Health management information & evaluation system relevance to Nursing

2.  Evaluation system is a periodic evaluation of system
to assess its status in term of original, current
expectation & to chart its future direction.
 System is a collection of components that work together to
achieve a common objective. (WHO)
 Information System A system that provides information
support to the decision-making process at each level of an
organization. (WHO)
 Health information System A system that integrates data
collection, processing, reporting, and use of the information
necessary for improving health service effectiveness and
efficiency through better management at all levels of health
services. (WHO)

3. Year and event Content
1982 MIES- Management information and Evaluation system was tried
to be introduced but has not taken roots.
1983 national
health policy
Envisaged a nationwide organizational setup to procure essential
health information
1983-85 HMIS version 1.0 in four participating state of Gujarat, Haryana,
Maharashtra and Rajasthan
1986-88 Development of HMIS with collaboration of WHO and National
Informatics Centre (NIC)
1989 Field testing of the HMIS in one district of Gujarat, Haryana,
Maharashtra and Rajasthan
1990-95 Implementation efforts in 13 states and Union Territories in
phased manner

4. 1996 March
review meeting
To take note of the changes suggested by the
implementing states and revise the HMIS 2.0
1997 CBHI organised a work Shop Officials of
Government of India, states, NIC, WHO,
Planning commission and deliberated on the
problems with the present HMIS version 2.0
2013 At present MIES uses version 2.0

5.  To enhance communication among
employees.
 To provide a system for recording &
aggregating information.
 Reduce expenses related to labour-intensive
manual activities.
 To support the organisation’s strategic goals
and direction.

6.  For getting Real time information regarding the
outbreak of epidemics.
 Need for an integrated tool for timely
monitoring of services.
 To evaluate the existing system, so as to
promote strategies to strengthen the existing
system.

7.  Planning systematically & coordinating
activities.
 Establishing databases on budgets, personnel,
facilities & equipment.
 Providing guidance in choosing entry points for
programme interventions & establishing active
partnerships with other organisations.

8.  Providing information on the status
of the population served, such as its
health.
 Guiding prioritizing by identifying
major problems.
 Providing indicators for monitoring &
evaluation of performance.
 Assessing the impact or
effectiveness of services.

9. 1. DIRECT APPROACH
2. PARALLEL APPROACH
3. MODULAR APPROACH

10.  The risk of systems failure is localized.
 The major problem can be easily identified &
corrected before further implementation.
 It supports & enhances the overall decision
making process.
 MIS enhances job performance throughout an
institution.
 It provides the means through which the
institutions activities are monitored &
information is distributed to management,
employees & customers.

11. A. Central level
1. CENTRAL BUREAU OF HEALTH INTELLIGENCE
(CBHI)
2. STATISTICS DIVISION IN THE DEPARTMENT
OF HEALTH AND FAMILY WELFARE
3. THE SAMPLE REGISTRATION SYSTEM (SRS)
4. CENSUS/ POPULATION SURVEY
5. HEALTH RECORDS SURVEY

12. STRUCTURE
Director (CBHI)
Dy. Director General of Health Services
Deputy Director
Asst. director (3)
Statistician (2)
Computer Assistant (5)
Director General of Health Services (Govt. of India)
Field survey units (six)

13. Political head- minister of cabinet rank Divided
into Health and Family welfare and headed by a
career bureaucrat.
Organised into Directorates of Health, Family
welfare, primary health, secondary health and
medical education, training etc., each headed by
promoted doctors.
Responsible for hospital care and implementer
of national programs and family welfare
Concentration of financial and personal powers.

14. Last administrative
unit ---- 1.0 to 2.5
million population
Headed by a civil
surgeon. District
medical officer doctor/
physician
Maintains the logistics of
drugs and supplies,
collects the statistics &
does not have much
financial and personal
powers
Coordinates and
controls nearly 10-
15 hospitals, 40-70
PHCs

15. • (1) Review the existing system
• (2) Define the data needs of relevant
units within the health system
• (3) Determine the most appropriate
and effective data flow

16. • (4) Design the data collection and reporting
tools
• (5) Develop the procedures and mechanisms
for data processing
• (6) Develop and implement a training
programme for data providers and data users.

17. •(7) Pre-test
• (8)Monitor and evaluate the system
•(9) Develop effective data dissemination
and feedback mechanisms

18. CONTENT AND FLOW OF MIES
From -
To
Periodicity Content
Sub-centre
to PHC
Monthly
Performance report – very exhaustive report on all aspects of
performance Family planning, immunization, Diarrhoeal diseases,
Malaria, leprosy, Blindness, Deaths of all types,
Inventory report – Malaria drugs, Family planning vaccines, ORS,
Basic drugs and others. it has column on consumption, balance
and whether it is
Sufficient or not.
Other
Basic equipment facilities – quarterly
It basically shows the list of 20 basic equipment and in case they
are out of order from a particular date.

19. PHC/
hospital to
District
Monthly
Family welfare—sterilizations, IUDs, Op, Condom
users, MTP etc., - stock position and the details of the
above staff wise and unit wise etc.,
Vital statistics - Births, still berths, deaths, maternal
deaths, infant deaths, neo natal deaths
FW performance like – AN cases, institutional
deliveries, vaccination, cold chain equipment,
surveillance on Diphtheria, measles etc.,
Medical intelligence data on 41 identified diseases
from general fever to Ulcer of stomach to snake bites
Hospital IP and OPIEC reports on contacts, group
activities, T.B., MALARIA, LEPROSY monthly reports.
District to
state HQ Monthly
Malaria, TB, Leprosy, Blindness etc., Each program
sends a summary of program statistics Summary
statistics for family welfare services (presently RCH)
State HQ
to centre Monthly
Malaria, TB, Leprosy, Blindness etc., Each program
sends a summary of program statistics Summary
statistics for family welfare services (presently RCH)

20. Location
/hospital
Person responsible
Sub-centre ANM
PHC/
Hospital
Pharmacist
statistical assistant with computer designation
District District statistical officer- health, family welfare
Dt. TB, Malaria, Leprosy officers
State Dy/Joint director Statistics- Family welfare
Dy/Joint director- Vital statistics
Surveillance Unit Sample Registration system
Central
Governme
nt
Central Bureau of Health Intelligence
Statistics Division- Department of Family Welfare, CGHS
Statistics Division- Department of Health
Sample registration system- head quarter

21. A. Structural issues
1. AT CENTRE
 No central databases
 Mostly in the manual books and reports
 Fragmented data with different ministries and
departments
 Depends on research institutions survey.
 Computers are employed for office functions

22. 2. AT STATE
 Mostly in the manual books and reports
 Fragmented data—different directorates
 Not much data from research institutions
 Computers given in many programs but old
now

23. 3. AT DISTRICT
 Mostly in the manual books and reports (Fragmented
data )
 Manual books and reports known to the person
writing them Mostly send reports and forget concept.
4. AT PHC/ VILLAGE
 One or two registers properly maintained Mostly from
the personal view.

24.  This section deals with the procedural issues
like excessive information, encryption issues,
problems with hospitals, absence of feedback
and others.

25.  The HMIES system processes the information in
such a way that only summaries reach the
higher levels. The details miss the attention of
the policy makers and managers.

26. Different levels of staff involved in the HMIS
process have series inadequacies as far as training
and development efforts are concerned.

27.  Unfortunately, the entire HMIS in India is in
black and white.
 Any information system these days means
DATABASES.
 At district level it is still worst and they use it
for word processing and other printing
works.

29.  RHIS focus on on-going data collection of health status,
health interventions, and health resources. Examples
include facility-based service statistics, vital events
registration, and community-based information systems.

30.  Routine Health Information Network (RHINO)
It is a collaboration of developing country governments,
donor agencies, technical groups, and private voluntary
organizations.
 Its purpose is to strengthen the role of evidence-based
decision-making by engaging organizations and
professionals in promotion of effective collection and use
of routine health information, especially at the district level
and below.

31.  An EMR is a computerized
medical record created in an
organization that delivers care,
such as a hospital or
physician’s office. Electronic
medical records tend to be a
part of local stand-alone health
information system that allows
storage, retrieval &
modification of records.

32.  Databases help collect and
store the details of every
transaction or the detailed
record.
 They give the ability to process
the data in a way that is
required for a specific task,
project or purpose. They help
relate and integrate huge sets
of data on identical fields.

34. Nursing management systems
are computer systems that
manage clinical data from a
variety of healthcare
environments, and made
available in a timely & orderly
fashion to aid nurses in
improving patient care

35.  Workload measurement & staffing
requirements
 Fiscal resource management
 Personnel management
 Staff scheduling

36. 1. In Nursing Administration
2. In Nursing Practice
3. In Nursing Research
4. In Nursing Education

37.  Evaluate quality
assurance programs,
defend resource
allocation to nursing.
 Identify outcomes of
nursing care.

38.  Enhance documentation by nurses’ provide
reliable data.
 Examining the interrelationships between
data elements and nursing outcomes.
 Facilitate development of the nursing process.

39.  To assess variables or multi
levels including institutional,
local, regional, & national.
 Identify trends integrate to
build information & to further
synthesize to develop nursing
knowledge.

40.  To develop body of
knowledge with focus on
nursing process to enable
staff educational needs
based on follow up care &
outcomes.
 To enhance student
nurses accurate
documentation.

41. Process Evaluation
Output Evaluation
Effects Evaluation
Short term impact evaluations