like, you might need some, I mean existing capacity within the country. If you're going to implement a large scale or kind of a very complicated tracker implementation as opposed to a very simple tracker where you are using few data and reforms, and probably few very simple workflows. For DHS to be customized. So in this entire COVID-19 related implementation, we had few aggregate components, but most of them were tracked. But we could not serve all the requirements the ministry had with this standard customization of DHS to track. This is where we had to do some advanced custom developments. We could do that within a short span of time. We got support from others stakeholders within the country. So, especially the ICT agency, like this is a government ICT agency, which is a government owned organization. And of course they were like volunteer developers, I mean they were mainly from the private sector, and we also could support from the University of Oslo and the DHS to community. So we were able to develop for the additional modules and create few integrations. With that, we were able to produce the COVID-19 surveillance package for Sri Lanka. So, again, like this we diffuse whatever we learned in our context in the global, I mean the DHS to community. With inputs from that as well as other countries, the University of Oslo was able to provide and develop and disseminate this COVID-19 digital health data toolkit for global use. So this is kind of a timeline of, I mean highlighting how fast the different modules were developed. So you can see like from early February, by about May, we were able to have all these modules developed. These were not just DHS to customizations that you can do from the front end, but in addition, we had to do some further developments as well. It did not actually stop there, right? So after the initial implementation, we had to maintain the system, especially throughout the last year. And towards the early this year, we had our, I mean like following our second wave of COVID-19, we also had the requirement to cater the vaccination, the COVID-19 vaccination related requirements by the DHS to base system. So this was a massive challenge for us. I will explain like why it was like that towards the end. So what I wanted to say was like, this is not just one time work and you are trying to implement tracker, you have to be agile and you will have to keep on developing components. Right. So this is the kind of ecosystem of different modules around COVID-19 surveillance, which is there in Sri Lanka. So what I want to highlight here is like, say for example, initially, like when the COVID-19 started, the focus was more on the board of entry, and then it changed to quarantine. And then when there were like more critical ill patients, we had to design, we had to focus more on hospital based system, as well as the ICU bed tracking system. So I'm trying to highlight the trajectory of the requirements and development of modules might change with the changing disease epidemiology. If you are like, especially if you're trying to develop a tracker based implementation for surveillance. So this you have to keep in mind. So, because like if you try to, you know, like plan everything and prepare a budget, which only focuses on, you know, the development which happens at the initial phase of the implementation, this might not always be true. So you need to be kind of prepared to address these kind of challenges. And of course, like from end, I mean, towards the beginning of this year, our main focus was around the immunization, and then to create the requirements around the citizen portal and issuing vaccinations. And of course, you are the integrations. So let's now focus on, I mean, like, what were the additional developments that we were able to do in Sri Lanka. As opposed to the generic DHS to track that we have. So what you're seeing here is like you must be very familiar. It's a generic tracker capture, but because I'm talking about advanced implementation, we had some challenges, especially in tracker performance and based on some end user experience so based on that we had to modify the tracker capture a bit so that we were kind of able to reduce the transmission of the data back and forth between the tracker capture and the front end application and the DHS to main platform through the API. So for the, to do that we did some modifications here so that's why you are seeing, like say for example this text in red as well as, of course you can't see here we have another additional button so that we were able to push the data at once to the DHS to instance from the tracker capture. And also you can see on this right top corner, we created additional widget in the tracker capture to issue the certificate. So this is kind of some additional work that we had to do, based on the requirements of the and this is the contact mapping visualization application which we decide based on the initial requirements, especially in the initial part of COVID-19 where like we had less number of cases and we needed to map it out at national level like how the DHS transmission to place across the population. And of course this application, I mean, again, another thing that I want to highlight is like, if the tracker implementations are very complex you might need to get support from the DHS to community as well as the regional especially in the Asia region, we have like very senior his notes such as his India and Vietnam, they have been around for very long time. So you can always contact them and get their support in case you need this kind of advanced implementations. And this is like we were initially wanting to track the mobility of the patients like based on of course with their consent. So this is one additional module we created on top of the existing DHS tracker to integrate the location based information that we captured from the mobile tower networks. And we also designed ICU bed tracking application. So this is again a tracker so what I want to highlight is like we can sit we configure the DHS to tracker just like what we normally do, but only thing that is changing here is rather than using the tracker capture application you can design the custom DHS to web application so you have, I mean, you can define your own interfaces. So this is what we have done here because the ICU staff they wanted a very simple interface just to mark the status of the bed, whether it is available, whether it is not, whether you can reserve that bed. So for this we designed a custom application which is working on top of the standard DHS to track. Then I will move on to the COVID vaccination so I will take this as an example to explain the challenges that you might encounter in advanced tracking implementations and how you can, I mean like how you can be prepared to face this challenges. COVID-19 vaccination again like we had to, I mean work a lot especially our team because we had no experience from other others in the community or implemented this because we had to one thing because we were kind of, I mean, in fact we were the first country to implement it in a kind of a very large scale manner, nationally. So for that, our team, I mean like we didn't do it alone, we always have discussions with the DHS community as well as regional disc nodes to see what they have gone through across all these years when implementing tracker. So similarly before implementing the COVID-19 for vaccination we had a discussion with the Spindia and Vietnam to understand the challenges they have gone through in implementing large scale tracker. So based on that we designed a module which has a couple of components, one thing is the immunization tracker, then you have the stock monitoring digital vaccination certificate and of course the citizen portal for booking the appointments. So, inside this module, as I mentioned the stock component we were using the DHS to aggregate, but for everything else we were using DHS to track. Initially we started off with using the simple default standard DHS to track a capture application to capture the data. So the modifications I showed you previously were done after implementation like so these two place about three to four months after the implementation of the vaccination instance in DHS to so I want to highlight right you might have to do changes you might have to learn from your implementation and the challenges and modify accordingly so you actually cannot plan the entire trajectory sometimes right at the beginning. So in the case based tracker data we are capturing the vaccination information the first and second doses now of course we are to complicate things further we are now planning to incorporate data for the third dose because the government is preparing to vaccinate selected population sectors on the third dose so we have to get prepared to incorporate those requirements. And we also have the AFI component as well as separate vaccination module specifically targeting information for pregnant others. And the next important thing about DHS to it's the analysis and visualizations. So for tracker analysis and visualizations so there are several built in capabilities. So the first thing is like we have different analytic tools in the DHS to so you may be already aware that if you're coming from aggregate background we have tools such as the data visualizer that you can design charts, as well as now we were table tabular output you can use that and you have the maps application in DHS to create visualizations of in the GIS visualizations and of course you can put these visualizations in the dashboard so that people will be able to quickly compare across different analytic output and take the decision. So what you're seeing here is one very simple visualization that we have done using the DHS to built in tools right so these kind of charts are quite simple. And then of course you can always have dashboards such as this where you kind of put together different pieces of analytic outputs that you create using the analytic tools in DHS to so just like in the aggregate you can also design them in the tracker and put them in the and then in addition you must be familiar that you can always download data out I mean from the DHS to and take it outside and do your analysis using Excel so it's also possible for trackers say for example if you want to download the line this is definitely possible in track as well. In addition we also did something called SQL views. So this SQL views is advanced kind of analytic feature which is available in DHS to so say for example if something is not I mean like if you want to obtain a particular table which is not possible using the. I mean the default visualizations or the analytic tools as well as the API you can of course use this SQL view so we are why I mentioned this is because like in the I mean as our next visualization strategy we are using custom applications so in when you're doing this custom applications sometimes. You will have to use this SQL views as well so just want to tell you like you have endless number of possibilities of having even visualizes so like the next time before you say to a client or to the ministry that this is not totally possible. On DHS to what you can do is probably you can discuss this in the DHS to community and ask whether other countries have. gone through the same experience and what are the other so this in fact is one custom application that we are we are using the SQL views as well as the DHS so here we wanted to you know like. Give some visualizations based on some outputs which we were not directly obtained from the standard analytic tools so to do that we kind of created the custom dashboards within the DHS to so this is of course for our. issuing of vaccination certificate so we needed some statistics from how many certificates generated and things like that so to do that to do that we kind of used another custom dash. Okay, so a little bit of background about the vaccination certificate so again we started early this year. What we did was we did some modifications to the existing tracker capture to include a widget, and then we also used another service I will come back to it a bit later another. global public good called I work, so we created an integration between DHS to and I work. And then, based on that we were able to produce this certificate so initially when we started this work we will be based on this smart vaccination certificate guidelines that which published. It was early this year but of course after that they have been couple of other publications recommendations from WTO. But like this is a kind of a sample certificate that we are producing in Sri Lanka. So to do that what we do is we have the DHS to like this with our standard tracker capture and of course we had to create this pool called a custom backend it's additional development. And then we integrate that with the third party service called diver. And again, we also had to integrate the DHS to with the citizen portal because the citizen portal is where you are kind of booking the appointments for the vaccination. So it's kind of like integrated system where we have the DHS to and few other systems that are kind of managed by different entities of the government. So for example, the DHS to is directly managed by the Ministry of Health, whereas the, the dive system and the citizen portal is mainly coordinated by the ICT, ICT agency of the government of Sri Lanka. Right, so challenges, of course, like, there are a lot of challenges like, for example, we needed some guidance on how to design these things, because it was totally new when you were trying to implement something for for something new to the world like COVID-19. And when it comes to the vaccination certificate, there was a requirement of pre registering the entire adult population of the country to DHS to. So for this, again, like, we didn't I mean, like we didn't have much time to experiment by ourselves even though we did. So here we took inputs from other his notes, especially, I mean, john who presented before like he had done some large scale implementations before so he had some experience around how to import this track entity instances or the person to from an external source like you have a massive Excel or CSV file, how to get it in like, of course, we had very nice inputs from DHS to colleagues so you really have to collaborate with them. If you're kind of doing something really new. DHS to has had some performance related issues of a large scale tracker implementation, most of which has been fixed over the last few months but still we are struggling at some certain areas. So the best thing that you have to do is like if you struggle with something like that always put it on the DHS to community, so that you can get some feedback and also you can make the DHS to core team aware of the issues that you are facing so these can be fixed really fast. Producing a cryptographically variable certificate was a major challenge because we did not have that functionality available in DHS to and the capacity of your team to do this custom requirements can also be a major challenge. So how we address few of these challenges like now, what country required for transparency across the entire vaccination process for health managers at different levels so to do that we had to create different level dashboards at health facility level that is like the vaccination centers and we called we have a layer sub district level called MOH so the Ministry of Health we have medical officer of health areas it's kind of like a sub district level. They are all the operation of the vaccination takes place so they needed their own dashboards to monitor and at district level they needed to additional requirements and then national level, you need a dashboards to be available for all the state. Not only the health, but also for the like the COVID-19 steering committee the main main ministers and the high level officials of the government so you had to create different types of dashboards to suit this requirement. And pre registration of the entire population we were able to do of course with some some tools we develop with the help of of course the University of Oslo and the global DHS to team. And one thing is like DHS to tracker and aggregate you should not kind of separate it out, although that's how you do it when you are configuring. You always should try to link it up so that because DHS is primarily recognized globally, and it has been proven across the years as HMIS platform so producing aggregate outputs is is really required and sometimes you might have to start with aggregate if your infrastructure and capacity is low, and then probably you might have you might then decide to move to trackers say for example you can start one form or like with one program you will go for track whereas you might have to continue with aggregate. So it's the same that we did in Sri Lanka. And of course we had to do some custom developments on DHS to thankfully we had the relevant expertise. Training and support is very crucial. Like, this is not totally a DHS to related thing like for any program that you are trying to introduce you have to do some very good capacity building and of course you have to be available to provide support so you have to plan all these things before you start even DHS to customization because this this sometimes take a lot of time to build capacity within the country and to you know structure it in a way where the support can actually work. And we received inputs about how to design the vaccination certificate from WHO and various entities which which was a major input especially the WHO country office because the WHO country office was really instrumental in implementing the DHS to vaccination system they were providing technical support as well as they were collaborating across the stakeholders who were involved in implementing this. And we had multi sector collaborations within the government it is like the ICTA and development partners as well as international in the DHS to community and the University of Austin. And of course you always have to know, again to the existing system so that you can share that you try to create a system in isolation there will be a lot of resistance because everyone wants. I mean, visibility of what is happening and they want to see data so that they can use it but so that's the kind of experience we had in implementing DHS to track. So I will stop there and I'm ready to take any questions if you have. Yeah, thank you Dr. Pamato the insights. So as we all saw in all three projects that we saw the implementations that the tracker implementations are basically a journey and they really don't stop at the development and the implementation is they really keep moving ahead in terms of requirements in terms of adding new features and keeping them sustainable with end user involvement doing capacity building and continuous sustenance. There was a question regarding the use of QR codes, so John and Pamod if you could just share insights that when the QR codes scan, do they take up the end user to internet based link or a URL or the QR code itself has the information embedded. So they're asking which way of implementing QR codes it's better either through guiding the user to a URL or showing the data which is already embedded in the QR code. Yeah, actually like with the COVID especially like you know like we've been using QR code in many different places it's not new but like for the COVID like what we call it's a cryptographically verified QR code that means it has a signing authorities and also data embedded to it. One of the whole point with that one is anyone who is reading the QR code don't really need an internet or anything but only you should have an authorized key to read it. If he does not have an authorized key to read it you won't you will just get some data but you will be not able to actually view what it's inside. So that's the one of the things which any system whether it is dialogue or EU or common paths or anything that that's the system what they are using it's not really normal QR code but it is a cryptographically very, very fact QR code with a public key and a private key. Public key is what is been shared across to all the places. Just to add something to what Jones says so I mean like I totally agree with him, but but now it all depends on what how you implement so for in, for example is Sri Lanka. Currently we are using the certificate only for the foreign travel purposes so we have a link on the certificate. Like we have a verification portal where people can go and verify so that means it depends on the internet. But having said that as shown mentioned because it has the QR code, the necessary that the minimal information that is required is within the QR code, but one challenge that I mean like if you if you are going to recommend it to like if someone asked like, can it be totally implemented offline. There may be a few things to consider like, especially in the case of like in case if some changes happen to a vaccination certificate. Like say for example, there was some information which are not correct and you had to re issue the certificate. There is something called revocation of the vaccine of the vaccination certificate. If that happens, then that information again needs to be updated to whatever the offline verifying mechanism so probably you might need a little bit of internet, probably periodically, but other than that you this these solutions should be ideally able to work offline. Thank you guys I think that that was very useful. So we have reached towards the end of the sessions we had planned for today. Thank you, KShap, John and Pamoth for sharing their presentations and insights. John has added the resources for the QR code related information in the chat box. Please take note of that. We will also put those resources on the Academy Slack channel for future reference. The link of the webinar would be uploaded on the YouTube channel. We will share the link on the Slack Academy page for the participants who would like to visit the webinar later. And any questions which are there for all the three speakers please feel free to add them on the Slack channel for the Academy. We will ensure that we will contact them and get the necessary clarifications which are needed. I hope that the webinar was useful for you to understand the different levels of tracker implementations that are happening in the Asia region. And we'll try to bring more such use cases in our future webinars. Another reminder for tomorrow's webinar we have another the second webinar in the series scheduled for tomorrow same time 12 to 2pm India standard time where we'll discuss the the latest tracker features and the future plans which are there in tracker development so we'll have a tour presentation and we'll take you through different functionalities and features and what things are in pipeline. Thank you guys had a pleasant experience. We again thank you all for giving us your precious time for attending the webinar and we look forward to have you guys tomorrow in the webinar and also the Academy beginning from next week 25th. Thank you guys and have a good day.