MISMISDr. Ejaz Ahmad KhanDr. Ejaz Ahmad Khan

Health Services Health Services AcademyAcademy

At the end of the session , At the end of the session , the Participants should be the Participants should be

able to:able to:•Understand the existing MIS Understand the existing MIS

internationallyinternationally•Interpret the strength and Interpret the strength and

weaknesses of the systemsweaknesses of the systems•Conceptualize Theory versus Conceptualize Theory versus

PracticalityPracticality

Learning MIS?Learning MIS?Participants on BoardParticipants on Board•What is Information System?What is Information System?•Can we manage without Can we manage without

information system?information system?•Why is it necessary to have an Why is it necessary to have an

MIS?MIS?•What can be possible methods?What can be possible methods?•ExamplesExamples

Example :Hardware Example :Hardware FrameworkFramework

Internet

Headquarters

Centre 1 Centre 3

Centre 2

HEALTH MANAGEMENT HEALTH MANAGEMENT INFORMATION SYSTEMINFORMATION SYSTEM

•The HMIS has been defined as a system that provides an appropriate information support to each decision making level of the health care delivery system.

MIS ApplicationMIS Application• Communication for better management• Effective Communication• Flows of Communication

• Communication Networks• Characteristics of information• Quantity of information• Quality of Information

Sharing the Information:Sharing the Information:

•COMMUNICATIONCOMMUNICATION

Contd.…….+Contd.…….+• Information is data which has been Information is data which has been

organizedorganized

• Communication is transmission of Communication is transmission of information (conveying meanings to information (conveying meanings to others), added with feelings and other others), added with feelings and other human elementshuman elements

Contd..Contd..

• Communicate = Make known, Communicate = Make known, Announce, Break Announce, Break the news, Advise, Transmit, Bestowthe news, Advise, Transmit, Bestow

• When managers communicate one or When managers communicate one or combination of the following occurs:combination of the following occurs:– information transmissioninformation transmission– motivationmotivation– controlcontrol– emotive expressionemotive expression

Effective CommunicationEffective Communication• Desire of communicator (values and Desire of communicator (values and

expectations)expectations)• Understanding of how others learnUnderstanding of how others learn• Receivers clarity about purpose Receivers clarity about purpose • Manner according to content, importance, and Manner according to content, importance, and

complexity of intended messagecomplexity of intended message• trust of receiver on sender (ascribed and trust of receiver on sender (ascribed and

achieved credibility)achieved credibility)• time frame (availability and allocation)time frame (availability and allocation)

Contd..Contd..

For Instance….For Instance….

Sender Message Receiver

Feedback

Encode Decode

Barriers Barriers

Flows of CommunicationFlows of Communication

• Downwards (info, verbal orders, instructions)Downwards (info, verbal orders, instructions)

• upward flow (reports, complaints, proposals)upward flow (reports, complaints, proposals)

• Horizontal and Diagonal (interdependence)Horizontal and Diagonal (interdependence)

Communication NetworksCommunication Networks• Chain Chain (follows authority relationships)(follows authority relationships)

• Y-shaped Y-shaped (2 to 1 reporting)(2 to 1 reporting)

• Wheel pattern Wheel pattern (4 to 1 reporting)(4 to 1 reporting)

• Circle pattern (1 to 2 reporting)Circle pattern (1 to 2 reporting)

• All-channel All-channel (wheel with all to report to each Other)(wheel with all to report to each Other)

InformationInformation• Information is data which has been Information is data which has been

organizedorganized• Information is the content of Information is the content of

communicationcommunication• Information tends to be formal, Information tends to be formal,

abstract and impersonal, when feelings abstract and impersonal, when feelings and other human elements are added and other human elements are added to transmission of information , it is to transmission of information , it is called as communicationcalled as communication

Characteristics of Characteristics of informationinformation• Reach relevant persons at right Reach relevant persons at right

timetime

• Reduce uncertainty for making Reduce uncertainty for making decisionsdecisions

• Assist relevant persons to act on itAssist relevant persons to act on it

Quantity of InformationQuantity of Information• Neither too much nor too littleNeither too much nor too little• Information generation implies costs (time Information generation implies costs (time

money and energy)money and energy)• Paradoxically less information lead to Paradoxically less information lead to

higher quality costshigher quality costs• Desired quantity of information is a balance Desired quantity of information is a balance

with tradeoffs (difficult but inevitable)with tradeoffs (difficult but inevitable)

Quality of InformationQuality of Information

•Exact, Authenticated, well-timedExact, Authenticated, well-timed•Should comply ‘ Oriented in time , Should comply ‘ Oriented in time ,

place and person’place and person’•Reliable and Validate-ableReliable and Validate-able•Meets the international standardsMeets the international standards

Information without meaning for receiver is nothing but noise, energy and time (wasted)

Classification of InformationClassification of Information

• Action Vs Non-actionAction Vs Non-action

• Recurring Vs Non-recurringRecurring Vs Non-recurring

• Documentary Vs Non-documentaryDocumentary Vs Non-documentary

• Formal Vs InformalFormal Vs Informal

• Historical Vs Future projectionsHistorical Vs Future projections

Designing an Information Designing an Information SystemSystem• What info should flow?What info should flow?• To whom it should flow?To whom it should flow?• When or at what frequency?When or at what frequency?• How and through what channel?How and through what channel?• Who will do what?Who will do what?• How it will be put together and summarized?How it will be put together and summarized?• How and when it will reported and to whom?How and when it will reported and to whom?

Health Sector Related MISHealth Sector Related MIS•           Ministry of Health.Ministry of Health.•             National Programme for PHC and FPNational Programme for PHC and FP•             Expanded Programme of Immunisation.Expanded Programme of Immunisation.•             Acute Respiratory Infections Control Programme.Acute Respiratory Infections Control Programme.•             Malaria Control Programme.Malaria Control Programme.•             National Tuberculosis Control Programme.National Tuberculosis Control Programme.•             AIDS Prevention and Control Programme. AIDS Prevention and Control Programme. • Ministry of Population Welfare.Ministry of Population Welfare.• Local Bodies (Municipal Corporations)Local Bodies (Municipal Corporations)• Census and SurveysCensus and Surveys

Relationships and Flow of Information in the Different MIS

Provincial DG Health Services

Federal Director General Health

National Programme Managers, EPI, Malaria, AIDS

Provincial Programme Managers, EPI, Malaria, AIDS

Divisional Director Health Services

Vaccinator/ CDC LHWMalaria / TB, ARI, etc.

District Health Offices

First Level Care Facility

District Programme Implementation Unit (NP-PHC/FP)

National Programme Managers, NP-PHC/FP

Provincial Programme Managers, NP-PHC/FP

ProblemsProblems• Data is often delayed and is not analysed promptly• Weak Vital Event Registration System• Multiple information systems organized through

public health programs work independently• Dis-integrated Hospital-based information• Missing information about private sector• Quality of information generated – not reliable• Non-utilization of information at micro and macro

levels• MIS component missing from regular training and

education programmes.• The current information systems is becoming

difficult to sustain given the available level of financial and human resources.

Prio

rity

Are

asChallengesChallenges

Consolidation(of what is already achieved)Initiate Modifications (Focus on client orientation, effectiveness and efficiency)

Further System Expansion

•Improve Data Quality•Promote Information Use

•Hospitals•Private Care•Other Department Facilities

•User-friendly computerization•Electronic info. sharing•Incorporate new technology (GIS)

Integrate of Multiple MIS Integrate of MIS with Devolution PlansResearch & Development

THANK YOU VERY MUCHTHANK YOU VERY MUCH• Please Go on to your Class Exercise Please Go on to your Class Exercise

after a Ten Minutes Teasing and after a Ten Minutes Teasing and RelaxingRelaxing