AN ASSESSMENT OF THE MANAGEMENT AND UTILIZATION LEVEL OF HEALTH INFORMATION MANAGEMENT SYSTEM

1.1 Introduction

Health Management Information System (HMIS) is a system that allows for the collection, storage, compilation, transmission, analysis and usage of health data that assist decision makers and stakeholders manage and plan resources at every level of health service (Wyatt et al., 2005). Health information is the processed data and knowledge that an individual or group use to support their decisions in the health sector (Wyatt et al., 2005; WHO, 2010). It is fundamental for the overall health system which informs decision-making in each of the other five blocks of the system and improving managerial decisions by providing quality information for evidence-based health practices. The World Health Organization (WHO)’s framework for health systems strengthening identifies six attributes of a health system (WHO, 2010).

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitations of the Study and Definition of technical terms.

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1.2 Background of Study

In recent years there have been thorough activities in the area of health information management in Ghana. This is partially in response to the overall changes in the development-planning arena. The current Poverty Reduction Strategy (GPRS II), which represents the Government’s development agenda, aims at transforming Ghana into a Middle Income Country by 2015. Within this framework, health care as well as protection of the vulnerable within a decentralized, democratic environment has been given a new boost. The Monitoring and Evaluation framework demands information from diverse areas of health care delivery and systems development.

The Health Metrics Network (HMN), the first global health partnership for developing and strengthening of health information system in low and low-middle income countries was set up to set international standards (WHO, 2012). HMN seeks to achieve standardization by adopting and adapting global health information standards that are aligned to broader efforts to improve the availability and quality of statistics (Ibid).

Health Management Information System (HMIS) was set up to enhance effective health services planning and decision making. Under ideal circumstances health data should be collected from several Health Service delivery units (Shaikh & rRabbani, 2005). These would include government, NGO, and private health units including hospitals, private clinics, drugs shops, Village Health Teams Traditional Healer and formally Traditional Birth Attendants’ Reports (Ssali & Kalere, 2013). However, there is still inefficiency in utilization of HMIS. Government, NGOs and Private health units do not normally see a reasonable percentage of patients submit reports but the quality of the reports is not ascertained.

Generally, despite the volume and variety of data generated through the routine Health Management Information System, the information is systematically under-analyzed and under-utilized for planning and programme reviews (Ranganayakulu, 2017). Completeness, timeliness and quality of reporting are often described as problematic, and the data are inevitably biased because they relate only to the populations using public health services. Investments in the information system are often minimal, and there are major lacunae in the availability and statistical capabilities of those charged with collecting, compiling and analysing the statistics. As a result, data generated through the routine system are rarely assessed for their quality and used to support decision-making (Mendhoza, 2015).

The overall goal of any HIMS is to enable health facilities make decisions in a more transparent and efficient approach, based on evidence with the objective of producing timely, relevant and quality information to support decision making. There has been a strong acknowledgement for the need of quality data right from the beginning of initiation of sector reforms; this is an essential part of the planning, management and policy development of the health system processes that were being introduced. Investments in terms of communication infrastructure and human resource for management and utilization of heath information however remain limited and uncoordinated. Public health decision-making is seriously reliant on a timely availability of sound data, and globally significant human and financial resources have been invested to improve health information systems (Lærum et al., 2004).

Therefore, in Nigeria where the research was carried out, the activities that was conducted is to assess the Management and Utilization Level of Health Information Management System.

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1.3 Statement of Problems

Investigation revealed that in the health industry good human relationship with patient is essential but in the instance where this is lacking, the patients tend to visit other healthcare facility for treatment. Thus, patients’ perception of functional issues which they perceive and interact with during the course of seeking treatment such as physical facilities, internal process, interaction with doctors, nurses and other support staff as poor and unresponsive (Boshoff & Gray, 2004; Algilanan & Connor, 2003).

Ondieki (2017) posited that most often, hospital employees render poor services or struggle to render good and timely services due to lack of effective records management which leads to long waits by patients. In the struggle to retrieve patient records which have been stored using paper based systems, the patients continue to wait for hours without any success.

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1.4 Aim and Objectives of Study

The aim of the study is to assess the Management and Utilization Level of Health Information Management System. In achieving this aim, the following specific objectives were laid out as follows:

1. To examine the levels of utilization of health data/information in the study area;
2. To investigate the main factors and constraints that influences the effectiveness of HIMS in the area under study;
3. To establish the type of health data/information generated at the health units and how it is processed and stored;
4. To assess the level of flow of data/information to and from the health unit; and
5. To make recommendations on how to improve the Health Management Information Management System (HIMS).

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1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

• What are the levels of utilization of health data/information in the study area?
• What are the main factors and constraints that influence the effectiveness of HIMS in the area under study?
• What is the type of health data/information generated at the health units and how it is processed and stored?
• What is the level of flow of data/information to and from the health unit?
• How can the existing Health Management Information Management System (HIMS) be improved?

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1.6 Research Hypothesis

In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.

Hypothesis One

• H0: There are no significant factors and constraints that influence the effectiveness of Health Management Information Management System in the area under study
• H1: There are significant factors and constraints that influence the effectiveness of Health Management Information Management System in the area under study

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1.7 Significance of Study

This study is important for many reasons. It will cast more light on the importance of Health Information Management System. The study will influence the medical personnel on proper records management practices and also adequate training for records keeping. It will help to identify the challenges hospital personnel face in use and management of electronic health records management and also help them understand how electronic health records management practices can influence and affect service delivery.

The study will also provide empirical, theoretical and conceptual framework, which will contribute to the existing knowledge in other related fields. The outcome of this research would help to identify ideal methods of managing electronic health records.

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1.8 Scope of Study

The scope of the research is focused on the Assessment of the Management and Utilization Level of Health Information Management System using Enugu State University Teaching Hospital (ESUTH) as a case study.

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1.9 Limitations of the Study

During the course of this study, many things militated against its completion, some of which are:

1. Time Constraint: The time frame given to accomplish this project was very short due to school academic calendar and it was carried out under pressure which made the researcher not to implement some necessary features.
2. Establishment Policies: Establishment policies posed a serious limitation as most staffs are not ready to release information needed for this project work. There were lots of information needed from the staffs of this establishment to enhance the study which took them time to release or they did not release at all for security purposes, hence the scope was reduced.
3. Research material: availability of research material is a major setback to the scope of the study.
4. Frequent power failure: This made the researcher append more money on fuel to ensure sustainable power.
5. Financial Constraint: Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

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1.10 Operational Definition of Terms

Electronic Health Records: This is an electronic store of patient’s health records, which are created, stored, managed and controlled by health personnel.

Records: This can be defined as any document or recorded information which is created, received and maintained by health personnel of Babcock University Teaching Hospital.

Records Management Practices: It refers a range of activities which an organization performs or carried out to properly manage its records. The key activities include records creation, use, storage, maintenance, retrieval and disposal.