AN INTRODUCTION TO HEALTH INFORMATION SYSTEMS (HIS)

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WHAT IS HIS?

• Health Information System : One that supports all hospital functions and activities such as patient records, scheduling, administration, charge-back and billing, and often links to or includes clinical information systems such as RIS. (Radiology Information System )

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ICT

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• Part of a HIS in which computer systems are used as ICT-tools (information and communication technology ) is referred to as its computer-supported part

• The remainder is being referred to as the non-computer-supported part

WHAT IS HIS? the question is not

whether a hospital should be equipped with a hospital information system or not,

but an appropriate question would be ... whether the performance should be

enhanced, for example, by using state of the art ICT-tools

HIS must consider all areas of a hospital: wards outpatient units service units (diagnostic, therapy, others) administrative departments management/executive units 4

WHAT IS HIS? HIS must consider all groups of persons

physicians nurses administrative staff technical staff health informaticians / health information

managers ...

... and last, but not least, patients visitors suppliers ... 5

WHAT IS A HIS?

Definitions of HIS abound Occram’s rule!

“an integrated effort to collect, process, report and use health information and knowledge to influence policy-making, programme action and research” WHO (2000) Guidance on Needs Assessment for National Health Information Systems Development.

“a set of interrelated components working together to gather, retrieve, process, store and disseminate information to support the activities of health system planning, control, coordination and decision-making, both in management and service delivery” Jack Smith, in: Health Management Information Systems – a handbook for decision makers. OUP, 2000.

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Hospital Information System

Registration Consulting Ward Nursing

Pharmacy

Stores & Purchase

RadiologyLaboratoryBlood Bank

Diet & Kitchen

And more...

BENEFITS OF HIS

Investment in HIS may result in many benefits (WHO):

helping decision makers to detect and control emerging and endemic health problems, monitor progress towards health goals, and promote equity;

empowering individuals and communities with timely and understandable health-related information, and drive improvements in quality of services;

strengthening the evidence base for effective health policies, permitting evaluation of scale-up efforts, and enabling innovation through research;

improving governance, mobilising new resources, and ensuring accountability in the way they are used. 8

HEALTH CARE DATATYPES OF HEALTH CARE DATA

Patient-Specific Data Clinical Data Administrative Data Financial and Billing DataAggregate Health Care Data Disease and Procedure Indexes Cost Reports Health Care Statistics Outcome Measures and Balanced

Scorecards

HEALTH CARE INFORMATION SYSTEMS

Foundational Terms & DefinitionsNHIN – National Health Information

NetworkAn Internet-based data exchange that will allow medical providers to share health data to improve care

Automated prescriptionsAccuracy of patient information

FOUNDATIONAL TERMS & DEFINITIONS

RHIO (Regional Health Information Organization):A regional organization of stakeholders enabling the exchange and use of health information to facilitate improvements in healthcare quality .

FOUNDATIONAL TERMS & DEFINITIONS

EMR – Electronic Medical RecordAn Electronic Medical Record

facilitates:access of patient data by clinical staff at any given location

accurate and complete claims processing by insurance companies

building automated checks for drug and allergy interactions

clinical notes prescriptions scheduling sending to and viewing labs

INFORMATICS TERMS AND DEFINITIONS

PHR – Personal Health RecordThe Personal Health Record (PHR) is an Internet-based set of tools that allows people to access and coordinate their lifelong health information and make appropriate parts of it available to those who need it.

INFORMATICS TERMS AND DEFINITIONS

PHR’s offer an integrated and comprehensive view of health information, including information people generate themselves such as symptoms and medication use, information from doctors such as diagnoses and test results, and information from their pharmacies and insurance companies.

Individuals access their PHRs via the Internet, using state-of-the-art security and privacy controls, at any time and from any location.

Access on a local computer with download capabilities

Paper records

PHR

Family members, doctors or school nurses can see portions of a PHR whennecessary and emergency room staff can retrieve vital information from it in a crisis.

People can use their PHR as a communications hub: to send email to doctors, transfer information to specialists, receive test results and access online self-help tools. PHR connects each of us to the incredible potential of modern health care and gives us control over our own information.

FOUNDATIONAL TERMS & DEFINITIONS

HIPAA Assurance: The Health Insurance Portability and

Accountability Act mandates that healthcare providers and health plans protect the privacy of patient records; one implication for medical IT providers is that a VPN can be used to secure transmission of medical records over the Internet

TYPES OF (HEALTH) INFORMATION SYSTEMS

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Strategic information

systems

Tactical information systems

Operational information systems

Decision support systems, simulation systems, financial forecasting, performance assessment

Management information systems

Electronic patient records, payroll, invoicing systems, patient administration systems, purchasing/inventory, office automation

Artificial Intelligence

HEALTH INFORMATION SUBSYSTEMS

A health information system can be considered to consist of several separate subsystems:

Data collection based on patient and service records and reporting from community health workers, health workers and health facilities

Programme-specific monitoring and evaluation(ex: EPI, Malaria, TB, HIV/AIDS)

Administration and resource management(budget, personnel, supplies)

Disease surveillance and outbreak notification

Data generated through household surveys (KPC, DHS)

Registration of vital events and censuses (births, deaths and causes of death)

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Administrative data

Routine service

data

Figure 3 - Health information sub-systems rarely interact

Householdsurveys

Census Behaviouralrisk

surveys

Behavioursurveys

EPI surveys

Vital registration

TBHIVMCH/FPEPI

MCH/FPHIVmalariaWater/san

Disease surveillance

HIVSTI

HIVEbolacancer

smokingexercisenutrition

MCHcauseofdeath

costsresources

HIS subsystems rarely interact

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Development steps of HIS

Management Information

System

Clinical Information

System

MIS

CIS

GMIS

Geographical Management Information System

THIS INFORMATION CAN BE CATEGORIZED AS

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INFORMATION WILL BE USED BY THE AREAS

Patient Administration Clinical Management Resource Management Financial Management Management Information System And more…

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Laboratory

Pharmacy

Radiology

Data Entry& Results Review

EventMonitor

Billing &Financial

MedicalLogic

Modules

MedicalEntities

Dictionary

DatabaseInterface

PatientDatabase

ResearchDatabases

Specialized Encoders MedLEE

HIS HAVE THE ABILITY TO LINK THE FOLLOWING MAJOR PLAYERS

Laboratories Pharmacies Researchers Doctors and consultants Banks and financial institutions Administrators And knowledge managers

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HIS should provide information, primarily about patients, in a way

that it is correct, pertinent and up to date, in time, accessible by the right persons at the right site in a usable format

knowledge, primarily about diseases, but also, for example, about the effects of drug interaction, to support diagnosis and therapy

information about the quality of patient care, hospital performance and costs

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