How to Respond
Platform for Sustainable
Health Management
National Health Emergency System
ICT-based Response System
ICT-based Response System
ICT System: Republic of Korea
Republic of Korea has the highest internet penetration rate among OECD countries (in terms of optical cables, as of 2017) and also has one of the highest smartphone ownership. The Korea’s IT network has been instrumental for responding to COVID-19 efficiently.

The use of ICT technologies, such as the Self-check Mobile App and Self-Quarantine Safety Protection App reduced administrative burden and allowed the Koreans to follow the national response measures more easily. During the MERS outbreak in 2015, the Drug Utilization Review (DUR) system was served to provide real-time information about those who entered Korea related to infectious disease. In 2018, the upgraded International Traveler Information System (ITS) was installed in the DUR system to establish a systematic platform for medical institutions. This system was enabled identifying their patient’s travel history from the stage of reception into institution (MOFA, 2020).
(1) Self-check Mobile APP
The Self-check Mobile App comprises:
① a screen where the user under the Special Entry Procedure is requested to enter information (such as passport information, nationality, contact information)
② a screen where the user conducts self-check of symptoms such as fever, cough, or sore throat and submits the results once a day (for up to 14 days after entering the country)
③ a screen directing the user to the KCDC 1339 Call Center/social media counseling channel and offering information on nearby screening
All inbound travelers are to install the App, check their condition for possible symptoms, and submit their self-check once a day for 14 days, starting from the date of entry. In addition, the list of all inbound travelers is provided to each local government, enabling the local authorities to strengthen the monitoring system.

* Self-check conducted for the following symptoms: fever (over 37.5℃), cough, sore throat/throat pain, difficulty breathing/shortness of breath
The Korean government advised inbound travelers to call the KCDC 1339 Call Center if they experienced suspected symptoms during their stay in Korea, using the contact information of the Call Center shown on the traveler’s Special Health Declaration.
Figure 1. Self-check Mobile App, Republic of Korea
(2) Self-quarantine Safety Protection APP
The Korea Centers for Disease Control & Prevention (KCDC) has released the user manual for Self-Quarantine Safety Protection Application. The special entry procedure from the Korean government for preventing importation of the virus through border screening is as follows (MOHW, 2020);

“all inbound travelers (Korean and foreign nationals) receive temperature screening and fill out the Health Questionnaire and Special Quarantine Declaration in accordance with the Special Entry Procedure. All travelers subject to the special procedure are allowed to enter the nation after their contact information and address of residence in Korea is verified. They are also required to install either the “Self-Quarantine Safety Protection App” or “Self-Diagnosis App” on their phones to monitor if they show symptoms that indicate infection of COVID-19 such as fever during their stay in Korea. All inbound travelers must install either of the two applications, to check their health status and record if they develop any symptom on a daily basis for 15 days beginning from the day of arrival. In addition, the list of incoming travelers is provided to each local government (city or province) in an effort to strengthen the monitoring system.”

Figure 3. Self-quarantine safety protection App
(3) HIRA ICT System: Overall Function
“HIRA” stands for the Health Insurance Review and Assessment Service in Republic of Korea. HIRA’s ICT system establishes the scope and standards of services covered by the national health insurance, efficiently manages healthcare resources, and evaluates the cost and quality of healthcare services. It consists of 6 systems; First, the Healthcare Data Acquisition System (HDAS) collects data in healthcare from healthcare providers. Second, the Health Data Review and Assessment System (HRAS) reviews claims and assesses quality of care. Third, the Korea Pharmaceutical Information System (KPIS) tracks and traces nationwide drug distribution data. Fourth, the Drug Utilization Review System (DUR) transmits real-time information to ensure safe drug use. Fifth, the Provider Integrated Profiling System (PIPS) provides data dashboard of each healthcare provider. Sixth, the Healthcare Big Data System (HBiG) assists users with detailed analysis using healthcare-related big data (HIRA, 2021).
(3) HIRA ICT System: DUR Service Procedure
  • The doctor sends the details of prescription to HIRA DUR service before issuing the prescription to the patient. HIRA sends a warning message in a pop-up window on the doctor’s computer screen within 0.5 seconds, in case there is a risk factor in the prescription when compared to the patient’s medication history, suspended drug list, and DUR standards. The doctor could choose to change the prescription or to proceed with the original prescription with a memo, explaining why the drug should be used exceptionally. The final prescription information is sent to and stored in the DUR system of HIRA
  • Pharmacists undergo the same process at the pharmacy when dispensing. For a warning message, the pharmacist could choose to change, or go ahead with the original prescription after checking with the doctor. The final dispensing detail information is sent to and stored in the DUR system of HIRA
Figure 5. HIRA's DUR service procedure
(3) HIRA ICT system: COVID-19 (DUR & ITS)
HIRA’s ICT system contributed to early detection, treatment, prevention of COVID-19, quick response to surging demand for the healthcare services, and translated evidence into policy. HIRA undertook the control of COVID-19 pandemic preemptively and systematically using 3 major factors; nationwide data aggregated from all healthcare providers and patients, pre-existing ICT network systems, and real-time data exchanges (Yoo et al., 2021).
Before the first case of COVID-19 (January 10th, 2020) in Korea, HIRA established the emergency response framework promptly. Throughout COVID-19 pandemic, the HIRA’s ICT system enabled to manage the crisis and ensure health system resilience (Yoo et al., 2021).
Figure 7. Strategies of HIRA in response to COVID-19
NHI, National Health Insurance; MFDS, Ministry of Food and Drug Safety; HIRA, Health Insurance and Assessment Service; KDCA, Korea Disease Control and Prevention Agency; DUR, drug utilization review; ITS, International Traveler Information System; DW, data warehouse; ETL, extract, transformation, load; OHDSI, Observational Health Data Sciences and Informatics.
(3) HIRA Open Application Program Interface (API)
In March 2020, HIRA opened 'Open API' data, which can provide information on COVID-19's National Safe Hospitals and Screening Centers, through a public data portal. Using the information collected from the API, the MOHW is disclosing the state of operation National Safe Hospitals and Screening Centers nationwide through the official website in real time. The main information disclosed includes clinics and operating hours by region, possible procedures, contact information, and location (including map service), and it is possible to search by integrating administrative region, institution name, and phone number.
Figure 8. Open API data

“Application programming interfaces enable information systems to communicate and transfer data among each other. Depending how it is configured, an API can enable a system to send or retrieve data that can update an individual’s record or provide collective data that can be used to create reports. An API also can send information from one system to another. A healthcare provider organization, for example, can input a patient’s information into a system that works with insurance companies and nearly automatically determine the patient’s coverage for a specific procedure or medication.” (Healthcare IT News, 2019).

WHO COVID-19-ESFT (Essential Supplies Forecasting Tool)
On March 11th 2020, the WHO designated the COVID-19 outbreak as a pandemic. Countries affected by COVID-19 had to immediately prepare for containment and mitigation strategies to control the spread of COVID-19. The COVID-19 Essential Supplies Forecasting Tool (COVID-19 ESFT) developed by the WHO is designed to help countries to forecast the needs of essential supplies to response to COVID-19. The items include personal protective equipment (e.g., masks and gloves), biomedical equipment for case management (e.g., ventilators and oxygen concentrators), diagnostic reagents and equipment, essential drugs for supportive care, and consumable medical supplies. This tool can estimate essential supply needs for a short period (12 weeks or fewer) or longer, but it does not quantify or account resources which are already available in locally or those pending delivery. Although COVID-19-ESFT is not designed as an epidemiological model, to estimate number of infections, it has simple exponential growth and Susceptible-Infectious-Removed (SIR) case forecast options built-in. The inputs such as doubling rates, clinical attack rates, contact rates and reproduction number are based on available data shared by experts and academic groups. The assumptions used in COVID-19-ESFT include the volume of patient testing, equipment use, staffing needs, infrastructure required, and oxygen demand, and these are informed by clinical guidance, current practice, and international standards. Users can change these assumptions and inputs to fit their own particular context. Also, assumptions are subject to change if new data are presented (WHO COVID-19 ESFT, 2020).
Figure 10. WHO COVID-19 Essential Supplies Forecasting Tool (COVID-19-ESFT)