Salale University
College of Health Sciences
Department of Adult Health Nursing
Seminar Presentation on: ENCEPHALITIS
Presented by : Kedir Mohammed ID : 182/15
Presented to : Bikila (Assistant professor)
OCT 3/05/ 2023
Fiche
CONTENTS
• Definitions
• Etiology
• Pathophysiology
• Clinical Manifestations
• Investigations
• Treatment
• Nursing Management
• Complications
• Summary
• Reference
At the end of this unit, the learner will beable
to;
Define HMIS
.
Describe deficits of HMIS in !thio"ia
#.
List ele$ents of HMIS
%.
OBJECTIVE
At the end of this unit, the learner will beable to;
• Define HMIS and its concepts and components.
• Discuss objectives of an HMIS
• Discus the ste"s of develo"ing HMIS
• The importance of health information management.
• Evolution of health information systems
• Define characteristics of good information
Health Management Information Systems
• System - Any collection of components that work to-
gether to achieve a common objective.
• Health System - All the activities whose primary purpose
is to promote, restore or maintain health.
• Information - Meaningful collection of facts or data.
• Information System - Systems that provide specific in-
formation support to the decision-making process at each
level of an organization.
• Health Information System - A set of components and
procedures organized with the objective of generating in-
formation which will improve health care management
decisions at all levels of the health system.
INTRODUCTION
• HMIS It is an aplication of the principle of man-
agement information system in health care system.
• HMIS collects, stores, analyses, and evaluates
health-related data from health facility to district,
regional and national administrative levels.
• It provides analytical reports and visualisations
that facilitate decision making at all these levels.
• HMIS are also referred to as routine health infor-
mation systems.
Why health information system
• Good management is a prerequisite for increasing the
efficiency of health services.
• Improved health information system is clearly linked to
good management.
• Information is crucial at all management levels of the
health services from periphery to the centre. It is re-
quired by policymakers, managers, health care
providers, community health workers.
• “Changing the way information is gathered, processed,
and used for decision-making implies changing the way
an organization operates.”
Objective of HMIS
Elements of HMIS
Design of HMIS
Some benefits of strong health information
systems
• help provide (continuity of) care to patients
• assist decision makers in detecting and controlling endemic
health problems
• monitor progress towards health goals and targets
• promote equity (still many people not counted!)
• strengthen the evidence base for health policies
• evaluate health system interventions and programs over
time
• Respond to new threats (e.g., Ebola, covid-19, chronic dis-
eases, drug resistance etc.)
• ensure transparency and accountability in the way (scarce)
resources are used_x0000_
What is wrong with current health MIS?
• Irrelevance of the information gathered
• Poor quality of data
• Duplication and waste among parallel health informa-
tion system
• Lack of timely reporting and feedback
• Poor use of information
• The difference in culture between data people and deci-
sion makers: Planning and management staff rely pri-
marily on “gut feeling” to formulate ad hoc decisions
rather seek pertinent data.
Steps involved in restructuring of Health
MIS
• Step 1: Identifying information needs and feasible indi-
cators
• Step 2: Defining data sources and developing data col-
lection instruments for each of the indicators selected
• Step 3: Developing a data transmission and processing
system
• Step 4: Ensuring use of the information generated
• Step 5: Planning for health MIS resources
• Step 6: Developing a set of organizational rules for
health information system management
Step 1: Identifying information needs and
feasible indicators
• Identifying information needs for follow-up of a preg-
nant woman in a primary level
• Identifying indicators to ensure efficient drug manage-
ment in a referral hospital
• Identifying indicators to ensure efficient Information,
Education and Communication in the community
• Identifying indicators to monitor the quality of supervi-
sion by the district management team
Step 2: Defining data sources and developing data
collection instruments for each of the indicators
selected
• Develop an appropriate record form for follow-up of
haemo-dialysis in a tertiary care hospital
• Develop a monthly reporting form for activities per-
formed in a primary level clinic
• Define data sources for a situational analysis at the dis-
trict level
• Develop data sources for monitoring the quality of
teaching in a medical college
Step 3: Developing a data transmission and
processing system
• Structure the information flow on pregnant women be-
tween the traditional birth attendant and midwife in the
health centre
• Ensure that monthly report forms from health centres
are entered in the district computer in a timely and ac-
curate manner
• Develop a mechanism for reporting of Research done
in a research centre
Step 4: Ensuring use of the information
generated
• Develop user-friendly feedback formats for regional
mangers on the utilization of inpatient services in the re-
gion
• Train health auxiliaries in follow-up procedures for hy-
pertension patients using a standard record form
• Develop a curriculum for the undergraduate and post-
graduate students depending upon the need in the coun-
try
• Ensure research on the priority health issues for the
country
Step 5: Planning for health MIS resources
• Create positions of computer operators in cases
where district level data processing is computer-
ized
• Submit revised recurrent cost budgets based on
proposed new data collection procedures
Step 6: Developing a set of organizational
rules for health information system man-
agement
• Develop standard case definitions
• Change the job description of doctors in cases where
health information system restructuring involves their
active participation in data collection
• Develop an instruction manual for computer opera-
tors
Main Source of HMIS Data
• They draw on:
individual patient records
family record cards
admissions and discharge registers
ward registers and tally sheets
community level records
infrastructure and resource records
records of health interventions delivered in com-
munities
Electronic HMIS
Sophisticated and powerful data management applications
are available for facilities to use to manage their data. For
example,
• The District Health Information System (DHIS2) d
Characteristics of the data
• Ownership and relevance
• Validity and reliability
• Aggregation of data
• Customizing information to the users’ needs
• Timeliness of feedback
Sybsystems of Health Information System
WHO proposes to categorize the health information system
under five interrelated “subsystems”:
• Epidemiological Surveillance (notifiable infectious dis-
eases, environmental conditions, and risk factors)
• Routine service reporting
• Special programmes reporting systems (tuberculosis
and leprosy control, MCH, school health)
• Administrative systems (health care financing systems,
health personnel systems, logistic systems)
• Vital registration systems (births, deaths, and migratory
movements)
A framework for defining information
needs and indicators
• Perform a functional analysis at each management level
of the health service system
Identify information needs and select feasible indicators
• Patient / Client management
• Health Unit management
• Health System management
Example Health System Indicators
Health status indicators
Infant mortality rate
Maternal mortality
• Life expectancy at birth
• Health care utilization indicators
• Immunization coverage
• Antenatal care coverage
• Proportion of births attended by a skilled birth at-
tendant
• Health resource indicators
• Distribution of qualified personnel
• Distribution of health services
Types of routine data collection methods
• Health unit data collection
• Community data collection
• Civil registration systems
Data collection instruments
• Data collection instruments for patient/ client
management
Curative
• Medical records
• Laboratory forms
• Referral forms
Preventive
• Growth cards
• MCH cards
• School health card
• Family registration records
What can be done to improve and ensure
data quality
• Keep the design of the information system as simple as
possible
• Involve users in the design of the system
• Standardize procedures and definitions
• Design of data collection instruments
• Develop an appropriate incentive structure
• Plan for effective checking procedures
• Training
Data collection instruments
• Home-based records: Immunization cards, Growth-
monitoring card, Maternal health card
• Health worker based records: Pregnancy/birth card,
death report form, child records, women’s register,
workers work form
• Supervisor’s based: Supervisor’s roster
• District-based records: Family enrollment forms, birth
registers, death registers, health worker’s report, super-
visor’s report
• Home office- and donor-based reports of health project
outputs and population health status
Elements of Health information system
management
Health Information system
• Hospital Information System is One that supports
all hospital functions and activities such as patient
records, scheduling, administration, charge-back
and billing, and often links to or includes clinical
information systems such as RIS. (Radiology In-
formation System )
The information of the hospital come from
• Front office
• Doctors consultation room
• Ward
• Laboratory
• The service providers like financial and
insurance service provider
• And so on
Information will be used by the areas
• Patient Administration
• Clinical Management
• Resource Management
• Financial Management
• Management Information System
• And more…
HIS have the ability to link the following
major players
• Laboratories
• Pharmacies
• Researchers
• Doctors and consultants
• Banks and financial institutions
• Administrators
• And knowledge managers
The aim of a HIS
• Is to adequately enable the execution of information
processing functions
– for patient care, including
administration as well as
– for research and education mainly
for university hospitals -
• considering economic hospital management, as well
as
• legal and other requirements
• therefore HIS contributes to a high quality of patient
care and medical research
• HIS should provide, as far as feasible,
the right information and
the right knowledge
at the right time
in the right place
to the right people
in the right form
so that these people can make
the right decisions
importance of HIS
• the information system of a hospital is an important
quality factor
• the information system of a hospital is an important
cost factor
• the quality of HIS is becoming increasingly relevant in
the competition between hospitals
• a HIS can provide a holistic view of patients and of a
hospital
• a HIS can be seen as the memory and nervous system
of a hospital
REFERENCE
• Ethiopia Health Management Information System
Scale-Up Project (USAID)
• World Health Organization (WHO). (2010). Mon-
itoring the building blocks of health systems: A
handbook of indicators and their measurement
strategies. WHO.
• WHO. (2000). Design and implementation of
health information system.
• legal and ethical issues in healthcare
• The main legal issues in the healthcare sys-
tem relate to medical negligence, informed
consent and confidentiality. Here are a few
legal issues that affect the healthcare system
on a regular basis:
• Antitrust issues and ACOs – Accountable
Care Organisations (ACOs) consist of
groups of doctors, hospitals and other
healthcare providers, who collaborate vol-
untarily to provide coordinated high-quality
care to patients.
• False claims and whistle-blower suits – This
refers to the National Health Service (NHS)
process of detecting healthcare fraud and
abuse perpetrated by dishonest physicians,
healthcare providers and suppliers.
• Healthcare system malpractice and tort re-
form – The main reason why governments
work on reducing medical malpractice and
have implemented tort reform is to reduce
expenditure on unnecessary healthcare ser-
vices.
• Ethical issues often involve the topics of
confidentiality, informed consent and pa-
tient-doctor relationships. Below are some
of the ethical issues that commonly arise in
the healthcare system:
• Patient confidentiality – A confidential rela-
tionship between physicians and their pa-
tients is essential.Patient information should
be available only to the physicians and
other healthcare personnel as required.
• Informed consent – Informed consent
means providing an in-depth understanding
of the risks and benefits of a treatment to a
patient
• Physician-assisted Suicide (PAS) and eu-
thanasia – Euthanasia refers to the process
of a deliberately ending a patient’s life in
order to relieve them of suffering. It is ille-
gal in most countries but is still a hotly de-
bated ethical issue surrounding whether it
should or should not be legalised.
