TIME SPECIFIC CONTENT AV STUDENT EVALUATION

OBJECTIVES AIDS TEACHER

ACTIVITY
HEALTH INFORMATION SYSTEM

INTRODUCTION
Health Information is an integral part of the national health system. It is a basic tool of management and a
key input for the progress of any society.
DEFINITION
Health Information System:
A health information system is defined as “a mechanism for the collection, processing, analysis and
transmission of information required for organizing and operating health services, and also for research and
training.”
Health Management Information System:
It is defined as a system that provides up-to-date, reliable, complete, timely information to health managers,
at various levels in order to make well-informed management decisions about programme performance and
operations3
OBJECTIVES
The objectives of the health information system are to:
provide reliable, relevant, up-to-date , adequate, timely and reasonably complete information for
health managers at all levels( central, intermediate and local)
to contribute towards achievements of objectives of health policies and programmes
To increase the efficiency and quality in health management.
sharing of technical and scientific information by all health personnel participating in the health
services of a country
provide at periodic intervals , data that will show the general performance of the health services
Assist planners in studying their current functioning and trends in demand and work load.
REQUIREMENTS TO BE SATISFIED BY H IS/ WHO EXPERT COMMITTEE
CRITERIA
A WHO Expert Committee identified the following requirements to be satisfied by the health information
systems:

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 1. The system should be population based
2. It should avoid unnecessary agglomeration of data
3. It should be problem oriented
4. It should employ functional and operational terms (e.g., episodes of illness, treatment
regimens, laboratory tests)
5. It should express information briefly and imaginatively
6. It should make provision for the feedback of data.

COMPONENTS OF HIS
HIS is composed of several related subsystems. A comprehensive health information system requires
information and indicators ion the following subjects:
1. demography and vital events
2. environmental health statistics
3. health status: mortality, morbidity, disability and quality of life
4. health resources: facilities, bed, man power
5. utilization and non-utilization of health services: attendance, admissions, waiting lists
6. indices of outcome of medical care and
7. financial statistics (cost, expenditure) related to the particular objective
USES OF HIS
The important uses to which health information may be applied are:
1. to measure the health status of the people and to quantify their health problems and medical and
health care needs
2. For local, national and international comparisons of health status. For such comparisons, the data
need to be subjected to rigorous standardisation and quality control
3. for planning, administration and effective management of health services and programmes
4. for assessing whether health services are accomplishing their objectives in terms of their
effectiveness and efficiency
5. for assessing the attitudes and degree of satisfaction of the beneficiaries with the health system,
6. For research into particular problems of health and disease.
USES OF HIMS
The main uses of the HIMS are to:
support decision-making and taking actions

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 help to assess community needs
prioritize the health needs
assess the performance of health workers or institutions
monitor programme operations
evaluate the programme/ measure its success or failure
plan better services and programmes at local level
justify the resources spent
to enhance research
helps to provide databases to client or community

HEALTH SYSTEM ORGANISATION3

Ministry of Health and Family

Welfare
State health Organisation
District Health Organisation
Community Health Centre
Primary Health Centre
Anganawadi workers and Sub centre
System
SOURCES OF HIS
The lifeblood of a health information system is the routine health statistics. Information requirements will
vary according to the administrative level at which planning is envisaged. The different sources are:
1. Census:
The census is an important source of health information. It is taken in most of the countries of the world at
regular intervals. usually at 10 years. A census is defined as “the total process of collecting, compiling and

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publishing demographic, economic and social data pertaining at the specified time or times, to all persons in
a country or delimited territory.” In India, the first regular census was taken in 1881 and the last census was
held in 2011. Although the primary function of census is to provide demographic information such as total
count of population and its break down into groups and subgroups such as age and sex distribution, it
represents only a small part of the total information collected. It contains a mine of information on subject’s
not only demographic, but also social and economic characteristics of the people, the condition under which
they live, how they work, their income and their basic information.
2. Registration of vital events:
The United Nations defines a vital events registration system as including “legal registration, statistical
recording and recording and reporting of the occurrence of, and the collection, compilation, presentation,
analysis and distribution of statistics pertaining to vital events i. e., live births, deaths, foetal deaths,
marriages, divorces, adaptations, legitimations, recognitions, annulments and legal separations,”
Registration of vital events has been the foundation of vital statistics. i keep a continuous check of
demographic changes.

3. Sample registration System (SRS):

The SRS is a dual-record system, consisting of continuous enumeration of births and deaths by an
enumerator and an independent survey every 6 months by an investigator-supervisor. The SRS now covers
the entire country. It is a major source of health information. It help to get more reliable information on
birth and death rates, age specific fertility and mortality rates, infant, under five and adult mortality, etc.
have become available.
4. Notification of diseases:
Historically notification of infectious diseases was the first health information sub-system to be established.
The primary purpose of notification is to effect prevention and /or control of disease. It is a valuable source
of morbidity data. But the limitations are:
a) notification covers only a small part of the total sickness in the community
b) the system suffers from a good deal of under-reporting
c) many cases especially atypical and subclinical cases escape notification due to non-recognition
In spite of all these it provides valuable information about fluctuations in disease frequency.
5. Hospital records:
Hospital data constitute a basic and primary source of information about diseases prevalent in the
community. The 8th report of the WHO Expert Committee on Statistics recommended that hospital statistics

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be regarded in all countries as an integral and basic part of the national statistical programme. The main
drawbacks are:
a) they constitutes only”a tip of iceberg”-information of patients seeking medical care is only been
provided.
b) the admission policy may vary from hospital to hospital
c) Population served by a hospital cannot be defined.
6. Disease registers:
A register requires that a permanent record be established, that the cases be followed up, and the basic
statistical tabulations are prepared both on frequency and on survival. In addition, the patients on a register should
frequently be the subjects of special studies.
7. Record Linkage:
The term record linkage is used to describe the process of bringing together records relating to one
individual, the records originating in different times or places. The term medical record linkage implies the
assembly and maintenance for each individual in a population, of a file of the more important records
relating to his health. At the moment, record linkage is beyond the reach of many developing countries.
8. Epidemiological surveillance:
As part of the National health programmes, surveillance systems is often set-up to report the occurrence of
new cases and on efforts to control the diseases.
9. Other health service records:
A lot of information is also found in the record soft eh hospital out-patient departments, primary health
centres and sub centres, polyclinics, private practitioners, mother and child health centres, school health
records, diabetic and hypertensive clinics, etc. But it will relate to only a certain segment of the general
population.
10. Environmental health data:
Another area in which information is generally lacking is the relating to the environment. Environmental
health data can be helpful in the identification and quantification of factors causative of disease. Collection
of environmental data remains a major problem in the future.
11. Health Man power statistics:
Information related to the number of physicians, dentists, pharmacists, veterinarians, hospital nurses,
medical technicians etc. The planning Commission will give estimates of active doctors of different States.
12. Population Surveys :
A health Information system should be population –based. The term “health surveys” is used for surveys

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related to any aspect of health. The different survey methods are:
a) Health Interview or face-to-face survey
b) Health examination survey
c) Health records survey and
d) Mailed questionnaire survey

13. Other routine statistics related to health:

The other statistics related to health are:
a) demographic: It gives information on population density, movement and educational level.
b) Economic:
c) Social security schemes:
14. Non-quantifiable information:
Health information system has multi-disciplinary inputs. There should be proper storage, processing and
dissemination of information.
TYPES
The Health Information System can be further classified as:
a) Prevention Information System:
An Information system which supports prevention in health care provides the potential consumer
group with data on how to develop and maintain health. This information system uses public
education as the policies and programs by which the goals are served. It is used for the public and is
a program that supports the public education process. It also enhances knowledge and understanding
which leads to improved decision making on both individual and health care issues.
b) Intervention Information System:
It is used to include emergency services, where need is immediate, and referral services, where it is
clear that a problem is developing but the patient does not know what to do and where to go for
treatment.
c) Treatment Information System:
The attempts to develop Treatment Information System are essentially efforts to maintain and
increase the practice in a more efficient and effective manner. It aids the treatment process and is
rightfully a part of the patient’s treatment plan.
d) Education and Training Information System:
Education and training can be either primary or continuing. The goals of these are providing quality

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 education and training for both new employees and continuing growth and development for
employees with tenure.
ROLE OF NURSE
As computers take on a growing presence in hospital settings, the need continues to increase for the
marriage of patient care and information technology. Enter the nurse informaticist—a role that perfectly
combines the two most important aspects of health care delivery in the 21st century. The role of nurse
informaticist has grown unequivocally, for multiple reasons. They are:
1) In Improving School health services-Computer usage has become more prevalent in both
schools of nursing and in health care facilities. The government has made health care informatics
a priority, which has led to increased funding for facilities that implement greater technology
2) the need become for nurses to become skilled in informatics- 18 national and regional
nursing informatics groups joined together in 2004 to form the Alliance for Nursing Informatics
(ANI), under the direction of AMIA and the Healthcare Information and Management Systems
Society (HIMSS). More than 2,000 nurses representing organizations from across the country
have gotten together to provide a consolidated forum for the nursing informatics community.
3) There are numerous ways for nurses to increase their informatics knowledge, either
through self-education, distance learning or an information technology training program.
Participation in one of the many nursing informatics groups is also an option for nurses who
would like to get involved with other tech-minded health care professionals.
CONCLUSION
The efficiency of any information system depends on a correct assessment of data requirements based on an
appraisal of the demands made by individual users and on the methodologies adopted in collection of data.
Health is a resultant of a multiplicity of factors and these put great demands on the information system that
could be visualized for the health sector. It not only implies a wide base of information with inter-sectoral
linkages, but a close monitoring of the progress made in the improvement of the health status. Technology
is, after all, where the health care industry is headed.
REFERENCES
Books
1. Park K. Park’s Textbook of Preventive and Social medicine. 21st edition. Bhanot publications ;2011: P

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 779-782
2. Clement I. Basic Concepts of Community Health Nursing. 2 nd edition. Jaypee publications; NewDelhi.
2009. P 485
3. Lal S, Adarsh, Pankaj. Textbook of community medicine. CBS Publishers and distributers. New Delhi.
2007. P 35-39, 328-332
4. Ziegenfuss D.G. Health Information Systems, A bibliography. IFI/Plenum Company. New York. 1984.
P 3, 6-7, 11, 14

Journals

1. Orlovsk C. The Emerging Role of the Nurse Informaticist [ Internet]. Available from:http://nursezone.com/nursing-news-events/devices-
and-technology/The-Emerging-Role-of-the-Nurse-Informaticist_24674.aspx
2. Harvard Business Review (HBR) [Entry Reviewed: 2011-08-21]
3. Health Care and Informatics Review Online (HCIRO) [Entry Reviewed: 2011-08-16]
4. electronic Journal of Health Informatics (eJHI) [Entry Reviewed: 2011-08-17]
5. Journal of Health Informatics in Developing Countries (JHIDC) [Entry Reviewed: 2011-08-22]
6. Health Informatics Journal (HIJ) [Entry Reviewed: 2011-08-03]
7. International Journal of Healthcare Delivery Reform Initiatives (IJHDRI) [Entry Reviewed: 2011-08-09]
8. Journal of Healthcare Information Management (JHIM) [Entry Reviewed: 2011-08-11]

JOURNAL DETAILS

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Harvard Business Review (HBR) [Entry Reviewed: 2011-08-21]

The Harvard Business Review has one goal: to be the source of the best new ideas for people creating, leading, and transforming
business. HBR's articles cover a wide range of topics that are relevant to different industries, sectors, management functions, and
geographic locations. They focus on such areas as strategy, leadership, teams, entrepreneurship, marketing, manufacturing, career
management, and the war for talent. While the topics may vary, all HBR articles share certain characteristics. They are written for senior
executives by experts whose authority comes from careful analysis, study, and experience. In addition, the ideas presented in these
articles have been tested in the real world of business and can be translated into action.

Health Care and Informatics Review Online (HCIRO) [Entry Reviewed: 2011-08-16]

Health Care and Informatics Review Online is a quarterly series dedicated to reviewing and interpreting significant developments in
healthcare delivery. The focus is on knowledge gained through the practical experience of managing health issues and the material is
relevant to a wide variety of managers and practitioners. An expansion in scope starting October 2003 brings particular focus on clinical
informatics and has been accompanied by an associated journal name change. Health Care and Informatics Review Online is published
with the support of the New Zealand Ministry of Health. The Ministry supports and encourages continual improvement of care and
services in the health and disability sector and recognises the role of Health Care and Informatics Review Online in sharing experience,
disseminating information and advancing discussion in the important area of clinical informatics.

electronic Journal of Health Informatics (eJHI) [Entry Reviewed: 2011-08-17]

The electronic Journal of Health Informatics (eJHI) is an international journal committed to scholarly excellence and dedicated to the
advancement of health informatics and information technology in healthcare. It is a journal for all health professions and informaticians
of all levels. eJHI aims to publish original, high quality papers related to health informatics and health informatics technology in a timely
fashion. It aims to provide health care workers with a readily accessible, electronic vehicle for sharing information about research,
knowledge, experiences, perceptions and wisdom with colleagues involved in all facets of health informatics and health information
technology.

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Journal of Health Informatics in Developing Countries (JHIDC) [Entry Reviewed: 2011-08-22]

This journal publishes submissions on health informatics that relate to developing countries. The submissions can be either articles,
letters, or webcasts/podcasts. The objective of this journal is to share and promote academic knowledge in the field. One of its aims is
also to encourage writers from developing countries to contribute their writings.

Health Informatics Journal (HIJ) [Entry Reviewed: 2011-08-03]

Information and communication technology are integral to all areas of health care, from organisational management to the delivery of
patient care and health promotion. In this fast-moving arena, Health Informatics Journal provides an international forum for the
exchange of practice, innovation and research. Representing the interdisciplinary nature of health informatics, the journal publishes peer
reviewed contributions from the fields of informatics and telematics, the health professions, computer science, engineering and
management. The Editor is keen to discuss papers on any subject relevant to healthcare informatics, but especially welcomes
contributions on e-health, electronic patient records, e-learning in healthcare, web-based information services; support for clinical
decision-making, knowledge management, quality control, evidence-based practice, modelling of healthcare service usage; healthcare
applications of mobile and pervasive technologies, assistive technology; evaluation and use of healthcare IT, design and development
methodologies for healthcare IT, security and confidentiality; future developments in technologies and applications.

International Journal of Healthcare Delivery Reform Initiatives (IJHDRI) [Entry Reviewed: 2011-08-09]

The International Journal of Healthcare Delivery Reform Initiatives (IJHDRI) publishes original papers in all areas of healthcare
management reform and information systems initiatives aimed at healthcare delivery improvement. It emphasizes empirical research but

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 may include specialized theoretical, methodological, and review papers from both practitioners and academics working in the healthcare
industry. It particularly looks at the analysis of ongoing and future initiatives to promote efficiency and reduce error, continuous increase
in cost of healthcare delivery, wider divide in the quality of health service available to different segments of our communities, and the
influence of increase use of IT in various healthcare delivery processes.

Journal of Healthcare Information Management (JHIM) [Entry Reviewed: 2011-08-11]

Journal of Healthcare Information Management is the only journal specifically for healthcare information and management systems
professionals. Each issue examines the implications of a specific topic (such as Scheduling, Community Health Information Networks,
TQM) in the areas of clinical systems, information systems, management engineering, and telecommunications in healthcare
organizations.

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