UNIVERSITY OF APPLIED MANAGEMENT

GHANA-CAMPUS

COURSE NAME: IT INFRASTRUCTURE AND STRATEGY

LECTURERS NAME: MR EMMANUEL FON TATA

INDEX NO: UAMM0020

DATE OF SUBMISSION: 20TH FEBRUARY, 2011

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 QUESTION TWO (2)

DISCUSS HOW YOU (AS A HEALTH CARE SERVICE

ADMINISTRATOR) WILL ENSURE EFFECTIVE
INFORMATION MANAGEMENT IN YOUR HEALTH

CENTRE: HEALTH CARE SERVICE CENTRE USED FOR

THE CASE STUDY: RIDGE HOSPITAL

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 TABLE OF CONTENT

PAGE NO

EXECUTIVE SUMMARY4

INTRODUCTION.5

DISCUSSION11

CONCLUSION..18

REFERENCES20

BIBLIOGRAPHY23

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 EXECUTIVE SUMMARY
During the last infinitesimal couple of decades, the health sector in
Ghana has felt incessant exigency to ameliorate and accelerate as far
as effective information management is concerned .It is in this vein
and context that the research paper in contention through unflinching
and relentless efforts and strides trampled upon some critical
parameters that constantly militate against the health care service
centres in their capacity and quest to live up to their billing as far as
effective information management is concerned.
Nevertheless, the notable ones of grave concerned that cannot be
underestimated are listed as below: (i) Over-reliance on paper
documentation of recording patients information or data at the
Ridge Hospital (ii) Language barrier (iii) Non-existence of full
disclosure of some drugs (iv) Poor quality of information, including
lack of consistency, duplication, and out-of-date facilities for storing
data (v) Lack of data ware house or reservoir (vi) Non-existence of
patients data or information automation etc.
Irrespective of the fact that the aforementioned debilitating factors
appears extremely insurmountable and quite a mission impossible
hurdle and task, some few key principles deemed fit and feasible to do
the trick for the Health Information Administrator in decimating or
neutralizing the prevalence of the aforementioned challenges and
debilitating characteristics are categorically spelt out as below: (a)
Removal or non-existence of language or communication barriers
(b) Full disclosure of drugs potency, side-effects and contra-
indications etc (c) Minimal indulgence and reliance on paper
documentation (d) Expedite introduction of data ware house or
reservoir (e) Automation of patients data or information just to
mention a few.
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 INTRODUCTION
By way of preamble, the terminology information refers to any
event that affects the state of a dynamic system. In its limited
perspective, it is basically a planned series of symbols. As a concept,
however, information has different connotations. In addition, the
concept of information is closely related to notions of constraints,
communication, control, data, form, instruction, knowledge,
meaning, mental stimulus, pattern, perception, and representation.
(www.wikipedia.org)
Information as we know it today includes both electronic and physical
information. The organizational structure must be capable of managing
this information throughout its life cycle regardless of the source or
format (data, paper and electronic documents, audio, video, etc) for
delivery through multiple channels that may include cell phones and
web interfaces.
INFORMATION MANAGEMENT
Information management (IM) is the collection and management
of information from one or more sources and the distribution of
that information to one or more audiences. This sometimes
involves those who have a stake in, or a right to that information.
Management means the organization of and control over the
structure, processing and delivery of information.
(www.wikibooks.org) In other words, it refers to the sum of all
activities, gathering, processing, organization and
dissemination of information in order to assist humanitarian
actors (medical practitioners/assistants/attendants) achieve their
goals in an effective and timely manner. Typical examples of
such goals include improved coordination, early warning

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(premonition), advocacy or transition.
(www.reliefweb.int/symposium/docs/conceptpaperweb.doc)

EFFECTIVE INFORMATION MANAGEMENT

Effective information management on the other hand is basically
a business discipline that analyses various types of information
to use as a resource to improve business operations especially the
health care services such as the Police, Ridge and Thirty-seven
(37) military hospitals. The gathering of the information may be
done electronically or manually. Information management (IM)
in contemporary world often includes Data Administration,
Information Technology or Computer Science and Business
departments. These departments usually help hospitals and
clinics control the amount of information collected or gathered
through the use of electronic means. Analysis is typically
executed electronically as well. (Abbot et al, 1995). Effective
management system can be collected from external or internal
business sources. Internal sources of business information may
include the accounting, production, executive management or
HR departments. External sources of business information often
include the economic market place, competitors, national
organizations or a local chamber of commerce.
(www.wisegeek.com)
A vast number of organizations of which medical entities are a part
usually nurture the information gathering processes based on
their specific operation needs and business environment.
During the last few decades, the health sector in Ghana has felt
increasing need to improve and accelerate as far as effective
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information is concerned. Also, with the ever-changing medical
landscape, challenges and opportunities continue to characterize
the health fraternitys ability to share, and effectively managed
information.
Todays IT offers many solutions but real progress is still only
possible through the willingness of people and their organizations
such as the health care service outfits to collaborate in sharing,
managing and communicating information as a reservoir or a
community.
One of the essential functions for health effectiveness is
information. It is quite unfortunate that the medical experts have
been slow to implement standards for communication and
sharing information. Structured data collection and entry has
been shown to be an effective way of providing decision-support
for health practice. (Bossert, 1998) The variety and complexity
of medical context is such that only the computerization or
automation of clinical records and computer-assisted input
protocols are as effective and capable of promoting and fostering
health information management.
THE FUNCTIONS OF A HEALTH INFORMATION
ADMINISTRATOR
The significance of the role that health care service
administrators play in ensuring effective information
management cannot be over-emphasized. A health information
administrator is a degree holder of health information
management. Common job title in contemporary job market are
related to line, staff, and/ or technical positions such as directors,
managers, privacy officer, compliance officer, claim analyst,

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clinical information specialist just to mention a few. (Lajca, 1999).
It is anticipated that job titles will change (e.g. health information
engineer, chemical information coordinator, data administrator,
information security officer) as health care enterprises expand their
reliance on information systems and technology. Health
administrators have, and will continue to assume roles that
directly contribute to the development of computer-based patient
record systems and a national health infrastructure.
(www.info@promotesolutions.se). The tasks or functions
performed by health administrators are diverse and dynamic within
the work environment. The health service care administrator in
general performs tasks related to the management of health
information and the systems used to collect, store, process,
retrieve, analyze, disseminate and communicate that information
regardless of the physical medium in which it is maintained. In
addition, health information administrators assess the uses of
information and identify its availability in terms of
inconsistencies, gaps, and duplications in health data sources.
(Bowns et al, 1999). Furthermore, they are capable of planning
and designing systems and serving as pivotal team members in
the development of computer-based patient record systems and
other enterprise-wide information systems. Their responsibilities
also include serving as brokers of information services.
(www.ahima.org). Among the information services provided are a
design and requirement definition for clinical and administrative
systems development, data administration, data quality
management, data security management, decision support
design and data analyses, and management of information-
intensive areas such as clinical quality/ performance

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assessment and utilization and case management. (Abbot et al,
1995)
Ghana, like the rest of the developing world is confronted with a
looming enigma in its health care and delivery system from an
unprecedented and simultaneous bulge in demand while there
are aggravating deficiencies in skilled workers needed to meet
this glaring necessity.
Out of the ordinary improvement in productivity will soon be
required just to maintain current service levels in a broad spectrum
of perspectives. This can only come to fruition if the ingenuity of
health care consumers becomes more pro-active and informed
participants in health care processes. Effective management
and delivery of better health information is crucial to the
aforementioned strategies. Better management and availability
of health care information is however, increasingly seen as an
important tool against disease in its own right and there is
undoubtedly incessant evidence that both health outcomes and
consumer satisfaction can be augmented by improving the way
health information is managed. (www.ehealthera.org). In short to
medium term, it is also a tool most likely to enable improvement of
the incongruous distribution of health care services which
undermines indigenous, rural and poor Ghanaians. Effective
information management, I reiterate, is currently recognized as a
key national priority in most developed countries such as the USA,
Canada and the rest of Europe. (www.connectingforhealth.nhs.uk)
Unflinching efforts aimed at ensuring effective information
management practices are paramount for many organizations
including the health care-service outfits, across the public and
private sectors. This is being driven by a vast array of factors,
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including an exigency to improve the efficiency and effectiveness
of health processes, the demands of compliance regulations and
the desire to deliver new services to clients thereby gaining a
competitive advantage at the expense of radical players in the
health industry.
Effective information management is such an arduous task.
There exists a vast array of systems to integrate, a huge range of
health needs to meet and complex medical issues to address.
Nevertheless, this research paper will attempt to accentuate on
some critical factors, mechanisms and strategies deemed
probable for not only health information administrators in
ensuring effective information management but also offer
within its jurisdiction, a series of principles that can be imbibed
into the health information administrators scheme of things and
also as a guide in the planning and implementation of proper
information management practices which will irrevocably
impact positively on health administration in most medical
outfits in Ghana. Also, an effective information management
encompasses issues relating to (a) People (b) Processes (c)
Products /Technology and lastly (d) Partners/Suppliers/
Content. Hence in order for this research paper to live up to its
billing, each of the aforementioned attributes will also be given
the requisite priority and addressed accordingly. Lastly, some
unrelenting challenges that militates against better and effective
information management such as (i) Little integration or
coordination between information, including lack of consistency,
duplication, and out-of-date information (ii) No clear strategic
direction for the overall medical technology environment just to

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mention a few will also be taken a critical and a thorough
scrutiny.

DISCUSSION
A HYPOTHETICAL CASE OF INFORMATION FLOW
FROM THE MEDICAL PRACTITIONER TO THE
PATIENT AT RIDGE HOSPITAL (ACCRA)
The health care service outfit is plagued with a lot of
encumbrances as far as the flow of information from the medical
expert to the patient is concerned. The storage of information to be
used at a later date is purely documented (hard copy storage)
making it extremely laborious and arduous a task for not only the
average medical assistant but also the patient as well.
It is in lieu of this that this research paper attempts to develop
mechanisms and strategies with the notion of curtailing these
mishaps which will undoubtedly foster and boost effective
information management in most medical outfits.
THE PROCESS OF INFORMATION FLOW
RECORDS SECTION: When an indisposed person visits a
health outfit (Clinic or Hospital), his or her details as regards what
he or she is suffering from, medical history, allergies just to
mention a few are taken notice of by the medical attendant at the
Out Patient Department Section (OPD) and documented on paper.
A permanent ID card is issued to the patient to be used for
subsequent visits to the health post. Also, details of the patients
BP (Diastolic and Systolic) levels, temperature are recorded in a
folder.

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CONSULTING ROOM
The health attendant (nurse) then sends the sufferers folder to
the medical practitioner for tentative scrutiny and diagnosis. The
medical doctor records the patients information or data on a card
(hard copy)
LABORATORY SECTION
Information on the patients blood, stool and urine sample is
taken notice of in this section. Again, the recorded information is
done on a paper. This is also replicated by the laboratory
technician after carrying out a series of tests on the patient.
Feedback is later sent to the medical expert for him or her to
make deductions and draws his or her conclusion as regards the
actual cause of the patients ailment or disease. This is
categorically done on paper.
PHARMACEUTICAL/DISPENSARY SECTION
It is at this stage that the sufferer hands over the folder/file (hard
copy) containing some directives (prescribed drugs) to the
medical practitioner intended to provide a panacea to the
ailment or malady at stake.
WARD SECTION
In situations where the patient will have to wait for a couple of
days for further examination, he or she is conveyed to the ward
with his or her information on a detailed folder. This will then be
kept by the patient to be utilized at a later date as and when the
need crops up.

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MAJOR CHALLENGES MILITATING AGAINST
EFFECTIVE INFORMATION MANAGEMENT IN THE
HEALTH OUTFIT (RIDGE HOSPITAL)
Organizations such as health care service outfits such as the
Ridge Hospital are confronted with a broad spectrum of
effective communication and information problems and issues.
In most instances, the growth of electronic information (rather
than paper) has only aggravated these issues of grave concern
over the past few decades. (Robertson, 2005). Nevertheless, the
most critical and exigent ones that cannot be overlooked are
listed as below: (a) Over-reliance on paper manner/mode of
recording information or data of patients (b) Language barrier i.e.
to say that poor communication and comprehension ability on the
part of the patient in deciphering the actual meaning of
information disseminated to him or her by a medical practitioner
(c) Non-existence of full disclosure of most drugs respect to its
efficacy or potency, side effects, contra-indications, allergies are
far-fetched and non-existent (d) Prevalence of large number of
disparate information management systems (e) Little integration or
coordination between information systems across the units in the
hospital under scrutiny (www.steptwo.com.au) (f) Wide range of
legacy systems requiring upgrading or expedite replacement (g)
Direct competition between effective information management
system (h) Limited and patchy adoption of existing information by
staff at the Ridge Hospital (i) Faint or no clear strategic direction
for the overall information technology environment (j) Poor
quality of information, including lack of consistency, duplication,
and out-of-date information (k) Little recognition and support of
effective information management by top-notch medical experts at
the hospital in contention (l) Limited resources for deploying,
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managing or improving information systems (m) Large number of
diverse medical needs and issues to be addressed (n) Difficulties in
changing working practices and processes of staff (high levels of
resistance to change and new innovations in the medical circles)
(o) Internal politics impacting on the ability to coordinate activities
within the medical outfits jurisdiction (p) Lack of IT infrastructure
to effectively manage the information data base of the facility at
the hospital (q) Non-existence of data ware house or reservoir to
take care of patients information or data (r) Rolling out rigid,
standardized remedies across a whole health care service centre,
even though individual units or departments may have different
pressing needs (s) Coercively forcing the use of a single IT system
in all cases, regardless of whether it is an ideal remedy for a
situation or problem at stake (t) Purchasing of a software or
program for life even though medical requirements will constantly
change as time goes on (Stagnation or Inertia mentality) and
lastly but not the least (u) Completely centralizing information
management activities, to ensure that every process is closely
monitored and controlled (Lippeveld et al, 2000)
Irrespective of the fact that the aforementioned draw backs look
quite an extremely insurmountable and herculean task, some
key principles can be adopted and factored into the Health
Information Administrators scheme of things to ensure that
information management activities and practices are effective
and successful within the medical jurisdiction and framework at
the Ridge Hospital. A few of these parameters which appear
quite feasible and appropriate have been expansiated and
addressed a little bit are listed as below:
LANGUAGE OR COMMUNICATION BARRIER

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Addressing the issue of barriers in language at the medical
fraternity in contention through effective communication, proper
sensitization, and advocacy, mass education campaign etc will
do the trick in ensuring that the accurate information about the
dosage and perception of some drugs, individual lifestyles are
disseminated and adhered to by the less privileged ones in our
society thereby enhancing effective information management
which will invariably ameliorate the mortality rate at the
hospital and the country as a whole.
FULL DISCLOSURE OF DRUGS
Medical doctors, pharmacists and other attendants/assistants in the
medical fraternity and precincts should endeavor to disclose fully,
a particular drugs potency level, contra-indication, side effects,
and correct dosage to the sufferer or patient which more often
than not promotes information quality and subsequently foster
effective information management.
OVER-RELIANCE ON PAPER DOCUMENTATION
The over-reliance on paper documentation at the hospital under
scrutiny should be considered a nip in the bud. Instead, the
effective utilization of state-of-the-art mode of storing data or
information is given the requisite precedence as well as the
usage of skilled workers to effectively manage those facilities,
equipments and tools so as to boost their longevity and shelf-life.
REDUCTION IN THE NUMBER OF DISPARATE
INFORMATION SYSTEMS
The number of disparate information systems in some
departments/units at the hospital should also be reduced

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drastically to the barest minimum thereby boosting information
or data in the hospital.

REVITALIZATION OF THE LEGACY SYSTEM

Candidly and categorically speaking, the legacy system that
thrives in some departments or units such as the OPD, X-Ray,
Dispensary, Archival, Administration, Finance etc need to be
upgraded or replaced with modern and sophisticated medical
paraphernalias, facilities, equipments which as it stands now
will irrevocably accelerate the rate at which information is
effectively managed and harnessed across most of the units at the
health care service centre in contention.
IINTRODUCTION OF DATA WARE HOUSE OR
RESERVOIR
In dealing with the enigma or debilitating information situation
at the OPD or Reception Centre and other units/departments at
the hospital, the ushering and the introduction of data ware
house or reservoir to take care of patients information or data
will be a more likely option to foster effective information
management at the health post as this initiative will beyond
reasonable doubt boost the transmission of data from one part of
the hospital to the other. The deployment of data ware house
will make it easy to work with the quality of information and
analysis across the hospitals processes, which can be extremely
difficult to do in the transactional system. A data ware house
typically supports key areas in the outfit such as the Dispensary,
Surgical, Wards, Dental, Emergency units just to mention a few.
Furthermore, a well-equipped data base outfit should be made
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available to the medical practitioner at the consulting room and
linked to the health care centres local network to ensure that the
doctor fully scrutinizes the patient for a tentative diagnosis to be
arrived at in order to come up with the appropriate remedy for
the sufferer through the use of the patient electronic file or
folder.
AUTOMATION OF PATIENTS DATA
It is also very exigent that the patients data or information
should be completely automated so as to ensure that all other
units benefits from such innovation or service as and when the
need arises.
EFFECTIVE UTILIZATION OF THE BARCODE SYSTEM
More so, the effective utilization of a unique barcode system
from the patient available data (electronically) at the laboratory
can also play a pivotal role in ensuring that accurate results of a
patients blood sample is drawn. This will invariably promote
information management to a varying degree or significant
extent.
Once a well equipped data ware or reservoir is instituted as
well as strict adherence to the issues discussed earlier, the flow
of information from the dispensary, ward, administration,
accounts (finance), HR, operations, maintenance units etc will
be effective, successful, productive and of the highest quality or
premium.
Again, information management systems need the active
involvement of medical attendants throughout the hospital. For
instance, medical attendants must endeavor to save all key files

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and folders into the document/records management system. In
this scenario, the challenge is to gain sufficient adoption to
ensure that the required information of a patient is recorded in
the existing system. Without a critical mass of usage, corporate
repositories will not contain enough information deemed to be
beneficial or useful.
It is indeed imperative and quite laudable that the systems such as
the introduction of data base facility in all the units that are
deployed should as a matter of fact be usable and useful for not
only the medical practitioner but also the assistants/attendants
and the patients in its entirety. (Hurtubise, 1984)

CONCLUSION
In my candid opinion, it appears as if about ninety-five percent
(95%) of data or information stored is done paper (hard copy)
which presupposes that a sizable room should be deemed fit to
harbor and contain all these voluminous files and folders of
patients. The mind-boggling and intriguing question that will be
posed to the Health Care Service Administrator is how these
large quantities of files/folders will be kept for a lengthy
number of days without falling prey/victim to rodents, insect
attack or damage as well as the vagaries of the weather (erratic
and unpredictable weather patterns prevailing in the country).
Effective and strong information management carried out in
support of coordinated processes will undoubtedly ensure that
relevant actors (medical practitioners, laboratory technicians and

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assistants/attendants) are working with the same or
complementary relevant, accurate and timely information and
baseline data. Properly collected and managed data during
emergencies at the hospital can benefit early recovery,
subsequent development and disaster preparedness activities.
(www.reliefweb.int/rw/lib.nsf/db)
It is also very important to prioritize the information or data
according to the pressing needs of the health outfit. Properly
analyzing the information gathered can help hospitals and
clinics immensely in choosing the proper medical practitioners
to implement health decisions and limit the amount of risk
associated with the information.
Furthermore, effective information management also involves
continual communication between medical experts and their
subordinates, and periodic reviews of the implementation
process taken by the health centre based on the information.
These principles can help ensure that the outfit judiciously
utilizes the information gathered to maximize its operations and
foster optimum performance and profitability in the long run.
Of course, much more can be written on how to ensure effective
information management as a health care service
administrator at the Ridge Hospital.
Nevertheless, I am of the opinion that future research work
carried out will explore, exploit and dichotomize this topic which
will undoubtedly provide additional impetus, guidance, insight
and also outline concrete strategies and mechanisms that can be
resorted to so as to foster and promote effective information

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managements in our vast array of health outfits of which the
hospital in contention is a part and the country as a whole.

REFERENCES
Abbot, W., Bryant, J.R & Barber, B. (1995) Information
Management in Health Care, Handbook A-Introductory Themes.
Trowbridge: Redwood Books

Avison, D. E, (1992) Information Systems Development: A Bata

Base Approach. 2nd Ed. London: Blackwell Scientific Publications.

Bossert, T. (1998) Analyzing the Decentralization of Health

Systems in Developing Countries: Decision Space, Innovation and
Performance, Social Science and Medicine, 47, 10, pp 1513-1527.

Bowns, I., Rotherham, G. & Paisley, S. (1999) Factors associated

with success in the implementation of information management
and technology in the NHS. Health Informatics Journal, 5, pp
136-145.
Hurtubise, R. (1984) Managing Information Systems: Concepts &
Tools. West Hartford, CT, Kumarian Press.

Lajca, S. (1999) British Journal of Health Care Computing &

Information Management 16/1, pp 20-28.

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Lippeveld, T, et al, (2000) Design & Implementation of Health
Information Systems, Geneva, World Health Organization.

Robertson, J. (2005) Ten (10) Principles of Effective Information

Management: A Journal of Information Management

UNHCR, (2007) Handbook for Emergencies.

www.reliefweb.int/rw/lib.nsf/db 900SID/AMMF-75TFLQ? Open
Document
www.ahima.org

www.connectingforhealth.nhs.uk

www.ehealth-era.org/database.html

www.health.nsw.gov.au

www.health.qld.gov.au

www.info@promotesolutions.se

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www.nhhrc.org.au

www.steptwo.com

www.wikibooks.org

www.wikipedia.com

BIBLIOGRAPHY
AHIMA Vision, (2006) A Blueprint for Quality Education in
Health Information Management. Chicago: AHIMA; 2007.
Available at www.ahima.org

Galliers, B. & Swan, J. (1999) Information Systems and Strategic

Change: A Critical Review of Business Process Reengineering, in:
Currie W.L & Galliers B. (Eds). Rethinking Management
Information Systems: An Interdisciplinary Perspective, pp 361-
387. Oxford University Press.

Kimaro, H, & Nhampossa, J. (2005) Analyzing the Problem of

Unsustainable Health Information Systems in Less-Developed
Economies: Case Studies from Tanzania and Mozambique,
Information Technology for Development, 11, 3, pp 273-298.

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Monteiro, E. (2003) Integrating Health Information Systems: A
Critical Appraisal, Methods, Inf. Med, 4, pp 428-432 (http:
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