NURSING ADMINISTRATION

1. HEALTH MANAGEMENT
INFORMATION SYSTEM
(HMIS)
BY JONES H.M- MBA/DMS
1/20/2021
JONES H.M-MBA/DMS
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2. INTRODUCTION
 In 1992, Zambia embarked on an ambitious reform program of the health sector
(Health Reforms).
 Aim was to improve health service delivery by providing equity of access to cost
effective quality health as close to the family as possible.
 Health management information system was the approach under the Health reforms
in Zambia which was initiated in order to have an effective and efficient system of
managing health information.
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3. UNIT OBJECTIVES
 Define key terms
 State the Principles of HMIS
 Describe International Technology
 Discuss the types of health information
 Demonstrate Knowledge and skills in Documentation and Reporting
 Discuss the role of a nurse in information management
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4. DEFINITION OF TERMS
 Health Management Information Systems ( or health care IT ) refers to the
management of information related to patient records, and other health care-related
information.
 Health information system refer to the system that captures, stores, manages
information related to the health of individuals or activities of organization
 Data – comprises raw facts, figures, records which are not processed.
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5.  Information - Processed data giving a meaningful picture.
 Information is data that is accurate and timely, specific and organized
for a purpose, presented within a context that gives it meaning and
relevance, and can lead to an increase in understanding and decrease
uncertainty.
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6.  Information is data that have been organized or analyzed in some
meaningful way (Stoner, Freeman and Gilbert, 2007)
 Data Analysis
 Data analysis is a process of inspecting, cleaning, transforming and
modeling data with the goal of discovering useful information,
suggesting conclusions and supporting decision making.
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7.  Information is valuable because it can affect behavior, a decision, or an outcome.
 For example, if a Doctor is told that the medical condition has deteriorated in the past
week, he/she may use this information as a reason to order laboratory tests, investigate
the problem in detail based on the prevailing symptoms and eventually adjust
treatment the patient is on.
 A piece of information is considered valueless if, after receiving it, things remain
unchanged.
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8.  For this reason, information helps people to plan, inform,
communicate with others and supports decision making.
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9. USES OF INFORMATION
 Information is essential for decision making, control and coordination of services
being provided:
 Evaluation and monitoring of services delivered.
 Making evidence based decision and planning
 Describing the health status of community/nation.
 It is used for reporting so as to provide management, staff and partners on how much
impact the programme is having with information on progress that a certain
programme is making
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10. PRINCIPLES OF HMIS
 The data collected should be analyzed and self-assessment should be
carried out at the level where data is collected. And information
should be used for decision making and action at that level
(Decentralization).
• Data should be collected for local management and not merely for
upward reporting for “higher” levels and to ensure that donors pay
out money.
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11. PRINCIPLES OF HMIS CONT…
 The information system should be designed to support the needs of its users – this
motivates them to provide quality data.
• The Information collected should be used to improve service delivery, not just to address
reporting needs to higher levels.
• Data should be collected for local action, self assessment and decision-making, not for
filing (Action oriented).
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12. PRINCIPLES OF HMIS CONT…
 A HIS must be flexible in order to adapt itself to changes of the
epidemiological situation and the state of health of the population,
data collection should react to changing needs, with data reported in
an appropriate timeframe according to its use, and be flexible in terms
of adaptation to changing local needs.
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13. PRINCIPLES OF HMIS CONT…
 A health information system needs to have a logical and transparent structure: all
stakeholders should be able to easily access analyzed information on key basic
programs and the public should be honestly informed of progress and achievements
of the health sector through regular press releases and annual publication of
comprehensive reports that critically analyze information and give a realistic picture of
successes and constraints.
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14. PRINCIPLES OF HMIS CONT…
 In a given health institution, for each target population, that is for each type of unit,
there shall be only one register.
• Several registers for the same target population put an unnecessary burden on the
health worker. It may be in the ‘general’ register, or more specific ones, for example for
malaria, tuberculosis, mother and child care.
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15.  Registers and reporting forms layout should have corresponding variables. In a HIS
which follows this principle, it is possible to calculate all required indicators that
a given target population and a given period by running through the register only
 A health institution sends a report on paper only to the higher-level institution that
needs it most or most urgently.
 It is then up to the latter to distribute it horizontally to those who require it.
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16. INFORMATION TECHNOLOGY
 This is the information technology which is applied to health care. It provides the
umbrella framework to describe the comprehensive management of health
information across computerized systems.
 Health Information Technology is defined as the application of information processing
involving both computer hardware and software that deals with the storage, retrieval,
sharing and use of health care information, data and knowledge for communication
and decision making.
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17. TYPES OF INTERNATIONAL
INFORMATION TECHNOLOGY
 Clinical Point of Care Technology
 This is when physicians deliver health care products and services to patients at the
time of care using information technology
 E.g. Computerized provider (physician) order entry (CPOE) which helps medical
practitioners to input medical instructions and treatment plans for the patients at the
point of care.
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18.  ePrescribing soft ware, Electronic sending prescriptions to pharmacies
. In just a few clicks a prescription is sent and the system displays the
prescription at the pharmacy, filled and waiting for the patient when
they get to pharmacy. ePrescription systems ensure that there is no
prescription mix up due to hard decipher handwriting. This system
enables to keep better track of patient records
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19. TYPES OF INTERNATIONAL INFORMATION
TECHNOLOGY
 Electronic Health Record (HER)
• They are real- time, patient-centered records that make information available instantly
and securely to authorized users e.g. SMART CARE cards.
 This is a digital version of a patient’s paper chart that allows to check a patients history,
diagnoses, treatment, medication and more. Data from HER can be can be shared
with other HERs sources. If the patient moves to another unit records can be viewed to
that unit and care is continued.
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20.  Electronic medical record (EMR)
 This system replaced paper records by digitalizing medical charting , making digital
versions of charts and patient histories.
 The system can alert you when patients are due for procedures and screening. This
system also enables physicians treat patients by looking at their history and
their health data against past entries. The difference between EMR and HER is on how
information can be shared by each.
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21.  Data from EMR can only be viewed within one office while HER can
share patients data with other HERs.
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22. SYSTEMS
 In Zambia we have two types of Health information systems as follows:
 Health management information systems. This is the system used by the ministry of
health to capture data or information on health in the first level hospitals (District
Hospitals) and the health centres.
 Hospital Management Information (Hospital MIS). This is a system which is used by
the ministry of health to capture information on health from the second level, third
level and specialist Hospitals.
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23. TYPES OF HEALTH INFORMATION
 These are information management systems that capture and display data related to
the delivery of health care services.
 Types of health information
 Disease surveillance systems
 District routine information system
 Laboratory information systems
 Hospital patient administration system
 Human resource management information system
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24. ROLE OF A NURSE IN
INFORMATION MANAGEMENT
 The nurse manager is concerned with every day planning and
strategic planning.
 As a manager your decision making abilities are enhanced when you
have the necessary information at your finger tips and when that
information is accurate and up to date.
 So as a manager you are expected to:
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25. ROLE OF A NURSE IN INFORMATION
MANAGEMENT CONT..
 Keep or access information regarding patient administration e.g.
 Patient admission.
 Patients statistics on bed occupancy, midnight census against average
number of patient days per ward or unit.
 Number of days each patient spent in the hospital
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26.  Aggregate information for reporting purposes.
 Collect information on stock levels which will assist in decision for replenishing.
 Confidentiality - safeguards information that is gathered within our places of work and
or interactions with other people. The nurse manager should be able to keep the
information in confidence. Confidentiality, for example, prevents nurses from disclosing
information shared with them by a patient in the course of a nurse–patient relationship.
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27.  Unauthorized or inadvertent disclosures of data gained as part of being
a service provider are breaches of confidentiality.
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28.  SECURING INFORMATION
 Securing information can be defined as “the procedural and technical
measures required:
 To prevent unauthorized access, modification, use, and dissemination
of data stored or processed in a computer system.
 To prevent any deliberate denial of service.
 To protect the system in its entirety from physical harm.
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29.  Security helps keep health records safe from unauthorized use.
 When someone hacks into a computer system, there is a breach of
security (and also potentially, a breach of confidentiality).
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30. DOCUMENTATION AND REPORTING
 Documentation is any written or electronically generated information
about a client that describes the care or service to the client.
 A report is a document characterized by information or other content
reflective of inquiry or investigation, which is tailored to the context of
a given situation and audience.
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31. REASON FOR DOCUMENTATION
 To facilitate communication:
 Through documentation, nurses communicate to other nurses and
care providers their assessments about the status of clients, and
nursing interventions that are carried out.
 Documentation of this information increases the likelihood that the
client will receive consistent and informed care or service.
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32.  To promote good Nursing care
 Documentation encourages nurses to assess client progress and
determine which interventions are effective and ineffective, and
and document changes to the plan of care as needed.
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33.  To meet professional and legal standards:
 Documentation is a valuable method for demonstrating that, within the nurse-client
relationship, the nurse has applied nursing knowledge, skills and judgment according
professional standards.
 The nurse’s documentation may be used as evidence in legal proceedings
through professional regulatory bodies. E.g. in a court of law, the client’s health record
serves as the legal record of the care or service provided.
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34. REPORTING
 Reports are accounts of events either written or verbal, heard or seen.
Written reports are important because they provide records which serve
as legal documents.
 HMIS reports provide records which are necessary in the management
of patients and in the aggregation of data.
 The following are some of the tools used in the HMIS reporting:
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35.  Out Patients’ attendance tally sheets.
 In patient admission registers
 ART cohort summary forms
 Stock cards for drugs etc.
 Antenatal and postnatal activity sheet
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36. The end
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