Computerized System In Himachal Pradesh Health Management Information System (HMIS)

Computerized System In Computerized System In Himachal PradeshHimachal Pradesh

Computerized System In Computerized System In Himachal PradeshHimachal Pradesh

Health Management Information Health Management Information System (HMIS)System (HMIS)

Health Management Information Health Management Information System (HMIS)System (HMIS)

Health Management Information System in Himachal Pradesh

Presentation by Ms. Harinder HiraPrincipal Secretary-HealthGovt. of Himachal Pradesh

Before:

Data was available but not accessible

Summary of data was calculated by hand and therefore prone to errors

Long delay to produce reports

“Data Storage”

Need for the New HMISNeed for the New HMISNeed for the New HMISNeed for the New HMIS

• Reform health information systemReform health information system• Transition from reporting system to Transition from reporting system to

conscious use of informationconscious use of information• Managerial decision makingManagerial decision making• Accuracy of Data Accuracy of Data • Facility wise performanceFacility wise performance• New computerized HIMS is expected to New computerized HIMS is expected to

increase coverage & improve quality of increase coverage & improve quality of servicesservices

• Reform health information systemReform health information system• Transition from reporting system to Transition from reporting system to

conscious use of informationconscious use of information• Managerial decision makingManagerial decision making• Accuracy of Data Accuracy of Data • Facility wise performanceFacility wise performance• New computerized HIMS is expected to New computerized HIMS is expected to

increase coverage & improve quality of increase coverage & improve quality of servicesservices

Existing MIS FlowExisting MIS FlowExisting MIS FlowExisting MIS Flow

Health Workers atHealth Workers atSC LevelSC Level

Health Workers atHealth Workers atSC LevelSC Level

Form 6Form 6Form 6Form 6Other HealthOther Health

ProgramProgramFormsForms

Other HealthOther HealthProgramProgramFormsForms

Reports to PHCReports to PHCReports to PHCReports to PHC

Form 7Form 7Form 7Form 7

AAAA

Collects and fills dataCollects and fills data

AAAA

Reports to BlockReports to BlockReports to BlockReports to Block


Reports to District H.Q.Reports to District H.Q.Reports to District H.Q.Reports to District H.Q.


Reports to DirectorateReports to DirectorateReports to DirectorateReports to DirectorateMonthly Bulletin on Monthly Bulletin on Process of DifferentProcess of Different

DistrictsDistricts

Monthly Bulletin on Monthly Bulletin on Process of DifferentProcess of Different

DistrictsDistricts

Today:

Data is accessible at all levels

Reports are produced on time

Reports are used for monitoring and decision support

Current Status A computerised information system (HMIS) has been installed

in 10 districts out of 12 districts of Himachal Pradesh.

Monthly Reporting Forms 6, 7 and 8 are entered into the HMIS from all Blocks.

HMIS is on trial basis in remaining district of Sirmaur and Tribal District of Himachal Pradesh.

Data from SC, PHC, CHC and Hospitals is available for reporting, supervision, planning and analysis

Computerized HMISComputerized HMISComputerized HMISComputerized HMIS

Data Collection at Data Collection at Health Facilities Health Facilities Form 6, 7 and 8)Form 6, 7 and 8)

District Computer UnitDistrict Computer UnitBlock Computer UnitBlock Computer Unit

Decision Support Decision Support SystemSystem

State DirectorateState Directorate

Health Managers / Health Managers / Program OfficersProgram Officers

Through Through FloppyFloppy

Through FTP, using phone Through FTP, using phone lineslines

New Computerized HIMS FlowNew Computerized HIMS FlowNew Computerized HIMS FlowNew Computerized HIMS FlowSC, PHC, Block PHC,SC, PHC, Block PHC,CHC and Other HealthCHC and Other Health

FacilityFacility

SC, PHC, Block PHC,SC, PHC, Block PHC,CHC and Other HealthCHC and Other Health

FacilityFacility

Feedback on IndicatorsFeedback on IndicatorsFeedback on IndicatorsFeedback on IndicatorsForm 6Form 6Form 6Form 6

Collects and fills dataCollects and fills data

PHC fills additional dataPHC fills additional dataOn form 7On form 7

PHC fills additional dataPHC fills additional dataOn form 7On form 7

Reports to BlockReports to Block Computer UnitComputer Unit

Reports to BlockReports to Block Computer UnitComputer Unit

Hospitals fill additional dataHospitals fill additional dataOn form 8On form 8

Hospitals fill additional dataHospitals fill additional dataOn form 8On form 8

Reports to DistrictReports to District Computer UnitComputer Unit

Reports to DistrictReports to District Computer UnitComputer Unit

Reports to StateReports to State Computer UnitComputer Unit

Reports to StateReports to State Computer UnitComputer Unit

Compiles data forCompiles data forDecision MakingDecision Making




Reports

• Reports are used at monthly Block meetings

• Reports help in the monitoring of activities

• Additional reports can be programmed if needed

Health Performance IndicatorsHealth Performance IndicatorsHealth Performance IndicatorsHealth Performance IndicatorsServices Percentage Recorded

1 ANC cases registered

2 Pregnant woman with 3 ANC check-ups

3 Registered pregnant woman receiving all ANC services

4 Registered high risk pregnant woman referred

5 Deliveries conducted by trained health personal

6 Deliveries conducted by TBA

7 Woman received 3 Post Natal Check-ups (PNC)

8 Male sterilization to total sterilization

9 Eligible couples covered by IUD

10 Births notified to Local Registrar

11 Still Births notified to Local Registrar

12 Maternal Deaths notified to Local Registrar

13 Utilization of health facility (O.P.D.)

14 Average per day O.P.D. workload per doctor

15 Infant Mortality Rate (IMR) per 1000 live births

16 Maternal Mortality Rate (MMR) per lakh live births

Male Female

17 Infant (0 to 1 year) fully immunized out of the eligible infants.

18 Incidence of Measles cases per 1000 population

19 Incidence of Whooping Cough cases per 1000 population

20 Diarrheal cases registered under 5 years per 1000 under 5 years population

21 Birth weight recorded less than 2.5 Kg

22 Birth weight recorded 2.5 Kg or more

23 High risk new born referred

24 Acute Diarrhea Disease under 5 years given ORS

25 Acute Diarrhea Disease cases referred

26 ARI cases treated with Co-trimaxozole

27 ARI cases referred

28 Infant Mortality Rate (IMR) per 1000 live births

Data Available in Form 6 (all health facilities)

1. Number of OPD cases2. Ante Natal Care3. Natal Care4. Pregnancy Outcome5. Post Natal Care6. Immunization7. Booster Immunization8. Childhood Diseases9. Child / Infant Deaths10. Contraceptive Services11. Abortions12. Communicable Diseases 13. Number of Blind14. IDD control (Iodine Deficiency)15. Leprosy Cases16. Registration of vital events (births, deaths)17. Interaction with the community

Data Available in Form 7 (PHC only)

1. Post natal care

2. RTI/STI

3. Contraceptive Services

4. Abortions

5. Communicable Diseases

6. Blindness Cases

7. Leprosy Cases

8. School Health

9. Equipment

10.Vacancy Position

11.Inventory of Drugs, Vaccines, Lab consumables and Equipment

Data Available in Form 8 (Add. for CHC, CH,

Dist. Hops., Zonal Hosp.)

1. Natal care

2. Post natal care

3. Contraceptive Services

4. Abortions

5. Leprosy Cases

6. Prevention of food adulteration

7. Inventory of Drugs

8. Staff Position

General Findings

• HMIS is their reporting, monitoring and supervision tool

• Situation with data transfer has improved

• User refresher training has to be intensified

• Maintenance of computers not secured

• Need to change form 6,7 and 8

General Findings: Data Analysis

• HMIS is a rich basis for additional data analysis

• Data analysis is limited (meaning no trends,

correlations, regressions) at the moment

CONCLUSIONCONCLUSION

• The vision of a new HMIS is that it is simple to operate & valuable to health staff.

• The system has been designed in such a way that health workers who collect the information must be able to use it also. The forms & formats developed should not be too many, bulky and complicated so as to avoid the temptation of not filling them.

• The system has been developed & pre-tested in 3 districts for a year.

Outlook and Perspectives: Reports

• Reports have improved, some calculations need to be corrected (in process).

• Visualisation of data/reports (graphs/charts) is available but has to be improved.

• Ranking of health services for selected indicators has been programmed and works

Outlook and Perspectives: Training and Maintenance

• Statisticians should be trained in additional software (Excel, Access, Windows).

• Statisticians are and will be trained in same basic hardware maintenance

FRIENDLY REMINDER:

• The purpose of HMIS is to improve health care delivery through improved monitoring, supervision and planning!

• HMIS is an essential tool to achieve that purpose

Challenge Ahead

• New Forms in NRHM

• Integrate HMIS proposed HIS(Health Information System) and other softwares to produce comprehensive reports.

• To take HMIS up to PHC level.

Computerized System In Himachal Pradesh Health Management Information System (HMIS)

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