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His Lab
His Lab
Only authorized personnel can have access information on the patient’s health. Doctors
may be given permission to update patient information while a rece tionist may only have the
authority to update a patient’s appointments. P Y
HIS assists communication among doctors and hospitals, However, medical professionals
must adhere to regulations on patient privacy and security to ensure that information is kept
confidential and safe from unauthorized access.
A good health information system delivers accurate information in a timely manner, enabling
decision-makers to make informed choices about the different aspects of the health institution, from
patient care to annual budgets. It also upholds transparency and accountability due to easier access to
information.
Ba :
elite
Dissemination Information
and Use RA Ciky
= Resources
Information i
a. Indicators
Products
These six components of health information systems can be categorized into inputs, processes, and
outputs. ;
Inputs refer to the health information system resources. These resources include health, institutional
coordinations and leadership, health information policies, financial and human resources, and infrastructures.
The indicators, data sources, and data management form.the process in HIS. Core indicators are
needed as bases for program planning, monitoring, and evaluation. Population- and institution-based
sources are also essential for decision-making as they provide guide to health service delivery. Importantly,
these data must be accessible and understandable by users and policymakers. —
Outputs refer to the transformation of data into information that can be used for decision-making
and to the dissemination and use of such information. ‘
Donaldson and Lohr (1994) explain that a comprehensive database for health information systems
include the following:
1, Demographic data refers to the facts about the patient which include age and birthdate,
gender, marital status, address of residence, race, and ethnic origin. Information on educational
background and employment is also recorded along with information on immediate family
members to be contacted during emergency.
Administrative data includes information on services such as diagnostic tests or out-patient
procedures, kind of practitioner, physician's specialty, nature of institution, and charges and
payments.
or
Health risk information records the lifestyle and behavior (e.g., use of tobacco products
history
engagement in strenuous activities) of a patient and facts about his or her family’s medical
different
and other genetic factors. This information is used to evaluate the patient's propensity for
diseases.
health.
Health status refers to the quality of life that a patient leads which is crucial to his or her
well-
This shows-the domains of health which include physical functioning, mental and emotional
of his or her
being, cognitive functioning, and social functioning. It also shows one’s perception
health in comparison with that of his or her peers.
admissions,
Patient medical history gives information on past medical encounters like hospital
illnesses
pregnancies and live births, surgical procedures, and the like. It also includes previous
and family history (e.g., alcoholism or parental divorce).
diagnoses, allergies
. Current medical management reflects the patient's health screening sessions,
ostic or therapeutic
(especially on medications), current health problems, medications, diagn
problems.
procedures, laboratory test, and counseling on health
various health
7. Outcomes data presents the measures of aftereffects of health care and of
problems. These data usually show the health care events (e.g., readmission to hospital,
unexpected complications or side effects) and measures of satisfaction with care. Outcomes
directly reported by the patient after treatment will be most useful.
ansmit be
store, manage, and tr alth. :
Health information systems (HIS) refer to systems that ¢
apture,
can be sourced from individu als o r act ivi tie s of health institutions,
related information that
. . i ures easi er file access, better control, Casi
HIS improves the delivery of health services because it ens
update, and improved communications.
; systems are health info
inf rmation system resources (inputs
The components of health information tra nsf ormation of data Into);
(processes); and
indicators, data sources, and data management
. information, and its dissemination and use (outputs).
The different data sources are demographic data, administrative data, health risk information, health
status, patient medical history, current medical management, an d outcomes
data.
Functions of HMIS —
detection,
The information from an HMIS can be used in planning, epidemic prediction and
Ministry of Health
designing interventions, monitoring, and resource allocation (Republic of Uganda
Resource Centre, 2010).
ion of three
Historically, all information systems, including HMIS, are built upon the conceptualizat
and data output. Each phase
fundamental information-processing phases: data input, data management,
comes with elements (Tan, 2010) that perform specific functions.
1. Data input includes data acquisition and data verification. -
through the input of standard ©
a. Data acquisition refers to the generation and collection of data
reading and capturing of data.
coded formats (e.g., bar codes) to assist in the faster mechanical
The authority, validity, and
b. Data verification involves data authentication and validation.
red data.:
reliability of the data sources help ensure quality of gathe
data storage, data classification, data
2. Data management, also called processing phase, includes
update, and data computation.
is advisable that data which are no
a. Data storage includes preservation and archiving of data. It
legislation.
longer actively used should be archived. At times, it is mandatory and part of
sets the efficiency of the system. Key
b. Data clas sification is also called data organization which
ificati on schemes for easier data search.
parameters should be used for data class
manipulation and data transformation
c. Data computation requires various forms of data
stical and probabilistic
ls, linear and nonlinear transformation, stati
(e.g., mathematical mode
function allows data analysis, synthesis,
approaches, and other data analytic processes). This also for other
and evaluation so that data can be used not only for decision-making but
tactical and operational use.
d. Data update facilitates new a nd changing information
and requires constant monitoring.
For HMIS, the mechanism for data maintenanc
e must be in place for updating changes for
manual or automated transactions.
Health Management Information System 61
Behavioral determinants
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. The
chance of the task being performed is affected by the individual perceptions on the outcome and the
complexity of the task (Aqil, Lippeveld, & Hozumi, 2009). Lack of motivation and enough knowledge on
the use of data has been found to be a major drawback in the data quality and information use. Changing
people's attitude towards data collection and analysis is necessary in order to maximize the performance of
" the RHIS process (Routine Health Information Network, 2003).
Organizational determinants
The important factors that affect the development of the RHIS process are the structure of the
health institution, resources, procedures, support services, and the culture within the organization (Aqil,
Lippeveld, & Hozumi, 2009). However, other factors which include lack of funds, human resources, and
management support contribute to the determinant of the RHIS process. | ,
Having a system in place which supports data collection and analysis and transforms it into useful
information will help in promoting evidence-based decision-making. Thus, all components within the
system are ideal in making the RHIS perform better. An improved RHIS performance means an effective
organizational culture that promotes information use by collecting, analyzing, and using information to
accomplish the organization's goals and mission (Sanga, 2015).
Technical determinants
Technical factors involve the overall design used in the collection of information. It comprises the
complexity of the reporting forms, the procedure set forward in the collection of data, and the overall
design of the computer software used in the collection of information (Sanga, 2015).
PRISM Framework
The Performance of Routine Information Systems Management (PRISM) is a conceptual framework
that broadens the analysis of HMIS or RHIS by including the three determinants of HMIS performance,
namely:
* Behavioral determinants — knowledge, skills, attitudes, values, and motivation of the people who
collect and use data,
. Organizational/environmental determinants — information culture, structure, resources, roles, and
responsibilities of the health system and key contributors at each level, and
© Technical determinants - data collection processes, systems, forms, and methods.
tizing
.
tysyatert
system. |
performance, which in turn improves the performance of the health
The PRISM framework, founded on performance improvement principles, defines the Vatig
components of the routine health information system an’ d their linkages tone produce better qualit ae,
and continuous use of information, leading to better health system perform nce and, conseq
uently bets a
» er
+ A health management information system (HMIS) is “specially designed toassist in the Management
and planning of health programs, as opposed to delivery of care (WHO, 2004):
* The 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.
+ Historically, all information systems, including HMIS, are built upon the conceptualization of three
fundamental information-processing phases: data input, , data management, and data output. Each
phase comes with elements that perform specific functions. The eight elements are data acquisition,
data verification, data storage, data classification, data computation, data update, data retrieval, and
data presentation. - “uP “Sot Roa as
¢ The determinants affecting HMIS performance are behavioral, organizational, and technical.
* The PRISM (Performance of Routine Information Systems Management): framework defines the
various components of the routine health information system (RHIS) and their linkages to produce
better quality data and continuous use of information, leading to better health system performance
and, consequently, better health outcomes.
Purpose of M&E
A robust monitoring and evaluation (M&E) system is required to assess the effect of an
integrated
service delivery. Appropriate indicators, data collection systems, and data analysis to support
decision-
making help guide the successful implementation of integrated services and measure the effect
on both
service delivery and use of services (FP/Immunization Integration ‘Working Group, n.d.).
-M&E Framework
A general framework of M&E of health system strengthening (HSS) was developed
by various global
partners and countries. Derived from the Paris Declaration on aid harmonization
and effectiveness and
the International Health Partnership (IHP+), this framework places health
strategy and related M&E
processes of each country at the center. The strengthening of a conimon country platform for the M&E of
HSS is the core of the framework. In doing so, there is better alignment and the monitori
ng of fundings for
health systems is easy.
There are four components of the framework as provided by WHO, namely, the indicator doniains,
data collection, analysis and synthesis, and communication use, intended for achieving greater
health impact. For monitoring medical services, indicators should be tracked to assess processes and
results associated with the various indicator domains. In this way, the strengths and weaknesses of
implementation are provided and can be used for troubleshooting in the system. In terms of outcomes and
impact indicators, the changes may not be directly caused by service delivery efforts for there are other |
factors to consider. However, these data are still useful in understanding the current health status and
context within a country (FP/Immunization Integration Working Group, n.d.).
It should be noted that shifts in outcome and impact indicators may not be directly attributable to
integrated service delivery efforts, as there are many other factors which influence these indicator |
However, where possible, it can be useful to collect these data in order to understand the broader health
context within a country, and the ways in which packages of interventions can lead to impact over time
(FP/Immunization Integration Working Group, n.d.).
Science
68 Health Information System for Medical Laboratory
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Immunization
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coverage (> Thi. Aree ssh stele
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Disease Prevention and Waar Tey ve!S
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per 1,000 population
Control
per 4,000 population, of.
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HMIS Indicators and Health Programs
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HMIS j . sary for monitoring different aspec
asp ts of ts
various health Prop;
is a source of routine data necessary d be carefully selected to meet the es Blam,
implemented in a country. The HMIS indicators show Sentigl
rious health programs and services
information necessary for monitoring the performance 0 va. : and to
4, interpartum period
» Family planning method acceptors (new and repeat)
« Family planning methods issued by type of method
These indicators, although not complete to monitor all aspects of maternal survival strategies, capture
data related to pregnancy, such as intrapartum and postpartum care, and are sufficient to give a broad
tions. More so, using these
indication of the performance of the package of maternal survival interven
indicators help prompt further investigations when problems on issues arise.
2,000
1,800
1,600
1,400
1200
1,000
800
600
400
200
Diarrhea and Congenital Other diseases Septicemia Accidental Chronic tower Dengue Fever Meningitis Pulmonary and
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168 215 184 | 140 |
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Philippines
Figure 7.1 Leading cause of under-five child mortality in the
(The 2012 Philippine Health Statistics, 2012) —
luation 73
iMMIS!Monitoring and Eva
Stop TB Program
_ Envisioning a tuberculosis-free world, the goal of the Stop TB
Program (STP) is to dramatically reduce
the global burden of tuberculosis (TB) by 2015. This is
in line with the WHO’s millennium development
goals and the Stop TB Partnership which aims to push
TB up the world political agenda. One of the main
objectives of the program is to achieve universal access
to high-quality care (i.e., universal access to high
quality diagnosis and patient-cent
ered treatment) for all people with TB (including
HIV and those with drug-resistant TB). those co-infected with
strategic plan that compr 1Ses all major disease programs and heath cyte i. ° : :
indi . lth
ere are different HMIS
can be use d in mo ni to ri ng the key aspects of the health
h
from whic g the five broad categories, namely, reproductive hea ,
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sy nization disease ation, and data quality.
mm , prevention and control, resources utiliz
s health programs
V HMIS isa source of routine data necessary for monitoring different aspe cts of variou
to meet the essential
implemented in a country. The HMIS indicators should be carefully s elected and to
programs and se rvices
information necessary for monitoring the performance of various health
present an overview of the available health resources.