HEALTH INFORMATION SYSTEM

FIRST SEMESTER / LESSON 1 – 8 / MIDTERMS TRANSES

LESSON 1: THE VISION, MISSION, GOALS AND OBJECTIVES CORE VALUES

OF THE INSTITUTION Competence
Compassion
EDUCATIONAL INSTITUTION Commitment to service
- carries out EDUCATION ACTIVITIES that engage students Responsive to social needs
with various learning environments and spaces Value-driven

Two types of Institution: EDUCATIONAL OBJECTIVES

- Objectives or Goals
o FORMAL INSTITUTION - SHORT STATEMENTS that learners should ACHIEVE within or
- Conventional classroom at the end of the course or lesson.
- STRUCTURED method of learning being
administrated by the GOVERNING body SMART: Specific, Measurable, Attainable, Realistic, Time-bound

o INFORMAL INSTITUTION
- Anything learned INDEPENDENTLY outside of the COMPARISON TABLE OF VISION AND MISSION
conventional classroom VISION STATEMENT MISSION
STATEMENT
VISION STATEMENT FUNCTION Inspires to give the Define the key
 END DESIRE aspiration of an academic institution best and shapes your measure of the
 Usually ONE SENTENCE STATEMENT describing the distinct understanding of why institution success.
and motivating LONG-TERM DESIRED TRANSFORMATION you are in the
resulting from institutional program institution.
 SHOULD be clear, memorable and concise. DEVELOPING When do we want to What do we do
 AVERAGE length of 14 WORDS STATEMENT reach success? today?

“The center for academic excellence in the field of Medicine, Arts and Where do want to go For whom do we
Science and the bastion for integrated formation of role models and forward? do?
top performing professionals”
How do we want to do Why we do what we
MISSION STATEMENT it? do?
- This answer the questions “WHAT YOU DO?” or “WHO YOU
DO FOR?” TIME Talks about the
- ONE SENTENCE relating the INTENTION of your institution’s Talks about FUTURE PRESENT leading
existence to the future.
- MUST be clear by using simple language, concise, “no QUESTION Where do we aim to What makes us
fluff” be? different?
- 5 to 14 WORDS with a MAX of 20 and valuable, that is inform, ABOUT How you will get
focus and guided. Where you want to be? where you want to
be?
“To develop competent, value-driven and globally competitive
professionals and leaders who are responsive to the changing needs
of the society by providing quality transformational education.”

VALUES STATEMENT
- A list fundamental doctrines that GUIDE AND DIRECT the
education institution and its belief
- This creates the MORAL DIRECTION of the institution and
its academic community that guides DECISION-MAKING
and create a YARDSTICK against any action.
1.
It consider the following questions:
o What values are distinct to our educational institution?
o What value should be the direction of the management of the
institution

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HEALTH INFORMATION SYSTEM
FIRST SEMESTER / LESSON 1 – 8 / MIDTERMS TRANSES

LESSON 2: HEALTH CARE SYSTEM  STEWARDSHIP

- Overall system oversight is a GOVERNMENT
HEALTH CARE SYSTEM RESPONSIBILITY
- Set the context and policy framework for the overall health
o (ROEMER 1991) system
- The combination of resources, organization, financing and - Generating appropriate data for policy making ranging from
management that culminate in the delivery of health services public health surveillance data to health system
to the population. performance.

o (WORLD HEALTH ORGANIZATION ‘WHO’ 2000)  HEALTH FINANCING

- All organization, institution and resources that are devoted to - Includes collecting revenue, pooling financial risk and
PRODUCE health actions. allocating revenue.

o HEALTH ACTION o REVENUE COLLECTION

- Any effort, whether in personal health care, public - Collection of MONEY to PAY for Health care
health services or through intersectoral initiatives, service.
whose primary purpose is to IMPROVE HEALTH.
o RISK POOLING
MAIN GOALS OF HEALTH SYSTEM - COLLECTION and MANAGEMENT of financial
resources in a way that spreads financial risks
- IMPROVING THE HEALTH OF POPULATION from an individual to pool members (WHO 2000)
- The overarching goal
- HEALTH STATUS should be measured over the ENTIRE Two main models:
population and across different socioeconomic groups
 BISMARCK MODEL
- IMPROVING THE RESPONSIVENESS OF THE HEALTH - Bismarck’s Law on Health Insurance of
SYSTEM TO THE POPULATION IT SERVES 1883
- RESPONSIVENESS represent the concept that the health - Otto von Bismarck (Prussian
system provides services in the manner that people WANT Chancellor)
or DESIRE and engages people as ACTIVE partners. - It uses INSURANCE SYSTEM, the
insurer are called “sickness funds”
- FAIRNESS IN FINANCIAL CONTRIBUTION - Usually financed by payroll deduction.
- Provide SOCIAL and FINANCIAL RISK PROCTECTION in - Bismarck- type health insurance plans to
health and be fairly financed COVER everybody, and they don’t make
- Paying for health care should NOT impoverish individuals or a PROFIT
families
 BEVERIDGE MODEL
FUNCTIONS OF HEALTH SYSTEM - Social Insurance and Allied services of
1942 – the Beveridge Report
 HEALTH SERVICE PROVISION - William Beveridge (Social reformer who
- Delivering health services is thus an essential part of what designed Britain’s National Health
the system does but it is not what the system is" (WHO Service)
2000) - Health care is PROVIDED and
FINANCED by the government through
 HEALTH SERVICE INPUTS TAX PAYMENTS
- The assembling of ESSENTIAL RESOURCES for delivering
health services  STRAGETIC PURCHASING
- Include human resources, medication and medical - Most risk-pooling organizations or purchasers use
equipment. COLLECTED and POOLED FINANCIAL RESOURCES to
finance or buy health care services for their members.

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HEALTH INFORMATION SYSTEM
FIRST SEMESTER / LESSON 1 – 8 / MIDTERMS TRANSES
W.H.O HEALTH SYSTEM FRAMEWORK
 SERVICE DELIVERY
- Deliver effective, safe, quality personal and non-personal
health intervention to those who need them, when and
where needed, with minimum waste of resources.
 HEALTH WORKFORCE
- Works in ways of responsive, fair and efficient to achieve
the best health outcomes possible given available
resources and circumstances.
 INFORMATION
- Ensures the production, analysis, dissemination and use of
reliable and timely information on health determinants,
health systems performance and health status
 MEDICAL PRODUCTS, VACCINES AND TECHNOLOGIES
- Ensures equitable access to essential medical products,
vaccines and technologies of assured quality, safety,
efficacy and cost-effectiveness, and their scientifically
sound and cost-effective use.
 FINANCING
- Need ADEQUATE FUNDS for health.
- Ensure people can use needed services, and are protected
from financial catastrophe or impoverishment associated
with having to pay for them
 LEADERSHIP AND GOVERNANCE
- involves ensuring STRAGETIC POLICY FRAMEWORK
exist and are combined with effective stewardship, coalition-
building, the provision of appropriate regulations and
incentives, attention to system-design, and accountability
PHILIPPINE HEALTH SYSTEM HISTORICAL BACKGROUND
 (1970) PRIMARY HEALTH CARE FOR ALL
- Developed a largely CENTRALIZED government-funded
and operated health care system
 (1979) ADOPTION OF PRIMARY HEALTH CARE
- Promoted participatory management of the LOCAL health
care system.
 (1982) REORGANIZATION OF DOH
- Integrated public health and hospital services
 (1986) MILK CODE 1986
- Prevention and nutrition to promote BREASTFEEDING
 (1988) THE GENERIC ACT
- Prescriptions are written using the generic name of the drug
by promoting and purchasing NON-BRANDED medicines
 (1991) RA 7160 "LOCAL GOVERNMENT CODE"
- TRANSER OF RESPONSIBILITY of health service
provisions to the LOCAL GOVERNMENT UNITS
 (1995) NATIONAL HEALTH INSURANCE ACT
- Aims to provide ALL citizens a mechanism for FINANCIAL
PROTECTION with priority given to the poor.
 (1996) HEALTH SECTOR REFORM AGENDA
- MAJOR organizational restructuring of the DOH to improve
the way health care is delivered, regulated and financed.
 (2005) FOURmula ONE (F1) FOR HEALTH
- ADOPTION of operational framework to undertake reforms
with speed, precision, and effective.
 (2008) RA 9502 “ACCESS TO CHEAPER AND QUALITY
MEDICINE ACT
- Promote and ensure ACCESS of AFFORDABLE QUALITY
DRUGS and medicine for all.
 (2010) AO 2010-0036 “KALUSUGANG PANGKAHALTAN”
- UNIVERSAL health coverage and access to quality health
care for all Filipinos
 (2013) SIN TAX FOR HEALTH
- Generate extra revenue for DOH by discouraging
HARMFUL consumption of ALCOHOL and TOBACCO.
 (2019) UNIVERSAL HEALTH CARE LAW
- ENROLLING all Filipino citizens automatically in the Nation
Health Insurance Program administered by PhilHealth.
- All Filipinos are guaranteed equitable access to quality and
AFFORDABLE HEALTH CARE SERVICES.
LEADERSHIP AND GOVERNANCE
- Under the Local Government Code (1991), LGUs were
granted autonomy and responsibility for their own health
services. National health programs are coordinate by the
DOH through the LGUs.
- The LGU make up political subdivisions of the Philippines
- LGUs are guaranteed local autonomy under 1987
Constitution and the LGC of 1991.
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HEALTH INFORMATION SYSTEM
FIRST SEMESTER / LESSON 1 – 8 / MIDTERMS TRANSES
The DOH as mandated has the duty to:
 Developing health policies and programs;
 Enhancing partner's capacity through technical assistance;
 Leveraging performance for priority health programs among
these partners;
 Developing and enforcing regulatory policies and standards;
 Providing specific programs that affect large segments of the
population;
 Providing specialized and tertiary level care
DIRECTIONS OF THE PHILIPPINE HEALTH SECTOR
 THE PHILIPPINE HEALTH AGENDA
(DOH ADMINITRATIVE ORDER 2016-0038)
“All for Health Towards Health for All”
 Population and individual-level interventions
 Access to health interventions through functional service
delivery networks (SDNs)
 FINANCIAN FREEDOM
 THE PHILIPPINE DEVELOPMENT PLAN 2017 – 2022
“Matatag, maginhawa, at panatag na buhay para sa lahat”
- This is the first of the FOUR key medium-term plans to
translate the vision of aspirations for the Filipinos and the
country.
 AmBisyon Natin 2040
- This is a collective long-term plan which envisions a
BETTER LIFE for the Filipinos and the country in the next
25 YEARS
 Building a middle-class society where no one is poor
 Promoting a long and healthy life
 Becoming smarter and more innovative
 A high-trust society
 SUSTAINABLE DEVELOPMENT GOALS 2030
- This is a COMPILATION of 17 developmental goals that
targets to end poverty, fight inequality and injustice and
confront issues involving climate change and its effects.
LESSON 3: PHILIPPINE HEALTH CARE DELIVERY SYSTEM
ALMA ATA DECLARATION HEALTH OF 1978
- Health is a fundamental human right and that the attainment
of the highest possible level of health is a most important
world-wide social goal whose realization requires the action
of many other social and economic sectors in addition to the
health sector
ASTANA DECLARATION
- Reaffirming the commitments expressed in the ambitious
and visionary Declaration of Alma-Ata 1978 and the 2030
Agenda for Sustainable Development, in pursuit of Health
for All.
DIRECTIONS OF THE PHILIPPINE HEALTH SECTOR
 HEALTH CARE SYSTEM
o (MILLER – KEANE, 1987)
- “an organized plan of health services”
 HEALTH CARE DELIVERY
o (WILLIAM – TUNGPALAN, 1981)
- “the rendering of health care services to the people”
 HEALTH CARE DELIVERY SYSTEM
o WILLIAM – TUNGPALAN, 1981)
- ”the network of health facilities and personnel which
carries out the task of rendering health care
 PHILIPPINE HEALTH CARE SYSTEM
o (DIZON, 1977)
- “a complex set of organizations interacting to
provide an array of health services in the PH”
GOALS OF PRIMARY HEALTH CARE
 Universal coverage to reduce exclusion and social disparities in
health
 Service delivery organized around people's needs and
expectations
 Public policy that integrates health into all sectors
 Leadership that enhances collaborative models of policy
dialogue.
 Increased stakeholder participation.
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FIRST SEMESTER / LESSON 1 – 8 / MIDTERMS TRANSES

GOALS OF PRIMARY HEALTH CARE  DIRECTING

- Education concerning prevailing health problems and the - This focuses on INITIATING ACTION in the organization
methods of identifying, preventing and controlling them. through effective leadership and motivation of, and
- Locally endemic disease prevention and control. communication of managers.
- Expanded program of immunization against major infectious
diseases. MANAGEMENT PRINCIPLE IN RELATION TO ORGANIZING
- Maternal and child health care including family planning.  AUTHORITY
- Essential drugs arrangement. - A manager's FORMAL and LEGITIMATE right to make
- Nutritional food supplement, an adequate supply of safe and decisions, issue orders, and allocate resources to achieve
basic nutrition. organizationally desired outcomes.
- Treatment of communicable and non-communicable disease
and promotion of mental health. Type of Authority:
- Safe water and sanitation. o LINE AUTHORITY
- MANAGERS have FORMAL POWER to
OTHER ELEMENTS OF PRIMARY HEALTH CARE direct and control IMMEDIATE
SUBORDINATES
 Expended options of immunizations
- SUPERIOR issues ORDERS and is
 Reproductive health needs
responsible for the RESULTS
 Provision of essential technologies for health - SUBORDINATES obeys and is responsible
 Health promotion ONLY for executing the ORDER according
 Prevention and control of non-communicable diseases to INSTRUCTIONS
 Food safety and provision of selected food supplements
o FUNCTIONAL AUTHORITY
PRINCIPLES OF PRIMARY HEALTH CARE - Managers have formal power over a
 BUILD on the Alma-Ata principles of equity, universal SPECIFIC subset of ACTIVITIES
access, community participation, and intersectoral
approaches o STAFF AUTHORITY
 Take account of BROADER population health issues, - NOT a REAL authority
reflecting and reinforcing public health functions - STAFF MANAGER does not ORDER or
 CREATE the conditions for effective provision of services INSTRUCT. Simply ADVISES,
to poor and excluded groups RECOMMENDS, and COUNSELS in staff
 Organize integrated and seamless care, linking prevention, specialists’ area of expertise
acute care, and chronic care across all components of the
health system  RESPONSIBILITY
 Continuously EVALUTE an STRIVE to improve - EMPLOYEE’S duty to perform ASSIGNED task or
performance activities.

MANAGEMENT OF PRIMARY HEALTH CARE  ACCOUNTABILITY

- Those with AUTHORITY and RESPONSIBILITY must
 PLANNING REPORT and JUSTIFY task outcomes to those ABOVE
- Setting PRIORITIES and determining performance targets them in the chain of command.

 ORGANIZING  CENTRALIZATION
- Refers to the MANAGEMENT FUNCTION on designing the - Decision making authority near TOP ORGANIZATIONAL
organization or the specific division, unit, or service for LEVELS.
which the manager is responsible.
 DECENTRALIZATION
 STAFFING - Decision making authority near LOWER
- Refers to ACQUIRING and retaining human resources and ORGANIZATIONAL LEVELS
developing and maintaining the workforce.
 FORMALIZATION
 CONTROLLING - WRITTEN DOCUMENTATION provided for the DIRECT
- Refers to MONITORING STAFF ACTIVITIES and control of the employees.
performance and taking the appropriate actions for
corrective action to increase performance.

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HEALTH INFORMATION SYSTEM
FIRST SEMESTER / LESSON 1 – 8 / MIDTERMS TRANSES

THE DEPARTMENT OF HEALTH MANDATE  INTERMEDIATE LEVEL HEALTH WORKERS

The Department of Health shall be responsible for the following:
 Formulation and development of national health policies,
guidelines, standards, and manual of operations for
services and programs
 Issuance of rules and regulations, licenses, and
accreditations
 Promulgation of national health standards, goals, priorities,
and indicators
 Development of special health programs and projects
 FIRST LINE HOSPITAL PERSONNEL
 Advocacy for legislation on health policies and programs
VISION BY 2030:
“A global leader for attaining better health outcomes, competitive and
responsible health care system and equitable health financing”
MISSION:
To guarantee equitable, sustainable and quality health for all
Filipinos, especially the poor and lead the quest for excellence in
health.
- Represent the first SOURCE of professional health
care
- ATTENDS to health problems beyond the competence
of village workers
- Provides support to FRONT – LINE health workers in
terms of SUPERVISION, TRAINING, SUPPLIES, AND
SERVICES.
- Community health workers : MEDICAL
PRACTITIONERS, NURSES, AND MIDWIVES
- Provide BACKUP health services for cases that
require hospitalization
- Establish CLOSE CONTACT with intermediate level
health workers or village health workers
- Community health workers: PHYSICIAN with
specialty, NURSES, DENTIST, PHARMACISTS, other
health professional

LEVELS OF HEALTH CARE FACILITIES

 PRIMARY LEVEL
- RURAL health units their sub-centers, chest clinics,
malaria eradication units, and schistosomiasis control units
operated by the DOH

 SECONDARY LEVEL
- SMALLER, NON – DEPRTMENTALIZED HOSPITALS
- emergency and REGIONAL hospitals in which services to
patients with symptomatic stages of disease
- Requires MODERATELY SPECIALIZED knowledge and
technical resources for adequate treatment are offered.

 TERTIARY LEVEL
- HIGHLY technological and SOPHISTICATED services
- Services offered by MEDICAL CENTERS and LARGE
hospitals
- These are the SPECIALIZED national hospitals.

LEVELS OF HEALTH CARE WORKERS

 VILLAGE / GRASSROOT HEALTH WORKERS

- FIRST contacts of the community and initial links to health
care.
- Provide SIMPLE curative and preventive health care
- Participate in activities geared towards the
improvement of the socio-economic level of the
community like food production program.
- Community health workers : VOLUNTEERS or
TRADITIONAL BIRTH ATTENDANTS

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HEALTH INFORMATION SYSTEM
FIRST SEMESTER / LESSON 1 – 8 / MIDTERMS TRANSES
LESSON 4: HEALTH INFORMATICS
- Information is the PRIMARY product of CLINICAL
LABORATORY
- It has resulted in the generation of HUGE amount of
routine data, particularly HEALTH CARE.
HEALTH INFORMATION SYSTEM
ROUSE (2016)
o the area of IT involving the design, development, creation,
use, and maintenance of information systems of the
healthcare industry
o it promises to MODERNIZE and streamline healthcare and
to connect different users and stakeholders in the e-health
market
o AUTOMATED and INTEROPERABLE health information
systems are expected to IMPROVE medical care, lower
cost, increase efficiency, reduce error, and improve patient
satisfaction.
HEALTH CARE SOFTWARE SYSTEMS
ELECTRONIC HEALTH RECORD (HER)
- A person’s OFFICIAL DIGITAL HEALTH RECORD
- Is shared among MULTIPLE healthcare providers and
agencies.
o PERSONAL HEALTH RECORD (PHR)
- Person’s SELF - MAINTAINED health record.
o HEALTH INFORMATION EXCHANGE (HIE)
- A health data CLEARINGHOUSE
- Comprised of healthcare organization that ENTER
into the interoperability pact and AGREE to SHARE
data between their various health IT systems.
o PICTURE ARCHIVING AND COMMUNICATION SYSTEMS
(PACS) AND VENDOR NEUTRAL ARCHIVES (VNAS)
- TWO widely used types of health IT
- Help healthcare professionals STORE and
MANAGE patient’s medical images
- VNAs can also be for the purpose of MERGING
IMAGING DATA from various departments into a
multi-facility health care system.
- Radiology Department have been the primary
repositories of medical images, presently, cardiology
and neurology have also become large-scale
producers of clinical images
HEALTH CARE SOFTWARE SYSTEMS
- A composition INDIVIDUALS, systems and processes
that want to SHARE, EXCHANGE, and ACCESS all
forms of health information, including discrete,
narrative and multimedia (The Healthcare
Information and Management Systems Society,
2017)
- An efficient health interoperability ecosystem provides
an information infrastructure that uses technical
standards, policies and protocols to enable seamless
and secure capture, discovery, exchange and
utilization of health information
HEALTH INFORMATICS IN THE CLOUD
ADVANTAGES
 INTEGRATED AND EFFICIENT PATIENT CARE
- Cloud technology offers a SINGLE ACCESS POINT
for patient information.
- Allow MULTIPLE doctors to REVIEW lab results or
notes on patient
- Physicians can SPEND MORE TIME deciding and
performing patient treatment instead of waiting for
information he needs coming from different
departments
 BETTER MANAGEMENT OF DATA
- Accumulation of electronic health records
- Allow more meaningful DATA MINING that can
better access the health of the general public
- MORE DATA can mean MORE OPPORTUNITIES
to identify trends in DISEASES and CRISES.
 ERROR REDUCTION
- 70% of clinicians decisions are based on laboratory
results
- Quality, accuracy, and precision of laboratory results
are INDISPENSABLE in Clinical care
- AUTOMATED SYSTEM can ELIMINATE
transcription, calculation and transmission error.
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HEALTH INFORMATION SYSTEM
FIRST SEMESTER / LESSON 1 – 8 / MIDTERMS TRANSES

DISADVANTAGES  EASY UPDATE

- HIS let doctors CREATE electronic medical records for
 POTENTIAL RISK TO PERSONAL INFORMATION their patients.
- Information contained within medical records may be - Patient information can be pulled up for REVIEW at any
SUBJECTED TO THEFT or other violations of privacy time and COPIES can be MADE for the patient upon
and confidentiality. request
- safeguards may be put in place in order to MINIMIZE
THREATS  COMMUNICATIONS
- HIS abet communication BETWEEN multiple doctors or
 CLOUD SET – UP SEEMS CUMBERSOME hospitals.
- Transition from a traditional to an automated system - According to Government Health IT, medical professionals
might be difficult to some members of healthcare MUST pay close attention TO CONFIDENTIALITY ISSUE.
organizations
- PROPER EDUCATION and ILLUSTRATION of its COMPONENTS OF HEALTH INFORMATION SYSTEM
function, hesitant practitioners may be able to see its
advantages  HEALTH INFORMATION SYSTEM RESOURCES
- include the legislative, regulatory and planning frameworks
 COST JUSTIFICATION required for a fully functioning HIS
- NOT ALL commercially available laboratory
information systems improved productivity  INDICATORS
- Might require considerable more staff time than - A core set of indicators and related targets is the basis for
manual system they replace a health information system plan and strategy.
- need to encompass determinants of health:
HEALTH INFORMATIC IN THE PHILIPPINES  Health system inputs
 Outputs
COMMUNITY HEALTH INFORMATION TRACKING SYSTEM  Outcomes
(CHITS)  Health status
- EMR developed through collaboration of the information and
communication technology and health workers  DATA SOURCES
- Primarily designed for use in Philippine health centers in TWO MAIN CATEGORIES
DISADVANTAGED AREAS
- It is currently utilized in 111 GOVERMENT HEALTH  POPULATION – BASED APPROACHES
FACILITIES. - censuses, civil registration and population
surveys
OTHERS: Linux, Apache, MySQL, PHP-based system released
under the general public license (GPL)
 INSTITUTION – BASED DATA
- Individual records, service records and
LESSON 5: HEALTH INFORMATION SYSTEM
resource records.
- Refer to any system that “CAPTURES, STORES, MANAGES or
 DATA MANAGEMENT
TRANSMITS information related to the health of individuals or
- COVERS ALL ASPECTS OF DATA:
the activities of organizations that work within the health sector.”
COLLECTION TO:
ROLE AND FUNCTION OF HIS STORAGE PROCESSING
QUALITY-ASSURANCE COMPILATION
 FILES ARE EASIER TO ACCESS FLOW ANALYSIS
- System are ELECTRONIC ,
- The days of HARD files and LOOSE papers are over  INFORMATION PRODUCTS
- Data MUST be transformed into information that will become
 MORE CONTROL the BASIS for evidence and knowledge to shape health
- ONLY AUTHORIZED STAFF can access the information action.
of the patient
- DOCTORS may have permission to UPDATE, CHANGE  DISSEMINATION AND USE
AND DELETE INFORMATION from the electronic medical - enhanced by making it readily accessible to decision-
record. makers
- THE RECEPTIONIST may ONLY have the authority to - providing incentives for, or otherwise facilitating, information
UPDATE a patient’s appointments use
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HEALTH INFORMATION SYSTEM
FIRST SEMESTER / LESSON 1 – 8 / MIDTERMS TRANSES
DATA SOURCES FOR HEALTH INFORMATION SYSTEM
 DEMOGRAPHIC DATA
- consist of FACTS such as age (or birth date), gender, race
and ethnic origin, marital status, address of residence,
names of and other information
- information about employment status, schooling and
education
 ADMINISTRATIVE DATA
- involves facts, with respect to SERVICES provided (e.g.,
diagnostic tests or outpatient procedures),
- Charges and amounts paid, the KIND of PRACTITIONER
(physician, podiatrist, and psychologist), physician specialty,
and
- NATURE OF INSTITUTION (general or specialty hospital,
physician office or clinic, home care agency, nursing home,
and so forth).
 HEALTH RISK INFORMATION
- Reveal lifestyle and behavior (eg. Using of tobacco
products)
- Facts about FAMILY HISTORY and genetic factors to
evaluate patient’s propensity for different diseases.
 HEALTH STATUS
- Is generally reported by individuals themselves
- Reflects domains of health such as PHYSICAL functioning,
MENTAL and EMOTIONAL well-being, COGNITIVE
functioning, social and role functioning, and perceptions of
one's health in the past, present, and future and compared
with that of one's peers.
 PATIENT MEDICAL HISTORY
- Consider data on previous medical ENCOUNTERS such as
hospital admissions, surgical procedures, pregnancies and
live births.
- Includes information on PAST MEDICAL PROBLEMS and
POSSIBLE family history or events
 CURRENT MEDICAL MANAGEMENT
- Includes the CONTENTS of ENCOUNTER forms or parts of
the patient record.
- Such information might reflect health screening, current
health problems and diagnoses, allergies
 OUTSOURCE DATA
- Comprise a wide array of measures of the effects of health
care and the AFTERMATH of various health problems.
- REFLECT health care events such as re-admission to
hospital or unexpected complications or side effects of care,
and also include measures of satisfaction with care.
- Outcomes assessed weeks or months after health care
events, reposts directly from individuals are desirable, these
are likely to be the least commonly available
(DONALD AND LOHR; 1994)
LESSON 6: HEALTH MANAGEMENT INFORMATION SYSTEM
Problems faces by hospitals using the traditional manual
process includes:
 No real time data available to monitor the performance of the
hospital
 Evidence based program management was a challenge
 Undue delays in receipt of data
 Retrieval of old manual records was ineffective and time
consuming.
 Duplication of records
 Monthly reports sent as hard copy which is a real challenge for
data analysis/comparison
 Drug inventory/equipment inventory maintenance.
 Lack of standard names and code
HEALTH MANAGEMENT INFORMATION SYSTEM
- An information system specially designed to assist in the
management and planning of health programs, as opposed to
delivery of care. (World Health Organization, 2004)
- It is a data collection system specifically designed to support
planning, management, and decision-making in health
facilities and organizations.
- The MAJOR role of HMIS is to provide quality information to
support decision-making at all levels of the health care system
in any medical institution.
- It also aims to aid in the setting of performance targets at all
levels of health service delivery and to assist in assessing
performance at all levels of the Health Sector (Ministry of
Health, 2010)
NEEDS TO BE:
 COMPLETE
- It should provide information on all key aspects of the
health system without duplication
 CONSISTENT
- If similar information is provided by different sources,
their definitions need to be consistent.
 CLEAR
- It should be very clear what all the elements are
actually measuring
 SIMPLE
- It should not be unnecessarily complicated
 ACCESIBLE
- Data should be held in a form readily accessible to all
legitimate users, and it should be clear who these
people are.
 CONFIDENTIAL
- It should ensure that people without legitimate access
are effectively denied.
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HEALTH INFORMATION SYSTEM
FIRST SEMESTER / LESSON 1 – 8 / MIDTERMS TRANSES
 COST EFFECTIVE
- The actual usage of each element should justify the
costs of its collection and analysis.
BASIC FUNCTION
- The information from the HMIS can be used in planning,
epidemic prediction and detection, designing Interventions,
monitoring and resource allocation (Ministry of Health, 2010).
- Historically, all information systems, including HMIS, are built
upon the conceptualization of three fundamental information-
processing phases
. time it takes to transmit the required data from the source to
EIGHT ELEMENTS OF THE HMIS
 DATA ACQUISITION
- This involves BOTH the generation and the collection of
accurate, timely, and relevant data.
- This is normally achieved through the input of standard coded
formats (e.g., the use of bar codes) to facilitate the rapid
mechanical reading and capturing of data.
 DATA VERIFICATION
- Involves the authentication and VALIDATION of gathered
data. The quality of collected data depends largely on the
authority, validity, and reliability of the data sources.
 DATA STORAGE
- The PERSERVATION and archival of data may be regarded
as part of the data storage function.
- When accumulated data are NO LONGER actively used in the
system.
- A method to archive the data for a certain period is usually
advisable and may sometimes be mandatory, as when it is
required by legislation
 DATA CLASSIFICATION
- This is also known as DATA ORGANIZATION.
- It is a critical function for increasing the efficiency of the
system when the need arises to conduct a data search.
- Most data classification schemes are based on the use of
certain key parameters. For example, data referring to a
patient population may be classified and sorted according to
various diagnostic classification schemes.
 DATA COMPUTATION
- Involves various forms of data MANIPULATION and data
TRANSFORMATION, such as the use of mathematical
models, statistical and probabilistic approaches, linear and
nonlinear transformation, and other data analytic processes.
- It allows further data analysis, synthesis, and evaluation so
that data can be used for strategic decision-making purposes
other than tactical and/or operational use.
 DATA UPDATE
- New and changing information is accounted for through the
element of data update. The dynamic nature of such data
modification calls for constant monitoring.
- For HMIS to maintain current data, mechanisms must be put
in place for updating changes in the face of any ongoing
manual or automated transactions.
 DATA RETRIEVAL
- Concerned with the processes of data transfer and data
distribution. The data transfer process is constrained by the
the appropriate end-user
 DATA PRESENTATION
- This is how users interpret the information produced by the
system. In situations where only operational or even tactical
managerial decision making is expected, summary tables and
statistical reports may suffice.
- The use of presentation graphics for higher-level managerial
decision analysis is particularly encouraged because these
appear to provide a better intuitive feel of data trend.
DETERMINANTS OF HMIS
PRISM FRAMEWORK
- Known as Performance of Routine Information System
Management (PRISM), this conceptual framework broadens
the analysis of routine health information systems to include
the three
- This framework identifies the strengths and weaknesses in
certain areas, as well as correlations among areas. This
assessment aids in designing and prioritizing interventions to
improve RHIS performance which in turn improves the
performance of the health system
KEY FACTORS
 BEHAVIORAL DETERMINANTS
- Knowledge, skills, attitudes, values, and motivation of
the people who collect and use data.
- The data collector and users of the HMIS need to
have confidence, motivation and competence to
perform HMIS tasks in order to improve the Routine
Health Information System (RHIS) process.
 TECHNICAL DETERMINANTS
 Data collection processes, systems, forms, and methods.
- Involve the overall design used in the collection of the
information. It comprises the complexity of the
reporting forms, the procedure set forward in the
collection of data, the overall design of then computer
software used in the collection of information (Sanga,
2015)
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 ORGANIZATIONAL/ENVIRONMENTAL DETERMINANTS:
- Information culture, structure, resources, roles, and
responsibilities of the health system and key contributors at
each level Health workers and data collectors work in
organizations’ environments which have value, norms, culture
and practice. The most important organizational factor which
affects the RHIS process is related to structure, resource,
procedure, support services and the culture
LESSON 7: HMIS – MONITORINING AND EVALUATION
M&E FRAMEWORK
 Monitoring and evaluation (M&E) is a core component of current
efforts to scale up for better health. Global partners and
countries have developed a general framework for M&E of
health system strengthening (HSS).
 The framework builds upon principles derived from the Paris
declaration on aid harmonization and effectiveness and the
IHP+, putting country health strategies, and the related M & E
processes such as annual health sector reviews, at the center.

MONITORINING HMIS INDICATORS TO HEALTH PROGRAM

- the systematic collection, analysis and use of information from
programs for three basic purposes:
- Learning from the experiences acquired (learning
function)
- Accounting internally and externally for the resources
used
- The results obtained (monitoring function) and taking
decisions (steering function).
EVALUATION
- Assessing an ongoing or completed program or policy as
systematically and as objectively as possible.
- The object is to be able to make statements about their
relevance, effectiveness, efficiency, impact, and sustainability
- Learning function - the lessons learned need to be
incorporated into future proposals or policy
- Monitoring function - partners and members review
the implementation of policy based on objectives and
resources mobilized. Monitoring and evaluation are
complementary
PURPOSE
- The PRIMARY AIM is to have a strong M & E and review
system in place for the national health strategic plan that
comprises all major disease programs and health systems.
 The disease data provide the status report on communicable
and no communicable diseases. The following sections illustrate
the relationship of HMIS information and some of the health
programs.
MATERNAL SURVIVAL STRATEGY & HMIS INDICATOR
 To routinely monitor the progress towards implementation of a
highly effective package of maternal survival interventions, the
HMIS is designed to provide albeit some of the core input,
process, and output indicators.
CHILD MORTALITY AND CHILD SURVIVAL INTERVENTION
 The EDHS 2011 estimated under-5 mortalities to be 88 per
1000 LB, that is, a 47% decline from 166/1000 LB in 2000.
Diarrhea, pneumonia, measles, malaria, HIV/AIDS, birth
asphyxia, preterm delivery, neonatal tetanus, and neonatal
sepsis are the major causes of under-5 deaths in Ethiopia, with
under-nutrition attributing to over one third of these deaths.
THE STOP TB PROGRAM
With the vision to have a TPB-fee world, the goal of the STOP TB
Program (STP) is to dramatically reduce the global burden of TB by
2015, in line with the Millennium Development Goals and the Stop TB
Partnership targets of the World Health Organization (2006).

PLAN
- The national M & E plan and system should address all
components of the framework and lay the foundation for
regular reviews during the implementation of the national plan.

According to the National Health Mission (2014), strategies for

operationalizing the framework should:
 be primarily country focused but also offer the basis for global
monitoring
 Address M & E needs for multiple users and purposes, including
monitoring program inputs, processes and results, tracking
health systems performance and evaluation
 facilitate the identification of indicators and data sources,
provide tools and guidance for data analysis, and show how the
data can be communicated and used for decision-making
 Bring together the monitoring and evaluation work in disease
specific programs with crosscutting efforts such as tracking
Human resources, logistics and procurement, and health service
delivery.

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LESSON 8: DATA QUALITY  MONITOR

 The overall utility of a dataset as a function of its ability to be - Capacity improvements and performance of the data
processed easily and analyzed for a database, data warehouse, management and reporting system to produce
or data analytics system. quality data

ASPECT OF DATA QUALITY DEVELOPMENT IMPLEMENTATION PLAN

 Accuracy  A project management tool that shows how a project will evolve
 Completeness at a high level. It helps ensure that a development team is
 Update status working to deliver and complete tasks on time
 Relevance (Visual Paradigm, 2009)
 Consistency  The plan validates the estimation and schedule of the project
 Reliability plan
 Appropriate presentation
 Accessibility  DEFINE GOALS / OBJECTIVES:
- Answers the question “What do you want to
LOT QUALITY ASSESSMENT SAMPLING (LQAS) accomplish?”
 it is a tool that allows the use of small random samples to
distinguish between different groups of data elements (or lots)  SCHEDULE MILESTONES:
with high and low data quality - Outline the high level schedule in the
implementation phase.
STEPS IN APPLYING LQAS:
 Define the service to be assessed – e.g DQA of DHIS  ALLOCATE RESOURCES:
 Identity the unit of interest a supervisory area, facility, - Determine whether you have sufficient resources,
hospital, a distinct and decide how you will procure what’s missing.
 Define the higher and lower thresholds of performance
based on prior information about the expected performance  DESIGNATE TEAM MEMBER RESPONSIBILITIES:
of the region of interest - Create a general team plan with overall roles that
 Determine the level of acceptable error each team member will play.
 From a table determine the sample size and decision rule
for acceptable errors to declare an area as performing  DEFINE METRICS FOR SUCCESS:
“below expectations” - How will you determine if you have achieved your
 The number of errors observed (mismatched data elements goal? (Smartsheet, 2017)
will determine reliability if the facility is performing above or
below expectations) DATA QUALITY TOOLS
 A data quality tool analyzes information and identifies
ROUTINE DATA QUALITY ASSESSMENT incomplete or incorrect data.
 The RDQA is a simplified version of the Data Quality Audit  Cleansing such data follows after the completion of the profiling
(DQA) which allows programs and projects to verify and assess of data concerns, which could range anywhere from removing
the quality of their reported data. abnormalities to merging repeated information.
 It also aims to strengthen their data management and reporting  Usually these data quality software products can share features
systems with master date management, data integration, or big data
solutions.
OBJECTIVES
 VERIFY RAPIDLY How to address data quality problems?
- The quality of reported data for key indicators at  PARSING AND STANDARDIZATION
selected sites - Refers to the decomposition fields into component
- The ability of data – management systems to collect parts and formatting the value into consistent layouts
manage and report quality data. based on industry standards and patterns and user
– defined business rules
 IMPLEMENT
- Corrective measures with action plans for  GENERALIZED “CLEANSING”
strengthening the data management and reporting - Means the modification of data values to meet
system and improving data quality domain restrictions, constrains on integrity or other
rules that define data quality as sufficient for the
organization.
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 MATCHING
- This is the identification and merging related entries
within or across data sets.
 PROFILING
- Refers to the analysis of data to capture statistics or
Meta data to determine the quality of the data and
identify data quality issues.
 MONITORING
- The deployment of controls to ensure conformity of
data to business rules set by the organization
 ENRICHMENT
- Enhancing the value of the data by using related
attributes from external sources such as consumer
demographic attributes or geographic descriptors
ROOT CAUSE ANALYSIS
- A root CAUSE analysis is a class of problem solving methods
aimed at identifying the root causes of the problems or events
instead of simply addressing the obvious symptoms.
- The aim is to IMPROVE the quality of the products by using
systematic ways in order to be effective (Bowen, 2011)
TECHNIQUES
 FAILURE MODE AND EFFECTS ANALYSIS (FMEA)
- To find various modes for failure within a system. FMEA
requires several steps for execution:
o All failure modes (the way in which an
observed (failure occurs) must be
determined.
o How many times does a cause of failure
occur?
o What actions are implemented to prevent
this cause from occurring again?
o Are the actions effective and efficient?
- Performed and updated any time new product or
process is generated, when changes are made to
current condition, or to the design, when new
regulation occur, or when there is a problem
determined through customer feedback
 PARETO ANALYSIS
- Operates using Pareto principle (20% of the work creates 80%
of the results)
- You will want to run Pareto analysis any time when there are
multiple potential causes to a problem.
- First, you will list potential causes in a bar graph across the
bottom - from the most important cause on the left to the least
important cause on the right.
- Then, you will track the cumulative percentage in a line graph to
the top of the table. The causes reflected on the table should
account for at least eighty percent of those involved in the
problem.
 FAULT TREE ANALYSIS
- It uses Boolean logic to determine the root causes of an
undesirable event. This technique is usually used in risk
analysis and safety analysis.
- At the top of the fault tree, the undesirable result is
listed. From this event, all potential causes tree down
from it. Each potential cause is listed on the diagram in
the shape of an upside down tree
 CURRENT REALITY TREE (CRT)
- The current reality tree analyzes a system at once. It
would be used when many problems exist and you want
to get to the root causes of all the problems.
- The first step in creating a current reality tree is listing all
of the undesirables or, problems.
- Then begin a chart starting with each of those problems
using causal language (if...and...then).
- The tree will depict each potential cause for a problem.
Eventually, the tree will show one because that is linked
to all four problems.
 FISHBONE OR ISHIKAWA OR CAUSE AND EFFECT
DIAGRAMS
- A fishbone diagram will group causes into categories
including:
o People
o Measurements
o Method
o Materials
o Environment
o Machines
- No matter what term you use for the fishbone diagram,
the truth is, that it is a useful technique that will help you
in your root cause analysis.
 KEPNER – TREGOE TECHNIQUE
- Also known as rational process is intended to break a
problem down to its root cause.
- This process begins with an appraisal of the situation -
what are the priorities and orders for concerns for
specific issues?
- Next, the problem analysis is undertaken to get to the
cause of undesired events.
- Then, a decision analysis is tackled, outlining various
decisions that must be made.
- Finally, a potential problem analysis is made to ensure
that the actions decided upon in step three are
sustainable.
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HEALTH INFORMATION SYSTEM
FIRST SEMESTER / LESSON 1 – 8 / MIDTERMS TRANSES

 RPR PROBLEM DIAGNOSIS

- One final technique used in root cause analyses is the
RPR Problem diagnosis. RPR stands for "Rapid
Problem Resolution" and it deals with diagnosing the
causes of recurrent problems

THREE PHASES:
o DISCOVER – team members gather data and
analyze their finding
o INVESTIGATE – a diagnostic plan is created and
the root cause is identified through careful
analysis of the diagnostic data
o FIX – the problem is fixed and monitored to
ensure that proper root cause was identified

 ASK WHY 5 TIMES

- Useful for getting to the underlying causes of a problem.
- By identifying the problem, and then asking "why" five
times - getting progressively deeper into the problem,
the root cause can be strategically identified and
tackled.

TRANSCRIBED BY: YSABELA ANGELA MEJIA