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Management information system (MIS)
The document presents a comprehensive overview of Management Information Systems (MIS) in healthcare, detailing its objectives, benefits, components, and types, including Health Management Information Systems and Logistics Management Information Systems. It emphasizes the importance of collecting and analyzing relevant health data for effective decision-making, program management, and resource allocation in public health. Additionally, it discusses the challenges of implementing these systems, such as data quality and reporting issues, alongside tools like DHIS2 for managing health information.
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Management information system (MIS)
- 1. MANAGEMENT INFORMATION SYSTEM Presentation By: BikramAdhikari (136) MPH-2018 School of Public Health and Community Medicine
- 2. Overview • Introduction • Information •Sources of Information • Information-Qualities • Information cycle • Information system • Health Information system • Management Information system(MIS) • Objectives • Benefits • Components of MIS • MIS Model • Pyramid structure of MIS • Types of Management Information system • Health Management Information System: Definition, objectives, Process, HMIS tools, Constraints • Logistics Management Information System: Definition, Goal, Logistic cycle, LMIS data flow, Benefits 5/15/2019 2
- 3. Introduction • Information: • Informationas a representation of knowledge • Information as data in the environment • Information as part of the communication process • Information as a resource or commodity • A stimulus originating in one system that affects the interpretation by another system of either the second system’s relationship to the first or of the relationship the two systems share with a given environment 5/15/2019 3
- 4. Introduction Sources of healthInformation: • Census • Registration of Vital Events • Sample Registration System (SRS) • Notification of Disease • Hospital Records • Disease Registers 5/15/2019 4 • Epidemiological Surveillance • Other Health Service Records • Environmental Health Data • Health Manpower Statistics • Population Surveys • Non-quantifiable information
- 5. Introduction Information Quality • Understandable •Relevant • Complete • Available • Reliable • Timely • Concise 5/15/2019 5
- 6. Introduction • Management • Managementis the act of getting people together to accomplish desired goals and objectives using available resources efficiently and effectively. • Management information • Important input at every level in the organization for decision making, planning, organizing, implementing, and monitoring and controlling. 5/15/2019 6
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- 8. Introduction Information system • Amechanism that ensures information is available to the managers as per their need and time. • It provides relevant information for decision making. • 5/15/2019 8
- 9. Introduction Health Information system •Collects data from the health sector and other relevant sectors, analyses the data and ensures their overall quality, relevance and timeliness, and converts data into information for health-related decision-making. • 4 key functions: • Data generation • Compilation • Analysis and synthesis • Communication and use. 5/15/2019 9
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- 13. Introduction • Management Informationsystem (MIS) • An organized, diverse and automated information system • Concerned with the process of gathering, storing and transferring relevant information • To support the • Management operations • Management analysis • Decision-making functions 5/15/2019 13
- 14. Introduction • MIS • "anorganizational method of providing past, present and projected information related to internal operations and external intelligence” • ''an integrated user machine system for providing information to support operations, management and decision making functions in an organization. The system utilizes computers, manual procedures, models for analysis, planning, control and decision making, and a database'' 5/15/2019 14
- 15. Introduction • It isa system, which provides the required information to each level of management at the right time, in the right form, covering the desired quantity and quality, so that it may form the basis of decision making. 5/15/2019 15
- 16. Objectives of MIS •To Facilitate the decision-making process • To Collects information in a systematic and a routine manner. • To Provide requisite information at each level of management to carry out their functions. • To Highlight the critical factors to be closely monitored • To Provide a system of people, procedures, query facilities for collecting, storing, retrieving and transmitting information. 5/15/2019 16
- 17. Benefits of MIS •Effective and efficient coordination between Departments • Quick and reliable referencing • Access to relevant data and documents • Use of less labor • Improvement in organizational and departmental techniques • Management of day-to-day activities • Day-to-day assistance in a Department and closer contact with the rest of the world. • Provides a valuable time-saving benefit to the workforce 5/15/2019 17
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- 20. Types of MIS •Health management Information system • Logistics management Information System • Fiscal Management Information system • Human Resource Management Information system • Drug Information Network • Ayurvedic Reporting System 5/15/2019 20
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- 23. Health management InformationSystem • HMIS is defined as a system that • Integrates: • data collection, data processing, reporting • Provides • up-to-date, reliable , complete and timely information to health managers • at various levels (PHC, CHC, SDH & District Hospitals.) • in order to improve effectiveness and efficiency of health services and make well-informed management decisions about program performance and operations 5/15/2019 23
- 24. Health management InformationSystem • Before the integration of all health programs in 1993, various vertical projects were using their own Information system with their own reporting and recording system. • DOHS designed and implemented the HMIS in entire country since 1994 with continuous financial and technical support from UNFPA and some other EDPs. 5/15/2019 24
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- 26. Importance of HMIS •Produces information needed by • Patients, communities, service providers, program managers, policy- makers, providers of funds, global agencies and organizations. • Identification and allocation of manpower and other resources • Effective and efficient uses of resources • Performance evaluation of program • Detect and control emerging and endemic health problems • Monitor progress towards health goals; and promote equity 5/15/2019 26
- 27. Objectives of HMIS •To manage and collect the health service delivery statistics from grass-root health service delivery points to the center. • To review the collected data for data processing, analysis and drawing inferences through appropriate indicators. • To develop competent human resource for Health Information Management System 5/15/2019 27
- 28. Objectives of HMIS •To assist in monitoring of program performances by providing the periodical feedback regarding achievement, coverage, continuity and quality of services through co-ordination with program divisions/centers, managers and service provides (Regional Health Directorate (RHDs), hospitals and district public/health offices) • To provide necessary information to policy-makers for developing appropriate health policies. 5/15/2019 28
- 29. Objectives of HMIS •To publish a comprehensive annual report of Department of Health Services. • To enhance the dissemination of health information to all concerned authorities using efficient methods and technologies. • To support PME (planning, monitoring and evaluation) of all health programs. 5/15/2019 29
- 30. Process of HMIS •Collection • Transmission • Storage • Retrieval • Analysis • Interpretation • Preparation for utilization • Presentation of information 5/15/2019 30
- 31. HMIS tool 5/15/2019 31 HMIS1 Master Register HMIS 1 Master Register HMIS 2 Multipurpose Contact Card HMIS 2 Multipurpose Contact Card HMIS 3 Child Health Card HMIS 3 Child Health Card HMIS 4 OPD Ticket HMIS 4 OPD Ticket HMIS 5 Immunization Register HMIS 5 Immunization Register HMIS 6 TT Register HMIS 6 TT Register HMIS 7 <5 Nutrition Register HMIS 7 <5 Nutrition Register HMIS 8 Micronutrient Distribution Register HMIS 8 Transfer/Referal Slip HMIS 9 Maternal Health Card HMIS 9 Maternal Health Card HMIS 10 Maternal Health Register HMIS 10 Maternal Health Register HMIS tools OLD HMIS Tools (2063)
- 32. HMIS tool 5/15/2019 32 HMIS11 Face Sheet (Hormonal) HMIS 11 CAC Register HMIS 12 Face Sheet (Non- Hormonal) HMIS 12 Face Sheet HMIS 13 Family Planning Register HMIS 13 Family Planning Register HMIS 14 Sterilization Register HMIS 14 Sterilization Register HMIS 15 IUD / Norplant Removal Register HMIS 15 IUD Norplant Removal Register HMIS 16 Out Patient Register HMIS 16 Out Patient Register HMIS 17 Outreach Clinic Register HMIS 17 Outreach Clinic Register HMIS 18 Specimen Collection Form HMIS 18A Specimen Collection Form - - HMIS 18B TB Sputum Examination Request form HMIS 19 Laboratory Examination Register HMIS 19 Laboratory Examination Register HMIS 20 Tuberculosis Treatment Card HMIS 20A Tuberculosis Treatment Card (Institution) - - HMIS 20B Tuberculosis Treatment Card (patient) HMIS tools OLD HMIS Tools (2063)
- 33. HMIS tool 5/15/2019 33 HMIS21 District Tuberculosis Register HMIS 21 Tuberculosis Register HMIS 22 Leprosy Examination and Treatment Card HMIS 22 Leprosy Examination and Treatment Card HMIS 23 Leprosy Clinical Register HMIS 23 Leprosy Clinical Register HMIS 24 Malaria Classification and Treatment Register HMIS 24 Malaria Classification and Treatment Register HMIS 25 Referral Slip HMIS - 25 Training/IEC Register HMIS 26 Defaulter Follow-up Slip HMIS 26 Defaulter Follow-up Slip HMIS 27 FCHV register HMIS 27 FCHV register HMIS 28 TBA Register HMIS 28 VHW/MCHW Diary HMIS 29 VHW/MCHW Diary HMIS 29 Closed tally-sheet HMIS 30 Universal Tally Sheet HMIS 30 Open Tally Sheet HMIS tools OLD HMIS Tools (2063)
- 34. HMIS tool 5/15/2019 34 HMIS31 VHW/MCHW Reporting Form HMIS 31 VHW/MCHW Reporting Form HMIS 32 PHCC/HP/SHP Reporting Form HMIS 32 PHC/HP/SHP Reporting Form HMIS 33 District Reporting Form HMIS 33 A District Reporting Form (Monthly) - - HMIS 33 B District Reporting Form (Quarterly) HMIS 34 Hospital Reporting Form HMIS 34 Hospital based Reporting Form HMIS 35 Admission Register HMIS 35 Admission Register HMIS 36 Discharge Register HMIS 36 Discharge Register HMIS 37 Hospital Tally Sheet Hospital Tally Sheet A (Indoor Summary) - - Hospital Tally Sheet B (Inpatient) - - Hospital Tally Sheet C (OPD Morbidity) - - Hospital Tally Sheet D (emergency) HMIS 37 HMIS tools OLD HMIS Tools (2063)
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- 36. 1. Common tools 1.1Master Register 1.2 Health Service Card 1.3 Outpatient Register 1.4 Referral/Transfer Slip 1.5 Defaulter/Discontinuation Slip 36
- 37. 2. Infant andChild Health 2.1 Child health Card 2.2 Immunization Register 2.3 Nutrition Register 2.4 IMCI Register 2.5 IMAM Child health Card 2.6 IMAM Register 2.7 IMAM Register Hospital Contd.. 37
- 38. 3. Family Health 3.1FP Face Sheet 3.2 Pills, Depo Service Register 3.3 IUCD/Implant Service Register 3.4 Sterilization 3.5 Maternal and Newborn health Card 3.6 Maternal and Newborn health service Register 3.7 Safe Abortion Service Register 38
- 39. 4. Community Services 4.1ORC Register 4.2 FCHV Service Register 4.3 Vitamin A Register 39
- 40. 5. Malaria, Kalazar,Leprosy • 5.1 Malaria, Kalazar,, Leprosy Sample Collection Form • 5.2 Malaria, Kalazar, Leprosy Laboratory Register • 5.3 Malaria, Kalazar Treatment Register • 5.4 Leprosy Examination and Treatment Card • 5.5 Leprosy Treatment 40
- 41. 6. Tuberculosis • 6.1Sputum Sample Collection Form • 6.2 TB Laboratory Register • 6.3 TB Treatment Card(HF) • 6.4 TB Treatment Card(Patient) • 6.5 TB Treatment Register • 6.6 PAL: Smoking Cessation Register • 6.7 DR TB Laboratory Register • 6.8 DR TB Treatment Register 41
- 42. 7. HIV/AIDS andSTI • 7.1 HIV Testing and Counselling Register • 7.2 STI Treatment Register • 7.3 PMTCT of HIV Service Register • 7.4 HIV Treatment and Care Register • 7.5 HIV Patient Treatment Card • 7.6 OST Register 42
- 43. 8. Hospital • 8.1Emergency Service Register • 8.2 Admission Register • 8.3 Discharge Register 43
- 44. 9. Monthly ReportingForm • 9.1 FCHV Reporting Form • 9.2 ORC Reporting Form • 9.3 PHCC/HP/SHP Reporting form • 9.4 Public Hospital Reporting form • 9.5 Private and NGO Health Facility Reporting Form 44
- 45. Key Features ofRevised HMIS • Address the needs of NHSP-II, policy and program • Enable selected indicators to be disaggregated by ethnicity and caste • Enable health facility level data reporting • Minimize duplication of work and burden on staff • Improve use of HMIS data in different levels for PME • Link HMIS with other MIS using uniform coding system • Improve data quality • Integrate vertical programs like EOC, Aama, CB-NCP, TB, HIV 5/15/2019 45
- 46. Constraints of HMIS •Reporting:Irregular, Inconsistent and incomplete, under reporting •Weak coverage: private sector •Discrepancy : Data reported and recorded •Complicated and tedious paper work •Poor Monitoring and supervision system •Information need of the program not updated to accommodate the changing needs •Monthly monitoring sheets need to be updated timely as of present indicators 5/15/2019 46
- 47. Constraints of HMIS •Gender specific, marginalized group data not yet fully incorporated in the reporting • Problems in Printing, Supply and Distribution of HMIS tools • Training for newly recruited health personnel • Refresher training • Computer training 5/15/2019 47
- 48. HMIS indicators byProgram 5/15/2019 48 Program No. of indicators 1 Safe Motherhood 38 2 Family Planning 3 3 Female Community Health Volunteer 13 4 Primary Health Care Outreach Services 4 5 Immunization 31 6 Integrated Management of Childhood 31 7 Nutrition 25 8 HIV/AIDS 32 9 Tuberculosis 33 10 Epidemiology and Disease Control 21 11 Leprosy 12 12 Curative Services 31 13 Health Facilities 29 Total 303
- 49. DHIS2 • A toolfor collection, validation, analysis, and presentation of aggregate and patient based statistical data, tailored (but not limited) to integrated health information management activities. • A free open source public health analytical tool (software) • developed by University of Oslo • recommended by World Health Organization (WHO) • being used in about 45 countries across the globe • A total of 54 countries are deploying DHIS2 on a national scale, 30 of which are in the pilot stage or early phase in their rollouts. • Roll out from fiscal year 2072/73 5/15/2019 49
- 50. DHIS2 • DHIS2 supportsthe different facets of the information cycle including: • Collecting data. • Running quality checks. • Data access at multiple levels. • Reporting. • Making graphs and maps and other forms of analysis. • Enabling comparison across time (for example, previous months) and space (for example, across facilities and districts). • See trends (displaying data in time series to see their min and max levels). 5/15/2019 50
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- 52. Logistics management system •LMIS • System of record and reports whether paper-based or electronic- based • Used to aggregate, analyze, validate and display data • From all levels of logistics system • that can be use to: • Make logistics decision • Manage the supply chain 5/15/2019 52
- 53. Logistics management system •Basic Motto of LMIS: • Right goods • In right quantity • In the right condition • To right place • At right time • For right cost • LMIS for ministry of health and Population was designed in 1994 • Tested in 4 districts of eastern Nepal with support of JSI and USAID • 1997-Implemented nation-wide • LMIS unit collect and analyze quarterly 5/15/2019 53
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- 55. Goals of LMIS •To obtain and move appropriate quantities of supplies in timely fashion to place where they are needed at reasonable cost. • To ensure availability of quality health commodities at health facilities and community level round the year 5/15/2019 55
- 56. Data Items forLMIS • Consumption • Stock on Hand • Losses/Adjustment 5/15/2019 56
- 57. Flow of LMISData 5/15/2019 57
- 58. Program Including LMIS •Family Planning Program • EPI • TB program • Control of Diarrheal Disease Program • ARI program • Nutrition • Leprosy Program • Essential Drugs 5/15/2019 58
- 59. Benefits Of LMIS •Reduce commodity cost • Enhance Program management • Provide decision making data to policy makers and managers in all level of government health system • Provide better and consistent customer services • Allow greater control of logistics flow and accountability of donated logistics • LMIS improves storage practices reducing waste and expiry 5/15/2019 59
- 60. References • https://www.researchgate.net/publication/241708484_A_definition_ of_information • Textbook of health management, Achyut Raj Dahal • PHO Loksewa Easy EntryExam preparation Book, Harischandra Ghimire • Several internet web-sites and articles 5/15/2019 60
Editor's Notes
- #8 a set of things working together as parts of a mechanism or an interconnecting network; a complex whole.
- #11 Inputs Health information system resources. These consist of the legislative, regulatory, and planning frameworks required to ensure a fully functioning health information system, and the resources that are prerequisites for such a system to be functional. Such resources involve personnel, financing, logistics support, information and communications technology (ICT), and coordinating mechanisms within and among the six components (Section 2.6). Processes Indicators. A core set of indicators and related targets for the three domains of health information outlined in Section 2.3 is the basis for a plan and strategy for a health information system. Indicators need to encompass determinants of health; health system inputs, outputs, and outcomes; and health status. Data sources can be divided into two main categories: (1) population-based approaches (censuses, civil registration, and population surveys) and (2) institution-based data (individual records, service records, and resource records). Section 2.4 describes a basic set of standards for each source and strategic elements in achieving these standards. A number of other data-collection approaches and sources—occasional health surveys, research, and information produced by community based organizations—do not fit neatly into either of the two main categories but can provide important information that may not be available elsewhere. Data management. This covers all aspects of data handling: collection, storage, quality-assurance, flow, processing, compilation, and analysis (Section 2.5). Specific requirements for periodicity and timeliness are defined where critical—as in the case of disease surveillance. Outputs Information products. Data must be transformed into information that will become the basis for evidence and knowledge to shape health action (Section 2.6). Dissemination and use. The value of health information can be enhanced by making it readily accessible to decision makers (giving due attention to behavioral and organizational constraints) and by providing incentives for information use (Section 2.7).
- #14 In an organization.
- #16 So MIS is: Right Information To the right person At the right place At the right time In the right form At the right cost
- #20 The working of the MIS model starts with data and information coming from different sources. The data provided by accounting information system is stored in the database. The data and the information are entered from the environment. Data based information is sent to the report writing software for generating periodic and special reports , as well as to the mathematical model for simulation of the various aspects of the organization’s operations. The output from the report writing software and the mathematical model is then sent to the people who are responsible for solving the problems. To solve the problem, effective decision making is required for productivity. There are decision makers which may or may not exist in the firm’s environment. The environment might consist of other organizations to which the firm has collaborated such as suppliers, to from an Inter Organizational Information System(IOS). In such case, MIS supplies information to the other member of the IOS [5].
- #27 For Periodic revision of objectives
- #50 Adopts: Revised HMIS EWARS
- #54 Enhances flow of Information which is important for successful implementation of logistic system Web-based LMIS is Implemented in Nepal