Health management information system

2. Introduction
Need of HMIS
Subsystems of HMIS
Steps of HMIS
Reference
Topic Outline

3. By the end of the training, the participants will be ab
le to:
 explain the role of HMIS in health services manag
ement

 describe benefit of HMIS tools in performing daily
tasks

Objectives

4. Definitions
System - Any collection of components that work t
ogether to achieve a common objective.
Health System - All the activities whose primary p
urpose is to promote, restore or maintain health.
Information - Meaningful collection of facts or dat
a.
Information System - Systems that provide speci
fic information support to the decision-making proc
ess at each level of an organization.
Health Information System - A set of component
s and procedures organized with the objective of ge
nerating information which will improve health care
Health Management Information Systems

5. • A system which provides a required information to each lev
el of management at the time, in the right form, covering th
e desired quantity and quality so that it may form basis for d
ecision making.
• Health Management Information Systems (HMIS) are one of
the six building blocks essential for health system strengthen
ing.
Health Management Information System
s

6. HMIS.....
• HMIS is a data collection system specifically designed to supp
ort planning, management, and decision making in health facil
ities and organizations.
• HMIS: process of
 Collection
 Transmission
 storage retrival
 Analysis

7.  Interpretation and preparation for utilization and
 Preparation of information which is necessary for decision ma
king for effective management
 The purpose of HMIS is to routinely generate quality health in
formation and use that information for management decision
s to improve the performance of health services delivery. _x00
00_
HMIS.....

8.  Measurement of community health
 Community diagnosis
 Finding solution to health problems
 prioritization
 planning Of intervention
 Directing and controlling health problems
 Development of procedure definitions, classificat
ion and methods of collection analysis, storage
and retrieval of data
 Establish administrative standards
 Determination of unmet and met health needs
 Monitoring and evaluation of health programs
 Demand social support for health activities
 Social health legislation
Purpose of HMIS

9. means that the information generated by HMIS is:
 relevant
 Timely
 complete (both in geographical coverage and in terms of ra
nge/amount of data it is supposed to provide)
 valid (provides the information that it is supposed to provid
e)
 reliable (the information is consistent)
 Sensitive
 Specific
 Capable of proper analysis and interpretation
Quality HMIS information_
x0000_

10. HMIS Indicators: Broad grouping
Family Health (21 indicators)
Reproductive Health (12 indicators)
Child Health (3 indicators)
Expanded Programme on Immunization (EPI) (6 indicators)
Disease Prevention and Control (47 indicators)
All Diseases (5 indicators)
Communicable Diseases (39 indicators)
+ Malaria (4 indicators)
+ TB and Leprosy (10 indicators)
+ TB/HIV co-infection (2 indicators)

11. Resources (28 indicators)
Assets (7 indicators)
Finance (9 indicators)
Human Resources (4 indicators)
Logistics (2 indicators)
Laboratory and Blood Bank (6 indicators)
Health Systems (12 indicators)
Health Service Coverage and Utilization (8 indic
ators)
Management (2 indicators)
HMIS and M&E (2 indicators)_x0000_

12. What is wrong with current health MIS?
• Irrelevance of the information gathered
• Poor quality of data
• Duplication and waste among parallel health information s
ystem
• Lack of timely reporting and feedback
• Poor use of information
• The difference in culture between data people and decisio
n makers: Planning and management staff rely primarily o
n “gut feeling” to formulate ad hoc decisions rather seek p
ertinent data.

13. Step 1: Identifying information needs and feasible i
ndicators
Step 2: Defining data sources and developing data
collection instruments for each of the indicators sele
cted
Step 3: Developing a data transmission and process
ing system
Step 4: Ensuring use of the information generated
Step 5: Planning for health MIS resources
Step 6: Developing a set of organizational rules for
Steps involved in restructuring of Health MIS

14. Step 1: Identifying information needs and feasible indicat
ors
• Identifying information needs for follow-up of a pregnant wom
an in a primary level
• Identifying indicators to ensure efficient drug management in a
referral hospital
• Identifying indicators to ensure efficient Information, Education
and Communication in the community
• Identifying indicators to monitor the quality of supervision by t
he district management team.

15. Step 2: Defining data sources and developing data collecti
on instruments for each of the indicators selected
• Develop an appropriate record form for follow-up of haemo-di
alysis in a tertiary care hospital.
• Develop a monthly reporting form for activities performed in a
primary level clinic.
• Define data sources for a situational analysis at the district leve
l.
• Develop data sources for monitoring the quality of teaching in
a medical college.

16. Step 3: Developing a data transmission and processing
system
• Structure the information flow on pregnant women between
the traditional birth attendant and midwife in the health cent
re
• Ensure that monthly report forms from health centres are en
tered in the district computer in a timely and accurate manne
r
• Develop a mechanism for reporting of Research done in a res
earch centre

17. Step 4: Ensuring use of the information generated
• Develop user-friendly feedback formats for regional mangers o
n the utilization of inpatient services in the region
• Train health auxiliaries in follow-up procedures for hypertensio
n patients using a standard record form
• Develop a curriculum for the undergraduate and post-graduat
e students depending upon the need in the country
• Ensure research on the priority health issues for the country

18. Step 5: Planning for health MIS resources
• Create positions of computer operators in cases where distric
t level data processing is computerized
• Submit revised recurrent cost budgets based on proposed ne
w data collection procedures
Step 6: Developing a set of organizational rules for healt
h information system management
• Develop standard case definitions
• Change the job description of doctors in cases where h
ealth information system restructuring involves their acti
ve participation in data collection
• Develop an instruction manual for computer operators

19. Information process
Data collection
Resources
Data transmission
Management
Data processing
Organizational rules
Data analysis
Information for use in
planning and management

20. Ways to enhance the use of information
in decision-making
• Characteristics of the data
• Characteristics of the problems and the decisions they requir
e
• Organizational or structural characteristics
• Cultural differences between ‘data people’ and ‘action people
’
• The communication between the two

21. Characteristics of the data
• Ownership and relevance
• Validity and reliability
• Aggregation of data
• Customizing information to the users’ needs
• Timeliness of feedback

22. Sybsystems of Health Information System
WHO proposes to categorize the health information system
under five interrelated “subsystems”:
• Epidemiological Surveillance (notifiable infectious diseases,
environmental conditions, and risk factors)
• Routine service reporting
• Special programmes reporting systems (tuberculosis and lep
rosy control, MCH, school health)
• Administrative systems (health care financing systems, healt
h personnel systems, logistic systems)
• Vital registration systems (births, deaths, and migratory mov
ements)

23. Communication
• Communication process within a health team
• Feedback process
• Communication products
– Time comparison
– Geographical comparison
– Comparison of actual performance vs. mean performanc
e
– Comparison of actual vs. planned performance

24. A framework for defining information needs and indica
tors
• Perform a functional analysis at each management level of th
e health service system
• Identify information needs and select feasible indicators
• Patient / Client management
• Health Unit management
• Health System management

25. Types of routine data collection methods
• Health unit data collection
• Community data collection
– to monitor activities performed in the community by healt
h unit staff or by community health workers
– to obtain more representative data on the health status an
d living environment of the communities served, including
data on births and deaths in the community, agricultural a
nd meteorological data, data on education etc.
– to assist in planning for health services that are more acce
ssible to community
• Civil registration systems

26. Data collection instruments
• Data collection instruments for patient/ client management
Preventive
• Growth cards
• MCH cards
• School health card
• Family registration r
ecords
Curative
• Medical records
• Laboratory forms
• Referral forms

27. Data collection instruments for health
unit management
• Service delivery records
 Registers
 Tally sheets (Abstract
 register
 Population charts
• Resource Management records
•

28. Health System Mo
del

29. Computers in MIS
• Optimization of the scarce resources available for health ca
re, specially in developing countries
• Information - accurate, comprehensive
• Retrieval of information - quick
• Decisions - quick
• Implementation - rapid
• Monitoring - adequate
• Large geographical area can be covered

30. What can be done to improve and ensure data quality
• Keep the design of the information system as simple as possi
ble
• Involve users in the design of the system
• Standardize procedures and definitions
• Design of data collection instruments
• Develop an appropriate incentive structure
• Plan for effective checking procedures
• Training

31. Data collection instruments
• Home-based records: Immunization cards, Growth-monito
ring card, Maternal health card
• Health worker based records: Pregnancy/birth card, death
report form, child records, women’s register, workers work
form
• Supervisor’s based: Supervisor’s roster
• District-based records: Family enrollment forms, birth regi
sters, death registers, health worker’s report, supervisor’s
report
• Home office- and donor-based reports of health project o
utputs and population health status

32. • Organization rules
– Data collection st
andards
– Case definitions
– Data transmissio
n
– Confidentiality
– Training standard
s
– Software design
– Procurement/ Dis
tribution
– Quality assuranc
e
Basic Health Serv
ices HIS
Staff
Training
HIS Supplies
Hardware/ Software
Financial Resources
Hospital HMIS
HMIS
Management
Elements of Health information system management

33. HMIS in context of Health Sector Reforms
• The more radical and innovative the proposed change is in r
egard to the information system, the greater the implicatio
ns for change in the organization
• Reforms: systemic, programmatic, organizational, & instru
mental
• The objective of producing and utilizing information more e
ffectively will affect the behavior and motivation of all pers
onnel

34.  Hospital Information System. One that supports all
hospital functions and activities such as;
 patient records
 scheduling
 administration
 charge-back and billing, and often links to or includ
es clinical information systems such as RIS. (Radio
logy Information System )
Hospital Information System

35. Registration Consulting Ward Nursing
Pharmacy
Stores & Purchase
Radiology
Laboratory
OT Blood Bank
Diet & Kitchen
And more...
Hospital Information System

36. Management Information Sy
stem
Clinical Informatio
n System
MIS
CIS
GMIS
Geographical Managemen
t Information System
Development steps of HIS

37. The information of the hospital come from
 Front office
 Doctors consultation room
 Ward
 Laboratory
 The service providers like financial and insurance service
provider
 And so on
The information in hospital

38. This information can be categorized as

39. • Patient Administration
• Clinical Management
• Resource Management
• Financial Management
• Management Information System
• And more…
Information will be used by the areas

40.  HIS have the ability to link the following major players
 Laboratories
 Pharmacies
 Researchers
 Doctors and consultants
 Banks and financial institutions
 Administrators
 And knowledge managers
The function of HIS

42. r Is to adequately enable the execution of information
processing functions
– for patient care, including
administration as well as
– for research and education mainly
for university hospitals -
r considering economic hospital management, as we
ll as
r legal and other requirements
• therefore HIS contributes to a high quality of patien
t care and medical research
The Aim of a HIS

43. r information, primarily about patients, in a way th
at it is correct, pertinent and up to date, in time, acce
ssible by the right persons at the right site in a usabl
e format
r knowledge, primarily about diseases, but also, fo
r example, about the effects of drug interaction, to s
upport diagnosis and therapy
r information about the quality of patient care, hos
pital performance and costs
HIS should provide

44. in other words:
• HIS should provide, as far as feasible,
r the right information and
r the right knowledge
r at the right time
r in the right place
r to the right people
r in the right form
• so that these people can make
r the right decisions

45. 1. Admissions, Medical Records & Abstracting (ADM
/MRI/ABS)
2. Billing/Account Receivable (BAR)
3. Community Wide Scheduling (CWS)
4. Data Repository (DR)
5. Imaging and Therapeutic Services (ITS)
6. Laboratory, Microbiology, Blood Bank & Anatomic
al Pathology (LIS)
7. Order Entry & Electronic Medical Record (OE/EM
R)
8. Patient Care System (PCS)
9. Pharmacy (PHA)
10. Remote Physician Access
ten application areas will be the necessary part of the HIS

46. • the information system of a hospital is an important qu
ality factor
• the information system of a hospital is an important cos
t factor
• the quality of HIS is becoming increasingly relevant in t
he competition between hospitals
• a HIS can provide a holistic view of patients and of a h
ospital
• a HIS can be seen as the memory and nervous system
of a hospital
importance of HIS

47. Thank you very much.
Any questions?