HMIS

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HMIS

  1. 1. Health Management Information System State Institute of Health and Family Welfare, Jaipur
  2. 2. Basic Definitions Data “Messages not evaluated for their worth in specific situations” Primary Secondary Information “Evaluated data” “A resource with cost & benefit “Potential knowledge” “An essential input for decision making SIHFW : an ISO 9001:2008 certified institution 2
  3. 3. Record “A document of transaction between a client and service provider containing details of who did what to whom, when and where”, e.g. A bill A prescription A discharge ticket A laboratory report A register SIHFW : an ISO 9001:2008 certified institution 3
  4. 4. Information System “Comprehensive, coherent arrangement organized on an organizational or major program basis to collect, process and provide coordinated information to serve multiple needs of management system” SIHFW : an ISO 9001:2008 certified institution 4
  5. 5. Data Triangulation The synthesis and integration of data from multiple sources through collection, examination, comparison and interpretation SIHFW : an ISO 9001:2008 certified institution 5
  6. 6. 12 step approach to triangulation Planning for triangulation 1.Brainstorm questions 2.Identify questions that are important, actionable, answerable and appropriate for triangulation 3.Identify data sources and gather background information 4.Refine the investigation question(s) Conducting triangulation 5.Gather data/reports 6.Make observations from each dataset SIHFW : an ISO 9001:2008 certified institution 6
  7. 7. 12 step approach to triangulation • Note trends across datasets and hypothesize • Check (corroborate, refute, modify) hypotheses • Identify additional data source(s) and return to step 5 • Summarize findings and draw conclusions • Communicating the results of triangulation • Communicate the results and recommendations • Outline next steps based on findings SIHFW : an ISO 9001:2008 certified institution 7
  8. 8. Characteristics of Data Sources for Triangulation 1. Programmatic data 2. Biological data (surveys) 3. Behavioural data SIHFW : an ISO 9001:2008 certified institution 8
  9. 9. Health Information System “an integrated effort to § collect, § process, § report and § use health information & knowledge for • influencing • policy-making, • program action, and • research. SIHFW : an ISO 9001:2008 certified institution 9
  10. 10. M.I.S. ? A two directional characteristic of information flow, with systematically designed arrangement to - Ø Generate Ø Collect Ø Analyze Ø Store Ø Present Ø Make available required information to different managerial levels for improved and timely decisions and actions SIHFW : an ISO 9001:2008 certified institution 10
  11. 11. Definition: Ø MIS is a system having a combination of Ø persons, Ø a set of manuals, and Ø certain equipments to Øselect, Østore, process and Øretrieve data to - reduce the uncertainty in decision making by yielding information to managers at the time they can most efficiently use it. SIHFW : an ISO 9001:2008 certified institution 11
  12. 12. Essential Features of Information System Ø Reliable Ø Not too much paper work Ø Data transmission - accurate and timely Ø Availability in disaggregated form Ø Shortest time lag between collection and transmission Ø Data must be available to assess both quantity and quality of health care Ø Simple- recording reporting and analysis SIHFW : an ISO 9001:2008 certified institution 12
  13. 13. Service statistics v/s MIS Ø Service statistics- generate data Ø MIS -utilization of data in the planning and control activities, in an organization SIHFW : an ISO 9001:2008 certified institution 13
  14. 14. Information in Health Care Delivery: why Ø Evidence based policy and strategic decision-making Ø Program management Ø Monitoring the process and outcomes Ø Evaluation of achievements SIHFW : an ISO 9001:2008 certified institution 14
  15. 15. HMIS- Need Ø Increasing utilization Ø Increasing client satisfaction Ø Increasing health status Ø Induction of manpower Ø Problem solving Ø Resource allocation Ø Rewards / Promotions Ø (at times for Fault finding) SIHFW : an ISO 9001:2008 certified institution 15
  16. 16. HMIS: Objectives • Strategic planning • Disease surveillance systems • Use of ICD-10 • National health database • Technical support to strengthen data analysis • Research • Use of scientific evidence based on research SIHFW : an ISO 9001:2008 certified institution 16
  17. 17. Other objectives • Medical care- – Quality assurance & – Assessment of outcome • Cost control & productivity enhancement • Utilization analysis and demand estimation • Program planning & evaluation • Simplification of Records • Education • Clinical research SIHFW : an ISO 9001:2008 certified institution 17
  18. 18. Sources of Data Ø Diaries Ø Family registers Ø Hospital registers / Records Ø Periodic reports Ø Rapid surveys Ø Exit interviews Ø National sample survey Ø Census Ø Special studies SIHFW : an ISO 9001:2008 certified institution 18
  19. 19. Data :attributes Ø Accurate Ø Valid Ø Reliable Ø Timely Ø Complete Ø Retrievable SIHFW : an ISO 9001:2008 certified institution 19
  20. 20. Collection of Data: Data Collection Tools ØReporting Formats ØOnline reporting ØEligible Couple Survey ØConcurrent Evaluation/ Studies ØSurvey by different Agencies ØMonitoring and Validation Exercise SIHFW : an ISO 9001:2008 certified institution 20
  21. 21. Data Requirements at Different Levels of Decision Making ……Top level…. Quality Quantity ….Middle level…. ….Lower level…. SIHFW : an ISO 9001:2008 certified institution 21
  22. 22. Health information Tools for Different Levels of the Health System Modeling estimates & Outbreak Surveillance Global Regions Vital Registration SRS Surveys Countries Censuses Provinces Districts HMIS Communities Facilities SIHFW : an ISO 9001:2008 certified institution 22
  23. 23. Health determinants Risk factors Behaviors Genetics Environment Socio- economic & Health Health status demographic systems outcomes Mortality Health Health systems systems Service Morbidity/ inputs outputs utilization disability Policy Information Well-being Financing Service Human availability & resources quality Organization SIHFW : an ISO 9001:2008 certified institution 23
  24. 24. Attributes of HMIS ØTimeliness ØAccuracy ØRelevance ØUp-to-datedness ØAdequacy ØNo Overloading ØFormat Clarity ØNo duplication ØExplicitness SIHFW : an ISO 9001:2008 certified institution 24
  25. 25. Strengths of HMIS Ø In streamlining and standardizing of data records. Ø In creation of an integrated warehouse Ø In collecting data from different sources Ø Conducting cross analysis. Ø Rationalizing of reporting flows Ø Supporting customized reporting. Ø Indicator based analysis. Ø Integration of various software applications such as GIS and Excel. Ø Conducting data quality validation. SIHFW : an ISO 9001:2008 certified institution 25
  26. 26. Ø HMIS does not offer “Ready - made” solution Ø Each HMIS is “Tailor made” specific to an organization and levels within it SIHFW : an ISO 9001:2008 certified institution 26
  27. 27. HMIS- Issue Ø Is there a policy existing for Health Information system? Ø Does an organizational structure exist at the National level for HMIS? Ø Functional linkages between sub-systems Ø Capacity building-potential, activities and resources SIHFW : an ISO 9001:2008 certified institution 27
  28. 28. Ø Is there a Fixed- frequency review of reports and records? Ø How are reports made and who makes them? Ø Is there a built in system for checking reliability of data generated at the lowest level ? SIHFW : an ISO 9001:2008 certified institution 28
  29. 29. HMIS- Purpose Planning Implementation Needed for Monitoring Information Evaluation Purpose • Monitoring • Control - Cost -Time -Resources SIHFW : an ISO 9001:2008 certified institution 29
  30. 30. HMIS-Application should Provide Support to- Ø Health Workers: ØUnderstand health needs ØPrioritizing clients ØEstimate requirement Ø Program Mangers: ØAssess quality & Coverage ØAllocate resources ØReduce wastage and duplication SIHFW : an ISO 9001:2008 certified institution 30
  31. 31. ØPolicy Makers: ØAssess cost-effectiveness ØDecide content & mode of service delivery ØDevelop norms ØFinancial ØInfrastructure ØStaffing ØLogistics SIHFW : an ISO 9001:2008 certified institution 31
  32. 32. Prerequisites of HMIS Ø Existing formats, transmission system & channels, capacity of data handlers and analyzers and the resources (hard and soft) available. Ø Exploring possibilities of additions and deletion of parameters Ø Complimentary or contradictory nature of sub-systems of the System SIHFW : an ISO 9001:2008 certified institution 32
  33. 33. Components -Basic Management process 5 components of the basic mgt. process in healthcare- 1. Establishing goals & Objective 2. Estimate demand for services 3. Allocate resources including manpower to meet demands 4. Control quality 5. Evaluate performance SIHFW : an ISO 9001:2008 certified institution 33
  34. 34. Establishing goals & Objective • Problem indicators »Mortality »morbidity »Social indicators »Economic data »Health seeking behavior • Data on services delivered by other community organizations • Resources available SIHFW : an ISO 9001:2008 certified institution 34
  35. 35. Estimate demand for services • Data on utilization • Demographic data • Community projections SIHFW : an ISO 9001:2008 certified institution 35
  36. 36. Allocate resources • Data on work force • Financial information • Capital requirements • Short term demand forecasts SIHFW : an ISO 9001:2008 certified institution 36
  37. 37. Control quality • Output measure • Quality control data • Work sampling & measurement • Medical audit SIHFW : an ISO 9001:2008 certified institution 37
  38. 38. Evaluate performance • Changes in problem indicators • Cost benefit analysis • Changes in community’s capability to provide services SIHFW : an ISO 9001:2008 certified institution 38
  39. 39. HMIS- Components Ø Identification Ø Collection Ø Classification Ø Processing Ø Communication Ø Interpretation Ø Storage Ø Retrieval SIHFW : an ISO 9001:2008 certified institution 39
  40. 40. Factors Required to Develop and Implement HMIS: Ø Strong political backing Ø A culture that values and uses information Ø Involving all levels in changes to HMIS Ø Starting with improving the paper based system Ø Ensuring the feedback loop is continuous and reliable SIHFW : an ISO 9001:2008 certified institution 40
  41. 41. Levels at Which We Need Information Ø Point of entry of client into the System Ø Point of Service Ø Point of decision-making SIHFW : an ISO 9001:2008 certified institution 41
  42. 42. Use of Information Ø National & State Ministries for ØAssessing impact ØPolicy development ØFinancial allocations Ø Health care professionals for ØTreatment in Hospitals/ CHC/ PHC ØChoosing alternatives between care lines SIHFW : an ISO 9001:2008 certified institution 42
  43. 43. Ø Legal bodies ØAs documentary evidence of care ØProtect interests of Health care professionals and patients Ø Insurance companies for reimbursement of claims SIHFW : an ISO 9001:2008 certified institution 43
  44. 44. Information in Health Planning • Information for assessing need • Information for controlling utilization and standards (quality of services) • Information for controlling deployment of resources • Information for increasing effectiveness of services SIHFW : an ISO 9001:2008 certified institution 44
  45. 45. HMIS- Designing Technical Requirements Ø Data collection instrument ØSimple ØMinimum Ø Develop a data flow mechanism ØWho generate ØWho consolidate ØWhom to be sent & How (mode) ØWhere & by whom to be analyzed ØWhom to be reported ØFrequency of compilation, Analysis & reporting SIHFW : an ISO 9001:2008 certified institution 45
  46. 46. Basic steps in designing HMIS Ø Determine organizational need for information Ø Identify sources of information Ø Decide on amount, form and frequency Ø Select means of information communication & processing SIHFW : an ISO 9001:2008 certified institution 46
  47. 47. HMIS- Designing information system Steps ØWhat data is needed ØWho generates in what form ØDetermine ØQuality organizational need for ØProcessing requirement information ØIdentify sources of ØTypes of formats for information reporting ØDecide on amount, ØFrequency of reporting form and frequency ØData storage system ØSelect means of information ØDevices for storage communication & ØWhat should be the channel processing for info. flow SIHFW : an ISO 9001:2008 certified institution 47
  48. 48. Designing HMIS 1. Design Requirements: ØClarity of Objectives ØAwareness of information need ØFlexibility to change SIHFW : an ISO 9001:2008 certified institution 48
  49. 49. 2. Considerations in information system design ØIdentifying & listing of objectives and norms ØIdentification of all decision points ØDetermination of relative importance & priority of identified decisions ØIdentifying information need for decision ØIdentification of relationship among decision sets ØSpecification of information system ØInstallation ØEstablishing a review mechanism SIHFW : an ISO 9001:2008 certified institution 49
  50. 50. 3. Information requirements - governed by ØDecision structure of Program ØLevels of decision making ØQuestions to be answered ØEconomics of information management, based on these requirements decision shall be taken regarding type of information, which could be- ØScientific& Technical (Related to problem & solution ØSituational (Program environment) ØProgrammatic9001:2008 certified institution system) SIHFW : an ISO (Intervention 50
  51. 51. HMIS- Process Formulated information (fixed) Constraining Planning Execution Information (Dynamic) Processed information (Dynamic) Monitoring & Control Reports Processing Reports inputs Storage SIHFW : an ISO 9001:2008 certified institution 51
  52. 52. Analyze the Data: ØBy allotted ELA/Targets ØBy comparison of last year progress ØBy health indicators ØBy annual action plan ØBy Five Year plans SIHFW : an ISO 9001:2008 certified institution 52
  53. 53. HMIS- Problem Areas Ø Unrealistic expectation of Managers Ø Addressing to –”Report to higher levels” rather than convincing of benefits Ø Too much information asked Ø Poorly trained, Over worked staff, (30-40 % time in reporting) Ø Information-selective & to handle out of pressure ad hoc exigencies Ø Many reporting levels- Data lost SIHFW : an ISO 9001:2008 certified institution 53
  54. 54. Ø Performance indicators ØShifting priorities within program ØNew additions- NO deletions Ø Indicators- simply output oriented Ø Program priorities & timeliness of information flow Ø Retrieval Ø Duplication Ø NO periodic review Ø NO feed back to initiate corrective measures SIHFW : an ISO 9001:2008 certified institution 54
  55. 55. HMIS supports Ø Decision makers to: ØDetect and control emerging and endemic health problems ØMonitor progress towards health goals, ØPromote equity Ø Empowering individuals and communities with ØTimely and understandable health-related information ØDrive improvements in quality of services SIHFW : an ISO 9001:2008 certified institution 55
  56. 56. Ø Supports Health Workers, in Ø Understand health needs (based on approaches like CNAA) Ø Prioritizing clients (Estimate requirements (based on Demographic profile, morbidity profile, coverage and /or Expectations) Ø Support Program Mangers, for Ø Assessing quality & Coverage Ø Allocating resources Ø Reducing wastage and duplication SIHFW : an ISO 9001:2008 certified institution 56
  57. 57. Ø Support Policy makers, to ØAssess cost-effectiveness ØDecide content & mode of service delivery ØDevelop norms: ØFinancial ØInfrastructure ØStaffing ØLogistics SIHFW : an ISO 9001:2008 certified institution 57
  58. 58. Reporting Formats under NRHM Institutions Reporting Format Sub centre Form No. 6 PHC Form No. 7 CHC/FRU/UFWC Form No. 8 Block level Form No. 9 A District level Form No. 9 SIHFW : an ISO 9001:2008 certified institution 58
  59. 59. Thank You For more details log on to www. Sihfwrajasthan.com or contact : Director-SIHFW on sihfwraj@yahoo.co.in

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