Health Information Systems
Health Information System for Medical Laboratory Science
                       Prepared by:
       Joseph Israel R. Guanlao, RMT, MSMT, MPH
Learning Objectives
• At the end of the lecture, the student should be able to:
  1. Define health information system;
  2. Discuss the different core indicators of a country’s health
     information system performance;
  3. Enumerate the different information sources of a health
     information system.
Health Information System
• Any system that captures, stores,
  manages, or transmits information
  related to the health of individuals
  or the activities of organizations
  that work within the health sector.
• A well-functioning HIS is an
  integrated effort to collect, process,
  report, and use health information
  and knowledge to influence policy
  and decision-making, program
  action, individual and public health
  outcomes, and research.
Health Information System
• Cover different systems that capture,
  store, manage, and transmit health-
  related information that can be
  sourced from individuals or activities
  of a health institution.
   1.   Disease surveillance systems
   2.   District level routine information system
   3.   Hospital patient administration systems
        (PAS)
   4.   Human resource management information
        systems (HRMIS)
   5.   Laboratory information systems (LIS)
Key Functions
Different Information in HIS
   Health       Health System   Health System
Determinants       Inputs         Outputs
           Health           Health
          Outcomes        Inequities
Components of HIS
• Resources – legislative, regulatory, and
  planning frameworks; personnel,
  financing, logistics support, ICT,
  coordinating mechanisms.
• Indicators – health determinants, health
  system inputs, outputs, outcomes, health
  status.
• Sources – population-based or
  institution-based.
Components of HIS
• Management – collection, storage,
  quality assurance, processing,
  compilation, and analysis.
• Information products – basis for
  evidence and knowledge to shape health
  actions.
• Dissemination and use – accessibility
  of generated information to decision-
  makers.
Different Levels of Applications
Individual
   Health Facility
      Population
         Public Health Surveillance
Individual Level
• Data on patient’s profile, healthcare
  needs, and treatment.
• Basis for clinical decision-making and
  sound individual health care.
• Problems can arise when health workers
  are overburdened by excessive data and
  reporting demands from multiple and
  poorly coordinated subsystems.
Healthcare Facility Level
• From aggregated facility-level records and from
  administrative sources.
• Enable healthcare managers to:
    1.   Determine resource needs;
    2.   Guide purchasing decisions for drugs, equipment,
         and supplies;
    3.   Develop community outreach.
• Provide immediate and ongoing information
  relevant to public health decision-making, provided
  that the data:
    1.   Is of high quality;
    2.   Relates to both public and private facilities;
    3.   Representative of the services available to the
         population as a whole.
Population Level
• Population level data are essential for
  public health decision-making and
  generate information about healthcare
  service utilization.
• Household surveys
   ✓ Primary source of data in developing countries
     where facility-based statistics are of limited
     quality.
   ✓ Good source of information on individual
     health beliefs, behaviors, and practices (critical
     health determinants).
Public Health Surveillance
• Brings together information from
  both facilities and communities.
• Focuses mainly on defining problems
  and providing a timely basis for
  action.
• Timeliness of reporting and
  response, and effective linkages to
  those in authority.
Major Health Information
Systems in the Philippines
Philippine Health Information Exchange
• A platform for secure
  electronic access and
  efficient exchange of health
  data and/or information
  among health facilities,
  healthcare providers, health
  information organizations,
  and government agencies.
Field Health Service Information System
• The official information system of the DOH that
  oversees gathering health data from the field.
• A major component of the network of information
  sources developed by the DOH that enable the
  agency to better manage nationwide health service
  delivery activities.
• An important source of data for the regular health
  status monitoring and evaluation along with other
  sources.
Field Health Service Information System
• Objectives:
  1. To provide data on health service delivery and selected program
     accomplishments at local levels;
  2. To provide data which, when combined with data from other
     sources, can be used for program monitoring and evaluation;
  3. To provide a standardized, facility-level database which can be
     accessed for more in-depth studies;
  4. To minimize the burden of recording and reporting in the service
     delivery level in order to allow more time for patient care and
     promotive activities.
Philippine Integrated Disease Surveillance
and Response
• An enhanced surveillance system that
  monitors notifiable diseases and other
  health-related events of public health
  importance utilizing an integrated approach.
• Key features of PIDSR relating to health data:
    1. Effective and efficient management of
        surveillance data and use of
        information for decision-making,
        including monitoring and evaluation of
        intervention programs at all levels;
    2. Open lines of communication with
        established feedback loops at all
        levels.
Notifiable Diseases
                         Category 1                                             Category 2
     Immediately reportable         Immediate reporting
      diseases / syndromes /          upon laboratory       Weekly reportable diseases / syndromes / events
             events                    confirmation
1.    Acute flaccid paralysis      1.   Poliomyelitis     1. Acute bloody diarrhea     13. Neonatal tetanus
2.    Anthrax                      2.   Cholera           2. Acute hemorrhagic         14. Non-neonatal tetanus
3.    Human avian influenza        3.   Measles               fever                    15. Paralytic shellfish
4.    Severe acute respiratory     4.   HIV / AIDS        3. Acute viral hepatitis         poisoning
      syndrome                                            4. Acute flaccid paralysis   16. Pertussis
5.    Adverse event following                             5. Bacterial meningitis      17. Rabies
      immunization                                        6. Cholera                   18. Typhoid and
6.    Any disease outbreak                                7. Dengue                        paratyphoid fever
7.    Any clustering of patients                          8. Diphtheria
      with similar disease,                               9. Influenza
      symptoms, or syndromes                              10. Japanese encephalitis
8.    Meningococcal disease                               11. Leptospirosis
                                                          12. Malaria
Surveillance in Post-Extreme Emergencies
and Disasters
• An early warning surveillance system that
  when activated in post-disaster and extreme
  emergency situations:
     1. Ensures early detection of increase in
        both communicable and non-
        communicable diseases;
     2. Monitors trends of health conditions;
     3. Enables identification of appropriate
        response in preventing diseases and
        averting deaths.
Key Features of SPEED
1. Utilizes syndromic surveillance;
2. Adopts available ICT such as SMS and the internet for data collection,
   analysis, and report generation;
3. Focuses on the 21 most common health conditions encountered after a
   disaster;
4. Features an alert notification system that instantaneously cues the health
   system where immediate response is most needed;
5. Complements the existing routine surveillance systems.
Mechanism of
SPEED
Applications of SPEED
• September 2010 – Fire, City of Navotas.
    • SPEED helped facilitate allocation and mobilization of tetanus toxoid for resident with fire-related injuries.
• October 2010 – Supertyphoon Juan, Paniqui, Tarlac.
    • The health trends in evacuation centers were monitored more closely by the local and national government.
• February 2011 – Eruption of Mt. Bulusan, Irosin, Sorsogon.
    • Local leaders were able to assess more readily the severity of respiratory problems experienced by residents.
• June 2011 – Flooding in Pigcawayan (Region XII), North Cotabato and North Cabuntalan,
  Maguindanao (ARMM).
    • Investigation and management of diseases with breached alert threshold were carried out more promptly, thus
      decreasing disaster-related morbidities and mortalities.
PIDSR and SPEED
  Characteristics                   PIDSR                                         SPEED
                                                             Early detection of unusual increases or occurrence
                    Early detection of outbreaks and early   in communicable and non-communicable
Objective
                    response                                 diseases/health conditions to provide early
                                                             response during emergencies and disasters
Diseases            Communicable disease with outbreak       21 communicable and non-communicable diseases
monitored           potential                                common during disasters
                    Yes, part and parcel of routine          No, activated only post-extreme emergencies or
Always activated?
                    surveillance                             disasters
                    Case-based surveillance, lab-based
Path of detection   surveillance, and event-based            Event-based surveillance
                    surveillance
Frequency of        Weekly for category 2 and within 24      Daily and immediately upon detection when
reporting           hours for category 1                     Notification Alert Level is breached
References
• HEMS-DOH (2011). Surveillance in Post-Extreme Emergencies and
  Disaster (SPEED) Operations Manual for Managers (1st Edition).
• NEC-DOH (2014). Manual of Procedures for the Philippine Integrated
  Disease Surveillance and Response (3rd Edition).
• Pacific Health Information Network. Health Information System.
  http://phinnetwork.org/resources/health-information-systems-his/