THE EVALUATION OF THE HOSPITAL INFORMATION SYSTEM (HIS) AT district HOSPITAL, SHIMLA, HIMACHAL PRADESH. Submitted by: Dr. Isha Jain PG/11/032. CONTENTS. Organization profile Introduction to HIS Rationale of the Study Objectives of the Study Methodology Results and Outcomes
Dr. Isha Jain
To enable networks of collaborative action with like-minded actors who aspire to the ideology of open source software, open standards and decentralized decision-making to create complementary strengths in providing integrated and public health friendly health information systems.
It works with a Vision “to enable and coordinate a network of excellence in public health informatics, specializing in integrated health information architectures, with a geographical focus on South-East Asia.”
HiSPIndia has a registered and head office in New Delhi, and project offices in Kerala, Himachal Pradesh, and Punjab
It is an old heritage hospital and was opened in 1885.
There is an average of about 1200 out- patient (OPD) visits per day.
It is the first district hospital of Himachal Pradesh where HIS is implemented by HiSPIndia.
It is the most established and functional government hospital.
It is a 150 bedded hospital with all functionalities.
Hospital information system (HIS)
Health management information system (HMIS)
As NRHM funded HiSPproject is in the process of implementing the HIS in 21 government hospitals of Himachal Pradesh, the results of this study will be useful for improving the existing system.
Note : All the values are in Percentages
Total No. of Clinicians = 23 Total No. of Nursing Staff = 40
Most of the users have technical issues like Computer hangs and Server problems but only the data entry operators also have printer related issues.
No. of Clinicians = 8 No. of Data Entry Operators = 6 No. of Nursing Staff = 16
Only 3 out of 8 Clinicians said that the procedures and diagnosis comply with their requirements
All of the Nursing staff said that HIS has in turn increased their time and effort because they have to maintain both the registers as well as the electronic records at the same time.
Most of the i.e., 12 out of 16 Nursing Staff make the patient entries by the end of the day and only 4 out 16 Nursing Staff makes them as and when patient comes
BY PASSIVE AND NON-USERS
NUMBER OF PASSIVE USERS:
CLINICANS: 9 NURSING STAFF: 9
NUMBER OF NON- USERS:
CLINICANS: 6 NURSING STAFF: 15 TECHNICIANS: 7
3 out of 15 doctors said they did not get the training
9 out of 24 nurses also did not get the training
FOR NURSES(24) : They have to attend to patients as well as clerical work.
FOR CLINICIANS(15): patient consultation at OPD
7 Nurses and 6 clinicians stated workload as a reason for non-usage of application
Most of doctors i.e. 8 (non-usersand passive users) also pointed out that diagnosis and procedures were incomplete and inadequate as a reason for non-usage of application.
When asked from nurses i.e., 24 (non-users and passive users) while doctors said they did not require any training.
SatisfactionLevel of the Users/Stakeholders with the Trainingprovided by the HIS Team
75% of the others Stakeholders, 35% of the Nursing Staff and 25% of the Clinicians were satisfied with the training and support provided by the HIS Team.
CHALLENGES FACED DURING MOBILE TRAINING AT SHIMLA DISTRICT.
Mobile services are emerging, making it accessible and citizen-centric by extending the benefits of remote delivery of government services to those who are unable or unwilling to access public services through the Internet
Governments are expressing interest in m Health as a complementary strategy for strengthening health systems and achieving the health-related Millennium Development Goals (MDGs) in low and middle income countries.
M Health is being applied in maternal and child health, and programmes reducing the burden of the diseases linked with poverty, including HIV/AIDS, malaria, and tuberculosis (TB).
Primary Health Care Services using Mobile ensures improved access to healthcare
The team interacted with various health workers during mobile training at various training centers and issues that came from health workers were noted and addressed.
There were about 201 health workers (ANMs).
Training should be started only when the use of technology is decided: Once the implementation is started there should be least changes in things. Browser based training has already been given to Syri block of Solan district and Shahpur block of Kangra district. And now SMS based training has to be given. We cannot ensure sustainability in mobile health implementation if we keep on changing our technology use.