Lesson 5

• Health informatics


  The application of both technology and systems in a healthcare setting
• Health Information Technology


  Focuses on tools
• Health Information Systems


  Cover the records, coding, documentation, and administration of patient and ancillary services
• Concerns about the cost and quality of healthcare are among the motivating factors why Health Information Systems are increasingly implemented across health industries all over the world
• The combination of elements in an HIS enables the provision of more efficient and effective healthcare services
• Health information systems


  Any system that "captures, stores, manages, or transmits information related to the health of individuals or the activities of organizations that work within the health sector"
• Examples of health information systems

  • District-level routine information systems
  • Disease surveillance systems
  • Laboratory information systems
  • Hospital patient administration systems (PAS)
  • Human resource management information systems (HRMIS)
• Well-functioning HIS


  • Integrated effort to collect, process, report, and use health information and knowledge to influence policy and decision-making, program action, individual and public health outcomes, and research
• Decisions informed by evidence

  Contribute to more efficient resource allocation
• Information about the quality and effectiveness of services


  Can contribute to better outcomes
• Sustainable HIS

  • Close to the source of collection, not overburden health delivery staff, not too expensive to run
• Employees


  • Need feedback on how the routine data they collect can be utilized and to understand the significance of good quality data for improving health
• Role of HIS

  Mechanism to keep track of everything related to patients, from patient's medical history, to medication logs, contact information, appointment times, insurance information, and billing and payment accounts
• Well-implemented HIS


  • Files are easier to access
  • More controls
  • Easy to update
  • Enables communication between multiple doctors or hospitals
• A good Health Information System delivers accurate information in a timely manner, enabling decision-makers to make better-informed choices about different aspects of the health institution, from patient care to annual budgets
• A good Health Information System upholds transparency and accountability due to the easier access to information
• Components of a Health Information System

  • Health information system resources
  • Indicators
  • Data sources
  • Data management
  • Information products
  • Dissemination and use
• Health information system resources


  Legislative, regulatory, and planning frameworks required to ensure a fully functioning health information system, and the resources that are prerequisites for such a system to be functional (personnel, financing, logistics support, information and communications technology (ICT), and coordinating mechanisms)
• Indicators

  A core set of indicators and related targets for the three domains of health information (determinants of health; health system inputs, outputs, and outcomes; and health status)
• Data sources

  • Population-based approaches (censuses, civil registration, and population surveys)
  • Institution-based data (individual records, service records, and resource records)
• Data management


  Covers all aspects of data handling: collection, storage, quality-assurance, flow, processing, compilation, and analysis
• Information products

  Data must be transformed into information that will become the basis for evidence and knowledge to shape health action
• Dissemination and use


  The value of health information can be enhanced by making it readily accessible to decision-makers and by providing incentives for information use
• Sources of Information for HIS

  • Demographic Data
  • Administrative Data
  • Health Risk Information
  • Health Status
  • Patient Medical History
  • Current Medical Management
  • Outcomes Data
• Demographic data


  Facts such as age (or birth date), gender, race and ethnic origin, marital status, address of residence, names of and other information about immediate family members, and emergency information. Information about employment status (and employer), schooling, and education.
• Administrative data


  Facts, with respect to services provided (e.g., diagnostic tests or outpatient procedures), and also typically include charges and amounts paid, the kind of practitioner (physician, podiatrist, 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


  Reveals lifestyle and behavior (e.g., whether an individual uses tobacco products or engages regularly in strenuous exercise) and facts about family history and genetic factors to evaluate propensity for different diseases.
• Health status (or health-related quality of life)


  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


  Data on previous medical encounters such as hospital admissions, surgical procedures, pregnancies and live births, and the like; it also includes information on past medical problems and possibly family history or events (e.g., alcoholism or parental divorce).
• Current medical management

  Includes the content of encounter forms or parts of the patient record. Such information might reflect health screening, current health problems and diagnoses, allergies (especially those to medications), diagnostic or therapeutic procedures performed, laboratory tests carried out, medications prescribed, and counseling provided.
• Outcomes data


  A wide array of measures of the effects of health care and the aftermath of various health problems; they might 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, and by means of reports directly from individuals (or family members), are desirable, although these are likely to be the least commonly available