hibbs is a program of the global health informatics partnership desalegn tegabu zegeye (md,mph)...
Post on 28-Dec-2015
224 Views
Preview:
TRANSCRIPT
HIBBs is a program of the Global Health Informatics Partnership
DESALEGN TEGABU ZEGEYE (MD,MPH)DEPARTMENT OF HEALTH INFORMATICS
UNIVERSITY OF GONDARFEBRUARY 2011
Introduction to Routine Health Information Systems
Objectives
Explain the roles of routine health information systems (RHIS) in health service management
Examine strategies used to improve routine health information systems
Acquaint with skills to carry out the process of improving RHIS performance
Discuss three categories of determinants that influence RHIS
Outline
Definitions
RHIS concepts
Strategies used to improve routine health information systems
Analytical Framework for Understanding RHIS Performance –The Prism Concept
DefinitionsHealth System - is defined as the system of all
actors, institutions, and resources that undertake “health actions” – i.e. actions whose primary purpose is to promote, restore, or maintain health (WHO 2000).
Information System - System that provide specific information support to the decision-making process at each level of an organization
Health Information System - “A system that provides specific information support to the decision-making process at each level of an organization.” (Hurtubise, 1984)
Why Health Information System?Good management is a prerequisite for increasing
the efficiency of health services
Improved health information system is clearly linked to good management
Information is crucial at all management levels of the health services from periphery to the centre. It is required by policymakers, managers, health care providers, community health workers
Routine Health Information System (RHIS)
Definition:
Ongoing data collection of health status, health interventions, and health resources
Examples: facility-based service statistics, health administration statistics and community-based information systems
RHIS includes…
Health service statistics for routine service and special program reporting
Administrative data (revenue and costs, drugs, personnel, training, research and documentation)
Epidemiological and surveillance data
Data on community-based health actions
Issues with Routine Data Collection Instruments
Content (comprehensive) Record filing (patient-retained vs. health unit-
retained) Layout (self-explanatory) Production form Electronic patient record
Guiding Principles of RHISData for decision making
Collection of only essential health data used for decision making
Data collection for local analysis and use by the health worker
Data collected by all health workers as they perform their day to day duties
Data processing and analysis are done starting from the point of collection
Integration of all routine information systems
Simple to operate and maintain
What is Wrong with Current RHIS? Irrelevance of the information gathered
Poor quality of data
Duplication and waste among parallel health information system
Lack of timely reporting and feedback
Poor use of information
The difference in culture between data people and decision makers: Planning and management staff rely primarily on “gut feeling” to formulate ad hoc decisions rather seek pertinent data
STEP 1: Assessment of theExisting System
Rapid Assessment of the current use and performance of the existing system.
Find out how and how well the current system works, to describe the various components of the system and the organizational environment
STEP 2: Develop Essential Indicators
Select essential indicators for management functions at each level of the health system:
Health status (and disease surveillance) indicators
Health services (and national program) indicators
Resource indicators (human, physical, financial)
What Data Elements Should be Collected?
Can provide useful information (affecting the management decisions)
Cannot be obtained elsewhere
Are easy to collect
Do not require much work or time
Can be collected relatively accurately
ESSENTIAL DATA SET based on indicators reflecting the health status of the community
Essential Dataset (continued)
WHAT?WHAT?
The minimum amount of data that needs to be collected
WHY?WHY?
For the effective management of services which allows them to make the greatest impact on the health needs of the community which they serve (improving coverage & quality)
HOW?HOW?
Through routine data collection
EDS - Choosing a TypeEDS - Choosing a TypeData - led
Focuses on the need to collect data which is required, is of interest, or may be useful
Is usually vague on what information output can be obtained from data
Action - led
Focuses on the need to collect data that reflect identified priority health needs & are required by pre-determined indicators
Indicator driven – national & local
Usually directly linked to specific objectives and targets
Action-led systems are the most practical way to go
Community Information Systems
District Information Systems
Zonal Information Systems
National Inf. Systems
International IS
Indicators,Procedures, datasets & use of info for ACTION:
Community
District
Province
National
International
• Standardised
• Usefulness
• Address the needs of all stakeholders
• User-friendly
• Dynamic
EDS at Each Level:EDS at Each Level:The Information Filter The Information Filter (From Shaw 2005)(From Shaw 2005)
Step 3: Data Sources and Data Collection Tools
Defining data sources and developing data collection instruments for each of the indicators selected.
Data collectionData collection
start small - as data quality improves & systems are streamlined - add slowly
collect data – linked to objectives - that can be used to calculate indicators
Data Sources and DataCollection Tools (continued)
Collect only data that is easily available - determine easiest site for recording of data - do not duplicate points of data collection
Use clear & standardised definitions
Train & provide ongoing support to data collectors – improve data quality
Data collection toolsData collection tools
Use a minimum number of tools - user friendly, familiar & acceptable
Step 4:Developing a Data Transmission
and Processing System
Information flows (including referral systems):
Horizontal data transmission
Vertical data transmission
Use appropriate communication technology:
Paper-based
Electronic: Telephones, diskettes
Data Processing and Analysis
Paper-based systems:
Error-prone
Computerized systems:
Off-the-shelve versus customized
Decision support systems
Use of appropriate technology
Capacity-building
Step 5: Ensuring Use of the Information Generated
How can we improve information use?
1.Ownership and relevance of the information must be felt among all potential users of the information, through active participation in the system design
2.Data need to be of appropriate quality, aggregated at the right level, and produced in a timely manner
Ensuring Use of the Information Generated (continued)
3. Performance-based management systems tend to increase use of information for decision making.
4. Cultural differences between data people and action people can be decreased through consensus building, teamwork, and training.
5. Data presentation and communication (feedback) should be customized for users at all levels.
Step 6: Planning for RHIS Resources
Adequate staffing
Adequate logistic system for printed supplies
Computer hardware/software and maintenance
Communications equipment
HIS line-item in MOH recurrent budget
Analytical Framework for Understanding Performance of
Routine Health Information Systems in Developing Countries
The Prism Framework
The Prism, or three-point framework, is predicated on the assumption that improving capacity in RHIS (and subsequently performance) requires interventions that address the environmental behavioral determinants of performance, and the technical determinants
It broadens analysis of routine health information systems to include the behavior of the collectors and users of data and the context in which these professionals work
RHIS Performance Diagnostic Tool
1. Data Quality Assessment at District or Higher Level
2. Use of Information Assessment at District or Higher Level
3. Data Quality Assessment at Facility Level
4. Use of Information Assessment at Facility Level
Sources
Aqil A, Hozumi D, Lippeveld T. 2005. PRISM tools. MEASURE Evaluation, JSI. Available online at: http://www.measure.com.
Aqil A, Lippeveld T. 2007. Training manual on continuous improvement of HMIS performance: quality and information use; focus on HIV/AIDS services. MEASURE Evaluation, Guangxi and Yunnan CDC.
Aqil, A, Lippeveld, T & Hozumi, D 2009, PRISM framework: a paradigm shift for designing, strengthening and evaluating routine health information systems. Health Policy and Planning, vol. 24, no. 3, pp. 217-228.
Aqil, A., Lippeveld, T 2010, Improving RHIS Performance For Better Health System Management, Routine Health Information System Course Trainer Guide.
Lippeveld T, Sauerborn R and Bodart C (eds.). Design and Implementation of Health Information Systems. Geneva: World Health Organization, 2000
Helfenbein, S. et al. (1987) Technologies for Management Information Systems in Primary Health Care. Geneva: World Federation of Public Health Associations
Sources (continued)
MEASURE Evaluation http://www.cpc.unc.edu/measure RHINONet:http://rhinonet.org
Shaw, V 2005, Health information system reform in South Africa: developing an essential data set. Bulletin of the World Health Organization, vol. 83, no. 8, pp. 632-636.
Health Metrics Network: http://www.who.int/healthmetrics
WHO,2000. World Health Report 2000: Health Systems: Improving Health Systems Performance; World Health Organization: Geneva.
The work is provided under the terms of this Creative Commons Attribution-ShareAlike 3.0 Unported License (“CCPL" or "license"). The work is protected by copyright and/or other applicable law. Any use of the work other than as authorized under this license or copyright law is
prohibited.
HIBBs is a program of the Global Health Informatics Partnershipwww.ghip.net
top related