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Lesson 5: Health Informatics Systems

Baseline Concept Understanding

Health Informatics Systems

Define Concepts, Role and Function of Health Information

System

5.1.2 Role and Function of Health Information Systems

Sheahan (2017) describes health information systems as a mechanism to keep
track of everything related to patients, from patients medical history, to
medication logs, contact information, appointment times, insurance information
and billing and payment accounts. She further elaborates the role that a well-
implemented can play in improving the services provided by a health institution:

1. Files Are Easier to Access

Health information systems have revolutionized the way that doctors and
health care professionals maintain patient information. These systems
are electronic, so the days of hard files and loose papers are over.

2. More Controls

Staff must be authorized to access the health information system. Doctors

may have permission to update, change and delete information from the
electronic medical record. The receptionist, however, may only have the
authority to update a patients appointments.

3. Easy to Update

Health information systems let doctors create electronic medical records

for their patients. Patient information can be pulled up for review at any
time and copies can be made for the patient upon request.

4. Communication

Health information systems abet communication between multiple

doctors or hospitals. According to Government Health IT, medical

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professionals must pay close attention to confidentiality issues, such as

patient privacy and security safeguards to ensure unauthorized users
cannot access the information.

A good Health Information Systems delivers the accurate information in a timely

manner, enabling decision-makers to make better-informed choices about
different aspects of the health institution, from patient care to annual budgets.
It also upholds transparency and accountability due to the easier access to
information.

Components of Health Information Systems

The Health Metrics Network (HMN), in their Framework and Standards for
Country Health Information Systems (2008), has defined a Health Information
System as consisting of six components:

Figure 5.1: Six Elements of an HIS

1. Health Information Systems Resources

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These include the legislative, regulatory and planning frameworks

required for a fully functioning health information system, and the
resources that are required for such a system to be functional. Such
resources involve personnel, financing, logistics support, information
and communications technology (ICT), and coordinating mechanisms
within and between the six components

2. Indicators

A core set of indicators and related targets is the basis for a health
information system plan and strategy. Indicators need to encompass
determinants of health; health system inputs, outputs and outcomes;
and health status

3. Data Sources

These can be divided into two main categories; (1) population-based

approaches (censuses, civil registration and population surveys) and (2)
institution-based data (individual records, service records and resource
records). A number of data-collection approaches and sources do not fit
into either of the above main categories but can provide important
information that may not be available elsewhere. These include
occasional health surveys, research, and information produced by
community based organizations

4. Data Management

This covers all aspects of data handling from collection, storage, quality-
assurance and flow, to processing, compilation and analysis

5. Information Products

Data must be transformed into information that will become the basis for
evidence and knowledge to shape health action

6. Dissemination and Use

The value of health information is enhanced by making it readily

accessible to decision-makers and by providing incentives for, or
otherwise facilitating, information use

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In addition to the six components, the HMN also further subdivides an HIS into
inputs, processes, and outputs.

Inputs

1. Health information system resources. These consist of the

legislative, regulatory, and planning frameworks required to ensure a
fully functioning health information system, and the resources that are
prerequisites for such a system to be functional. Such resources involve
personnel, financing, logistics support, information and communications
technology (ICT), and coordinating mechanisms within and among the
six components (Section 2.6).

Processes

2. Indicators. A core set of indicators and related targets for the three
domains of health information outlined in Section 2.3 is the basis for a plan
and strategy for a health information system. Indicators need to
encompass determinants of health; health system inputs, outputs, and
outcomes; and health status.

3. Data sources can be divided into two main categories: (1) population-
based approaches (censuses, civil registration, and population surveys)
and (2) institution-based data (individual records, service records, and
resource records). Section 2.4 describes a basic set of standards for each
source and strategic elements in achieving these standards. A number of
other data-collection approaches and sources occasional health surveys,
research, and information produced by community based organizations do
not fit neatly into either of the two main categories but can provide
important information that may not be available elsewhere.

4. Data management. This covers all aspects of data handling: collection,

storage, quality-assurance, flow, processing, compilation, and
analysis (Section 2.5). Specific requirements for periodicity and timeliness
are defined where critical as in the case of disease surveillance.

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Outputs

5. Information products. Data must be transformed into information that

will become the basis for evidence and knowledge to shape health
action (Section 2.6).
6. Dissemination and use. The value of health information can be
enhanced by making it readily accessible to decision makers (giving due
attention to behavioral and organizational constraints) and by providing
incentives for information use (Section 2.7).

Different data sources for Health Information System

Figure 5.2: Sources of Information for HIS

Demographic data consist of facts such as age (or birth date), gender, race
and ethnic origin, marital status, address of residence, names of and other
information about immediate family members, and emergency information.
Information about employment status (and employer), schooling and education.
Administrative data involves facts, with respect to services provided (e.g.,
diagnostic tests or outpatient procedures), and also typically include charges
and amounts paid, the kind of practitioner (physician, podiatrist, psychologist),
physician specialty, and nature of institution (general or specialty hospital,
physician office or clinic, home care agency, nursing home, and so forth).
Health risk information reveals lifestyle and behavior (e.g., whether an
individual uses tobacco products or engages regularly in strenuous exercise)
and facts about family history and genetic factors to evaluate propensity for
different diseases.
Health status (or health-related quality of life), is generally reported by
individuals themselves, reflects domains of health such as physical functioning,

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mental and emotional well-being, cognitive functioning, social and role

functioning, and perceptions of one's health in the past, present, and future and
compared with that of one's peers.
Patient medical history considers data on previous medical encounters such
as hospital admissions, surgical procedures, pregnancies and live births, and
the like; it also includes information on past medical problems and possibly
family history or events (e.g., alcoholism or parental divorce).
Current medical management includes the content of encounter forms or
parts of the patient record. Such information might reflect health screening,
current health problems and diagnoses, allergies (especially those to
medications), diagnostic or therapeutic procedures performed, laboratory tests
carried out, medications prescribed, and counseling provided.
Outcomes data comprise a wide array of measures of the effects of health care
and the aftermath of various health problems; they might reflect health care
events such as re-admission to hospital or unexpected complications or side
effects of care, and also include measures of satisfaction with care. Outcomes
assessed weeks or months after health care events, and by means of reports
directly from individuals (or family members), are desirable, although these are
likely to be the least commonly available (Donaldson and Lohr, 1994).

KEY POINTS TO REMEMBER

 Health information systems refer to 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.
 HIS improves the services because files are easier to access, more
controls, easy to update and communication.
 The components of an HIS are (Inputs) Health Information System
Resources; (Processes) Indicators, Data Sources, Data Management;
(Outputs) Information Products and Dissemination & use.
 The different data sources are: Demographic data, administrative data,
Health Risk Information, Health Status, Patient medical history, Current
medical management and outcomes data.

Learning Outcomes Assessment

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