MANAGING INFORMATION SYSTEM IN HIS IN DEVELOPING COUNTRIES

INTRODUCTION

HIS IN DEVELOPING COUNTRIES  According to the World health organization (WHO, 2000), implementing health information systems (HIS) is a good way to strengthen the health care systems in developing countries.  The purpose of information system is to reduce data and paper handling, while increase efficiency and reduce time. In other words, to achieve good output materials for decision making.  Many developing countries still rely on storing, collect and record information on paper and less though IT.

Question discussing today  Current practices in China/Zambia in terms of implementation/managing of information system in their healthcare  What is the main reason for the failures in both countries?  Compare to UK, how can developing countries learn from them?  Can you give any advice to developing countries?, What is the lesson learned? / what need to be considered implementing and managing HIS in developing countries.

CURRENT CHINESE HEALTHCARE INFORMATION SYSTEM  Second software generation  Urban area: Only use IT software in payment and billing systems  Rural area: Only use paper to record  Independent, no sharing

OVERALL MANAGEMENT AND PLANNING PROBLEMS  No clinician engagement in the HIS, the clinic is operated like grocery  Lack of coordination between big hospitals. -- The medical record of patients are not shared among hospitals  The hospitals have no incentive to report their data to National Health Department -- make it difficult to have a data research of China’s current health situation  Poor integration of diverse software system within hospital ding to the World health organization (WHO, 2000), implementing health

FINANCE AND EXPERTISE RELATED PROBLEMS  The spend on HIS in is low -- only 0.7% of national health budget.  -- 70% goes to hardware and only 20% are used to improve the HIS software  Software problems: -- local designed software is immature -- not localized international software cannot fit the hospital system  Lack of skilled workers with IT and healthcare and hospital management knowledge  Poor implementation leads to a large amount of work- process redundancy

UK NHS INFORMATION SYSTEM MANAGEMENT

HEALTHCARE SYSTEMATIC STRUCTURE

INFORMATION FLOW AMONG INDIVIDUAL CENTRES IIn parallel, consistent with information and procedural standards SSame organizational model applied in the computerization AAll units of the hospital mutually interact consistently HHowever, the diversity of the individual hospital organizations, varies preferences, complex clinical protocols makes difficult to make the system efficiently useable in the whole structure

IMPLICATIONS OF THE UK NHS INFORMATION SYSTEM MANAGEMENT  A consistent and integrate information system must consider the three viewpoints:  - From the organizational viewpoint - From the operating viewpoint - From the technological viewpoint  The NICE1 technological distribution platform  The DHE2 application infrastructure  The user-oriented applications

Examples of UK healthcare information system  Every citizen with a NHS reference number which records health information and makes it possible to share patient information safely, efficiently and accurately across NHS organizations and social care  Summary Care Records provide healthcare staff treating patients, in an emergency or out-of-hours, with faster access to key clinical information  Electronic Prescription Service makes the prescribing and dispensing process safer and more convenient for patients and staffs  Picture Archiving and Communications System enables images such as x-rays and scans to be stored electronically and viewed on screens.

CRITICAL ISSUES IN IMPLEMENTATION OF HMIS Five main issues:  Stakeholders dimension  Roles and responsibilities should be clearly defined  Social and cultural dimension  People in the area are resistant to change.  Financial sustainability dimension  Costly to implement. Ability to meet financial obligations on the long term  Technology/Infrastructure  Lack of infrastructure in that area. Ie. Power supply  Human capacity development dimension  High illiteracy levels. People need to be trained to use the new technology

RECOMMENDATIONS

LESSONS LEARN FROM THE FAILED INFORMATION SYSTEMS TThree valuable lessons: 1.Medical information should be integrated across all departments in the hospital 2. Effective information system planning is necessary 3. Using the same information system used in developed countries in is not always a good idea for developing countries.

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