Official Lecture#5 - Health Information Systems

Tuesday, 27 September 2022 12:11 PM

HIS Lec
1ST SEMESTER DISCUSSION NOTES
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Health Information Systems
- The application of both technology and systems in a health care setting.
- While health information technology [HIT] focuses on tools and is a subset of HIS, health
information systems [HIS] cover the records, coding, documentation, & administration of
patient & ancillary services.
- HIS is the umbrella term for all the systems―it includes the people & the processes designed
to create, store, manipulate, distribute, & disseminate information.
- HIT, on the other hand, involves the technology involved in the systems themselves (e.g.,
hardwares, softwares, data bases, and etc.)―it includes the study, the design, the
implementation, support, or management of computer-based information systems.
- Concerns about the cost & quality of health care are among the motivating factors why
health information systems are increasingly implemented across health industries all over
the world.
- The combination of elements in a health information system enables the provision of more efficient and effective health care services.
- The components of a health information system [HIS] are correlated and translated into harmonious operations.
- According to Sheahan (2017), he defines HIS as "…a mechanism which keeps track of everything related to the patient such as the patient's medical history, contact
information, medication logs, appointment schedule, insurance information, & financial accounts including billing and payment."―HIS covers a large scope.
- In essence, health information systems [HIS] cover different systems that capture, store, manage, and transmit health-related information that can be sourced from
individuals or activities of a health institution.
- Different systems it covers include:
► Disease surveillance systems
► District-level routine information systems
► Hospital patient administration systems [PAS]
► Human resource management information systems [HRMIS]
► Laboratory information systems [LIS]
- The information collected from a well-functioning HIS is very useful in policymaking and decision-making of health institutions.
- Such information then becomes the basis in creating program action, mobilization, & general improvement of public health―this translates to efficient resource
allocation at the policy level (better aligned to needs), and improvement of the quality and effectiveness of health at the delivery level.
- HIS should have the ff. properties:
► Sustainable - policies, protocols, & goals implemented should be sustainable in the long-run.
► User-friendly - even if endorsed from one administration to another generation, whoever will be in-charge should be to use the system proficiently and without
much difficulty; This applies especially to end-users which comprise doctors, healthcare professionals, & patients who want to look at their own records.
► Economical
- According to Pacific Health Information Network (2016), health care personnel should be educated on the use of the routine data collected from the system and the
significance of good quality data in improving health.

Roles & Functions of Health Information Systems

- A good HIS delivers accurate information in a timely manner, enabling decision-makers to make informed choices about the different aspects of the health institution,
from patient care to annual budgets.
- It also upholds transparency and accountability due to easier access to information.
- General roles & functions of a HIS include:
(1) Easier access to files
- The systems have revolutionized the collection & management of patient information.
- The need for a hardcopy of the patient's medical records becomes optional as the systems are electronic.
- Patient information becomes accessible to both the patient and healthcare providers, eliminating situational threats that involve data compromise such as those
that stem from mere negligence.
(2) Better control
- Only authorized personnel can have access to information on the patient's health.
- Doctors may be given permission to update patient information while a receptionist may only have the authority to update a patient's appointments.
- Those who access the data and make changes have their identity identified & recorded accordingly to ensure a non-anonymous movement.
- Receptionists may only have the authority to update any appointment-level changes.
(3) Easier update
- After the creation of the record, patient information can be accessed and reviewed any time and copies can be printed or released to the patient upon request.
(4) Improved communications
- HIS assists communication among doctors & hospitals.
- However, medical professionals must adhere to regulations on patient privacy & security to ensure that information is kept confidential and safe from
unauthorized access―those who can access the patient's information should be limited to those in authority or human medical staff directly invol ved in the
patient's care & treatment.
- One of the most important issues & concerns that we need to remember when talking about data, is the privacy of salient information from patients.

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COMPOENNTS OF HEALTH INFORMATION SYSTEM
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Components of Health Information Systems
- The Health Metrics Network [HMN], in its Framework & Standards for Country Health Information Systems (2008), defines health information systems as consisting
of 6 critical components.
- Includes:
(1) Health information systems resources
- These include the framework on legislation, regulation, planning, and the resources required for the system to be fully functional.

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 - These include the framework on legislation, regulation, planning, and the resources required for the system to be fully functional.
- Where the funds come from for a HIS to work at its maximum potential.
- Includes:
► Personnel
► Logistics support
► Financing
► ICT
► Component's coordinating mechanism
(2) Indicators
- The basis of the HIS plan & strategy includes indicators and related targets such as the determinants of health.
- Indicators include:
► Health system inputs
► Health system outputs
► Health system outcomes
► Health status
- According to WHO, there are (4) determinants of health:
(1) Social & economic environment
(2) Physical environment
(3) Person's individual characteristics
(4) Person's individual behaviors
(3) Data sources
- Divided into:
(1) Population-based approaches
- Includes:
► Civil registration
► Censuses
► Population surveys
(2) Institution-based data
- Includes:
► Individual records
► Resource records
► Service records
(*3) Community-based approaches
- Not directly classified under the other 2 main categories, but may provide useful information.
- Includes:
► Occasional health surveys
► Research & other information produced by community-based organizations
(4) Data management
- Refers to the handling of data, starting from collection & storage to data flow & quality assurance, processing, compilation, & data analysis.
(5) Information products
- Data is transformed into useful information that serves as evidence and provides insight crucial to shaping a health action.
- Encompasses the result that you will obtain out of the data gathered.
(6) Dissemination and use
- HIS enhances the value of health information by making it readily available to policymakers (to be able to allocate funds & implement/modify/retract laws
accordingly) and data users.
- These 6 components of HIS can be broadly categorized into:
(1) Inputs
- Refer to the HIS resources.
- These resources include health, institutional coordinations, & leadership, health
information policies, financial & human resources, and infrastructures.
(2) Processes
- Refer to the indicators, data sources, & data management.
- Core indicators are needed as bases for program planning, monitoring, & evaluation.
- Population- and institution-based sources are also essential for decision-making as they
provide guide to health service delivery.
- Importantly, these data must be accessible and understandable by users & policymakers.
(3) Outputs
- Refer to the transformation of data into information that can be used for decision-making and to the dissemination & use of such information.

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DIFFERENT DATA SOURCES FOR HEALTH INFORMATION SYSTEMS
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Different Data Sources for Health Information Systems
- Donaldson & Lohr (1994) explains that a comprehensive database for health information systems include the integration of 7 different data sources.
- Includes:
(1) Demographic data
- Refers to the facts about the patient which include age & birthdate, gender, marital status, address of residence, race, & ethnic origin.
- Information on educational background & employment is also recorded along with
information on immediate family members to be contacted during emergency.

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 Includes:
(1) Demographic data
- Refers to the facts about the patient which include age & birthdate, gender, marital status, address of residence, race, & ethnic origin.
- Information on educational background & employment is also recorded along with
information on immediate family members to be contacted during emergency.
- Includes:
Age Birthdate Gender Marital status
Address of Race & ethnic Educational background & Immediate family
residence origin employment members
- These include data that can be answered by the patient himself/herself or any
representative immediate family member.
(2) Administrative data
- Includes information on services.
- Includes:
Diagnostic tests Outpatient procedures Kind of practitioner
Physician's specialty Nature of institution Charges & payments
(3) Health risk information
- Records the lifestyle & behavior (e.g., use of tobacco products or engagement in strenuous activities) of a patient and facts about his/her family's medical
history and other genetic factors―pertains to the information handled on the administrative side.
- This information is used to evaluate the patient's propensity for different diseases―determines what diseases are prone to manifest in the patient in
accordance to the lifestyle the patient has been practicing for a long time (e.g., habits acquired/practiced).
(4) Health status
- Refers to the quality of life that a patient leads which is crucial to his or her health.
- This shows the domains of health.
- Domains of health include:
(1) Physical functioning
(2) Mental & emotional well-being
(3) Cognitive functioning
(4) Social functioning
- It also shows one's perception of his/her health in comparison with that of his/her peers (gauging one's health in comparison to others surrounding you).
(5) Patient medical history
- Gives information on past medical encounters like hospital admissions, pregnancies & live births, surgical procedures, and the like.
- It also includes previous illnesses & family history (e.g., alcoholism or parental divorce).
- Includes:
Hospital admissions Pregnancies & live births Surgical procedures
Previous illnesses (e.g., alcoholism) Family history (e.g., parental divorce)
(6) Current medical management
- Reflects the patient's up-to-date or out-standing status of care, treatment, diagnoses, and overall medical management.
- Includes:
Health screening sessions Diagnoses Allergies (especially on medications) Current health problems
Medications Diagnostic or therapeutic procedures Laboratory tests Counselling on health problems
(7) Outcomes data
- Presents the measures of aftereffects of health care and of various health problems.
- These data usually show the health care events (e.g., readmission to hospitals, unexpected complications or side effects) and measures of satisfaction with care.
- Outcomes directly reported by the patient after treatment will be most useful (was a patient triage-d for a long time? was the delivery of care efficient?).
- Surveys are usually administered to patients (and sometimes watchers as well) once they are discharged from their admission to accomplish this.

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Health Information Systems Video Link: Lesson 5 Health Information Systems

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