Health information systems and health communications: narrowband and broadband technologies as core public health competencies.
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Competency-Based Education↗
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OOMM--Object-Oriented Matrix Modelling: an instrument for the integration of the Brasilia Regional Health Information System.
The development of Health Information Systems is widely determined by the establishment of the underlying information models. An Object-Oriented Matrix Model (OOMM) is described which target is to facilitate the integration of the overall health system. The model is based on information modules named micro-databases that are structured in a three-dimensional network: planning, health structures and information systems. The modelling tool has been developed as a layer on top of a relational database system. A visual browser facilitates the development and maintenance of the information model. The modelling approach has been applied to the Brasilia University Hospital since 1991. The extension of the modelling approach to the Brasilia regional health system is considered.
Brazil↗
Strengthening health information systems to address health equity challenges.
Special studies and isolated initiatives over the past several decades in low-, middle- and high-income countries have consistently shown inequalities in health among socioeconomic groups and by gender, race or ethnicity, geographical area and other measures associated with social advantage. Significant health inequalities linked to social (dis)advantage rather than to inherent biological differences are generally considered unfair or inequitable. Such health inequities are the main object of health development efforts, including global targets such as the Millennium Development Goals, which require monitoring to evaluate progress. However, most national health information systems (HIS) lack key information needed to assess and address health inequities, namely, reliable, longitudinal and representative data linking measures of health with measures of social status or advantage at the individual or small-area level. Without empirical documentation and monitoring of such inequities, as well as country-level capacity to use this information for effective planning and monitoring of progress in response to interventions, movement towards equity is unlikely to occur. This paper reviews core information requirements and potential databases and proposes short-term and longer term strategies for strengthening the capabilities of HIS for the analysis of health equity and discusses HIS-related entry points for supporting a culture of equity-oriented decision-making and policy development.
Developing Countries↗
Information systems ... health care information exchange just got a little easier in New York City.
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Community Networks↗
Developing a health information system for a primary health care centre in Alexandra, Johannesburg.
The development of a health information system, which went through 6 overlapping phases, appropriate for a primary health care centre at the Alexandra Health Centre and University Clinic (AHC) is reviewed. The three essential concepts were data, information and indicators. The system at the AHC moved from unused data to unused information and to operational indicators. It also moved from a concern with data and information to one concerned with communication of information. The way a health information system evolves is, to a large extent, a reflection of the information needed by the group that is planning the system. In the AHC information needs were initially felt by senior management and attempts to involve other staff failed because of lack of timely feedback and a lack of management skills at all levels. In the process of trying to involve people and of getting to the correct type and amount of information, it became obvious that a health information system is complex and involves data as the major outputs, with people being the common thread of the system.
Community Health Centers↗
Health information systems: between shared care and body area networks. Findings from the Section on health Information Systems.
OBJECTIVES: To summarize current excellent research in the field of health information systems (HIS). METHODS: Synopsis of the articles selected for the IMIA Yearbook 2006. RESULTS: Current research in the field of HIS is focused on supporting transinstitutional health care processes including health record systems, integration of new data types and knowledge based decision support, patient empowerment, the utilization of new technologies like wearable systems or ubiquitous computing in home and personal care, and methods and tools for the analysis, development, management, and evaluation of HIS. CONCLUSIONS: The best paper selection of articles on HIS comprises examples of excellent research on integration of HIS based on standards for electronic health records, methods and tools for HIS oriented change management, the use of wearable systems for telemedical surveillance of chronically ill patients, technology driven home care concepts for the elderly and physically disabled, and data privacy issues arising from the emergence of new clinical data types in the context of biomedicine. Besides successful research concerning important aspects of HIS, achieving interoperability and integration of health information subsystems and technology remains an important field of work.
Awards and Prizes↗
Improving the quality of care and reducing health care costs through a point-of-service health care information system.
Health care information systems will become critical to the success of health care providers. These systems must make the process of health care delivery more effective and more efficient, assisting the provider in improving the quality of care while maximizing cost reduction through more appropriate care and reduction in administrative costs. The system must be able to capture accurate encounter data for outcomes analyses and capable of use by multiple health plans for their unique policies or programs such as disease management. The most effective means of achieving all of the above will be to re-empower the physicians through software placed in a mobile computing environment with full integration among all participants.
Ambulatory Care Information Systems↗
Graduate education in health decision support systems (HDSSs): reconfiguring the health information system (HIS) basket or putting HDSS Humpty Dumpty together again?
Building on previous discussions in graduate health information system (HIS) education, this article focuses on the design of a course in health decision support systems (HDSSs). The goal here is not simply to add to existing prospectives of HIS theories and methodologies, but to prepare these students for changing trends in HIS technologies and applications and for new challenges in HIS administration and impacts arising from these emerging, more advanced, and complex technologies. Specifically, advancing HDSS technology: (1) promises to close the gap between theory and practice, (2) creates a new perspective for the application of information technologies in health care organizations, and (3) enhances innovations in the management and implementation of health information technologies. This paper highlights the need for graduate education in HDSS domain knowledge and how such knowledge can be taught in preparing students for managing change in the future health care environment.
British Columbia↗
Integration of child health information systems: current state and local health department efforts.
Public health departments at the state and local levels are pursuing integration strategies to consolidate child health information systems to improve child health. Eighteen health departments were interviewed in this exploratory research study to gather information to describe their current activities related to integrating child health information systems. Results illustrate the common systems being brought together and the technical process for doing so, financing mechanisms, range of anticipated information-users and their method of access to the integrated system, and common internal and external challenges and strengths that the health departments face. The evidence suggests a trend towards more efficient and thoughtful use of the multiplicity of information systems within public health departments as programs consolidate and share data and expand electronic communication with their external partners in the health care delivery system to improve children's health.
Child↗
3LGM2-modeling to support management of health information systems.
OBJECTIVE: Both regional health information systems (rHIS) and hospital information systems (HIS) need systematic information management. Due to their complexity information management needs a thorough description or model of the managed information system. METHODS: The three layer graph-based meta-model (3LGM(2)) and the 3LGM(2) tool provide means for effectively describing and modeling HIS by hospital functions, application systems and physical data processing components. The 3LGM(2) tool has been used to model parts of the information system of the health care system of the German federal state Saxony and of the Leipzig University Medical Centre. RESULTS: Experiences showed, that 3LGM(2) is suitable for supporting information management even in rHIS. We explain some benefits for information management in regional as well as local settings. CONCLUSIONS: Acceptance of the 3LGM(2) depends strictly on its integration in management structures on the institutional, regional, and even national or European level.
Germany↗
Health information systems in humanitarian emergencies.
Health information systems (HIS) in emergencies face a double dilemma: the information necessary to understand and respond to humanitarian crises must be timely and detailed, whereas the circumstances of these crises makes it challenging to collect it. Building on the technical work of the Health Metrics Network on HIS and starting with a systemic definition of HIS in emergencies, this paper reviews the various data-collection platforms in these contexts, looking at their respective contributions to providing what humanitarian actors need to know to target their intervention to where the needs really are. Although reporting or sampling errors are unavoidable, it is important to identify them and acknowledge the limitations inherent in generalizing data that were collected in highly heterogeneous environments. To perform well in emergencies, HIS require integration and participation. In spite of notable efforts to coordinate data collection and dissemination practices among humanitarian agencies, it is noted that coordination on the ground depends on the strengths and presence of a lead agency, often WHO, and on the commitment of humanitarian agencies to investing resources in data production. Poorly integrated HIS generate fragmented, incomplete and often contradictory statistics, a situation that leads to a misuse of numbers with negative consequences on humanitarian interventions. As a means to avoid confusion regarding humanitarian health statistics, this paper stresses the importance of submitting statistics to a rigorous and coordinated auditing process prior to their publication. The audit trail should describe the various steps of the data production chains both technically and operationally, and indicate the limits and assumptions under which each number can be used. Finally emphasis is placed on the ethical obligation for humanitarian agencies to ensure that the necessary safeguards on data are in place to protect the confidentiality of victims and minority groups in politically sensitive contexts.
Altruism↗
[Which health information systems for the evaluation of health actions?].
The evaluation of health actions requires large amounts of information allowing an assessment of relevance, coherence, efficacy, efficiency and impact of these interventions. Information systems should support evaluation processes by helping to obtain pertinent indicators, tracers and standard operating procedures. To reach this objective, specific functions need to be implemented, including traceability, documentation, investigation and scientific awareness. But this supposes that health information systems respect quality criteria that this article defines. The following criteria are considered: simplicity, validity, acceptability, informative value, representativeness, continuity, reactivity, fluidity, flexibility of the system, and also confidentiality of information. The historical developments of medical informatics have induced the creation of independent information systems, answering to specific objectives. This lack of integration is an obstacle to the evaluation of health actions because of the difficulty to view transversally and longitudinally the sequence of actions for a same patient. Thus integrated health information systems, organised around patient care episodes, are necessary to support evaluation and to contribute effectively to decision making in public health, because the evaluation of health actions implies the availability of information about the individuals who are the targets of these actions.
Decision Making↗
[Importance of health information systems in the process of reform and reconstruction of health care].
Reform and reconstruction of health care system can not be carried out without health information systems and modern information and communication technologies. In other hand, health information system of The Federation of BiH must be an object of both reform and reconstruction. This thesis points out that reform of health information system is a crucial priorities in order to improve and fasten reform. There is a paradigmatic question: who provides service, to whom, what is the price, and what is the final solution? In order to answer this question, an integral health information system that will be computer supported is necessary. For integral work and information exchange, computers must be connected and follow the same operating procedures. Benefits of an integral health information system, as well as impact factors for its implementation are discussed in the paper.
Bosnia and Herzegovina↗
Health information systems: the foundations of public health.
Public health decision-making is critically dependent on the timely availability of sound data. The role of health information systems is to generate, analyse and disseminate such data. In practice, health information systems rarely function systematically. The products of historical, social and economic forces, they are complex, fragmented and unresponsive to needs. International donors in health are largely responsible for the problem, having prioritized urgent needs for data over longer-term country capacity-building. The result is painfully apparent in the inability of most countries to generate the data needed to monitor progress towards the Millennium Development Goals. Solutions to the problem must be comprehensive; money alone is likely to be insufficient unless accompanied by sustained support to country systems development coupled with greater donor accountability and allocation of responsibilities. The Health Metrics Network, a global collaboration in the making, is intended to help bring such solutions to the countries most in need.
Decision Making↗
Trends in health information systems technology.
Major trends in health information systems technology are described. The new paradigm for information systems is integrated, patient-centered computing. The computer system and files are designed around information-capture needs along the continuum of care instead of around charge capture or inventory. The need for patient information in the future will not be limited to the health system but will extend to work sites and homes. Health systems will move to full client-server architecture, higher-speed data transmission, and greater network capacity. Computing standards will be instituted nationwide. With changes in the economics of health care, physician order-entry systems are inevitable. Many health systems and system vendors are making progress in achieving the computer-based patient record (CPR); health systems will require the CPR if they are to be truly integrated. Trends in health care and health care information technology will require that pharmacists innovate and adapt as never before.
Continuity of Patient Care↗
Hospital information systems and the development of a national health information system.
Hospitals require information to support medical quality assurance, cost containment, productivity improvement, utilization analysis, program planning and evaluation, research, and education. Although hospitals could benefit from participation in a national health information system, many would be reluctant to participate particularly if participation were federally mandated. Incentives to participation should include funding of developmental costs, standardized computer software, guarantees of system stability, and prompt reporting back to participating hospitals.
American Hospital Association↗
A population-based health information system.
The authors introduce the Population Health Information System, its conceptual framework, and the data elements required to implement such a system in other jurisdictions. Among other innovations, the Population Health Information System distinguishes between indicators of health status (outcomes measures) and indicators of need for health care (socioeconomic measures of risk for poor health). The system also can be used to perform needs-based planning and challenge delivery patterns.
Canada↗
Outcomes research and community health information systems.
The developments in outcomes research and community health information systems are pursuing essentially parallel courses in this country, and yet integrating the lessons from each other could yield more informed health policy decisions. This article provides the linkage between these two developing fields, discusses indicators of community health, describes several approximations to an outcomes-based community health information system in this country, and specifies a model (POPULIS) of such a system from Canada. Although POPULIS can serve as a prototype for health policy decision making, the outcomes-based community health information system, which can be constructed in this country, is constrained by the pluralistic system of health care we have and the lack of any centralized planning about health.
Community Health Planning↗