What is the InHCc Health Care Management Information System and why is it needed

The InHCc Health Management Information System is used to manage the care of the individual, manage the Healthcare organization, and manage the strategic development of Health Sector Reform policy for the population. The InHCc System is designed to help Health Care Managers understand the role of data in developing solutions to provide effective and efficient health care.

The InHCc System will be the starting point for what InHCc will propose as a beginning of a National Health Management Information System. The individual organizational units using the InHCc System may range in size from the individual medical practitioner whose office may be equipped with a single PC and modem, to the local clinic, to the local and district hospital, to the National Health Department.

The InHCc Healthcare Management Information has all the benefits that are given in the section on Benefits. In many cases InHCc has extended those benefits....

Benefits of a Health Information System   

Complex health services can only be provided to clients who need them at the time they need them if those managing and delivering the services have access to reliable, well-structured and timely information

The InHCc Health Care Management Information System addresses each of the key issues of Health Care Reform.

The InHCc Healthcare Management Information Systems contains more than just health data. The InHCc system has an extensive database of the family's health as well as demographic, social, and economic data. We consider this just as important as the "physical" treatment given to the individual.

• How can we treat individuals if they do not come for healthcare services until they are really sick

• How can we treat individuals if they do not have the money or know how to buy the medicines that they need

• How can we treat individuals if their religion tells them that they do not need the care that is prescript to them.

• How can we treat individuals if we are unable to determine the effectiveness or the procedures without the cost...

Management for Change

Collected Information must reflex changes that evolve gradually over a person's lifetime and include family information over generations. A person's healthcare needs will change and evolve in time, as does the protocols used in practice, and the economic and social environments within which the client lives and is cared for. 

The InHCc Information System will not attempt to mirror the concepts of today's static systems, but rather to create a new concept of a virtual, distributed healthcare information system. 

Many health care organizations serve communities with a diverse population. Clients may speak multiple languages, be culturally diverse, or present other barriers that make the process of entering and accessing the health care system very difficult. Understanding the individual’s social environment becomes very important in “treating” the whole person. Unless this information is obtained, we will continue treating only the symptoms and will never be able to treat the “cause of the problem.”  In order for the organization to eliminate or reduce these barriers the organization must first understand their target population. This information can only be obtained through the collection of detail data of the local environment.

Managers of health care should focus on the improvement in the quality of care of the individual. It is not sufficient to measure “the end results” of health reform on a population but rather more importantly it is necessary to manage the day-to-day health care of the individual.  It is only through the care of the individual that quality of care can be defined. The organization must maps each and every client’s visit to the management of the client, to the management of the clinical setting, and finally to the management of the national health care program.

The InHCc Information system collects many indicators that are practical and useful in management for change. We are not concern with the static "gold standard" design but rather how to manage our changing environment. It is only through the collection of sufficient amounts of data that informed decisions regarding policies, programs and practices can be made; it is only through analyzing process flow that efficient organizations and management structure be created; and it is only though  data analysis that effective financial and resource allocations system be put in place.

Many tomes on developing indicators start off by listing as many indicators as possible and then going on to state that “the number of indicators discussed is much too large for practical use” and then develop a smaller list of 10-20 indicators that “should be adequate.” These abbreviated lists are neither meaningful nor useful to management.

Although much is said of sustainability and how to measure it, most indicators only reference the “percent of total health system financed by tax revenue” or some other abstract indicator. These indicators say nothing about the ability of the lowest health care organizations to meet demand and to supply to the client what she or he needs. It says nothing about how much of that money goes to the care of the individual client. It is only by measuring the success of these organizations in treating the individual client that sustainability can be measured.

If the lowest level units are not successful in management, then no amount of government expenditures will matter.

The priorities of the InHCc Health Care Management System reflect the belief that health care information should focus on the client and the household. This means that when a health care professional is offering care, the client’s and the client’s household information should be available quickly and accurately and must be available across time, place and clinical perspective.

Most importantly, the InHCc system is designed not only around what the users require now, but rather is designed to discover and identify new areas of care. It is only after the data results are seen can the manager determine what is to be done. This implies that the way the data is organized and its structure may change over time.

The InHCc system has been designed as a completely normalized database. This provides the ability of each healthcare professional, at any level of the organization, and for each stakeholder to view data the way that he or she wants to view the data. There are no predefined sets of rules other than rules for access rights and security measures.

The presentation of the data to the user is built around Microsoft’s standards designs and procedures. Data will be available both at the local level and also in a centralized database. The centralized database provides that all information will be available across all operating systems and hardware configuration. InHCc takes the approach that it is impossible to manage a distributed health care system across all manner of operating systems and locations (it is impossible to know where the client may have visited) and has instead opted for a centralized database warehouse. The centralized database eliminates many problems that exist with existing systems and provides for many advantages that are not present on existing systems. (Discussed on the InHCc web site).

Security is enhanced in the InHCc system because all identifying data is deleted from the client record once it is saved in the centralized database. By striping all identifying information, researchers and administrative managers may access the data without concerns for confidentiality. An identifying number is assigned to each client such that information can be traced over all events, but the identity of the client themselves is available only to the health care professionals directly treating the client. (Discussed on the InHCc Web site).

Data is easily useable across languages. Because all the data is numerically coded, only the descriptions of the codes need to be translated in the database (which is static). Once the descriptive tables are translated in the database, for example, a researcher in English can view all data entered by an organization in Spanish. Clinicians may use their own local descriptions of events without the need to learn new terms…the code in the background will always be the same for that event across all languages.

Data can be easily shared between two or more care givers. When a client is being cared for at two sites, such as a hospital and a local clinic, the information captured by either site can be automatically replicated to the centralized database. Either site may then request that information on any client be replicated to that site.

This system will recognize that client information comes from varies sources and at different times. Client care does not happen in a vacuum. It is the relationship of a single episode to all other internal and external information in our environment that gives us the knowledge that we can use to improve our decision making ability. It is NOT the one single client healthcare record that guides health care management but rather it is the information COLLECTED FROM OF ALL SUCH SOURCES The health of a client can not be managed unless information is gather from his whole environment. 

Diagrams  

• Organization Design
• Network Design 

Success

Our success relies on the following factors:

• Planning for change and implementing processes to manage change
• Teaching users not only how to operate the system but also why is it done
• Train the trainer
• Proving teaching and training in the format that the user can best learn
•  Plan for re-training after an initial period
• Set goals and monitor the performance against these goals.
• Be flexible
• Learn from those that are actually doing the job

Data

The InHCc HMIS requires a lot of data and it requires a lot of time to collect this data. However, all the data does not have to be collected at the same time and/or by the same individual Because every member of the Health Team sees exactly the same information, every member of the team can add additional data to the Client Record.

In addition, since every member of the household can be questioned over time, data can be crosschecked for accuracy by asking the same question to different members of the family (this is especially when verifying economic data)

Challenges and Solutions

This Web Site section will discussion how the InHCc system can solve many of the Challenges that exist in today's health systems.

InHCc attempts to address all issues of healthcare "Reform." Some of which are:

• Health Policy Reform
• Quality Health Care
• Efficiencies Resources Allocation
• Risk Taking and Equity in the Market
• Health Care Education and Client Access to Information
• Market Share and “subsidizing”
• Critical Mass and insufficient Funding
• Increase Productivity of the Client
• Increase Productivity of the Physician
• Health Care of the Social Unit
• Health Care Financing
• Subsidies to the Client
• Hospitals Care
• Preventive versus Curative Care
• Problem Focus versus Comprehensive Examinations
• Sustainability
• Health Care and Democracy
• Health Care Management

Objectives

• Develop a modern integrated Health Management and Information System that functions at all levels of the organization

• Develop innovative health care models that address the human and social content of health care as well as the quality of services.

• Development of effective leaders and well trained managers that are able to administer resources and services effectively.

• Develop innovative process models to increase the efficiency of health care delivery. 

• Provide for the future by development of a Research and Advance Data Analysis Department.

• To offer technical assistance to health service providers and institutions of higher education in the areas of research, training, and development of human resources, organization structures and health serviced delivery

• Support institutional Integration of the Federal Secretariat of Health, State Health Agencies, and Local health agencies, and service providers

The InHCc System provides a framework which supports the separate needs for information in one integrated system. These needs are:

• Use of data for the delivery of services (client care)

• Use of data for Transactional or day-to-day requirements (Operational)

• Use of data for Management  (Strategic)

• Use of data for Predicting the Future (Predictive Analysis)

• Research

 Specific Objectives

Communication and Behavior

•  Communicate what is important throughout the organization

•  Communicate the results of an action

•  Shape behavior – people act according to the way they are measured.

Management

The specific management objectives of the InHCc Health Care Management System are:

• At the Clinical Level

  • Provide individual detail client information

  • Provide sufficient detail information to predict trends

  • Manage the client based on his or her individual needs

  • Manage local resources based on local trends and local needs

  • Measure the local organization’s performance against their goals

  • Measure the local organization’s performance again the overall organization’s goals

  • Measure the changes in the local health conditions as a result of this management

  • Provide sufficient information to evaluate management and to reward management for work well done

• At the Middle Management level

  • Provide detail information on the organizational units for which they are responsible
  • Provides for immediate feed back of deviations of the local organizations goals from the goals of the overall organization.
  • Provides for decentralized control without any loss of information or overall control. 
  • Provides for an environment where managers can manage and teach others to manage. 
  • Provides for the ability to select good health care procedures by being able to compare in detail among the many and select those procedures that offer the best results.

  • Provides for the ability to use all indicators from all locations simultaneously and analyze the relationships among them.

• At the National Level

  • Provides the ability to easily select from a large collection of indicators and in sufficient detail to evaluate health care policies objectively.
  • Provides the ability to manage each and every unit and not just the “averages.”
  • Provides for immediate feed back of deviations of the local organizations goals from the National goals.
  • Provides sufficient detail information to predict trends and assess where trouble areas may exist before they exist
  • Provides the ability to take timely correction action
  • Accurately estimate costs
  • Provides for the efficient and effective use of scarce resources by analyzing supply and demand at each and every operating unit and moving scarce resources where they can best be utilized.
  • Provides for each stakeholder to access selectively as much or as little information as they may need…over the Internet…and in real time.  

The InHCc System is designed to help discover new variables, indicators, and the relationships between them that are meaningful and useful. It provides the ability to focus on processes and perform complete analysis of these processes.

Information Services will become important as governmental agencies seek to gain more information in order to improve health and to reduce health care costs. “Adoption of data warehousing in health care has been slowed by the lack of understanding of the benefits offered by the technology” (CDW).