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These three must INTERACT to support operations
and management in delivering essential
HIS: CONCEPT AND TECHNOLOGY
information. (demographics and medical history)
● These essential information can help with
1 BASIC CONCEPT OF HEALTH
the decision making and making of policies
INFORMATION SYSTEM for our community and must be treated
HEALTH INFORMATION SYSTEM (HIS) with confidentiality (privacy act)
● Is the intersection between healthcare’s WHAT IS THE MAIN GOAL OF HIS?
business process and information systems ● To improve the quality of healthcare
● Its purpose is to deliver better healthcare services. (considering healthy people,
services prevention, maintaining healthy lifestyle)
● has become increasingly important as ● Providing good healthcare
economic, social, politic and technological HAUX (2006)
factors have advanced over time ● “ Health information systems are systems
● DOH ACADEMY, DOH learning system that process data and provide information
● support healthcare professionals working in and knowledge in a healthcare
healthcare facilities as well as healthy or sick environment”
persons in their live situations ● HEALTHCARE ENVIRONMENT , focuses on
THE TIMELY RELEVANCE OF HIS Maintaining health and treating diseases,
● Nowadays, the widespread use of preventive measures
information and communication
HIS IS UTILIZED MORE IN A HOSPITAL
technologies (ICT) has permeated almost
all aspects of life including the health
SETTING THAN IN A SMALL HEALTH UNIT
sector. In a hospital health information system:
HIS was introduced to fully utilize especially
● ● The hospital is the healthcare environment as
the internet in providing better healthcare. well as a healthcare institution
● electronic consultation ● A well utilized and managed HIS in the
WHAT DOES HIS INVOLVE? hospital setting contributes to a high quality,
Involves interaction between: efficient patient care.
● People - may be healthy or sick, entities ● In smart cities small health units HIS is utilized
● Process - data gathered from the people but in some rural areas it is not utilized.
must be processed, entity type/ entity types
we can use
● Technology - human actors and technical
actors, entity type/ entity types we can use,
non/computer based application
components
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and knowledge for communication and
2 COMPONENTS OF HIS decision making.
ELECTRONIC MEDICAL RECORD(EMR)
HEALTH INFORMATICS
Protti et al. (2009)
Conrick (2006)
● Resides at the center of any health
● It is the field that concerns itself with the
information system
cognitive, information processing and
● it is a medical record in a digital format
communication tasks of medical practice,
ELECTRONIC HEALTH RECORD (EHR)
education and research
Protti et al. (2009)
● include the information science and
● Refers to an individual patient’s health
technology that support those tasks
record in a digital format.
TOOLS IN HEALTH INFORMATICS
● EHR systems coordinate the storage and
● Computers
retrieval of individual records with the aid of
● Clinical guidelines
computers
● formal medical terminologies
● are usually accessed on a computer, often
● information and communication systems
through a computer network. There is an
existence of the internet and intranet.
“Information and knowledge logistics aims at
INTRANET, networking within an
making the information and knowledge available
organization
at the right time, place to the right people in the
● Part of HIS that collects the patient’s
right form so that these people can make the right
information and health from different
decisions”
healthcare settings/ healthcare
environments. The collection of a person's
“Emphasis is on clinical and biomedical
health data from a certain facility.
applications. It has the added possibility of
● can be scattered throughout public and
integrating clinical components to more
private institutions
administrative type health information systems.”
ELECTRONIC PATIENT RECORD (EPR)
Protti et al. (2009)
HEALTH INFORMATION TECHNOLOGY
● An electronically stored health information
Goldschmidt (2005)
about one individual uniquely identified by
● The application of information processing
an identifier
involving both computer hardware and
● EPR technology entails capturing, storing,
software. (The software must support the
retrieving, transmitting and manipulating
volume of our patient and must be
patient specific, healthcare related data
updated)
singly and comprehensively
● Deals with the storage , retrieval, sharing
● includes clinical,administrative and
and use of healthcare information, data
biographical data.
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● The availability of these patient data may
“Managing these components include Planning, trample on the patient’s right to
Directing and Monitoring or Evaluation of the task confidentiality
of each component” For HIS to be effective:
● Only a necessary portion of the patient
information should be made available to
someone from the system who performs a
certain function
EMR A medical record in a digital
● For example, those working in the billing
format
section of the hospital should not have
EHR An individual patient’s medical
access to the patient’s medical history.
record in a digital format
Richard and Ronald (2008)
EPR An electronically stored health ● Fostering good relationship with customer
information about one individual (patient) will retain them and attract them
uniquely identified by an to become loyal customers, and create
identifier greater mutual understanding, trust and
Difference between EMR,EHR,EPR satisfaction
● A good relationship will encourage patient’s
involvement in decision making.
Arora (2003)
● good relation will foster effective
communication which is often associated
with improved physical health, more
effective chronic disease management,
and better health related quality of life.
MANAGING RELATIONSHIP MUST
CONTINUALLY DEVELOP AND GROW
1 OF THE ISSUES CONSTANTLY TACKLED ● A good relationship is a dynamic one that
IN THE APPLICATION OF HIS the organization becomes alert to and
aware of changing needs.
To manage the relationship between healthcare
● In turn, when healthcare organizations
providers and patients:
manage well, patients will want to come
● Delivery of speedy and quality healthcare
back, because loyalty and trust are built.
services to patients entails that much patient
data should be made available to different
members of a healthcare system
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● The customer, clients and patients will know they can be easily and effectively
that if they present a difficulty, the managed.
organizations will resolve professionally ● In turn, this increased the tendency of
people to know more and actively
3 HISTORY OF HEALTH INFORMATION participate in health promotion,
SYSTEMS prevention, and care.
EFFECTS OF THE TREND
● Healthcare is undergoing a paradigm shift, Builds on health telematics, networks and
moving from 'Industrial Age Medicine to services
Information Age Healthcare' (Smith, 1997) Links:
● This 'paradigm shift' is shaping healthcare ● Hospitals
systems (Haux et.al, 2002) and ● Laboratories
transforming the healthcare-patient ● Pharmacies
relationship (Ball, 2001). ● primary care
● The World Wide Web has changed the way ● social centers
the public engage with health information
(Powell et al., 2003). ● This link offers a 'virtual healthcare
Kuhn and Giuse, 2001.
•The Web has become a popular channel to Most developed countries have fully utilized HIS in
deliver information products or services, their systems:
including those in the healthcare industry. ● This is because they have the resources,
expertise, and capital to implement them.
4 FUTURE TRENDS OF HEALTH ● HIS has not been fully utilized in developing
INFORMATION SYSTEM countries.
● The vision of a paperless hospital is
delineated as the embodiment of the future
Health Information Systems.
● It is hoped that the improvement brought
by a paperless healthcare delivery system
will make it more reliable, effective, and
efficient.
MOST COMMON TREND IN HIS
Adoption of e-health systems toward the use of
EMR:
● The systems move patient information
from paper to electronic file formats so
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● annual reports
HEALTH MANAGEMENT INFORMATION ● outcomes
SYSTEM
DATA SOURCES
HEALTH MANAGEMENT INFORMATION SYSTEM
● Kung diin halin aton information or data
● Key component of strategic information
● divide into two categories: population base
system
and institution base
● one of the six building blocks essential for
● Population based
health system strengthening
● evidences
● Data collection system specifically designed
● service records
to support planning, management, and
DATA MANAGEMENT
decision making in health facilities and
● refers to the handling of data, collection,
organizations. (respecting the decision of the
storage of data, processing and analyzing
patient)
INFORMATION PRODUCTS
● data is now transferred into a useful
1 6 ELEMENTS OF HIS information that will provide us insights
crucial on how we shape our health action
● can be evidences, annual reports, health
status of the community (can be also under
indicators)
● evidences
DISSEMINATION AND USE
● enhances the value of health information
by making readily available to the
community
● infographics
● annual reports
HEALTH INFORMATION SYSTEMS RESOURCES
● Personnel, support staff, Logistics support
(nonhuman and human) and financing.
Also includes ICT
● financing
INDICATORS
● Basis of HIS plan, includes related targets
● example: birth rate, death rate,
maintenance of high blood pressure
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5. Develop the procedures and mechanisms
for data processing
6. Develop and implement a training program
for data providers and data users
7. Pre-test, and if necessary, redesign the
system for data collection, data flow, data
processing and data utilization
8. Monitor and evaluate the system
9. Develop effective data dissemination and
feedback mechanisms
10. Enhance the HMIS
MONITORING & EVALUATION
2 WHAT IS HMIS MONITORING
HMIS is a data collection system and generating ● Is an ongoing, continuous process of
quality information specifically designed to: collection of routine data that measures
● support planning program progress towards achieving
● management program objectives
● decision making in health facilities and ● Is used to track changes in program
organizations. performance over time
HMIS is one of the building blocks essential for ● Is used to determine if activities need
health system strengthening adjustments during the intervention to
improve desired outcomes
PURPOSE OF HMIS ● Permits decisions regarding effectiveness of
● To routinely generate quality health the program and efficient use of resource
information that provides specific
information support for the decision WHY DO WE NEED TO DO MONITORING
making to monitor and improve
performance of the health sector.
● Regular and systematic assessment of
STEPS IN DEVELOPING HMIS
progress
1. Review the existing system
● Continued review of partners' capacity
2. Define the data needs of relevant units
development needs
within the health system
● Improve results-based reporting on
3. Determine the most appropriate and
achievements
effective data flow
● Strengthen teamwork and ownership of
4. Design the data collection and reporting
the UNDAF among implementing partners
tools
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● Feeds into evaluation and real-time -Improved positioning to influence next
learning development planning framework
EVALUATION MONITORING VS EVALUATION
● Measures how well the program activities
MONITORING simply means counting or
have met expected objectives (objectives
determining the frequency of a
need to be smart
certain parameter (indicator)
● It measures the extent to which changes in
EVALUATION goes beyond counting the
outcomes can be attributed to the program
frequency: it determines if such
or intervention
count has any significance at all
● determining the overall worth or significance
● Systematic, impartial assessment
● External, separated from program
management 1 M&E TERMINOLOGIES
● Determines whether results made a M&E PLAN
worthwhile contribution to national ● a variable that measures a particular
development priorities aspect of a program (input, process,
Criteria: relevance, efficiency, effectiveness, output, outcome, impact), usually related to
impact, sustainability achievement of objectives
3 key functions: INDICATOR
● Programme improvement The routine collection and analysis of
●
● Accountability measurements or indicators to determine
● Organisational learning undergoing progress toward objectives
TRANSFORMATION
WHY DO WE NEED TO DO EVALUATION ● conversion of data into information
Whether we are Doing the Right Things ANALYSIS
- Relevance/rationale/justification ● relates objectives and activities to
- Client satisfaction problems, and shows how indicators and
Whether we are Doing it Right tools measure achievement of objectives
- Effectiveness/coherence INPUT
- Efficiency: optimizing resources set of resources (e.g. funds, policies,
●
- Sustainability personnel, facilities, supplies, etc.) that are
- Impact needed to implement a program/activity
Whether there are Better Ways of Doing it PROCESSES
- Alternatives ● The activities carried out to achieve the
- Good practices program's objectives
- Lessons learned
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OUTPUTS MONITORING VS EVALUATION
● immediate results achieved at the program
level through the execution of activities
● a program is said to be successful if the
outputs match the objectives
Examples of outputs include:
- number of people trained, product availability,
improved skills
OBJECTIVES
● aims of a program
● When the outputs meet or match the
objectives, then the program is considered
successful
OUTCOMES
● short-term results obtained at the
population level following activities
● (e.g., access, contraceptive prevalence,
percent of pregnant women receiving
antenatal care, etc.)
IMPACT
● long-term effects, or end results, of the
program
MONITORING VS EVALUATION
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Contradictions between variables
DATA QUALITY
ELEMENTS OF DATA QUALITY Calculation errors
Relevance ● Mistakes in adding or other operations
● Data collected and reported by HMIS is Typing error
relevant to the information needs of the ● Data is wrongly entered into the computer
health system for routine monitoring of Capture in wrong box
program performance ● TB cured in the place of Treatment
Timeliness Completed
● Data is collected, transmitted and
processed according to the prescribed WHAT HAPPENS WHEN DATA IS NOT
time and available for making timely RELEVANT, TIMELY, ACCURATE, OR
decisions.
COMPLETE?
Accuracy
● It won’t have any added value in our monitoring,
● Data in the database reflect no
only adds burden on our data collectors
inconsistency between what is in the
● it will not help us make timely decisions to fix the
registers and what is in the databases problem
/reporting forms at facility level. ● prevent us from seeing the actual performance
Completeness of our program
● Refers to all the relevant data elements in a ● we will not be able to see the complete picture
patient/client register are filled of the performance at different levels
● decision making should be based from the
evidence we have
COMMON SOURCES OF DATA ERROR in
HMIS REPORTS
WHAT IS THE EASIEST WAY OF
Missing data
CHECKING REPORTS FOR
● Data items for whole months missing (ex -
HIV positive women delivered in facility) COMPLETENESS?
Duplicate data ● through visual scanning (eyeballing)
● Multiple counting of a fully immunized child
Thumb suck TECHNIQUES TO CHECK HMIS DATA
● When data collection tools are not used ACCURACY
routinely, staff just fills digits in a likely-
Lot Quality Assurance Sampling (LQAS)
looking number (often using preferential methodology
end digits! /0 & 5/) ● Technique useful for assessing whether the
Unlikely values for a variable desired level of data accuracy has been
● A man being pregnant; low birth weight achieved by comparing data in relevant record
babies exceeding number of deliveries
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forms (i.e. registers or tallies) and the HMIS
reports.
Routine Data Quality Assessment (RDQA)
● Use at health facility level
● Helps to perform data accuracy at
administrative level by enabling quantitative
comparison of recounted data to reported data
● Helps to assess reporting such as under or over
reporting on the data
● The most common type of conceptual F. is
Mosley-Chen Framework. Commonly used
FRAMEWORKS in the study of child survival. Socio-
WHAT ARE FRAMEWORKS
economic determinants act through the
● key elements of M&E plans that depict the
following five. "proximate" or biological
components of a project and the sequence of
determinants to impact child health
steps needed to achieve the desired
outcomes
● help increase understanding of the program's
goals and objectives
● define the relationships between factors key
to implementation
● delineate the internal and external elements
that could affect its success
● crucial for understanding and analyzing how
a program is supposed to work
Results framework
4 COMMON TYPES OF FRAMEWORK ● strategic frameworks"
● diagram the direct causal relationships
Conceptual Framework
between incremental results of the key
● "research framework"
activities all the way to the overall objective
● useful in identifying and illustrating the
and goal of the intervention
factors and relationships that influence the
● clarifies the points in an intervention at
outcome of a program or intervention
which results can be monitored and
● typically shown as diagrams illustrating
evaluated
causal linkages between key components
of a program
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Logical Framework
● WALA TI DEFINITION SA PPT
Logic Model
● "M&E framework" SUMMARY
● provides linear interpretation of a project's
planned use of resources and its desired
ends
● Has five essential components
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