OVERVIEW

HEALTH DATA
OF SARS-
MANAGEMENT
COV-2
TESTING
ELECTRONIC DATA
MGT/DHIS-2

Yakob Wondarad
(MOH/EPHI)
 LEARNING OBJECTIVES
Through this module you will be able to:
• Information Revolution
• PHEM facility-level record keeping
• Recognize which documents and records should be available at
clinical/testing facilities
• PHEM Record Keeping Best Practices
• PHEM Notifiable Diseases
• Electronic reporting Via DHIS-2
• Dashboard of PHEM/COVID on DHIS-2
 WHAT IS INFORMATION REVOLUTION FOR HEALTH?
 One of the five transformation agendas of the Health Sector
Transformation Plan (HSTP)
 Its objective is to transform and enhance the culture of data
use to positively impact population health and health-system
performance through evidence-based decision making at all
levels of the health system.
 FMOH has developed a national Information Revolution
Roadmap
 It is cascaded down to the regional and woreda levels to allow
the initiatives to be implemented throughout all levels of the
health sector
WHY IS INFORMATION REVOLUTION A
TRANSFORMATION AGENDA?
Appropriate and timely use of health and health
related information is an essential element in the
process of transforming the health sector.
Effective information use is important across range of
activities in the health system
Accurate and reliable information is eminent in light
of addressing issues related to equity in the health
sector.
 WHAT ARE THE AREAS WHERE INFORMATION
REVOLUTION IS EXPECTED?

 Advancing the data collection, aggregation, reporting and

analysis practice:

 Promoting the culture of information use

 Harnessing ICT

 Data visibility and access

 Strengthening verification and feedback systems

 Strengthen research, evaluation and survey

PILLARS OF INFORMATION REVOLUTION

Pillar 1:
Cultural Transformation for Health
Data Use
Pillar 2:
Digitalization and scale-up
 PILLAR 1: CULTURAL TRANSFORMATION FOR HEALTH
DATA USE


Priority areas for Transformation of Information Use

Availability of relevant and quality data for disease, health service coverage, quality and
equity measurement.

Strengthen programmatic birth and establish linkage with civil registration and vital statistics
system (CRVS)

Strengthen health workforce capacity and motivation to collect, analyze, and use information
at the frontline and program level

Surveillance and response

Patient safety and response

Patient engagement and awareness raising
 PILLAR 2: DIGITALIZATION AND SCALE-UP

PRIORITY
Digitalization and scale-up of priority health information systems

District health information system (DHIS-2)

Electronic Community Health information System (eCHIS)

Electronic Integrated Financial Management Information System (eIFMIS)

Electronic Human Resource Information System (eHRIS)

Health Geographic Information System (HGIS)

Electronic Laboratory Information System (eLIS)

Electronic Regulatory Information System (eRIS)

Strengthen Master facility service

Health Data Depot (HDD)

Data presentation tools and techniques
 PILLAR 2:

Point of service health information systems

Electronic Medical/Health Record (EMR/EHR)

Telemedicine and tele-education (TM, TE)

Mobile health (mHealth)

Electronic community health information system (eCHIS)

Electronic logistics management information system (eLMIS)

Standards-based digital registries

National Health Data Dictionary

Master Facility Registry
RECORD KEEPING
Keeping good records helps us remember with accuracy and completeness
Record keeping
• Is a tool for professional practice
• Can help the care process
• It is not separate from other HCW duties
• Is obligatory (not an optional extra to be fitted in if circumstances allow)

What are records? What are documents?

• Information captured on worksheets, • Written policies, process
forms, and charts descriptions, and standard
• operating procedures (SOPs)
Used to keep track of patient and
facility information • Used to communicate
information
 BENEFITS OF GOOD RECORD KEEPING
• Promotes better communication and dissemination of information
• Supports clinical audit, research, allocation of resources, and performance planning
• Supports patient care and patient-centered communication
• Supports delivery of services and helps improve accountability

Keeping good records at clinical sites and testing facilities allows HCWs to:
• Communicate accurately and effectively
• Minimize errors
• Monitor quality systems
• Develop policies & plans
• Monitor and evaluate programs
 PHEM/COVID RECORD KEEPING BEST PRACTICES
Record information immediately after the procedure is complete
• Accurate records are critical for the patient’s file
• Include interventions and any response to the interventions
Four Principles everyone must follow:
1. Be honest
2. Be accurate
3. Only include relevant, helpful patient information, written by an authorized HCW
4. Not breach patient confidentiality

Best practices apply whether keeping records by-hand or electronically

• Information should be documented the same way every time
 RECORDS TO KEEP ONSITE
• PHEM Manuals • Specimen transfer logs
• Country policies and algorithms • COVID-19 test request forms
• Safety manuals • COVID-19 Antigen Testing Logbook
• Standard Operating Procedures • Temperature logs
(SOPs) including: • Test kits, supplies & equipment
• PHEM register and logbooks Inventory records
• Preparing disinfectant
• Sample collection
• Testing procedures
• Waste management
• Performing Quality Controls
• External Quality Assessment
performance / participation
records
 STORAGE BEST PRACTICES
Documents and records must be kept:
• In a safe, accessible place
• In secure place (to maintain integrity by avoiding / prohibiting unauthorized
changes)
• In a place free from vermin or weather degradation (to avoid deterioration)

Ensure complete confidentiality of patients’ records by properly storing

records that contain COVID-19-related information
• Keep out of view of other patients and staff
• Keep in a locked cabinet when not in use
 PHEM NOTIFIABLE DISEASES ( N=23) 14
IMMEDIATELY & 9 WEEKLY
1.Anthrax 1. Severe malnutrition (all ages)-we
2. Cholera have indicator for age <5 years
3. Dracunculiasis/Guinea Worm Disease
2. 2. Relapsing fever
4. Measles
5. Neonatal Tetanus 3 . Typhus
6. Rabies (human) 4. Meningococcal meningitis
7. Smallpox 5. Malaria
8. Yellow Fever
6. Dysentery
9. SARS
7. Typhoid fever
10. Avian Influenza
11. AFP/polio 8. Viral Hemorrhagic Fever (not
further specified)
12. Pandemic Influenza
13. Maternal Death(Institutional and community) 9. Scabies
14. Perinatal Death
 COLLECTING & ANALYZING PHEM AND COVID DATA
• Record daily and weekly PHEM and Covid(Antigen &PCR data)
• Collect the totals in the facility
• Review for trends
• Plotting on a graph can reveal trends or outliers, like:
• Trends of PHEM disease report
• Change in testing volume
• Change in positivity rate
• Increases in invalid test results
 CORRECTING ERRORS
If PHEM/Covid reports fall outside acceptable range/criteria or have unusual
trends:
• Conduct further investigation to determine the reasons (root causes)
• This may be done during supervisory visits
• Sites should seek help from supervisors if they have difficulty identifying problems and
corrective actions
• Review errors broken-out by HCW tester or batch to identify root causes due to:
• Operator error (e.g. with new or untrained staff)
• Batch issues
• Specific testing phase issues (e.g., pre-examination, examination, post examination)
• Undertake and document actions to correct errors
• Record which measures are put in place to prevent them from re-occurring (preventive
actions)
• Monitor effectiveness of actions
COVID-19 ANTIGEN TESTING
• Track the QI data regularly over time as appropriate (weekly, monthly, quarterly)
PHEM/COVID REPORTING – SUPERVISORY
LEVEL

Regular data reporting to the national or supervisory

level is critical
• Must be Complete and timely to avoid any
potential delays in response to the pandemic
• Data can be sent electronically with proper
connectivity
INTRODUCTION TO DHIS2
 WHAT IS DHIS 2?
 District Health Information System (DHIS 2) is a system/tool
for collection, validation, analysis, and presentation of
aggregate or individual data.
 DHIS2 is the world’s largest HMIS platform
  Approximately 2.4 billion people live in countries where
DHIS2 is used
 Including NGO-based programs, DHIS2 is in use in more than
100 countries
 It is a generic tool that can be easily customized to fit to any
field that is dependent on data collected and analyzed for
decision making.
THE BASICS: WHAT IS DHIS2? …
Open source, web-based software platform
Capturing, analysis and dissemination of data
Handles routine data, events and surveys
Self-service analysis tools
Communication (messaging and feedback)
Global network initiative
 ETHIOPIA DHIS2

 Implemented for routine HMIS from MOH to Health post level

 Implemented for PHEM system
 Implemented for Covid 19 case based surveillance
 Implemented for Antigen RDT data mgt
 Developed and in phase of piloting for COVAX
 NGOs implemented for different surveys and services like HIV..
 Developed and in phase of piloting for Yellow fever
 Under development for SARI/ILI Case based and aggregate
 Others
 ETHIOPIA DHIS2
 Currently, there are are more than 4000 online and 2000 offline access
sites
 Daily, weekly, monthly, quarterly, bi-annual, and annual aggregate data are
almost reported at all public health facilities
 Over 8,000 data workers were trained on how to capture, analyze, and
report data using DHIS-2
 Over 4,500 data USERS were trained on usage, analysis and utilizing data
for action using DHIS-2
URL
dhis.moh.gov.et - Use for PHEM
covid.moh.gov.et - Use for COVID
DHIS2
COVID-19
CASE
SURVEILLA
NCE
TRACKER
PROGRAM
 NEXT STEPS
 Collaboration with HMIS Officer/HIT on PHEM DHIS-2 data mgt
 Share and Use of respective health facility DHIS-2 Privilege(User name &
Password)
 Periodic reviewing of PHEM and COVID reports
 PHEM specific dashboard
 Performance comparison against the target and across specific catchment
areas
 Conduct PHEM data review meeting and strengthen of feedback at facility
and higher level
 Thank You!!!
THANK
THANKYOU!!!!!!!!!!!!!
YOU!!!!!!!!!!!!!