Parng I-ming, director-general of the Ministry of Health and Welfare’s Department of Information Management, explains how information and communication technology is critical to Taiwan’s COVID-19 management strategy. (Photo by Chen Mei-ling)

Ministry of Health and Welfare’s Department of Information Management Director-General Parng I-ming (龐一鳴) sits down to talk about the role information and communication technology plays in the Taiwan Model of epidemic prevention.

Information and communication technology [ICT] has played a pivotal role in the Taiwan Model. How has it been used in the country’s COVID-19 response?

Parng I-ming: At the beginning of the COVID-19 pandemic, very little was known about the coronavirus and its implications. All we knew was that the outbreak was first reported in the Chinese city of Wuhan in late 2019.

As there was no vaccine at that time, we adopted the basic principles of infectious disease prevention to combat the disease. We implemented strict face mask, social distancing and quarantine policies to reduce potential exposure to the coronavirus. All these systems relied on the use of ICT.

To prevent panic buying of face masks and ensure equitable access for all residents, the government assembled new production lines to meet domestic demand and launched a name-based mask distribution system utilizing the National Health Insurance [NHI] database to provide a low-cost, guaranteed number of masks to each individual every two weeks.

As the outbreak originated overseas, we quickly enforced strict border control and quarantine measures. The NHI system was adapted to keep track of individuals’ travel histories by integrating the NHI database with data from the National Immigration Agency [NIA].

Looking at other countries, we noted that COVID-19 spreads rapidly. It is important to prevent community transmission where the source of the disease is unclear. This kind of a situation can easily spiral out of control and lead to the health care system buckling under strain from a large influx of patients. That is why we flagged individuals with a history of travel to areas affected by COVID-19 using the NHI MediCloud system.

Contact history and occupation were also included in the data to allow health care staffers to obtain first-hand information concerning a patient’s history of travel, occupation, contact, and cluster [TOCC].

In February 2020, we launched the quarantine system for entry to optimize quarantine capacity and speed up the immigration clearance process. Travelers with smartphones can log in to the system before departure or upon arrival in Taiwan and fill out a form providing personal contact information, health status and travel history in order to receive a health declaration pass that can be presented at immigration for clearance.

The information collected is shared with the centralized epidemic prevention tracking system to facilitate follow-up measures. At-risk individuals placed under home isolation and quarantine are then contacted by local civil and public health officers either via telephone or in person.

The electronic fence system is implemented in compliance with the Personal Data Protection Act and aids home isolation and quarantine by sending an alert to local civil, public health and police officials to follow up on the person’s whereabouts when necessary.

We have also developed a chat bot in the instant messaging software Line called the Disease Containment Expert to allow individuals under home isolation and quarantine to voluntarily report their health statuses to the competent authority on a daily basis while providing relevant disease prevention information. In addition, it can list numbers for services such as food delivery, garbage disposal and medical assistance during the quarantine period.

What has made the Taiwan Model so successful in its efforts to utilize ICT?

Parng: Taiwan’s NHI system is well developed and deeply embedded into public health infrastructure, so it played a vital role in our coronavirus response. All citizens and eligible foreign residents are enrolled in the program and have an NHI card.

Insured individuals use the card when seeking medical attention— through this health care providers can access the MediCloud system that stores patient information, including examination, discharge, medication and surgery records. During the pandemic, we added patients’ history of TOCC to the system, which facilitates case identification and implementation of subsequent measures.

The NHI also contributed to the success of the name-based mask distribution system, and effective integration of the NHI and NIA databases assisted our disease prevention efforts by tracking travel history.

What measures are being taken to protect personal privacy and prevent infringement of individual rights when utilizing technology as part of the Taiwan Model?

Parng: The government has worked tirelessly to make the disease prevention system, including all use of ICT and collection of personal data, as transparent as possible. In accordance with the Personal Data Protection Act, all government agencies are required to inform individuals when collecting their personal information.

Data collected and shared in the centralized epidemic prevention tracking system can only be retained for 28 days and must be deleted after that time. It cannot be used for any purposes other than investigations into COVID-19 outbreaks.

How has the Taiwan Model helped realize the World Health Organization’s goal of Health For All?

Parng: So far, Taiwan has donated critical medical supplies and personal protective equipment to over 80 countries around the world, including in Africa, the AsiaPacific, the Caribbean, Europe, Latin America, North America, Southeast Asia and West Asia. In addition, we have shared the source code of our quarantine system for entry with nine allies, namely Belize, Guatemala, Haiti, Honduras, Nicaragua, Paraguay, St. Kitts and Nevis, Saint Lucia, and St. Vincent and the Grenadines. We have also shared our epidemic prevention experience during virtual conferences with a number of countries including fellow Asia-Pacific Economic Cooperation member economies, Belgium, the Czech Republic, India and Switzerland.

2021 WHA