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1. HARAR HEALTH SCIENCES COLLEGE 6/22/2025 By Kidist D. 1 DEPARTMENT OF MEDICAL LABORATORY SCIENCES Module name: Health Informatics Module code: HInf-M4421

2. CHAPTER 4 Health Information System (HIS) 6/22/2025 By Kidist D. 2

3. LEARNING OBJECTIVES At the end of the chapter you will be able to: Health Information Systems Overview Why health information system Classification of health information system Health information system reform 6/22/2025 By Kidist D. 3

4. Health Information Systems Overview A health information system (HIS) refers to a system designed to manage healthcare data. This includes systems that collect, store, manage and transmit a patient's electronic medical record (EMR), a hospital's operational management or a system supporting healthcare policy decisions. 6/22/2025 By Kidist D. 4

5. Health Information Systems(HIS) WHO: The HIS provides the underpinnings for decision-making and has four key functions: data generation, analysis and synthesis, and compilation, communication and use. The HIS collects data from the health sector and other relevant sectors, analyses the data and ensures their overall quality, relevance and timeliness, and converts data into information for health-related decision-making. 6/22/2025 By Kidist D. 5

6. Health Information System (HIS) Health information has been variously described as the “foundation” for better health, as the “glue” holding the health system together, and as the "oil” keeping the health system running. It is a system that provides specific information support to the decision making process at each level of the health system. 6/22/2025 By Kidist D. 6

7. HIS is an integral part of the health system, the operational boundaries of which include: all resources, organizations and actors that are involved in the regulation, financing, and provision of actions whose primary intent is to protect, promote or improve health. Health Information System (HIS) 6/22/2025 By Kidist D. 7

8. The goal of HIS The ultimate objective of a health information system is to produce information for taking action in the health sector. 6/22/2025 By Kidist D. 8

9. Why health information system? Good management is a prerequisite for increasing the efficiency of health services. Information is crucial at all management levels of the health services. The system, provides information on past, present and projected future and relevant events inside and outside the organization. It is required by policy makers, managers, healthcare providers, community health workers. 6/22/2025 By Kidist D. 9

10. Classification of HIS Classification of Health Information System Operational Health Information System and Tactical systems Health Information System 6/22/2025 By Kidist D. 10

11. Con.. Operational Systems :- are designed to manage day-to-day activities and processes in healthcare settings. They focus on real-time operations and data handling. Key Features: Real-Time Data Entry: Capture patient information immediately during encounters. Patient Management: Schedule appointments, manage admissions, and track patient flow. 6/22/2025 By Kidist D. 11

12. Con… Billing and Claims Processing: Handle invoicing, insurance claims, and payments. Clinical Documentation: Maintain accurate and timely clinical records. Examples: Electronic Health Records (EHRs) Laboratory Information Systems (LIS) 6/22/2025 By Kidist D. 12

13. Con… 2. Tactical Systems:- support decision-making and strategic planning by analyzing data and generating insights. Key Features: Data Analysis: Aggregate and analyze data for performance metrics and population health. Reporting Tools: Generate reports for quality improvement and regulatory compliance. Decision Support: Provide clinical decision support tools to enhance care delivery. Examples:- Clinical Decision Support Systems (CDSS),Health Analytics Platforms 6/22/2025 By Kidist D. 13

14. Health information system …… 6/22/2025 By Kidist D. 14

15. Building blocks of health system The WHO describes health systems in terms of six core “building blocks”: Service delivery Health workforce Health information systems Access to essential medicines Financing Leadership/governance 6/22/2025 By Kidist D. 15

16. Components of Ethiopian HIS The Health Metrics Network’s “Framework and Standards for Country HIS” describes the six components of a HIS and the standards needed for each. HIS resources It includes networks (internet access), computers, skilled human power, policy, legislatives, guidelines, software, etc. to ensure a fully functioning HIS. 6/22/2025 By Kidist D. 16

17. Components of Ethiopian HIS…. Indicators Indicators need to encompass determinants of health; health system inputs, outputs, and outcomes; and health status. Indicators in the context of Health Information Systems (HIS) are metrics used to evaluate performance, quality, and outcomes in healthcare. Examples:- Maternal Mortality Rate, Child Immunization Coverage, Bed Occupancy Rate 6/22/2025 By Kidist D. 17

18. Components of Ethiopian HIS…. Data sources Population based (Census, vital Registration, population based survey) Facility based (Individual records, Service records, Administrative records. Data management This covers all aspects of data handling : collection, storage, quality-assurance, flow, processing, compilation, and analysis. 6/22/2025 By Kidist D. 18

19. Components of Ethiopian HIS… Information products. Data must be transformed into information that will become the basis for evidence and knowledge to shape health action. 6. Dissemination and use. Dissemination and use of health information are critical for improving health outcomes and informing policy decisions. 6/22/2025 By Kidist D. 19

20. Components of Ethiopian HIS… 6/22/2025 By Kidist D. 20

21. Factors affecting successful implementation of HIS in the Ethiopia implementation of HIS can be affected by numerous factors. Some of the factors are: Proportion of budget spending on ICT is low. Education and Training of system users (cost of capacity building) is high. Poor linkage between information sources and limited Information use for decision making. 6/22/2025 By Kidist D. 21

22. Factors affecting successful implementation of HIS in the Ethiopia …. Standards in clinical terminology and concerns on data privacy and security. Challenges of data entry and difficulty in interpreting record with other information sources and systems. Shortage of ICTs and in adequate skilled human power (HI) for all facilities. System failure and high maintenance costs. 6/22/2025 By Kidist D. 22

23. CHAPTER 5 Routine health information system 6/22/2025 By Kidist D. 23

24. At the end of the chapter you will be able to: Introduction to Routine health information system Information cycle Data collection, Data processing, Data presentation Information utilization Data quality Health management information system (HMIS in Ethiopia) 6/22/2025 By Kidist D. 24 LEARNING OBJECTIVES

25. Introduction RHISs are defined as systems that provide information at regular intervals of a year or less to meet predictable information needs. These include paper-based or electronic health records and facility- and district-level management information systems. It comprises data collected at regular intervals at public, private and community level heath facilities and institutions. The data give picture of health status, health service and health resources. 6/22/2025 By Kidist D. 25

26. Health Systems and Health Information Systems Health system - It also sometimes referred to as health care system , is the organization of people, institutions, and resources that deliver health care services to meet the health needs of target populations. HIS refers to a system designed to manage healthcare data. This includes systems that collect, store, manage and transmit a patient's EMR, a hospital's operational management or a system supporting healthcare policy decisions. 6/22/2025 By Kidist D. 26

27. Health Management Information System (HMIS) in Ethiopia System: A collection of components that work together to achieve a common objective. Health System: All the activities whose primary purpose is to improve, restore or maintain health. Information: Meaningful collection of facts or data. Information System: A system that provides information support to the decision-making process at each level an organization. 6/22/2025 By Kidist D. 27

28. Con… Management information system: A formal method of making available accurate and timely information to management that is necessary to facilitate the decision making process and enable the organizations planning, control and operational functions to be carried out effectively. 6/22/2025 By Kidist D. 28

29. Con… Health Management Information System: it is an application of the principles of management information system in healthcare systems. Or HMIS is an info system specially designed to assist in the management and planning of health programs, as opposed to delivery of care. 6/22/2025 By Kidist D. 29

30. Con.. HMIS is a system specifically designed to support planning, management, and decision making in health facilities and organizations. The ultimate goal of the HMIS is to generate quality data and use that data for management decisions there by improve health service provision. 6/22/2025 By Kidist D. 30

31. Purposes of HMIS Routine collection and aggregation of quality health information. Availing accurate, timely and complete data. Provide specific information support to health decision making process. Strengthening the use of locally generated data for evidence based decision making. 6/22/2025 By Kidist D. 31

32. Components of HMIS HMIS has two main components : Information management and Use of the information for management purpose. 6/22/2025 By Kidist D. 32

33. 1. Information management Data collection: recording of health data using HMIS data collection tools such as individual and family folder, registers, tally and reporting formats. Data processing: is a process of cleaning, entering and aggregation of data. Data analysis and presentation: is a process of interpretation and comparison of generated information in the form of sentence, tables and graphs . 6/22/2025 By Kidist D. 33

34. 2. Using information for management purposes Problem identification: identifying problems using key indicators. Prioritizing problems: problems identified should be prioritized. Decision-making: decide what types of actions need to be taken. Action taking: implementing the agreed action. 6/22/2025 By Kidist D. 34

35. Con.. e. Monitoring: closely following the progress of the activities. f. Evaluation: assessing the desired result has been achieved. 6/22/2025 By Kidist D. 35

36. Con… At national level, the current reformed HMIS is working with 131 standardized indicators that were revised since 2017. The revised indicators are tracking using the new software adopted called District Health Information System version two (DHIS 2) Six classical epidemiological questions; who, what, when, where, why and how about the health status of the people will be answered. 6/22/2025 By Kidist D. 36

37. The DHIS Who gets sick? Information about who gets sick is collected on a set of data collection tools, client cards, registers, tally sheets and data input forms What conditions? The DHIS concentrates on diagnoses of local public health importance that are identified in the situation analysis. 6/22/2025 By Kidist D. 37

38. Con… Where do clients come from? The DHIS is based upon facility information so that all information can be related to the geographical catchment area of the facility and the people who live there. The computer can be used to prepare larger scale maps of entire districts or provinces using a Geographical Information System (GIS). Early action based on knowledge of where clients are found can be a powerful tool to control outbreaks of disease. 6/22/2025 By Kidist D. 38

39. Con… When do people get sick? The monthly DHIS data allows facility staff to graph conditions and use of services over time and to compare numbers of cases in different months of the year. 6/22/2025 By Kidist D. 39

40. Con… Why do they get sick? Social or economic conditions; water, sanitation, diet, housing, education, and habits like smoking or sexual practice have more direct influence over health than health services. the DHIS provides information to enable research to be focused on the most important conditions. 6/22/2025 By Kidist D. 40

41. Con… How do we overcome the problems? Analysis of the DHIS identifies the common problems, the age groups that are affected and the places they occur. This gives facility health managers the knowledge to plan, implement and evaluate activities to overcome such problems. 6/22/2025 By Kidist D. 41

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43. Information Cycle 6/22/2025 By Kidist D. 43

44. Data quality Commonly seen data quality errors Incomplete Data : Missing values for critical fields, such as patient demographics or treatment out comes. Inaccurate Data: Errors in data entry, such as incorrect patient IDs, medication dosages, or diagnostic codes. Duplicate Records: Multiple entries for the same patient, leading to confusion and inconsistencies in treatment histories. 6/22/2025 By Kidist D. 44

45. Con… Outdated Information: Use of old data that may not reflect the current health status or treatment protocols. Inconsistent Data : Variations in data formats or terminology, such as different units of measurement or coding systems. Invalid Data: Entries that do not conform to expected formats, such as dates in the wrong format or impossible values (e.g., age over 150). 6/22/2025 By Kidist D. 45

46. Con.. Poor Documentation: Insufficient or unclear documentation of data sources, processes, and changes, making it difficult to trace data quality issues. 6/22/2025 By Kidist D. 46

47. Elements of Data Quality 6/22/2025 By Kidist D. 47

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49. End of Chapter 5 49 Tank you