HIS: Lesson 6 - Health Management Information System

Health Management Information System

• An information system specially designed to assist in the management and planning of health programs, as opposed to delivery of care. (World Health Organization, 2004)

• It is a data collection system specifically designed to support planning, management, and decision-making in health facilities and organizations.

The problems faced by hospitals using the traditional manual process:

1. No real time data available to monitor the performance of the hospital

2. Evidence based program management was a challenge

3. Undue delays in receipt of data

4. Retrieval of old manual records was ineffective and time consuming.

5. Duplication of records

6. Monthly reports sent as hard copy which is a real challenge for data analysis/comparison

7. Drug inventory/equipment inventory maintenance.

8. Lack of standard names and code

Health

Clinical studies assist in the understanding of medical terminology, clinical procedures, and database processes

Management

Management principles enhanced by finance, law, and planning help administer the health care enterprise

Information Systems

The ability to analyze systems and to design and  implement advanced computer applications make the transfer of patient information efficient and effective

Major Role of HMIS

• Is to provide quality information to support decision-making at all levels of the health care system in any medical institution.

• It also aims to aid in the setting of performance targets at all levels of health service delivery and to assist in assessing performance at all levels of the Health Sector (Ministry of Health, 2010)

HMIS needs to be:

• Complete

• Consistent

• Clear

• Simple

• Accessible

• Confidential

• Cost Effective

Complete

It should provide information on all key aspects of the health system without duplication

Consistent

If similar information is provided by different sources, their definitions need to be consistent

Clear

It should be very clear what all the elements are actually measuring

Simple

It should not be unnecessarily complicated

Accessible

Data should be held in a form readily accessible to all legitimate users, and it should be clear who these people are

Confidential

It should ensure that people without legitimate access are effectively denied

Cost Effective

The actual usage of each element should justify the costs of its collection and analysis

Basic Functions Of HMIS

• The information from the HMIS can be used in planning, epidemic prediction and detection, designing interventions, monitoring and resource allocation (Ministry of Health, 2010)

• Historically, all information systems, including HMIS, are built upon the conceptualization of three fundamental information-processing phases

Eight Elements Of The HMIS

• Data Acquisition

• Data Verification

• Data Storage

• Data Classification

• Data Computation

• Data Update

• Data Retrieval

• Data Presentation

Data Acquisition

This involves both the generation and the collection of accurate, timely, and relevant data. In HMIS, this is normally achieved through the input of standard coded formats (e.g., the use of bar codes) to facilitate the rapid mechanical reading and capturing of data

Data Verification

Involves the authentication and validation of gathered data. The quality of collected data depends largely on the authority, validity, and reliability of the data sources

Data Storage

The preservation and archival of data may be regarded as part of the data storage function. When accumulated data are no longer actively used in the system, a method to archive the data for a certain period is usually advisable and may sometimes be mandatory, as when it is required by legislation

Data Classification

This is also known as Data Organization. It is a critical function for increasing the efficiency of the system when the need arises to conduct a data search. Most data classification schemes are based on the use of certain key parameters. For example, data referring to a patient population may be classified and sorted according to various diagnostic classification schemes

Data Computation

• Involves various forms of data manipulation and data transformation, such as the use of mathematical models, statistical and probabilistic approaches, linear and nonlinear transformation, and other data analytic processes

• It allows further data analysis, synthesis, and evaluation so that data can be used for strategic decision-making purposes other than tactical and/or operational use

Data Update

New and changing information is accounted for through the element of data update. The dynamic nature of such data modification calls for constant monitoring. For HMIS to maintain current data, mechanisms must be put in place for updating changes in the face of any ongoing manual or automated transactions.

Data Retrieval

Concerned with the processes of data transfer and data distribution. The data transfer process is constrained by the time it takes to transmit the required data from the source to the appropriate end-user.

Data Presentation

• This is how users interpret the information produced by the system. In situations where only operational or even tactical managerial decision making is expected, summary tables and statistical reports may suffice.

• The use of presentation graphics for higher-level managerial decision analysis is particularly encouraged because these appear to provide a better intuitive feel of data trend.

Determinants Of HMIS Performance Area

Prism Framework

Behavioral Determinants

Technical Determinants

Organizational/Environmental Determinants

Prism Framework

• This framework identifies the strengths and weaknesses in certain areas, as well as correlations among areas. This assessment aids in designing and prioritizing interventions to improve RHIS performance which in turn improves the performance of the health system.

• Known as Performance of Routine Information System Management (PRISM), this conceptual framework broadens the analysis of routine health information systems to include the three key factors: Behavioral Determinants, Technical Determinants, and Organizational/Environmental Determinants

Three key factors of PRISM

1. Behavioral Determinants

2. Technical Determinants

3. Organizational/Environmental Determinants

Behavioral Determinants

• Knowledge, skills, attitudes, values, and motivation of the people who collect and use data.

• The data collector and users of the HMIS need to have confidence, motivation and competence to perform HMIS tasks in order to improve the Routine Health Information System (RHIS) process.

Technical Determinants

• Data collection processes, systems, forms, and methods.

• Technical factors involve the overall design used in the collection of the information. It comprises the complexity of the reporting forms, the procedure set forward in the collection of data, the overall design of the computer software used in the collection of information (Sanga, 2015)

Organizational/Environmental Determinants

• Information culture, structure, resources, roles, and responsibilities of the health system and key contributors at each level.

• Health workers and data collectors work in organizations’ environments which have value, norms, culture and practice. The most important organizational factor which affects the RHIS process is related to structure, resource, procedure, support services and the culture.