Defining Health Information Systems

Health information systems (HIS) provide evidence for policy and program-level decisions to support better health outcomes at both the individual and population levels. However, the meaning of the term “HIS” varies across sources, often with no clear or precise definition.

Health information is an integral part of a functioning health system. Health information systems (HIS) provide evidence for policy and program-level decisions to support better health outcomes at both the individual and population levels. However, the meaning of the term “HIS” varies across sources, often with no clear or precise definition.

For example, a literature review may yield thousands of HIS-related documents, but searches find routine health information systems, health management information systems, health information technology, and other terms used interchangeably. HIS, by contrast, is an umbrella term and refers to a system composed of the components, producers, users, and other actors that contribute to the production and use of health information.

How Does MEASURE Evaluation Define HIS?

Health information is one of six core functions of the health system (USAID, 2015). Health information generated by an HIS supports data-informed decision making at each level of a health system. An HIS encompasses all health data sources required by a country to plan and implement its national health strategy. Examples of these data sources are electronic health records for patient care, health facility data, surveillance data, census data, population surveys, vital event records, human resource records, financial data, infrastructure data, and logistics and supply data. Health information can inform the planning and targeting of national and subnational health programs to support the achievement of health equity and universal health coverage. In addition, an HIS supports a country’s ability to report on progress in meeting the ambitious goals of global initiatives such as the Sustainable Development Goals (SDGs), an AIDS-free generation, ending preventable child and maternal deaths (EPCMD), and the elimination of malaria.

How Do Others Define HIS?

The Health Metrics Network (HMN) outlined six essential components of health information systems: HIS resources, indicators, data sources, data management, information products, and dissemination and use. Further, the HMN framework tells us that for a health system to function, various policy, administrative, organization, and financial prerequisites must be in place. Supportive legislature and regulatory environments are needed to enable confidentiality, security, ownership, sharing, retention, and destruction of data.

The World Health Organization (WHO) states that an HIS provides the underpinnings for decision making and has four key functions: data generation, compilation, analysis and synthesis, and communication and use. An HIS collects data from the health sector and other relevant sectors; analyzes the data and ensures their overall quality, relevance, and timeliness; and converts data into information for health-related decision making.

Vital Wave Consulting (for the Bill & Melinda Gates Foundation) states that the term HIS applies to nationwide data collection efforts which integrate a broad range of critical health-related data, ultimately covering an entire national population and that can be used at all levels of the health system to support improved service delivery and health outcomes. An HIS is not primarily about technology. Whereas technology can enhance efficiency and effectiveness of information systems, collection and use of reliable data does not necessarily require sophisticated technology. Even simple, paper-based systems can be effective if well-conceived. In sum, it is important to recognize the role technology can play, while keeping in mind that the performance of an information system and the quality of decisions it supports are seldom a matter of technology alone.

HIS Subsystems

The following terms are used to describe health information systems that serve various purposes. Depending on the context, many of these terms are used interchangeably and do not fit discrete categories. The following also provides links to more information and resources.

Routine health information system (RHIS): An RHIS refers to facility-based HIS that collect routine health information; these systems generate data collected at public and private health facilities and institutions, as well as at community-level healthcare posts and clinics—at regular intervals of a year at least. The data give a picture of health status, health services, and health resources. Most of the data are gathered by healthcare providers, by supervisors, and through routine health facility surveys. The sources of those data are generally individual health records, records of services delivered, and resource health records.

Health management information system (HMIS): The term HMIS is often used interchangeably with RHIS, though an HMIS may not include data on disease or health outcomes. An HMIS is a data collection system specifically designed to support planning, management, and decision making in health facilities and organizations.

Community-based health information system (CHIS): A CHIS (sometimes written as CBIS) refers to data from a community (not clinical) setting. Communities may be linked to a facility or a district.

Civil registration and vital statistics (CRVS):  A CRVS system registers births and deaths, issues birth and death certificates, and compiles and disseminates vital statistics, including cause of death information.

Electronic health management information system (eHMIS): An eHMIS is a facility-based data aggregation system usually used for public health-related decision making. An eHMIS is mainly used by public policy makers, health officers, researchers, planning departments of health offices, HMIS focal persons, data entry clerks, and many others, ranging from health facility to federal management levels.

Financial management information system (FMIS): An FMIS supports the automation and integration of public financial management processes including budget formulation, execution, accounting, and reporting.

Human resource information system (HRIS): An HRIS includes both the technology products that enable country governments and companies to manage their staff and the people, policies, procedures, and data necessary to make that management possible. These systems provide relevant, timely data that can be used to make human resource-related decisions.

Logistics management information system (LMIS): An LMIS collects data about essential medicines and commodities and often uses this information for activities, such as filling routine supply orders for health facilities.

Surveillance system: Surveillance refers to the ongoing collection of systematic data for use in planning, implementing, and evaluating public health policies and practices. A communicable disease surveillance system can provide early warnings of potential public health threats and support monitoring of disease.

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