Introduction to HIS (1) from wabi.pptxfy

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1. Health Information System (HIS) BY; WABI T.(BSc,MPH)

2. Learning Objectives At the end of this session students will be able to: Explain concepts of Health System and Health Information System Describe Routine health information system Explain concepts of Health Management Information System Describe Community Health Information System

3. Concepts of Health System It is the sum total of all organizations , people , resources and all activities whose primary purpose is to promote, and maintain health. What are the objectives of Ethiopian health system ? To see healthy, productive and prosperous Ethiopians . What is Health system?

4. Health system building blocks WHO health system framework (six core building blocks)

5. What is HIS? It refers to any system that captures, stores, manages or transmits information related to activities of organizations, which will improve health care management decisions at all levels of the health system. Users of HIS health care providers, patients and researchers

6. Components of HIS (six) According to the Health Metrics Network’s “Framework and Standards for Country Health Information Systems” Health information system resources Indicators Data sources Data management Information products Dissemination and use

7. Components of HIS by inputs, processes, and outputs category Inputs Process Outputs 1. HIS resources. HIS coordination and leadership HIS information policies HIS financial and HR HIS infrastructure   2. Indicators . 3. Data sources Censuses Civil registration Population surveys Individual records Service records 4. Data management Data storage Data quality Data processing & compilation 5. Information products (Data transformed in to information) 6. Dissemination and use

8. Functions of HIS: Four key functions Data generation Compilation Analysis and synthesis Communication and use

9. Goal of health information systems The ultimate objective of a health information system is not to gain information it is to produce information for taking action in the health sector .

10. Routine Health Information System ( RHIS ) “RHIS is a system that provides specific information support to the decision-making process at each level of an organization.” (Hurtubise, 1984) It is a structured system for collecting, processing, analyzing, and disseminating health data on a regular basis. It is designed to support decision-making, improve health service delivery, and enhance public health outcomes.

11. Information Generating Process Data Collection Data Processing Data Analysis USE OF INFORMATION FOR DECISION-MAKING Info-needs / indicators Management Resources Organizational Rules How RHIS works? Data Transmission

12. Basic requirements for RHIS Information needs adapted to the management functions of health system. Well-functioning data handling process- forms and template Sufficient and appropriate resources and management Adequate staffing. Adequate logistic system for printed supplies. Computer hardware/software and maintenance. Communications equipment.

13. RHIS Performance Diagnostic Tool Performance of Routine Information System Management (PRISM) is a framework designed to assess and improve the performance of Routine Health Information Systems (RHIS). It focuses on ensuring that health information systems are effectively utilized to enhance decision-making and health outcomes Information System Management Series Tools to assess Routine Health Information System performance, identify technical, behavioral and organizational factors that affect routine health information systems.

14. Factors that affect the RHIS performance. Factors Technical Organizational Behavioral

15. 15 PRISM Framework PRISM Framework for Understanding RHIS Performance

16. Organizational factors Resources. Structure of the health system. Roles and responsibilities. Organizational culture. Example: Clear roles and responsibilities related to decision-making.

17. Technical factors Standard indicators. User-friendly format for reporting. Trained people. Timely data availability. Appropriate technology. Data collection forms. 17 Example: User-friendly data collection form

18. Behavioral factors Motivation. Attitudes and values. Confidence. Sense of responsibility. Example: Feeling of confidence to make decisions. Empowerment.

19. HMIS in Ethiopia

20. Health Management Information System (HMIS ) HMIS : refers to a comprehensive system designed to collect, manage, analyze, and disseminate health data to support decision making in health managements and policy HMIS is crucial for monitoring health programs, assessing health outcomes, and facilitating effective resource allocation Users; Health managers, policy makers and administrators Purposes of HMIS Increase accurately, time and complete data to support decision making at each level of the health system Strengthening the use of locally generated data for evidence based decision making

21. Main sources of HMIS data Clinical Data; like report from healthcare facilities, Electronic Health Records (EHRs) Public Health Surveys: Patient registries Epidemiological Data: Household surveys Research Studies: Vital statistics Community Health Workers: Field reports

22. Users of HMIS data Hospital Administrators Utilize data for operational management, resource allocation, and quality improvement. Public Health Officials Epidemiologists: Analyze data for disease surveillance and outbreak investigation. Policy Makers Government Officials: Rely on HMIS data to inform health policies, regulations, and funding decisions.

23. Researchers Academics and Scientists: Analyze HMIS data to conduct studies on health trends, interventions, and outcomes. Non-Governmental Organizations (NGOs) Program Managers: Utilize data to monitor program performance, evaluate impact, and report to stakeholders and donors. Community Health Workers Field Agents: Use data to track patient health status, manage caseloads, and provide targeted interventions in the community.

24. Milestones of HMIS development in Ethiopia Before 2008 G. C The health sector didn’t have a standardized HMIS: There were no: Standardized set of core indicators, and Standardized recording and Reporting tools and procedures The HMIS was not fully institutionalized Poor information use at all levels Very Limited resources for HMIS Limited application of information technology

25. Milestones of HMIS development in Ethiopia 2008 to 2013 G.C HMIS has been reformed to capture core indicators A set of 108 core indicators were selected Standardized data recording and reporting tools were developed Individual medical records, Registers, Tally sheets Reporting formats Huge investment on capacity building and HMIS infrastructure HIT curriculum was developed

26. Milestones of HMIS development in Ethiopia 2014-2016 G.C. The HMIS was revised for the first time A total of 122 core HMIS indicators were selected. The recording and reporting procedures and tools were revised Since then some improvements have been observed with regards to: Data quality and Information use for evidence-based decision making  

27. Milestones of HMIS development in Ethiopia 2017 till now The HMIS indicators were revised A set of 131 core indicators were selected The recording and reporting procedures and tools were revised Pillars of Information revolution roadmap development in Ethiapia were developed: Cultural transformation in information use and Digitalization

28. HMIS reform is necessary to improve Efficiency (Time & money) Effectiveness (Meets performance expectations).

29. HMIS reform guiding principles Guiding principles for HMIS Reform include:   Standardization: Common definitions throughout the health sector 2 . Integration: One reporting channel Simplicity: Reduce number of data items, limited to those required by indicators selected and user friendly user friendly forms and procedures Institutionalization: ensure its implementation at all levels of the health system.

30. Components of HMIS Information management Data collection : Recording of health data using registers, tally, individual and family folder etc. for routine and non-routine activities. 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. 30

31. 2. Using information for management purposes Problem identification: identifying problems using key indicators Prioritizing problems and decision making : Problems identified should be prioritized and decide what types of actions need to be taken. Action taking: Implementing the agreed action. Result monitoring: Assessing the desired result has been achieved. Components of HMIS… 31

32. HMIS tool and procedures Common Tools Individual medical recording tools Registers Tally sheets Reporting formats

33. HMIS Indicators It’s a specific measurable variables that measures the value of the change in meaningful units that can be compared to past and future units It focuses on a single aspect of a program or project. E.g MMR, IMR

34. Types of Indicators Count Indicators Measures the number of event without a denominator Proportion Indicator Values are typically expressed as a percentage Rate Indicator Measures the frequency of an event during a specified time usually expressed per 1000 Ratio indicator The numerator is not included in the denominator

35. Classification of Indicators Input Measures resource needed to carry out the activity Process Monitors activities that are carried out Output Measures immediate results of activities, Outcome Changes in knowledge, attitudes, behavior Impact Long term effects, effects in the health status

36. E.g. Child health care Input= Policies, human resources, materials, financial resources Process=holding of meetings, conduct of training courses, distributing of medicines, developing and testing of health education materials, giving health education Output= number of medical assistants trained, the total duration of the training, number of holding of meetings, numbers of distributing of medicines packets, numbers of children receiving medicine Outcome= the proportion of sick children correctly managed by the trained health providers Impact =  reduction in child mortality, reduction in child morbidity

37. ASSIGNMENTS 2: Take malaria control, monitoring and evaluation Then what are the indicators you put under Input, process, output, outcome and impact

38. The rationale for the current HMIS indicator revision Gap in monitoring HSTP and annual health sector performance using the existing indicators Emerging of new initiatives and programs(Emergency and critical care, New vaccines (HPV1&2) Focus on new priorities in health system (Emerging diseases and expansion of control programs (NCDs) Focus on Quality, equity and universal health coverage

39. Different types of Reporting formats styles By Health institution: Health post, Health center ,Hospital , clinics and WorHO/ZHD/RHB By reporting Period: Immediate/ Weekly report Monthly /Quarterly/annual administrative report

40. Assignment 2 Identify a types of disease which are reported Immediately/ Weekly report/Monthly /Quarterly/annual report

41. HMIS reporting hierarchy

42. CHIS The Community Health Information System (CHIS) is a family-centered health information system designed for the health extension worker (HEW) to manage and monitor her work in educating households and delivering an integrated package of promotive, preventive, and basic curative health service to families To improve quality of data at community level To facilitate quick retrieval of data at community level To create basic information at the community level for facilitating evidence-based practices What are the purposes of CHIS?

43. Essential Functions of CHIS To promote community engagement in health To identify community needs To support case management and continuity of care To document individual-level needs to support care planning To enable bidirectional referrals To track lost to follow-up patients