File Name: design and implementation of health information systems .zip
This handbook proposes strategies that build on the experiences of immunisation information system IIS experts; provides case studies from actual programmes to highlight particular aspects of IIS practice, including functionalities, benefits, challenges, and implementation. An IIS can support authorities in guiding public health actions and constitute an integral part of well-functioning vaccine programmes. IIS are confidential, population-based, computerised information systems that record, store, and provide access to consolidated individual immunisation information. The full potential of IIS lies in their ability to better support vaccination programme monitoring by providing access to a large set of data on vaccination. The handbook proposes strategies that build on the experiences of IIS experts; provides case studies from actual programmes to highlight particular aspects of IIS practice, including functionalities, benefits, challenges, and implementation.
Information systems organization and administration 2. Data collection methods I. Lippeveld, Theo II. Sauerborn, Rainer III. Applications and enquiries should be addressed to the Office of Publications, World Health Organization, Geneva, Switzerland, which will be glad to provide the latest information on any changes made to the text, plans for new editions, and reprints and translations already available.
World Health Organization Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.
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Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The editors alone are responsible for the views expressed in this publication. Shrestha Introduction 49 A general framework for defining information needs and indicators 50 Performing a functional analysis at each management level of the health services system 51 Identifying information needs 51 Defining and classifying essential indicators 56 Selecting essential indicators 60 Summary 70 References 71 v.
Shrestha and Claude Bodart Introduction Data transmission Data processing Data quality Threats to data quality from poor recording and reporting Conclusion References Chapter 9 Population-based community health information systems by David Marsh Introduction History: population-based community approaches Rationale Development of population-based community health information systems Conclusion References Chapter 10 Management of health information systems by Eckhard Kleinau vi.
The editors were able quickly to agree on the basic orientation and content of the book to address the information needs of routine services management. The health professionals who were called upon to contribute chapters have extensive experience in health information systems development and use in many different situations.
Yet the task proved to be more daunting than we anticipated. There was, for instance, a need for a common conceptual framework. WHO has placed emphasis on addressing priority health and service problems, but emphasis on strengthening service performance particularly at the peripheral level proved to be a common principle among the contributors to this book. Only a few conceptual nuances, terms and styles of presentation required negotiation.
The development of health information systems is a fast-moving field. Not only is information technology changing rapidly, but concepts and methods for making the best use of existing data for managing health services and resources are quickly evolving. Efficiency in information management is becoming increasingly essential because of the concern for cost control in services and the way service staff spend their time.
Approaches such as the use of health indicators are rapidly becoming the norm rather than the exception in order to reduce data handling, while increasing validity and timeliness. Efficient use of minimum data for managing cases, clinics and community health is essential, and it is toward this end that this book has been designed.
WHO is pleased to present this collection of health information system concepts, experiences and examples. We encourage public health administrators to react to these chapters and share with us, and with each other, new methods and techniques for health information system development and use that have proved effective in their countries.
Their careful review of the manuscripts was extremely helpful. The Harvard Institute for International Development in Cambridge USA generously provided a grant to fund some of the time of the editors and other administrative costs. The editors also wish to thank Laraine and Don Lippincott for their editorial work. In the last 20 years, he assisted ministries of health in health information system restructuring in Cameroon, Chad, Pakistan, Eritrea, Niger, Palestine, and recently also in Morocco.
His experience as a health practitioner at the district level dates back to the years , when he worked as a district health physician in Burkina Faso. Sapirie has 30 years of experience in developing, applying and transferring methods in health planning, health programme evaluation and enhancing health information systems at global, regional and country levels. Laura B. Her research interests are in the areas of monitoring and evaluation, health and mortality, and ageing. David R. As a pediatrician and public health physician, he taught epidemiology and health systems development at the Aga Khan University, Karachi, Pakistan, and presently develops, monitors, evaluates, and documents primary health care programs in Africa, Asia, and Latin America.
Kleinau has more than 15 years of experience as a manager and consultant in public health and primary health care in Africa, Asia, Central America and the USA. Over the past 20 years, his career has combined public health work and information system development in a variety of developing countries. He joined the epidemiological evaluation unit of the Onchocerciasis Control Programme in West Africa in and carried out field epidemiological studies as well as biomedical research.
He is currently in charge of certification of elimination and eradication of diseases in the Communicable Diseases cluster at WHO. Good management is a prerequisite for increasing the efficiency of health services. The need to do more with less is especially important because the health sector faces ever increasing demands while receiving stagnant or decreasing resources.
Good management is also a prerequisite for increasing the effectiveness of health services. As an example, the effectiveness of polio vaccines may be diminished by breakdowns of the cold chain, incorrect assessment of the age of the child, failure to follow up on children who do not come for booster shots, and other such flaws.
The challenge for health systems is to optimize the management of service delivery in a way that minimizes losses in effectiveness. The World Health Organization WHO has long identified health information systems as critical for achieving health for all by the year Mahler, A report of a WHO meeting clearly links improved management to improved health information systems: Of the major obstacles to effective management, information support is the one most frequently cited.
Unger and Dujardin and Lippeveld et al. For information to influence management in an optimal way, it has to be used by decision-makers at each point of the management spiral.
Examples of these decision points include undertaking situational analysis, setting priorities, or implementing a programmed activity see Fig. Information is crucial at all management levels of the health services, from the periphery to the centre.
This means that not only policymakers and managers need to make use of information in decision making but also care providers, including doctors, health technicians, and community health workers.
Unless this occurs, the considerable opportunity costs involved in set-up and maintenance of health information systems can be difficult to justify. Helfenbein et al. Or as Newbrander and Thomason 1. Similarly, our hypothesis is that the development of rationally structured routine information systems, closely adapted to the information needs of health services at the district, health centre, and community levels, can potentially contribute to the overall improvement of health service management.
Definitions A system is conveniently defined as any collection of components that work together to achieve a common objective. The objective in the case of a health information system then is to improve health services management through optimal information support. We define information as a meaningful collection of facts or data. While consensus on the definition of system and information is quickly established, defining the term health information system is less obvious.
At the outset, health information systems were oriented to collect information on diseases surveillance and on health service output. While these functions are certainly important, we prefer to start from the definition of information systems as commonly used in industry. Hurtubise describes them as systems that provide specific 2. The ultimate objective of health information systems is therefore not to gain information but to improve action.
Applied to the health sector, we can now define health information systems as a set of components and procedures organized with the objective of generating information which will improve health care management decisions at all levels of the health system. The widely used term health management information system could be misleading, since it may suggest that there are different information systems for different functions, for example management information systems, epidemiological surveillance systems, and administrative information systems.
We consider all these as subsystems see also Chapter 2 of a unified health information system and therefore prefer the latter term.
In summary, health information systems integrate data collection, processing, reporting, and use of the information necessary for improving health service effectiveness and efficiency through better management at all levels of health services. What is wrong with current health information systems? Most health care providers in developing countries equate information systems with filling endless registers with names and addresses of patients, compiling information on diseases e.
Furthermore, the data received are often not helpful for management decision making because they are incomplete, inaccurate, untimely, obsolete, and unrelated to priority tasks and functions of local health personnel. Current health information systems are therefore widely seen as management obstacles rather than as tools.
The reasons can be summarized in five points: Irrelevance of the information gathered According to a WHO Expert Committee , Many of the data recorded and reported by the health service staff are not needed for the tasks the staff perform.
Yet data that are needed are frequently not collected. For example, appropriate indicators to monitor continuity of care of individual patients or clients are rarely included in health information systems. The common denominator of these two observations is a lack of a consensus between producers and users of data at each level of the health care system regarding the information needed.
For example, at the first level of care, auxiliary health staff without laboratory or X-ray facilities are required to report on diseases such as leishmaniasis, diphtheria, and peptic ulcer. Another reason data quality is low is lack of motivation among health services personnel. Duplication and waste among parallel health information systems Historically, national reporting systems, even in developed countries, are rarely the result of a coordinated effort to address information needs of health planners and managers.
Designed as vertically structured empires, these programmes replaced line managers with programme directors who managed separate categories of personnel, facilitated separate training programmes, and created separate programme information systems which tended to focus on one specific disease e.
These programme information systems existed side by side and in addition to the general routine health information system, which was considered insufficient and incapable of delivering the data needed for programme management. While these separate systems could indeed provide real information support for programmatic decisions, and the quality of information generated tended to be better than that of the general information system WHO, , the net result was that routine health information systems became chaotic and bothersome Ho, ; Foreit et al.
The literature reveals several design and implementation problems. The result is that health workers are drowned in a multitude of reports to be com- 4. Elimination of duplication and waste requires a unified system rather than better coordination among the existing parallel structures. Lack of timely reporting and feedback The process of transmitting, compiling, analysing, and presenting the data is usually so tedious that by the time a report is prepared, the data are frequently obsolete and decisions are often made without any information input.
Planners and managers face deadlines and time constraints in their daily decision making. Outdated information, even if of high quality, is of low value to them. Delays in data transmission and lack of feedback at the district level are often caused by the presence of strong vertical programmes.
Health facilities report data directly to national programme managers, and line managers at the district level receive outdated feedback reports, if any. Poor use of information Despite the evidence that much of the generated data is irrelevant, of poor quality, redundant, or obsolete, there are nonetheless some useful data sets available. Unfortunately, researchers have not adequately evaluated or documented information use, and the prevailing sentiment that information is poorly used is based mainly on anecdotal evidence.
However, a few existing studies do point to some of the culprits. This raises serious concerns, given the current effort to decentralize decision making and build capacity at the district level. Dunn revealed another impediment to ensuring use of information: the difference in culture between data people and decisionmakers, which is difficult to bridge.
Consequently, planning and management staff rely primarily on gut feelings to formulate ad hoc decisions rather than seek pertinent data. We will explore the factors that lead to the failure to use information and provide suggestions for solving this problem in Chapter 3.
Efforts to reform health information systems The chaotic status and inefficiency of most existing information systems in developing countries are linked to the structural weakness of the system and lack of integration in the overall health system.
This can be explained by the fact that historically, as in most developed countries, information systems were not intentionally planned to provide management support to the health services in an integrated way.
However, an innovative and reliable way to safeguard the identity of individuals and provide protection of medical records from criminals is already in effect. Design and Implementation of Healthcare Biometric Systems provides innovative insights into medical identity theft and the benefits behind biometrics technologies that could be offered to protect medical records from hackers and malicious users. The content within this publication represents the work of ASD screening systems, healthcare management, and patient rehabilitation. It is designed for educators, researchers, faculty members, industry practitioners, graduate students, and professionals working with healthcare services and covers topics centered on understanding the practical essence of next-generation healthcare biometrics systems and future research directions. Buy Hardcover. Add to Cart.
Teamwork in health is defined as two or more people who interact interdependently with a common purpose, working toward measurable goals that benefit from leadership that maintains stability while encouraging honest discussion and problem solving. Researchers have found that integrating services among many health providers is a key component to better treat undeserved populations and communities with limited access to health care. As in many developing countries, lack of reliable data and grossly inadequate appreciation and use of available information in planning and management of health services were two main weaknesses of the health information systems in Malawi. As a first step towards conceptualization and design of the system, a minimum set of indicators was identified and a strategy was formulated for establishing a system in the country. The information provided on this website is not official U. Government information and does not represent the views or positions of the U.
Information systems organization and administration 2. Data collection methods I. Lippeveld, Theo II. Sauerborn, Rainer III. Applications and enquiries should be addressed to the Office of Publications, World Health Organization, Geneva, Switzerland, which will be glad to provide the latest information on any changes made to the text, plans for new editions, and reprints and translations already available. World Health Organization Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved.
Design and implementation of health information systems I edited by Theo Lippeveld,. Rainer Sauerborn, Claude Bodart. nformation systems-organization and.
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Introduction Health information systems encompass the range of technology in health care used to acquire, store, deliver and analyze medical data. In particular, healthcare provider order entry, has been shown to reduce medical errors, while systems that display recently completed laboratory testing may decrease redundant testing. Despite these benefits, hospitals have been slow to adopt these technologies.
Я говорю о наших собственных гражданах. О юристах, фанатичных борцах за гражданские права, о Фонде электронных границ - они все приняли в этом участие, но дело в другом. Дело в людях. Они потеряли веру.
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