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Health Information System (HIS)

Dr. Ahmed M. Al- Haddad

Definition
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It is a mechanism for the collection, processing,
analysis and transmission of information required
for planning, organizing and operating health
services.

 World Health Assembly (WHA) declared the

need for the complete of the health information
system in 1973.
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Objective of the health information system

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To: provide a complete of reliable, relevant,
Up-to-date, adequate, timely and reasonably
information for health managers at all levels of
public health in the country and also for
research and training purposes.

Distinction between “data” and “information”

and “intelligence”
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There are differences between data, information
and intelligence.
“Data” consist of discrete observations of events
that carry little meaning when considered alone;
Data as collected from operating health care system
or institution are inadequate for planning.
Data need to be transformed into “Information” by
reducing them; summarizing them, and adjusting
them variations for such as the age and sex
composition of the population, so that comparisons
over time and place are possible.
It is the transformation of information through
integration, and processing with experience and
perceptions based on social and political values that
produce “Intelligence”.
Data that are not transformed into information and
information that is not transformed into intelligence
to guide decision-maker, policy maker, planners,
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administrators, health care personnel themselves,

researcher and trainer are of:- little value”.
 Data need reducing and summarizing to
become information but information’s need
processing, adjusting and justification to
become intelligence.
Requirements for health information system
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1)The system should be population-based
2)The system should be avoid the unnecessary
agglomeration of data
3)The system should problem-oriented
4)The system should employ functional and
operational terms ( e.g., episodes of illness,
treatment regiments, laboratory test )
5)The system should express information briefly
and imaginatively ( e.g., tables, charts and
percentages)
6)The system should make provision for the
feedback of data
Component of health information system
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1) Demography and vital events
2) Environmental, epidemiological and health
statistics
3) Health status: mortality, morbidity, disability
and quality of health
4) Health resources: facilities, beds, and
Manpower
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5) Utilization and non utilization of health

services, attendance, admission and waiting
list
6) Indices of outcome of medical care
7) Financial statistics: cost and expenditure
related to the particular objective

Uses of health information system

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1)To measure the health status, requirements and
needs of people and to quantify their health
problems and medical and health care needs
2) For local, national and international
comparisons of health status. Such as
comparisons the data need to be subjected the
standardization and quality control
3) For planning , administration and effective
management of health services and programs
4) For assessing whether health services are
accomplishing their objectives in terms of their
effectiveness and efficiency
5) For assessing the attitudes and degree of
satisfaction of the beneficiaries with the health
system
6) For research into particular problems of
health and disease
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Sources of health information

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There are different sources of health information as
follow:
1) Census:
Definition by United Nation (UN) in 1981:
It is the total process of collecting, compiling and
publishing demographic, economic and social
data pertaining at a specified time to all persons
in a country.
It is taken in most countries of the world at
regular intervals usually of 10 years.
It needs considerable organization, vast
preparation and several years to analyze the
results that usually drawbacks the results of
census quickly.
Although the primary function of census is to
provide demographic information such as total
count of population. The census contain a mine
of information not only demographic but also
social and economic characteristics of people, the
conditions under which they live, how they work,
their income and other basic information
These data provide a frame of references and
base line for planning, action and research not
only in the field of medicine, human ecology and
social sciences but in the inter governmental
system.
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2) Registration of vital events:

Definition by united nation (UN) 1n1981:
It is a Legal registration, statistical recording and
reporting of the occurrence, and collection,
compilation, representation, analysis and
distribution of statistics pertaining to vital events
i.e., live births, deaths, foetal deaths, marriages
and divorces e.g.…
Whereas the census is an intermittent counting of
population, Registration is the continuous of
check on the demographic changes.

3) Sample registration system (SRS):

Since the census is intermittent and civil
registration is deficient in many country
was initiated the SRS at the national levels
(every 6 months) by investigators to provide
reliable estimated birth and death “rates”

4) Notification of diseases:
Historically notification of infectious diseases
was the first health information system to be
established.
The primary purpose of notification is to effect
prevention and control of the diseases, also SRS
is a source of morbidity i.e.. the incidence and
distribution of diseases.
Lists of notifiable diseases vary from country to
country, usually diseases which are considered to
be serious menaces to public health are included
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in the list of notifiable diseases.

At the international level, the following diseases
are notifiable to the WHO in Geneva under the
international health regulation (IHR), viz. cholera,
plague and yellow fever.
A few others – louse-born typhus, relapsing fever,
polio, many types of influenza, malaria, rabies and
salmonellosis are subject to international
surveillance.
The concept of notification has been extended to
many non-communicable diseases and conditions
notably cancer, congenital malformation, mental
illness, stroke and handicapped persons.

5) Hospital record:
According to the report of WHO expert
committee in 1963:
Hospital statistics is an integral and basic part of
the national statistical programme.
The main drawbacks of hospital data are:
1) They constitute only the ”Tip of the Iceberg”
as they provide information only those patients
who seek medical care, but not on a
representative sample of population
2) The admission policy may vary from hospital
to hospital, therefore hospital statistics tend to
be highly selective
3) Population at risk (in the area) cannot be
defined, So hospital records only cases who
came to the hospital
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Therefore hospital statistics are considered a poor

guide to the estimation of disease frequency in the
community, but such information may be of great
value in the planning of health services.
Bed occupancy rates, duration of stay, and cost-
effectiveness of the treatment policies are useful in
monitoring in use of hospital facilities.

6)Disease Registers:
Disease registers or Morbidity registers are a
source of information to the duration of illness,
case fatality and survival, so the registers follow-up
of patients and provide a continuous account of the
frequency of diseases in the community.
Disease registers exit only for common diseases
and conditions such as: stroke, cancer, myocardial
infarction, blindness, congenital defects, congenital
rubella, tuberculosis and leprosy etc...

7) Record Linkage:
It is a method of studying the association
between diseases which may have aetiological
significance.
It is describe the process of bringing records
relating to one individual or to one family (file
of health).
These events (records) are: birth, marriage, death,
hospital admission, discharge, sickness, absence
from work, prophylactic procedures and use of
social services etc…
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Therefore in practice record linking has been

applied only in the limited scale as twin studies,
chronic diseases, epidemiology and family or
genetic studies.

8) Population Surveys:
A health information system should be
population based, so the types of population
surveys would be covered under health
survey for diagnosis health problems and
diseases in the community as follow
1) Surveys for evaluating the health status of a
population that is community diagnosis of
problems of health and diseases.
It is information about the distribution of
these problems provides the fundamental
bases for planning and development needed
surveys
2) Surveys for investigation of factors
affecting health and disease, e.g.…
environment, occupation, income,
circumstances associated with onset of
illness.
These survey are helpful for studying the
natural history of disease. And obtaining
more information about disease aetiology
and factors
3) Surveys relating to administration of health
services e.g.… use of health services,
expenditure on health, evaluation of
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population needs and unmet needs,

evaluation of medical care etc…
9) Epidemiological surveillance:
The data of national disease control and
surveillance programs in the country of
example malaria, schistosomiasis,
poliomyelitis, tuberculosis; leprosy and other
endemic diseases have yielded morbidity and
mortality data for the specific diseases.

10) Environmental health data:

Health information system are now sought to
provide data on various aspects of air, water,
noise pollution, harmful food, industrial
toxicants, inadequate waste disposal,
explosion with increasing production and
consumption of material goods.
These data can be help in the identification and
quantification of factors causative of disease.
11) Health manpower statistics:
Regarding medical education, statistics of
numbers
Admitted, numbers qualified that given every
year, all these information are importance in
information on health manpower
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12) Other health services record:

These data from hospital outpatient
departments, primary health centers,
movement and educational level of population,
employment and unemployment
data and non-quantifiable information such as
information on health policies, health
legislation, public attitudes, procedures and
technology etc….in other words; a health
information system has multi-disciplinary
inputs which should be proper storage,
processing and dissemination of information.