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LEARNING MODULE
HEALTH INFORMATION SYSTEM FOR MED LAB SCIENCE
WEEK 4 – HEALTH MANAGEMENT INFORMATION SYSTEM

Health Management Information System responsibilities of the health professionals at the level of
Hospitals using the traditional manual process do collection.
not have real-time data and delays in the receipt of data • The information collected is functional as it is to be
pose a challenge to evidence-based program used immediately for management and should not wait
management. Accurate and real-time records of for feedback from higher levels.
equipment and drugs could not be obtained in a timely • Information collection is integrated for there is one set
manner resulting in problems in accountability, of forms and no duplication of reporting.
monitoring of expiry dates, stocks, and auto indenting. • The information is collected on a routine basis from
Inventory of medicine and equipment was a tedious task every health unit.
due to lack of standards in filing names and codes in the
institution.
Roles of the HMIS
As defined by the World Health Organization
(2004), health management information system (HMIS) An HMIS needs to be complete, consistent, clear,
is “specially designed to assist in the management and simple, cost-effective, accessible, and confidential
planning of health programmes, as opposed to delivery (Janneh, 2002). It should be complete with all
of care.” The health component of HMIS refers to clinical information but avoiding duplication and consistent in
studies to understand medical terminologies, clinical assigning definitions to similar information from various
procedures, and database processes; management sources. It should also be simple to use and clear as to
refers to the principles that help administer the health what is measured by the elements. The eligible users
care enterprise; and information system refers to the must have access and should be able to use the system
ability to analyze and implement applications for with ease. The confidentiality of patient information and
efficient and effective transfer of patient information. An data privacy should always be a top priority. While
HMIS is one of the six building blocks essential for health providing all these benefits, the system must prove its
system strengthening. It is a data collection system cost-effectiveness through operations.
specifically designed to support planning, management,
and decision-making in health facilities and Functions of HMIS
organizations.
Historically, all information systems, including HMIS, are
HMIS was developed within the framework of the built upon the conceptualization of three fundamental
following concepts (Republic of Uganda Ministry of information-processing phases: data input, data
Health Resource Centre, 2010): management, and data output. Each phase comes with
• The information collected is relevant to the policies and elements (Tan, 2010) that perform specific functions.
goals of the health care institution, and to the


1. Data input includes data acquisition and data considers the duration of transmittal of required data
verification. from the source to the appropriate end-user. The
a. Data acquisition refers to the generation and economics of producing the needed information is a
collection of data through the input of standard coded significant criterion.
formats (e.g., bar codes) to assist in the faster b. Data presentation is the reporting of the
mechanical reading and capturing of data. interpretation of the information produced by the
b. Data verification involves data authentication and system. Summary tables and statistical reports are
validation. The authority, validity, and reliability of the expected but the use of visuals is encouraged especially
data sources help ensure quality of gathered data. for high-level managerial decision-making because they
provide a better intuitive perspective of the data trend.
2. Data management, also called processing phase,
includes data storage, data classification, data update, List of functions of HMIS
and data computation.
a. Data storage includes preservation and archiving of Listed below are the possible functions in an HMIS with
data. It is advisable that data which are no longer actively the corresponding type of information that can be
used should be archived. At times, it is mandatory and captured and tracked in the system (Behavioural Health
part of legislation. Collaboration Solutions, 2006).
b. Data classification is also called data organization
which sets the efficiency of the system. Key parameters 1. Client data relates to all the information of the client
should be used for data classification schemes for easier which is related to his or her transactions, reports, and
data search. other information such as client billing data, clinical data
c. Data computation requires various forms of data and other client data.
manipulation and data transformation (e.g., 2. Scheduling is observed to distribute resources to areas
mathematical models, linear and nonlinear that need them. An example is linking the schedule to the
transformation, statistical and probabilistic approaches, billing of the entity.
and other data analytic processes). This function allows 3. Authorization tracking focuses on monitoring of the
data analysis, synthesis, and evaluation so that data can authorized personnel and their use of the authorized
be used not only for decision-making but also for other units.
tactical and operational use. 4. Billing refers to the notification of the charges for the
d. Data update facilitates new and changing information patient and other related documents such as the
and requires constant monitoring. For HMIS, the compliant electronic claim.
mechanism for data maintenance must be in place for 5. Accounts receivable (A/R) management ensures that
updating changes for manual or automated transactions. customers are properly notified about their bill and will
settle it accordingly. Data for A/R management include
3. Data output includes data retrieval and data tracking aging of unpaid services, tracking reasons for
presentation. denials and aged receivable report by payer source.
a. Data retrieval pertains to the processes of data 6. Reporting refers to reports issued by the entity which
transfer and data distribution. The transfer process could be basic reports or report writer.


7. Medical record, also called an electronic health record within the organization (Lippeveld, 2000). However,
(EHR), is a collection of digital information about a other factors which include lack of funds, human
patient. Aside from patient registration, the data could resources, and management support contribute to the
include assessment, treatment plan, and determinant of the RHIS process.
progress/encounter notes.
8. Compliance refers to procedure that should be Having a system in place which supports data collection
followed for the improvement of the condition of the and analysis and transforms it into useful information
patient or the service provided such as treatment plan will help in promoting evidence-based decision-making.
and progress note. Thus, all components within the system are ideal in
9. Financial data refer to information relating to the making the RHIS perform better. An improved RHIS
performance of the entity collected for administering performance means an effective organizational culture
purposes. These include financial reports, general ledger, that promotes information use by collecting, analyzing,
payroll, and accounts payable. and using information to accomplish the organization’s
goals and mission (Sanga, 2015).
Determinants of an HMIS Performance Area
The determinants affecting the performance of an HMIS Technical determinants
may be behavioral, organizational, and technical. Technical factors involve the overall design used in the
collection of information. It comprises the complexity of
Behavioral determinants the reporting forms, the procedure set forward in the
The data collector and users of the HMIS need to have collection of data, and the overall design of the computer
confidence, motivation, and competence to perform software used in the collection of information (Sanga,
HMIS tasks in order to improve the routine health 2015).
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 PRISM Framework
task (Aqil, Lippeveld, & Hozumi, 2009). Lack of The Performance of Routine Information Systems
motivation and enough knowledge on the use of data has Management (PRISM) is a conceptual framework that
been found to be a major drawback in the data quality broadens the analysis of HMIS or RHIS by including the
and information use. Changing people’s attitude towards three determinants of HMIS performance, namely:
data collection and analysis is necessary in order to
maximize the performance of the RHIS process (Routine • Behavioral determinants – knowledge, skills, attitudes,
Health Information Network, 2003). values, and motivation of the people who collect and use
data,
Organizational determinants • Organizational/environmental determinants –
information culture, structure, resources, roles, and
The important factors that affect the development of the responsibilities of the health system and key
RHIS process are the structure of the health institution, contributors at each level, and
resources, procedures, support services, and the culture


• Technical determinants – data collection processes,
systems, forms, and methods.

KEY POINTS TO REMEMBER:
ü A health management information system
(HMIS) is “specially designed to assist in the
management and planning of health programs,
as opposed to delivery of care (WHO, 2004).”
ü 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.
ü 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.
ü The determinants affecting HMIS performance
are behavioral, organizational, and technical.
ü 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.