RATIONALISING HEALTH INFORMATION SYSTEMS TO IMPROVE HEALTH OUTCOMES - PowerPoint PPT Presentation

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RATIONALISING HEALTH INFORMATION SYSTEMS TO IMPROVE HEALTH OUTCOMES

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Characteristics of Good Health. Surveillance Systems (cont) Relevant to users ... Example of project to maximise efficiency of existing health information systems ... – PowerPoint PPT presentation

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Title: RATIONALISING HEALTH INFORMATION SYSTEMS TO IMPROVE HEALTH OUTCOMES


1
RATIONALISING HEALTH INFORMATION SYSTEMS TO
IMPROVE HEALTH OUTCOMES Public Health
Services Queensland Health Australia 1998-2000
2
Dr Magnolia Cardona Coordinating
EpidemiologistMB.BS, MPH, Grad DAE, CHEcon
3
Objectives of this lecture
  • Provide an overview of information system types
    and potential uses
  • Increase awareness on need to balance amount of
    data with cost and confidentiality concerns
  • Present case scenarios to set up and enhance
    information systems

4
Characteristics of Good Health Surveillance
Systems
  • Clear objectives
  • administration
  • routine documentation
  • monitoring
  • research/evaluation
  • Simple (MDS)
  • Standard item format
  • Justification and validation of items

5
Characteristics of Good Health Surveillance
Systems (cont)
  • Relevant to users
  • Minimum burden to providers
  • Amenable to modification
  • Provision for security/confidentiality
  • Associated reporting system
  • Feedback to collectors
  • Linked to action

6
Options
  • Paper-based centralised
  • Sentinel/selected surveillance
  • Computerised stand alone
  • Single site
  • Multicentre

7
Options
  • Computerised networked
  • Encrypted data transfer
  • Combination
  • Paper-based notifications
  • electronic entry at central location

8
Setting up a Health Information System Which
option is best?
9
SCENARIO Cholera epidemic in Africa
  • No routine surveillance
  • Poorly kept clinical records
  • Understaffed facilities
  • Unreliable communications
  • No ongoing funding
  • No computers

10
Cholera epidemic in Africa
Example of a paper-based system that worked in an
endemic area for at least 2 years
11
Occupational exposure to bloodborne illnesses
among health staff
  • Hundreds of health facilities
  • Infrequent incidents
  • Non-compulsory recording
  • No ongoing funding
  • Confidentiality issues
  • Compensation issues

12
Nutritional Status Monitoring in
a remote indigenous community
  • Routine surveillance of some conditions
  • Somehow comprehensive clinical records
  • Services staffed by community
  • Unreliable communications
  • Some funding available
  • Some computers usable

13
Major stakeholders concerns
  • How the data will be collected
  • How the data will be used
  • Who will have access to the data
  • Confidentiality issues
  • Perceived discrimination
  • Financial implications

14
Indigenous Community Health
  • Computerised system
  • Easy front-end
  • Complete patient information (alias/residence)
  • Promotes opportunistic P.H. action
  • Capability for health worker plans
  • Population based reporting system
  • Generates customised prevalence/incidence

15
Burden of depression at Medical Practitioners
rooms
  • Non-standard recording practices
  • ? Availability of clinical records
  • Busy medical practices
  • Variable communication systems
  • Low computer coverage
  • Ethical issues
  • Incentives required for doctors

16
Doctors-based Sentinel Surveillance
  • Enables documentation of non-hospital data
  • Burden of disease measurement
  • Paper-based with weekly notifications
  • Limited patient information conditions
  • Selected Locations (self-selected doctors)
  • Inability to calculate prevalence/incidence

17
Example of project to maximise efficiency of
existing health information systems
  • Real case scenario

18
Improve health outcomes through enhancement of
Public Health information systems
Aim
19
Objectives
  • High quality /timely data
  • Minimise duplication/cost
  • Standard coding practices
  • Common table structures
  • Common operating environment
  • Shared hardware
  • Data Linkage

20
Inventory of Databases
  • Purpose/Scope /Contents
  • Size/Accessibility
  • Operating system/server/interface
  • Data tables
  • Remote access/re-development
  • Special requirements
  • Staff involved

21
Integration Protocols
  • Hardware /software
  • Data definitions NHDD
  • Reference tables
  • Data Entry Transfer
  • Security /Confidentiality

22
Working Group
  • Discuss IT requirements
  • Re/development experience
  • Security Principles
  • Sharing of reference tables
  • Integration protocols
  • Recommendations

23
Levels
Integration
Business
User interface
Data use (structure)
Database (execute instructions)
Platforms (hardware)
Network (WAN, LAN)
24
BSR
PSR
Lead
NOCs
VIVAS
MODDs
Business
?
?
?
Interface
?
Data use
?
?
?
?
Database
?
?
?
?
?
Platforms
?
?
?
?
?
?
Network
?
?
?
?
?
?
25
How does this improve Health Outcomes?
  • Outbreak response/timing
  • Immunisation rates
  • Prescription control
  • Standard Indigenous identifiers
  • Early cancer detection\QA

26
Summary
  • Relevance cost-effectiveness
  • Consultation with users and data holders
  • Financial considerations
  • Ethical implications
  • Ultimate goal to improve health
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