Unit 2: Health Informatics, Health Information Technology & Health Management

Information System

Topic 1. Health Informatics

Introduction

Public health informatics is the application of computer science and information

technology to public health. The patient health information system is an example
on how data are being collected, stored and retrieved in an instant manner. This
may give a chance to every patient enjoy the quick services in the hospitals.

Topic 1 will guide the learners to define health informatics and its role in health
the care environment.

Learning Objectives

At the end of the unit, you should be able to:

 define health informatics
 Identify the advantages and disadvantages of health informatics in the
cloud
 Discuss health informatics in the Philippines

Presentation of Contents

A. HEALTH INFORMATICS.

Health Informatics applies the principles of information science to solve problems using
data. It involves the practice of information processing and the engineering
of information systems. The field considers the interaction between humans and
information alongside the construction of interfaces, organizations, technologies and
systems. As such, informatics encompasses many academic disciplines,
including computer science, information systems, information technology and statistics.
Since the advent of computers, individuals and organizations increasingly process
information digitally. This has led to the study of informatics with computational,
mathematical, biological, cognitive and social aspects, including study of the social
impact of information technologies.

 Figure 2.1 below defines the health informatics as an application technology tools
and information systems in a healthcare setting or context.
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Information System

Public health informatics describes the application of informatics techniques in managing

the proper care to every patient. Its main focus is on the health of the population
including the social problems associated with burden of chronic illnesses. The term e-
health is often used to denote consumer and patient perspective, whether it refers to the
personal health record or to access to the medical record created by the health team
during the course of care. Once almost impossible to obtain without a lengthy wait and
without paying for copying charges, one’s own medical record in electronic form is
potentially only a few clicks away. Timothy Schultz presents examples of the application
of big data technology across the pharmaceutical life cycle – from genomics and drug
development through clinical monitoring, and finally pharmacovigilance, the detection,
assessment and prevention of the adverse effect of drugs.

Health Informatics in the Cloud

The role of cloud technology is undeniably significant in our everyday lives. Currently,
83 percent of the health care organizations are making use of clinical-based
applications, and it is changing the landscape of the health care system and health
informatics. However, both benefits and threats exist (University of Illinois, 2014)

Advantages of Cloud Technology

1. Integrated and Efficient Patient Care. Cloud technology offers a single
access point for patient information which allows multiple doctors to review
laboratory results or notes on patients. Physicians can spend more time
deciding and performing patient treatment instead of waiting for information
from different departments.
2. Better Management of Data. The accumulations of electronic health records
will allow more meaningful data mining that can better assess the health of
the general public. More data can mean more opportunities to identify trends
in diseases and crisis.
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Disadvantages of Cloud Technology

1. Potential Risks to Personal Information. The strength of cloud technology is
also the very characteristics that makes it vulnerable to data breaches. The
information contained within medical records may be subjected to theft, or
other violations of privacy and confidentiality.
2. Cloud Setup Seems Cumbersome. The transition of a traditional to an
automated system might be difficult for some members of the health care
organization that may not be familiar with cloud technology.

Health Informatics in the Philippines.

The Philippines used the Community Health Information Tracking System (CHIT), an
electronic medical record developed through the collaboration of Information and
Communication Technology (ICT) community and health workers, primarily designed for
use in the Philippines health centers in disadvantaged areas.

Despite the development of health informatics in the Philippines, still suffers from issues
that humper progress, one this is the lack of interest in the field, decision makers do not
use the benefits of information technology in the health sector. The large initial
expenditure for a health information system remains another barrier to the integration of
IT in the Philippines health care system

Topic 2. Health Information Technology

Introduction

Health Information Technology (HIT) is an area in information technology involving

various tasks in order to improve the medical care in the country.

Topic 2 will guide the learners to identify the technological systems needed in the health
care industry.

Learning Objectives

At the end of the topic, you should have been able to:

 define health information technology, health interoperability ecosystem, and

 identify the different types and functions of health information technology in
the health care industry.
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Presentation of Contents

B. HEALTH INFORMATION TECHNOLOGY (HIT)

Rouse (2016) defines Health Information Technology (HIT) as the area of Information
Technology (IT) involving the designs, development, creation, use, and maintenance of
information systems for the health care industry. Automated and interoperable health
care information systems are expected to improve the medical care, lower costs,
increase efficiency, reduce error, and improve patient satisfaction while also optimizing
reimbursement for ambulatory and in-patient health care providers.

Health information technology vows to provide innovative to health care delivery and
connection among users and stakeholders in the e-health market. Systems such as
electronic health records, decision support systems, and personal health records are
promising and are becoming widely deployed worldwide (Kushniruk & Borycki, 2017).

Rouse (2016) enumerates the following types of health information technology:

a. EHR - Electronic Health Record, also called Electronic Medical Record
(EMR). One of the fundamental components of health information technology
infrastructure.
b. PHR – Personal Health Record. A personal self-maintained health record;
c. HIE – Health Information Exchange. Is the health data clearing house which
is comprised of health care organizations with interoperability pact to share
data among their health information technology systems.
d. PACS – Picture Archiving and Communication Systems.
e. VNA – Vendor Neutral Archives.
f. PACS and VNAs integrate radiology into the main hospital workflow.
Radiology used the primary repository for medical images. Other specialties
such as cardiology and neurology are also among the large scale producers
of images.

Topic 3. Health Information Management

Introduction

Health Information Management (HIM) is specially designed to assist in the

management and planning of health programmes as opposed to delivery of care. (WHO)

Topic 3 will guide the learners to identify the health information management system in
the health care industry.

Learning Objectives
 Unit 2: Health Informatics, Health Information Technology & Health Management
Information System

At the end of the unit, you should be able to:

 define health information management system (HIMS),
 identify the roles and functions of HMIS, and
 discuss the three fundamental information processing phases: data input, data
process/management and data output.

Presentation of Contents

HEALTH INFORMATION MANAGEMENT (HIMS)

Health Information Management System - Also known as HIMS, is “specially designed to

assist in the management and planning of health programmes, as opposed to the
delivery of care-WHO 2004”. The health components of HIMS refers to clinical studies to
understand medical terminologies, clinical procedures, and database processes;
management refers to the principles that help administer the health care enterprise, and
information system refers to the ability to analyze and implement applications for
efficient and effective transfer of patient information. An HMIS is one of the six building
blocks essential for health system strengthening. It is a data collection system
specifically designed to support planning, management, and decision making in health
facilities and organizations.
HIMS is a set of integrated components and procedures organized with the objective of
generating information that will improve health care management decisions at all levels
of the health system. It is a routine monitoring system that evaluates the process with
the intention of providing warning signals through the use of indicators. As the health
unit level, HMIS is used by the health unit in-charge and health unit management
committee to plan and coordinate health care services in their catchment area.

 HMIS was developed with the framework of the following concepts (Republic of
Uganda Ministry of Health Resource Center, 2010).
 The information collected is relevant to the policies and goals of the health care
institution, and to the responsibilities of the health professionals at the level of
collection.
 The information collected is functional as it is to be used immediately for
management and should not wait for feedback from higher levels.
 Information collection is integrated for these is one set of form and no duplication
of reporting.
 The information is collected on a routine basis from every health unit.

Roles of HMIS

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. In addition to encouraging the
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use of health information in hospitals. It also iams to aid in the setting of performance at
all levels of health service delivery and to assist in assessing performance at all levels of
the health sector. (Republic of Ugaddan Ministry of Health Resource Center 2010).

AN HMIS needs to be complete, consistent, clear, simple, cost-effective, accessible, and

confidential (Janneth, 2002). It should be complete with all information but avoiding
duplication and consistent in assigning definitions to similar information from various
sources. It should also be simply to use and clear as to what is measured by the
elements. The elible users must have access and should be able to use the system with
ease. The confidentiality of patient information and data privacy should always be a top
priority. While providing all these benefits, the system must prove its cost-effectiveness
through its operation.

Functions of HMIS

The information form an HMIS should be used in planning, epidemic prediction and
decision, designing interventions, monitoring, and resource allocation (Republic of
Ugaddan Ministry of Health Resource Center 2010).

Historically, the aforementioned systems, including HMIS, are build ipon the
conceptualization of three fundamental information- processing phases: data input, data
management and data output. Each phase comes with elements (Tan, 2010).

1. Data input includes data acquisition and data verification.

a. Data acquisition refers to the generation and collection of data through input
of standard coded formats (e.g., bar codes) to assist in the faster mechanical
reading and capturing of data
b. Data verification involves data authentication and validation. The authority,
validity, and reliability of the data sources help ensure quality of gathered
data.
2. Data Management. Also called processing phase. Indicates data storage, data
classification, data update, and data computation
3. Data output includes data retrieval and data presentation

List of Functions of HMIS

1. Client data releases to all the information of the client which is related to his or
her transactions, reports, and other information such as client billing data, clinical
data, and other client data.
2. Scheduling is observed to distribute resources to areas that need them. An
example is the linking of schedule to the billing of the entity.
3. Authorized tracking focuses on monitoring of the authorized personnel and their
used of the authorized units.
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Information System

4. Billing refers to the notification of the charges for the patient and other related
documents such as the compliant electronic claim.
5. Accounts receivables (A/R) management ensures that customers are properly
notified above their bill and will settle it accordingly. Data for A/R management
include tracking aging of unpaid services, tracking reasons for denials, and aged
receivable report by prayer source.
6. Reporting refers to the reports issued by the entity which could be basic reports
or report writer.
7. Medical record, also called an electronic health records (EHR), is a collection of
digital information about a patient. Aside from patient registration, the data could
include assessment and treatment plan, and progress/encounter notes.
8. Compliance refers to procedure that should be followed for the improvement of
the condition of the patient or service provided such as treatment plan and
progress notes.
9. Financial data refers to information relating to the performance of the entity
collected for administering purposes. These include financial reports, general
ledger, payroll, and accounts payable.

Determinants of HMIS Performance Area

The determinants affecting the performance of HMIS may be behavioral, organizational
and technical.

Behavioral determinants. The data collection 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. The chance of the task being
performed is affected by the individual perceptions on the outcome and the complexity of
the task (Aqil, Lippeveld, & Hozumi, 2009). Lack of motivation and enough knowledge
on the use of data has been found to be a major drawback in the data quality and
information use. Changing people’s attitude towards data collection and analysis is
necessary in order to maximize the performance of the RHIS process (Routine Health
Information Network, 2003).

Organization determinants. The important factors that affect the development of the
RHIS process are the structure of the health institution, resources, procedures, support
services, and the culture within the segmentation Aqil, Lippeveld, & Hozumi, 2009).
However, other factors which include lack of funds, human resources and management
support contribute to the determinant of RHIS process.

Having system is place which supports data collection and analysis and transforms it
into useful information will help in promoting evidence based decision-making. Thus, all
components within the system are ideal in making the RHIS perform better. As
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improved RHIS performance means an effective organization culture that promotes

information use by collecting, analyzing and using information to accomplish the
organization’s goals and mission (Sanga, 2015).

Technical determinants. Technical factors involve the overall design used int eh
collection of information. It comprises the complexity of the reporting forms, the
procedure set forward in the collection of data and the overall design of the computer
software used int eh collection of information (Sanga, 2015).

PRISM Framework

The performance of Performance of Routine Information System Management (PRISM)

is a conceptual framework that broadens the analysis of HMIS or RHIS by including the
three determinants of HMIS performance, namely:

Behavioral determinants – knowledge, skills, attitudes, values, and motivation of the

people who collect and use the data.

Organizational/environment determinants – information culture, structure, resources,

rules, and responsibilities of the health system and key contribution at each level, and
Technical determinants - data collection process, systems, forms, and methods.

This framework identifies the strengths and weaknesses in certain areas, as well as the
correlation among these areas. This assessment aids in designing and prioritizing
interventions to improve RHIS performance, which in turn improves the performance of
the health system.

The PRISM framework, founded on performance improvement principles, defines the

various components of the routine health information system and their linkages to
produce better quality data and continuous use of information, leading to better health
system performance and, consequently, better health outcomes (Aqil, Lippeveld, &
Hrozumi, 2009).

Summary:

 A health management information system (HMIS) is “specially designed to assist

in the management and planning of health programmes, as opposed to the
delivery of care-WHO 2004”.
 The major role of HMIS is to provide quality information to support decision
making at all levels of health care system in any medical institutions.
 HMIS are built upon the conceptualization of three fundamental information
processing hases: data input, data management, and data output. Each phase
 Unit 2: Health Informatics, Health Information Technology & Health Management
Information System

comes with elements that perform specific functions. The eight elements are:
data acquisition, verification, classification, computation, update, retrieve and
presentation.
 The determinants affecting HMIS performance are behavioral, organizational and
technical.
 The PRISM framework defines various components of the RHIS and their
linkages to produce better quality data and continuous use of information, leading
to better health system performance and, consequently, better health outcomes.

Application

Activity No. 2: Designing Patient Information Form using Visual Studio 2008
(YouTube Link)

1. Create a project in Visual Studio 2008 and name it as HIS (Figure 1).

Figure 1 Visual Studio 2008 Interface

2. Design a Main Form for the Health Information System (Figure 2).
Unit 2: Health Informatics, Health Information Technology & Health Management
Information System

Figure 2 Main Form

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3. Design a form and add controls for the following information of Patient: (Figure
3)

Information Control Properties

Label Text: Full Name
Full Name
TextBox Name: txtfullname
Label Text: Address
Address
TextBox Name: txtaddress
Label Text: Birth Date
Birth Date DateTImePicker Name: dtpbirthdate
Format: Short
Label Text: Gender
ComboBox Name: cmbgender
Gender
Items: Female
Male
Label Text: Civil Status
ComboBox Name: cmbcivilstatus
Civil Status Items: Single
Married
Widowed
Label Text: Contact Number
Contact Number
TextBox Name: txtcontactno

Figure 3 Patient Form

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4. Design a form and add controls for the following information of Physician:
(Figure 4)

Information Control Properties

Label Text: Full Name
Full Name
TextBox Name: txtfullname
Label Text: Contact Number
Contact Number
TextBox Name: txtcontactno
Label Text: Professional Fee
Professional
DateTImePicker Name:
Fee
txtprofessionalfee

Figure 4 Physician Form

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Feedback

1. List down all the acronyms used in the lesson and give the meaning.

Acronym Meaning
1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

2. Differentiate between Health Information Technology versus Health

Informatics
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3. What are the tasks of Health Information Management in the CHITS? List
down at least 5 main functions.

References:

1. Ebuen, B. U. et. al. (2019). HEALTH INFORMATION SYSTEM for MEDICAL

LABORATORY SCIENCE. C & E Publishing, Inc. Quezon City.
2. https://www.cdc.gov/publichealth101/informatics.html
3. http://www.eruditedevforum.com/
4. World Health Organization
5. Department of Health