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Overview/Importance of HMIS . Health Management Information Systems, the Private Sector, and HIV/AIDS: a discussion of implementation and outcomes. Video Conference, World Bank Offices, Washington, D.C. 18 January 2006 Xenophon M. Santas ( xsantas@cdc.gov )

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overview importance of hmis

Overview/Importance of HMIS

Health Management Information Systems, the Private Sector, and HIV/AIDS: a discussion of implementation and outcomes.

Video Conference, World Bank Offices, Washington, D.C.

18 January 2006

Xenophon M. Santas (xsantas@cdc.gov)

Global AIDS Program, Informatics Team

Centers for Disease Control and Prevention

the emergency plan
The Emergency Plan
  • A multi-agency $15 billion U.S. initiative to provide HIV care, treatment, and prevention services to HIV affected populations in the developing world
  • HMIS committee – draws expertise from USAID, CDC, HRSA, Census Bureau, DoD, and Peace Corps
    • Includes technical expertise from private partners
    • Works closely with counterparts at WHO and UNAIDS
health management information systems hmis
Health Management Information Systems (HMIS)
  • Key component of strategic information systems
  • Definition: “targeted monitoring, evaluation, and surveillance data used to answer key questions about
    • The state of the epidemic
    • The delivery and process of prevention, care, and treatment services
    • The effectiveness of these services
    • Capacity needed to improve programs, meet planning and reporting requirements, and reach goals for impacting the epidemic
strategic information key components
Strategic Information Key Components
  • HIV/AIDS surveillance
  • Population-based bio-behavioral surveys and facility surveys
  • Health Management Information Systems for facility-based reporting
  • Program-level monitoring and reporting (non-facility based)
  • Targeted evaluation studies
components of an information system
Components of an Information System
  • Human resources
  • Communications infrastructure
  • Protocols and training
  • Supervision
  • Quality control
  • Analysis and feedback
  • Paper-based data collection forms
  • Electronic databases
  • Hardware and software

Organizational

Technological

examples of information systems supporting hiv programs
Examples of Information Systems Supporting HIV Programs
  • Pharmacy management
  • Laboratory management
  • Logistics/supply chain management
  • Program monitoring (OVC, palliative care)
  • Facility-based patients systems (e.g., ART)
  • Vital statistics registries
  • Facility-based surveys (e.g., ANC clinics)
  • Population-based surveys
  • National notifiable disease reporting systems
strategic information data flow
Strategic Information Data Flow

President’s Emergency Plan Countries

United States

Surveys

Country

(BSS, AIS,

Specific

etc.)

U.S. in

-

country

Survey Results

(e.g., MACRO)

Offices

Embassy

USAID

CDC

CRIS+ or

other

system

D.C.

Headquarters

System

Washington, D.C.

Facility-

based service

providers

Ministries of

Health

Other services

CRIS+ or

(OVC

, peer

-

Other

other

education,

Databases

system

(e.g. BuCen)

etc.)

traditional hmis partners
Traditional HMIS Partners
  • International Organizations (WHO, UNAIDS)
  • National Governments (MOH, NAC)
  • Donors
  • Provincial governments
  • NGO’s
  • Local universities/schools of medicine
  • U.S./European universities
  • Private partners
pepfar hmis subcommittee goals 1
PEPFAR HMIS Subcommittee Goals (1)
  • Provide assistance in the collection of Emergency Plan core indicators
  • Improve capacity to collect client-level and clinical service information that will assist in daily management of individual patient care
  • Improve capacity to collect facility-, district- and country-level information that will assist with clinic and program management
  • Develop strategies for better data collection and program monitoring from non-facility-based care or prevention activities, such as OVC services.
pepfar hmis activities 1
PEPFAR HMIS Activities (1)
  • Minimum data set for use in monitoring ART produced by WHO, with input from HMIS subcommittee
  • Concept Paper: Developing Facility-based Management Information Systems, May 2004
  • Protocol: Assessment of Health Information Systems developed to describe methods for evaluating and assessing country health management information systems, and to aid in obtaining comparable descriptions of these systems (www.rhinonet.org, under the “PEPFAR” tab)
    • Describes background, framework, objectives, team composition, and methodology
    • Four data collection forms:
      • A. HIV/AIDS program inventory
      • B. National HIS overview
      • C. National and sub-National Infrastructure Assessment
      • D. Facility Assessment
    • Translations available in French and Portuguese
pepfar hmis activities 2
PEPFAR HMIS Activities (2)
  • HMIS assessments conducted/initiated
    • Haiti
    • Côte d’Ivoire
    • Mozambique
    • Tanzania
    • Nigeria
    • Uganda
  • Antiretroviral Therapy (ART) Software Inventory (www.rhinonet.org)
  • New Technology White Paper
pepfar hmis activities 3
PEPFAR HMIS Activities (3)
  • Software Tool Enhancements
    • HRSA’s CareWare patient care and management software
      • Pharmacy module for tracking prescriptions and dispensing invoices; inventory and prescription adherence reports
      • Language translator
      • Flexible forms creator that allows user to select certain fields of interest and place them on a form in the order of interest.
      • Regimen builder and tracker
      • PEPFAR reports
      • HL7 export for “transportable” core data
      • Study and produce a feasibility report on integrating biometric patient identifier system with CareWare (e.g., thumbprint reader).
      • Technical assistance and training
      • Collaboration with CDC-Uganda, Track 1 (and other) grantees.
      • Output data to CDC PMTCT aggregate reporting system
    • CDC’s Epi-Info data analysis tool
pepfar hmis activities 4
PEPFAR HMIS Activities (4)
  • ART Facility-Level Systems and Electronic Medical Records (EMR). Support development of
    • Electronic standards for information systems to be used in the monitoring of clinical care (including ART)
    • Guidelines for security and confidentiality of patient data (joint activity with WHO)
    • A standardized Health Level Seven (HL7) message to facilitate secure electronic transmission and exchange of data across data systems
    • Publish specifications for electronic systems that support the care of HIV infected patients
pepfar hmis activities 5
PEPFAR HMIS Activities (5)
  • Enhanced support/management of Graphical Information Systems (GIS) activities
  • Support routine production of maps.
  • Develop/enhance an Emergency Plan web site, both password-protected and for public access
  • Support to WHO for their HealthMapper and Service Availability Mapping (SAM) projects
  • Develop and maintain an inventory of laboratory information systems (LISs) suitable for use in both focus and non-focus countries
pepfar hmis activities 6
PEPFAR HMIS Activities (6)
  • Develop specifications/requirements for in-country program monitoring and evaluation data systems
    • Visit at least three countries with extensive U.S. government presence
    • Develop and document recommendations
  • Support UNAID’s Country Response Information System (CRIS) for enhanced/better management of U.S. mission-specific data