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Health Management Information Systems

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by

Ali Nusrat

on 11 June 2014

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Transcript of Health Management Information Systems

What can be done to improve and ensure data quality
Health Management Information Systems
Good management is a prerequisite for increasing the efficiency of health services.

Information is crucial at all management levels
of the health services from periphery to the center. It is required by policymakers, managers, health care providers & community health workers.

“Changing the way information is gathered,
processed, and used for decision-making implies changing the way an organization operates.”

Health Information System
A set of components and procedures organized with the objective of generating information which will improve health care management decisions at all levels of the health system.

The ultimate objective of
health information system is not
“to gain information” but “to improve action”
FUTURE PLAN
Central HMIS cell ensure the complete implementation at all the levels.

To ensure the availability of HMIS Instruments throughout Organization.

To ensure the availability of Hardware at each levels.

To ensure the reporting on HMIS from FLCF Cell to Central Cell.

To minimize the error rate in HIS reporting from the Hospitals.

To ensure the timeliness of monthly reporting from all FLCF HIS cell to central HMIS cell.

Types of routine data collection methods
Development of community health information systems

Determining community health activities

PHC-MAP programme.
Autodiagnosis.
Iran’s Vital horoscope.
Community-based maternal. records.
Community-based growth. monitoring.
What is wrong with current health MIS ?
Irrelevance of the information gathered
Poor quality of data
Duplication and waste among parallel health information systems
Lack of timely reporting and feedback
Poor use of information
The difference in culture between
data people and decision makers:
Planning and management staff rely
primarily on “gut feeling” to formulate
ad hoc decisions rather seek
pertinent data
Strengths & weakness
The DHIS program was launched in the year 2009-2010 but the working & functioning is questionable.

The Installed DHIS software needs to be user friendly and renewed & restructured according to new needs/demands.
Room for Improvement
By general assessment of existing system, overall the system is weak, Data collection is poorly organized and flow of information is fragmented
HMIS is meant for data collection to decision making but this objective is hardly accomplished with the present system.
Lack of HMIS culture at FLCF.

Data collected is inadequate, incomplete, unreliable, untimely and rarely pertain to decision making.
Unfortunately the present inf. System is woefully inadequate filling endless registers with names and addresses of patients, compiling information on diseases every week or every month, and sending out reports without ever receiving any feedback
NEEDS / GAPS

Non inclusion of Primary care and community health services
Non Integration of MIS of all vertical programs with HMIS.
No Supervision and Monitoring of HIS activities at all levels (FLCF & District level).

No Vehicle for supervision & monitoring at Central level.

NO
Supporting Staff, specially Computer personnel / Data analyst.
NO
Refresher trainings
No
Incentive for Computer personals / Data analyst
Service delivery functions in health units
First level (Dispensaries)
To provide curative care for the most common health problems including immunization.
To provide prenatal care services.
To provide family planning services.

Secondary level (First referral level)
To organize out-patient referral clinics.
To provide in-patient services.
To manage medical, surgical & gynecological emergencies.
To provide X-ray and laboratory facilities.

Tertiary level
To provide all types of surgical interventions.
To provide specialized care.

Management functions in a health service system
Health policy formulation, including policy on intersectoral activities.
Production of national health plans and guidelines for local planning.
Advisory role on allocation of resources, particularly capital funds.
Source of high level technical advice for specific programmes.
Training and regulation of health personal development.
Regulation of private profit and nonprofit health organization.
Control of national health organizations and research institutes.
Liaison with international health organizations and aid agencies.
The central level (Ministry of Health) is responsible for:

State level is responsible for:
State health planning and programme monitoring.
Co-ordination of all regional health activities.
Employment and control of the health personnel.
Budgeting and Auditing the health expenditure.
Managerial and technical supervision of district health teams.
Provision of supplies and other logistical support.

Step 1: Identifying information needs and feasible indicators
Identifying information needs for follow-up of a pregnant woman 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 the district management team.

Step 2: Defining data sources and developing data collection instruments for each of the indicators selected
Develop an appropriate record form for follow-up of in a tertiary care hospital i.e. D.M, HTN.
Develop a monthly reporting form for activities performed in a primary level clinic.
Define data sources for a situational analysis at the district level.
Develop data sources for monitoring the quality of teaching in a medical college.

Step 3: Developing a data transmission and processing system
Structure the information flow ( pregnant women between the traditional birth attendant and midwife) in the health center.
Ensure that monthly report forms from health centers are entered in the district computer in a timely and accurate manner.
Develop a mechanism for reporting of Research done in a research centre.
Step 4: Ensuring use of the information generated
Develop user-friendly feedback formats for regional mangers on the utilization of inpatient services in the region.
Train health auxiliaries in follow-up procedures for using a standard record form.
Develop a curriculum for the undergraduate and post-graduate students depending upon the need in the country.
Ensure research on the priority health issues for the country.

Step 5: Planning for health MIS resources
Create positions of computer operators in cases where district level data processing is computerized.
Submit revised recurrent cost budgets based on proposed new data collection procedures.

Step 6: Developing a set of organizational rules for health information system management

Develop standard case definitions.
Change the job description of doctors in cases where health information system restructuring involves their active participation in data collection.
Develop an instruction manual for computer operators.
Health unit data collection
Community data collection
to monitor activities performed in the community by health unit staff or by community health workers.
to obtain more representative data on the health status and living environment of the communities served, including data on births and deaths in the community, agricultural and meteorological data, data on education etc.
to assist in planning for health services that are more accessible to community.

Civil registration systems

Challenges
Integration of five interrelated "Subsystems” as proposed by WHO
Epidemiological Surveillance (notifiable infectious diseases, and risk factors, Disease pattern, Incidence rate & prevalence rate))
Routine service reporting, Integration of Special vertical programs reporting systems (tuberculosis and HIV control, MCH, school health) with HMIS.

Administrative systems (health care financing systems, health personnel systems, logistic systems & Drug Supplies and distribution).

Vital registration systems (births, deaths, and migratory movements)
vertical programs
18 priority health problems
Preventive care and promotional activities
GIS
EMR

Action Plan
Our intention is to produce a complete, accurate, and timely information for managers to use as a basis for making appropriate decisions that contribute to the
quality
expansion and
sustainability

of their programs and Health Deptt..
Data collection instruments
Data collection instruments for patient/ client management
Curative
Preventive
Growth cards
MCH cards
School health card
Family registration records

Medical records
Laboratory forms
Referral forms

Other issues
Content (comprehensive)
Record filing (patient-retained vs.. health unit-retained)
Layout (self-explanatory)
Production form
Electronic patient recrd

Data collection instruments for health unit management
Service delivery records
Registers
Tally sheets (Abstract register
Population charts
Resource Management records
Characteristics of new HMIS Model
Optimization of the scarce resources available for health care.
Information - accurate, comprehensive
Retrieval of information - quick
Decisions - quick

Implementation - rapid
Monitoring - adequate
Large geographical area can be covered

Characteristics of new HMIS Model
More speedy communication of data
At national, state & district levels, processing can be done for valuable information
Obtaining coverage levels for various activities
Age-specific & area-specific figures
Check suspect data from BHU, RHC & UHC

Identification of problems requiring research
Prompt reporting of results

Achieve data standards

Data for comparative purposes

Characteristics of new HMIS Model
Helps to assess the incidence and prevalence of diseases so that the magnitude of the problems and their importance can be known.
Helps to identify high risk groups & to establish priorities and plan preventive programs.
Helps understand the local epidemiological trends and patterns.
Useful in monitoring and impact evaluation of control programs against specific diseases.
Active Surveillance.
Passive Surveillance.
Sentinel Surveillance.
Keep the design of the information system as simple as possible
Involve users in the design of the system
Standardize procedures and definitions

Develop an appropriate incentive structure
Plan for effective checking procedures by real time checking of reporting & flow of data.
Training

Population-based community health information systems
Epidemiology
Empowerment
Efficiency
Equity
Effectiveness
The five E’s
Data collection standards
Case definitions
Data transmission
Confidentiality
Training standards
Software design
Procurement/ Distribution
Quality assurance
Private sector
Elements of Health information system management
Organization rules

Geographical Information System
Definition:
GIS can be defined as a set of elements that allow the computerized handling of geographically defined data, their entry, storage, analysis, and presentation

Process:
Linking an already existing, computerized health information system database to a digitized map
Sources of geographical data:
Digitizing maps, Surveys using global positioning systems

Sources of attribute data:
Routine health information system data, Census data, Survey data, Data from other sectors
Advantages:
Health outcome, Program planning, Displaying performance indicators, Analytical possibilities, Displaying health care coverage, Inter sectoral use of geographical information system

Existing System Lacks
Inappropriate data collection

Failure to report data
Unintentional recording and reporting of inaccurate data
Intentional recording and reporting of false data

Errors in processing data - Editing, Coding, Data entry, Tabulating
Advantages of our HMIS
Community
Easy access to Health Facility.
Proper Referral System of the Patient.
Proper follow-up of the patient.
Enhance Immunization Coverage and decrease the disease burden.
DEWS - Early Warning System.
Health Authorities
Help the Program manager to
plan preventive and curative activities,
Monitor outcome and plan the resources.
plan their budgets.
Help the Health Authority to Analyze the reports and plan human and financial resources and logistics
Help the Health Authorities.
Epidemiology
Empowerment
Efficiency
Equity
Effectiveness
Human & financial resources
Cutting Edge of our HMIS
Real time check of Flow of data.
Digitization of Data at FLCF facility through mobile phones.
Proper check on the Quality of data.
GIS
EMR
DEWS
Help to achieve MDG4 (Reducing the child Mortality) MDG5 (improving the maternal health and MDG6 (combating HIV, Aids, Malaria & TB).
Help the government to access international Funding and donor agencies.
It will help the government in GOOD GOVERNANCE.
Why health information system?
Full transcript