UNITY 5: HMIS

TOPIC: HEALTH MANAGEMENT INFORMATION

SYSTEM.
TARGET GROUP: STUDENT NURSES

FACILITATOR: MR. HANYINDE

 INTRODUCTION
Medical informatics began to take off in the US
in the 1950s with the rise of the microchip and
computers. Early names for medical informatics
included medical computing, computer
medicine e.t.c
 DEFINITION OF TERMS
HMIS (Health informatics, Health care
informatics or medical informatics)
• The intersection of information science,
computer science, and health care which deals
with the resources, devices, and methods
required to optimize the acquisition, storage,
retrieval, and use of information in health and
biomedicine
• DATA: It is a collection of facts which are not
yet processed. When it is processed it
becomes information.
• INFORMATION: this is a systematically
collected and processed data in the course of
the study or is a fact which is an observable
and measurable phenomenon
(Basavanthappa, 2003).
Record
• Is a written account of what has happened,
been done etc.
• The facts, events that are known and
sometimes of somebody (Froner, 1983)
Recording (charting)
• A process of making entries on client’s records
(Kozier, 1987).
Report
It is a written or verbal description on account of
the client’s health history, current health status,
treatment and progress” (Kozier, 1987).
 The Zambian HMIS
The Zambian Government in its interest to
enhance the delivery of Health Care to its
people, commenced the National Health
Reforms (NHRs) in 1992. Within the Health
Reforms (HRs) the need for improvement of the
health management information system was
recognised at an early stage.
Hence the HMIS was formed in 1995 to establish
a self-sustaining monitoring and evaluation
system which would improve decision making at
all levels of the health care system with timely,
valid and appropriate information required to
increase the effective utilisation of quality health
services.
• The NHRs saw the establishment of the
Central Board of Health (CBoH) in 1995
through the National Health Services Act
(NHSA) of 1995
• However, the restructuring process in MoH
paved way for the dissolution of CBoH in 2006
by the then Minister of Health, Honourable
Sylvia Masebo, Member of Parliament (MP)
(MoH, 2006).
 Factors which led to the formation of the
HMIS
• The MoH had an archaic (old fashioned)
information system which over time was
failing to deliver its intended purpose.
• Some of the problems that were in the old
system are:-
• Delay - health institution staff delayed reporting
due to lack of feedback.
• Unreliability - Reporting was incomplete
(sometimes even fake), too late, contradictory and
often not processed or analyzed at national level.
• It was difficult for Government to control the
quality and what information was disseminated
externally.
• Fragmentation - Each department in the ministry
concentrated on its own interest.
 Design of the HMIS
The HMIS was designed with the following
characteristics:-
1. Decentralisation - Who collects analyzes.
Analysis and self-assessment was to be carried
out at the level where data was collected and
used for decision making at that level. Data was
not merely collected for upward reporting.
2. Action oriented - data was supposed to be
collected for decision making. Health
Management Boards require operational
information for day to day management and
supervision.
3. Responsive - data should be reported in an
appropriate timeframe according to its use, and
flexible in terms of adaptation to local needs.
4. Transparent - Obtaining information should
be easy and dissemination facilitated by the
newly created Regional and National Resource
Centres.
 SUBSYSTEMS OF HMIS
The HMIS was designed with the following
subsystems:-
• Health Status - This measures the outputs of
the health system (curative care, preventive
activities, and health promotion) as well as
new outcomes in health.
• Finances - This focuses on financial inputs into
the health system. It allows managers to
measure costs involved in delivering the six
priority thrusts (push) for health services as well
as providing basic accounting information.
• Human Resources - This subsystem allows for
the understanding of staffing patterns,
movements and training requirements.
• Drugs and supplies - Information will be used to
measure utilisation and stock management. The
distribution system will change from a "push to
a pull" system to allow districts to determine
their own needs for drugs and supplies.
• Assets - Information on the infrastructure and
equipment inputs (including transport) allow the
district and central levels to plan and budget for
maintenance and rehabilitation/upgrades.

A total of 70 indicators were proposed for the inclusion

in the HMIS. Notifiable diseases like cholera and Measles
that require immediate action from the regional and
central levels were also included in the system.
The HMIS tools include not only computers but
also clinical guidelines, formal medical
terminologies, and information and
communication systems. In Zambia documents
used in HMIS includes registers, forms,
computers etc.
The areas where HMIS tools are applied are
areas of nursing care, clinical care, dentistry,
pharmacy, public health and biomedical
research. In Zambia the broad areas are district,
hospital, training institutions like schools, etc.
 TYPES OF DATA
There are different ways of classifying data. The
most common ones are;
By source
1. Primary data; this is data which is collected by
surveyors/researchers from the field. It is fresh
data collected through interviews and
participant observation. There behaviour
generate information about the community
beliefs, norms, values and influence structures.
2. Secondary data; this is previously collected
data e.g minutes from community meetings,
reports from surveys, registers, public
documents, statistical data, health records etc.
 By measurements
1. Qualitative data

• Data that is not given numerically; e.g. favourite

colour, place of birth, favourite food, type of care etc.
• 2. Quantitative data: Data that is numerical.
Types of quantitative data
 Discrete data
• Data that can only take specific numeric values; e.g.
shoe size, number of brothers, number of cars in a car
park etc.
 DATA COLLECTION
This is very important activity. Data collected
should be accurate and reliable, clearly written.
It must be written under the correct
classification e.g morbidity, mortality, fertility
etc.
 METHOD
 INTERVIEW; this involves asking questions
using a structured questionnaire as a guide to
elicit answers from the client.
 OBSERVATIONS; the health worker observes
for certain situations or conditions using
his/her senses e.g eyes/ ears, touch etc and
fills in the check list. Instruments such as
thermometer, sphygmomanometer etc can
also be used for observations.
 TOOLS USED FOR DATA COLLECTION

A measuring device used in gathering of

information needed to address a research
problem. It may take the form of questionnaire
or interview schedule, focused group discussion
guide, or some other type of tool for eliciting
information.
 TWO CLASSIFICATION
1. Mechanical Devices
• These are used in physical sciences, such as
microscopes, telescopes, thermometers, rulers, and
monitors. Mechanical tools allow for precise
measurement that can be replicated with accuracy.
2. Clerical Tools
• These are tools which a researcher uses to study
people and gather data on the feelings, emotions,
attitudes and judgments of the subjects. Commonly
used in nursing research.
 CLERICAL TOOL
1. Questionnaires
2. Interview guide
3. Check list
4. Tally sheets
5. Focus group discussion guide
6. Other specially prepared forms
 Data collection technique

• This is the actual method on how the data is

going to be collected; it allows for systematic
collection of information from respondents
e.g. administering a questionnaire, .
 DATA INTERPRETATION

• This involves the application of statistics and

includes; data analysis, data presentation or
presentation of information, dissemination of
findings, discussion of findings and
implications, implementation of the findings
and recommendations.
• After data collected, it is sorted out such as
with serial numbers. The analysis is done by
reading through the entire data. Data is edited
for accuracy, completeness, uniformity and
consistency. Reading through the data several
times enables you as a researcher to organize
the raw data into conceptual categories and
create titles.
 Presentation of findings

• Data can be presented in frequency tables,

graphs, column and pie charts according to
need. Cross tabulations of the variables can be
done to identify relationships among them.
This enables us to illustrate and compare data.
 USES OF DATA
1. It helps management to plan in health and
educational services, and other social services.
2. To analyse trends in disease (mortality and
morbidity)
3. For monitoring health care delivery system and
decision making
4. Helps to investigate abnormal statistics
5. For planning and budgeting (Finance allocation
of resources).
6. Evaluating performance
7. For planning and budgeting (Finance)
8. Planning and Evaluating Client’s Care
9. Communication
10. Research
11. Statistics
12. Education
13. Audit
 ROLE OF THE NURSE IN RELATION TO
STATISTICS
 Improve registration of births and deaths by collecting
and recording all health status- the nurse midwife attends
to mothers during antenatal and postnatal clinics.
 He /she must know and classify the births and deaths
according to ages.
 A nurse is in a unique position to advise mothers and
fathers before registration so as to get correct
information.
 He/ she must record notifiable morbidity properly and
promptly.
 To keep and submit records of illnesses.
 COMMON TERMS
• MORBIDITY RATE: this refers to the number of cases of a
particular disease occurring in a single year per specified
population unity, as
X 1000.
• MORTALITY RATE: This refers to the death rate which
reflects the number of deaths per unit of population in
any specific region, age group, dx, or other classification
usually expressed as deaths per 1000, 10,00o or
100,000. (Mosby Elsevier (2006) MEDICAL DICTIONARY
7th EDITION,
Pat Joiner publishing services U.S.A.)
 DEFINE THE FOLLOWING
1. Prevalence rate
2. Infant mortality rate
3. Maternal mortality rate
4. Life expectance
5. Neonatal mortality rate
 ANY QUESTIONS ????
IF THERE ARE NO QUESTIONS
Welcome to nursing
And thank you for your attention