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PubMed2005

Evaluation of existing district health management information systems a case study of the district health systems in Kenya.

INTRODUCTION: This paper discusses some of the issues and challenges of implementing appropriate and coordinated District Health Management Information System (DHMIS) in environments dependent on external support especially when insufficient attention has been given to the sustainability of systems. It also discusses fundamental issues which affect the usability of DHMIS to support District Health System (DHS), including meeting user needs and user education in the use of information for management; and the need for integration of data from all health-providing and related organizations in the district. METHODS: This descriptive cross-sectional study was carried out in three DHSs in Kenya. Data was collected through use of questionnaires, focus group discussions and review of relevant literature, reports and operational manuals of the studied DHMISs. RESULTS: Key personnel at the DHS level were not involved in the development and implementation of the established systems. The DHMISs were fragmented to the extent that their information products were bypassing the very levels they were created to serve. None of the DHMISs was computerized. Key resources for DHMIS operation were inadequate. The adequacy of personnel was 47%, working space 40%, storage space 34%, stationery 20%, 73% of DHMIS staff were not trained, management support was 13%. Information produced was 30% accurate, 19% complete, 26% timely, 72% relevant; the level of confidentiality and use of information at the point of collection stood at 32% and 22% respectively and information security at 48%. Basic DHMIS equipment for information processing was not available. This inhibited effective and efficient provision of information services. CONCLUSIONS: An effective DHMIS is essential for DHS planning, implementation, monitoring and evaluation activities. Without accurate, timely, relevant and complete information the existing information systems are not capable of facilitating the DHS managers in their day-today operational management. The existing DHMISs were found not supportive of the DHS managers' strategic and operational management functions. Consequently DHMISs were found to be plagued by numerous designs, operational, resources and managerial problems. There is an urgent need to explore the possibilities of computerizing the existing manual systems to take advantage of the potential uses of microcomputers for DHMIS operations within the DHS. Information system designers must also address issues of cooperative partnership in information activities, systems compatibility and sustainability.

Data Collection↗
PubMed1995

The management information system and change processes in health systems.

This report describes a management information system (MIS) designed by PAHO's Health Systems and Services Division in collaboration with technical experts from a number of different countries. This MIS, a methodology currently used at the institutional or national level in more than 21 countries of the Americas, is a strategic and practical instrument that is easy to apply, interpret, and use, and whose purpose is to facilitate fundamental changes in health management. Based on the management concept that inputs, processes, and outputs are quantifiable, the MIS places special emphasis on health system productivity, an essential condition for achieving health coverage that is both adequate and equitable.

Community Mental Health Services↗
PubMed2004

A management information system model for process-oriented health care.

OBJECTIVE: To develop a conceptual model of a management information system for process-oriented health care organizations. METHODS: Qualitative data was collected from two case studies in process-oriented health care settings. The first study addressed the information requirements of health care managers and the second study focused on organizational activities and clinical practice. From these data, preliminary models were iteratively developed, interpreted, and further revised. SETTING: A county hospital in southern Sweden with 30 clinics and 3,200 employees. RESULTS: A conceptual model of a management information system for process-oriented health care organizations was developed in two parts: one part that describes the organizational interface of the model and the other part that describes the architecture of the model. CONCLUSION: A conceptual model has been developed for local-level integration of management information systems and organizational procedures in process-oriented health care organizations

Delivery of Health Care↗
PubMed1979

Planning for management information systems in drug treatment organizations.

An attempt to set up a management information system for individual drug abuse programs throughout a state is described. The principles upon which the system is based are discussed along with the problems encountered in its implementation. A series of guidelines for establishing management information systems in operating human services agencies is included.

Administrative Personnel↗
PubMed2005

Evaluation criteria for the district health management information systems: lessons from the Ministry of Health, Kenya.

BACKGROUND: The District Health Management Information Systems (DHMISs) were established by the Ministry of Health (MoH) in Kenya more than two decades ago. Since then, no comprehensive evaluation has been undertaken. This can partly be attributed to lack of defined criteria for evaluating them. OBJECTIVE: To propose evaluation criteria for assessing the design, implementation and impact of DHMIS in the management of the District Health System (DHS) in Kenya. METHODS: A descriptive cross-sectional study conducted in three DHSs in Kenya: Bungoma, Murang'a and Uasin Gishu districts. Data was collected through focus group discussions, key informant interviews, and documents' review. The respondents, purposely selected from the Ministry of Health headquarters and the three DHS districts, included designers, managers and end-users of the systems. RESULTS: A set of evaluation criteria for DHMISs was identified for each of the three phases of implementation: pre-implementation evaluation criteria (categorised as policy and objectives, technical feasibility, financial viability, political viability and administrative operability) to be applied at the design stage; concurrent implementation evaluation criteria to be applied during implementation of the new system; and post-implementation evaluation criteria (classified as internal - quality of information; external - resources and managerial support; ultimate - systems impact) to be applied after implementation of the system for at least three years. CONCLUSIONS: In designing a DHMIS model there is need to have built-in these three sets of evaluation criteria which should be used in a phased manner. Pre-implementation evaluation criteria should be used to evaluate the system's viability before more resources are committed to it; concurrent (operational) - implementation evaluation criteria should be used to monitor the process; and post-implementation evaluation criteria should be applied to assess the system's effectiveness.

Biomedical Technology↗
PubMed1999

Public health and the Air Management Information System (AMIS).

This paper discusses the importance of public health studies with respect to risk assessment and risk management in the framework of air quality management. This is performed with respect to the Air Management Information System (AMIS), which was set up recently by the World Health Organization. The Air Management Information System is an information-exchange system in the scheme of the Global Air Quality Partnership providing information on all issues of air quality management between its participants: municipalities, countries' environmental protection agencies, international organizations, World Bank and international development banks, and nongovernmental organizations. Public health studies of air pollution-induced health effects are an important ingredient for decisions with respect to the management of air quality. First, they are to be used to derive air quality standards from air quality guidelines. Secondly, they serve to assess the causal link between observed health effects in the population and the causative agents in the air. Thirdly, they can be used to estimate ideal (in the sense of not being expressed in monetary terms) or economic damage functions that are necessary to assess the magnitude of the ideal or economic damages to human health. The latter are necessary for a sensible cost-benefit analysis in which the costs of control measures to reduce air pollution are compared with the costs of health effects.

Air Pollution↗
PubMed1992

Information systems management under pressure.

Changes in clinical management and reimbursement approaches have placed new pressures on psychiatric hospitals to have immediate access to critical information. Information systems management is in the difficult position of responding--while under this pressure--to a host of requests for computer applications that may be at cross purposes with each other. Pine Rest Christian Hospital, a full-continuum, 146-bed, not-for-profit psychiatric facility in Grand Rapids, Michigan, has been preparing tactics to deal with information systems management under pressure. This paper describes the consequent information systems management approaches and some of the critical computer applications Pine Rest has installed.

Decision Making, Organizational↗
PubMed1977

FP/MIS: a management information system for a community family planning clinic.

The management information system (FP/MIS) used by the Howard University Center for Family Planning Services, which operates community family planning clinics in Washington, D.C. is described. The system was developed to satisfy program objectives in patient management, program planning and evaluation, resource management, federal reporting systems and clinical, epidemiological and health services research. The data collection forms used in the system and the output from the four data display groups--patient profile, resource management, quality of care and epidemiology-are described along with examples of their use.

Computers↗
PubMed1985

Medicaid program; Medicaid Management Information Systems; conditions of approval and reapproval and procedures for reduction of Federal financial participation--HCFA. Final rule.

This final rule provides the additional requirements to the conditions and procedures for initial approval and reapproval of Medicaid Management Information Systems (MMIS) that were added by section 1903(r) of the Social Security Act (as amended by section 901 of the Mental Health Systems Act of 1980, Pub. L. 96-398). These provisions are intended to improve States' MMIS, ensure efficient system operations, and make the procedures for detection of fraud, waste, and abuse more effective. In addition, this final rule specifies the procedures we follow in reducing the level of Federal financial participation in State administrative expenditures if a State fails to meet the conditions for initial operation, initial approval, or reapproval of an MMIS.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1983

Medicaid program; Medicaid Management Information Systems; conditions of approval and reapproval and procedures for reduction of federal financial participation--Health Care Financing Administration. Proposed rule.

This proposal adds to regulations new conditions and procedures for initial approval and for reapproval of Medicaid Management Information Systems (MMIS) to update the regulations to reflect additional requirements added by section 901 of the Mental Health Systems Act of 1980 (Pub. L. 96-398). The proposal specifies procedures for reducing the level of Federal financial participation in a State's administrative expenditures when a State fails to meet the conditions for initial operation, initial approval or reapproval of an MMIS. It also proposes procedures with respect to waivers of the conditions of approval and reapproval and to appeals of adverse decisions. These provisions are intended to improve States' MMIS, and to ensure efficient system operations, and to detect cases of fraud, waste, and abuse effectively.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1993

Developing a primary health care management information system that supports the pursuit of equity, effectiveness and affordability.

A key set of goals of primary health care (PHC) includes equity, effectiveness and affordability. By equity, we mean universal coverage and care according to need; by effectiveness, that the system has a favorable impact on mortality and serious morbidity; by affordability, that the system is within the budgetary reach of government and communities. There are other requirements of PHC as well: that the system be socially and culturally acceptable, and that communities are active participants in the development and implementation of the system. Further, the PHC system should be compatible with larger system of a region or country, and possibly serve as a prototype for the development of larger health systems. With these requirements in mind, the Aga Khan University has developed a series of community-based, urban PHC systems, each serving a population of about 10,000, in the katchi abadis (squatter settlements) of Karachi. These communities are severely deprived, with high infant, child and maternal mortality rates. The PHC systems are designed to achieve equity, effectiveness and affordability, and within 3-5 years have advanced substantially toward those goals. A key factor in those developments has been the management information system (MIS), which has served as a basis for planning, managing and evaluating the PHC systems. Central questions about such an MIS are: What kind of MIS design is necessary to support the pursuit of those goals? What problems arise in the MIS as such a system is implemented? What kinds of changes and adaptations need to be considered in the MIS as the PHC system itself matures? What does the PHC system cost, and what part of the total cost of the PHC system is attributable to the MIS? How practical is this kind of MIS, developed in small prototype PHC systems, for replicability in larger health systems? What are the possibilities and requirements for simplification in order to be used in health systems that are less intensively managed? The experience of AKU in Pakistan in the development of PHC systems, with associated management information systems, helps to answer these questions.

Community Health Services↗
PubMed1999

A management information system for nurse/midwives.

The experiences of nurse/midwives with a simple management information system in the private sector are reported from four facilities in Nigeria. When such a system is being introduced, special attention should be given to strengthening the ability of health workers to record and collate data satisfactorily.

Adult↗
PubMed1997

Evaluating the benefits realized from a nurse management information system.

The information requirements of nurse managers have been uncreasing rapidly in recent years. The demand for access to relevant and accurate information has led to the development of computerized information systems for use a ward level. However, once implemented, few information systems have been evaluated to identify the benefits that will be realized. This paper presents the results of a study carried our in Oxford to evaluate one nurse management information system using a multi-method approach to identify ways in which returns may be manifested. It suggests that evaluation should be an active process planned at the same time is defining information requirements.

Attitude of Health Personnel↗
PubMed1996

The Iowa CHMIS (Community Health Management Information System): work in progress.

The Iowa Community Health Management Information System (CHMIS) is a legislatively authorized system that is designed to meet Iowa's shared information needs and reduce administrative costs. A public/private partnership has been planning this system for over three years, implementation is scheduled to begin in July 1996. At that time, certified transaction networks will route claims data between providers and payors, a subset of that data will be stored by a centralized data repository. As the system evolves, provider access will be expanded and additional data elements will be captured.

Community Networks↗
PubMed1997

Transforming a health care information management system.

The article presents results from a survey of 98 top executives at Baylor Health Care System (BHCS), a large, multifunction health care organization in Dallas, Texas. The survey assessed the executives' perceptions of current BHCS quality practices using the first survey developed for the health care industry based on the Malcolm Baldrige National Quality Award (MBNQA) criteria. Findings regarding the quality of BHCS internal and external data and information include the need for a $50 million information system transformation to achieve seven critical success factors for all business units and improved internal and external data and information for the business process redesign and quality transformation. Results highlight the need for further research investigating the information and analysis MBNQA criteria.

Attitude of Health Personnel↗