Mzuzu University

Introduction to Health Information Systems (HIS)

Lecture 1: Introduction to
Health Information Systems
Informatics + Public Health = HMIS

* Slide from UiO Course:

INF5761/INF9761
 ‘Health information’ means different things to
different people
For public health managers, it means aggregate data;
Health Management Information System (HMIS)
For the nurses and doctors, it means data related to patient care;
Electronic Medical Records (EMR)

Laboratory, human resources,

logistics, finance, etc…

* Slide from UiO Course:

INF5761/INF9761
Definitions
System
set of principles or procedures according to which something is done; an
organized scheme or method

Information System
• Provide specific information support to the decision making process at each
level of an organization
(Winter, A. 2010)

Health Information System(HIS)

• An information processing and storing subsystem of a health care
organization
• Maybe a single institution(a hospital) or a group of health care
institutions(healthcare network)

“produce relevant information that health system stakeholders can use for
making transparent and evidence-based decisions for health system
interventions”
- Health Metrics Network (WHO)
Health Information is part of the Health
System

* Slide from UiO Course:

INF5761/INF9761
 Discussion (10 min)

• What does “Health Information” mean to you?

• What kind of information do you collect in your daily school
routine work?
• Which ones are related to “health”?
• Which ones are not directly related to “health”?
• What kind of information do you need to know to help you
plan your work?
• What do you do with the information?
Health information subsystems
A National health information system consist of several subsystems such
as:

Routine data collection based on patient and service records and

regular reporting from community health workers & health facilities

Disease surveillance and outbreak notification

Programme-specific monitoring and evaluation

(ex: EPI, Malaria, TB, HIV/AIDS)

Administration and resource management

(budget, personnel, supplies)

Data generated through household surveys

Registration of vital events and censuses

(births, deaths and causes of death) * Slide from UiO Course:
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Some benefits of good health information
systems
- providing (continuity of) care to patients (medical staff)
- assist decision makers in detecting and controlling
emerging and endemic health problems
- monitor progress towards health goals/targets (MDGs)
- promote equity (many not counted!)
- strengthening the evidence base for effective health
policies
- permitting evaluation of health system interventions over
time
- ensuring accountability in the way resources are used

* Slide from UiO Course:

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Strengthening Country Health Information
Systems

• The Health Metrics Network (HMN)

• Launched in 2009
• Global health partnership to strengthen the “entire
health information and statistical systems”

Better Better Better

Information Decision Health
 District above

Facility

Community

WHO HMN Framework 2009

Six components of Health Information System
1. Health Information System Resources
Physical and structural prerequisites

• HIS coordination and leadership

• MOH, disease surveillance and control unit, central statistics
office.
• National committee
• HIS strategic plan
• HIS information policies
• Legal framework and ethical parameters
• HIS policy
• International Health Regulations – reporting public health
emergencies.
• HIS financial and human resources
• HIS infrastructure
2. Indicators
A set of measures that show changes in the country’s
health profile

• Determinants of health
• Health system inputs, outputs and outcomes
• Health status
WHO HMN Framework 2009
 Examples of Health System Indicators
Health status indicators:
 Infant mortality rate
 maternal mortality
 life expectancy at birth
 prevalence/incidence of infectious diseases
Health care utilization indicators:
 immunization coverage
 antenatal care coverage
 proportion of births attended by a skilled attendant
Health care resource allocation:
 distribution of qualified health personnel
 distribution and type of health services
 distribution of health expenditure on personnel,
supplies, facilities

Where does the information come

from?

* Slide from UiO Course:

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3. Data Sources
an integrated HIS brings together data from a variety of
sources

• Population Based:
• Generate data on all individuals within defined
populations
• Institution Based:
• Generate data as a result of administrative and
operational activities
• Health Research
WHO HMN Framework 2009
WHO HMN Framework 2009
4. Data Management
enable easy access to relevant information for
those who need it, while protecting the privacy of
individual patients

• Data storage
• Ensuring data quality
• Data processing and compilation
5. Information Products
• Information products are collated from a range of
sources, and synthesized into usable statistics that
can be analyzed and compared.

• Transforming data into information

6. Dissemination and Use
• Provides direct benefit to al those who participate
in it, providing an ongoing incentive for users to
continue to strengthen the system

• Using information for decision making

• Institutionalizing information use and demand
• “Culture of information”
Review!
• What are the six components of a health information
system?
Six Components of Health
Information Systems
Inputs
1. Health information system resources
Processes
2. Indicators
3. Data Sources
4. Data Management
Outputs
5. Information Products
6. Dissemination and use
Review!
• What are the six different data sources for health
information system?
• Which ones are population-based?
• Which ones are institutional-based?
WHO HMN Framework 2009
Guiding Principles for developing a Health
System in a country
• Country leadership and ownership
• Responding to country needs and demands
• Building upon existing initiatives and systems
• Broad-based consensus and stakeholder involvement
• Gradual and incremental process with a long-term vision
WHO HMN Framework 2009
 OVERVIEW OF HIS IN MALAWI

CENTRAL MONITORING AND

EVALUATION DIVISION

CENSUS & CENTINEL HEALTH PROGRAMME OPERATIONS

SURVEILLANCE HMIS DATA
SURVEYS RESEARCH

OTHER ROUTINE LIMS PAMIS

LMIS IDSR IFMIS/NHA HRMIS
HIS

* Slide from MOH CMED Presentation

 OVERVIEW OF HIS IN MALAWI

* Slide from MOH CMED Presentation

* Slide from MOH CMED Presentation
 HIS PROGRESS

• HIS Strategy
• Strategy to create legal, policy and regulatory
framework for the NHIS
• Strategies for resource mobilization for HIS
• Strategies to strengthen M&E in Health Sector
• Strategies to improve data quality

* Slide from MOH CMED Presentation

 HIS PROGRESS

• eHealth Strategy
• Strategies for strengthening health ICT foundations:
eHealth Information Standards, Computing
Infrastructure, Connectivity, Power etc

• Strategies for eHealth Solutions: National Priority

eHealth Solutions, Telehealthcare, E-Learning etc

* Slide from MOH CMED Presentation

 HIS PROGRESS
• HIS Policy
• HIS Resources and Infrastructures
• Information Needs and Data Sources
• Data Collection
• Confidentiality
• Data Compilation/Aggregation
• Data Analysis
• Data Storage
• Data Access
• Data Ownership

* Slide from MOH CMED Presentation

 HIS PROGRESS

• Electronic Systems
• EMRs
• All district hospitals and Referral Hospitals;
Some Health Centers
• Community level systems

• Aggregate Systems (DHIS)

• National level implementation
• Customized all programme reports
• Trained district programme cordinatinators
• Useful for both data management and analysis

* Slide from MOH CMED Presentation

Conclusion
• Health information is part of the health system
• There are many subsystems for the national
system, but they should be integrated and work
together to provide high quality data for decision
making at all levels of the health system.

Better Better Better

Information Decision Health