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**InHCc HMIS**

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Index - Same Level Subject

Assessing HIS
Change Management
Healthcare Processes
Certification Process
Accounting and Financial
Human Resources
Information Management
Management
Data Analysis and Data Mining
Error detection and Fraud Prevention
Surveillance
Research
External Communication and Reporting
Marketing
Safety and Security
Software and Programming
"Bells and Whistles "
Client and Household Care
Quality of Care
Education and Training
Administrative
Government and Political
Employee Efficiency
 

Index - Child Subjects

Introduction

While healthcare professionals "say" that computers interfere with their relationship with their patients, research has shown just the opposite. Patients refer physicians that use computers and believe that physicians that use computers can deliver better care.

The greatest efficiencies comes about by preventing the duplication of information. It seems now that every discipline (physician, nurse, respiratory therapy, etc) asks of the patient and takes the same information. It appears from the note taking that no healthcare professional talks to anyone else.

Staff Efficiencies

It was said in one paper that “users can often develop a short list of indicators that require only modest investments in primary data collection. Costs can also be minimized by developing short lists of indicators that need to be collected only every three to five years. ” InHCc believes this is a waste of money and time and definitely can not be used for management!

Any investment should be evaluated by calculating the returns based on the inputs and outputs; it is NOT evaluated by how much it costs to implement or how easy it is. Indicators that are not used to manage and effect changes… return nothing; the return on investment is zero. It makes no difference how easy or cheap data are to collect if the data can not be used to create useful information to manage.

InHCc research shows that people are willing to pay for good health care; it is the same with data collection. If you do not use it, do not collect it. Good data can be, but not necessarily so, a large cost, but in the end the rewards are even greater. 

    Intellectual property is the most valuable resource that an organization can have. 

• Allows clinicians to gather clinically relevant, structured data without additional time or effort while in the process of documenting a routine clinic note. Electronic data entry enables the HCP to document (and code) encounters in one-third the time it takes to create a text-based medical record with better readability and without the need for transcription. 
• No requirement to duplicate data (estimated to be 30% of a HCP time)
• Better access to data. No need to "pull a chart". Client Data is immediately available.
• Ability to review all medical data before client encounter.
• No lost data.
• Reduction in time to process routine work
• No illegible handwriting
• No waiting to use medical data on an individual client. All data is available to anyone in the Organization at all times.
• Better and more complete data entry. Rules and standard protocols determine what the HCP puts into the medical record. 
• Write once use many times. Only need to write information one time. In Subsequent encounters there is only a need to verify current information. Medication history only has to be updated at each encounter.

• Automatic Laboratory enter values

• Improved employee morale

• More accurate information

• Redefined Clerical work

Administrative work

• Since all data is coded automatically, reports can be created automatically.
• There is no "transcriptions"
• Appointments are easier to make and schedule

Monitoring and Evaluation

Monitoring and Evaluation came out of the requirements that the donors wanted to be sure that the money they were giving away was being spend "correctly." In the beginning It had little to do with improving the "Management" of the projects. Today, since the donor's are the still the ones that have the money. Monitoring and Evaluation is still being funded.

Management and “Monitoring and Evaluation" ask very different questions for very different reasons. Management is concerned with “How can an organization meet its goals and make an impact.” Monitoring and Evaluation is concern with “Did the organization meet its goals and have an impact.” Monitor and Evaluation can only answer its question after the fact; the manager wants and needs to know his answer before the fact.  

The questions that a Manager asks is how do we provide what resources (services), at what prices, to which clients, at what costs.  If the manager does not get his answers, the answer for Monitor and Evaluation will always be, "No, the project does not have an impact." It may have had nothing to do with project design; the manager just has not done his or her job.   

Monitoring and Evaluation is static in nature; Management is ongoing. Results from Monitoring and Evaluation tells the researcher what has happened in the past but may give little help as to what may be necessary in the future. When a Monitoring and Evaluation study gets its results, that does not mean that the next time that it is implemented, or if it is implemented in a different place, or by a different group of people, the results will be the same. Management deals with trends and forecasts of the clients that it directly serves. Data results are continuous and group specific.

The question now becomes “Can Monitoring and Evaluation be replaced by a good Management System?” I believe that the answer to this question is a resounding and unqualified YES. By developing good “Management Systems,” both the needs of management and the monitoring and evaluation researchers will be met. 

It has been purposed that because you can not generalize from the "Project" to the Population, i.e. apply the data results from the project to the population at large, other tools need to be used to collect the population data then those tools used for Managing the Project... Monitoring and Evaluation. 

Evaluation (Impact) is first measured by using the variables (indicators)  related to the individual Project. Since the InHCc System includes more variables than the traditional Evaluation programs, the conclusion is that it will product a better measure or evaluation...however, impact can only be measured by knowing what else is happening (to the population/in the environment) around the Project. An example, is what if the Project is showing very good results (fertility has dropped from 5.5 to 4.0 in your catchment area, but...the whole population is also showing the very same good results (also fertility has dropped from 5.5 to 4.0). Your project has not produced a significant change. (see below for other factors that can influence the results).   

Monitor and Evaluation believes that in order to determine the impact, data must be obtained from two separate sources: (1) the project, and (2) the population. The reasoning being that because the project doesn't cover all segments of the population a survey must be performed to include this "left out group" in the results (monitoring and evaluation is concern with generalities, not specifics). Traditionally, this question has been answered by population surveys such as the Demography and Health Survey (DHS). It is InHCc's view that if the number of cases included in the Management System (the InHCc project) is sufficiently large and the Management System is implemented in "Surveillance" areas  then a Population Survey will be unnecessary.  

A Management System is better able to analysis what is happening in its environment. Because management measures trends on a daily basis (not the one year or two year schedule as most Monitoring and Evaluation programs), significance events can be immediately recognized. Monitoring and Evaluation averages these events and it is thus more difficult to identify them. Whereas, the number of cases in the DHS are generally of a limited number, very costly to perform, and static, data from the Management System is on an order of magnitude 1000 greater, time variant, and "Free." 

With a good Management System, the project can be monitored by using the traditional Budget and Variance method. In order for Monitoring and Evaluation to monitor, indicators are created that in must cases are too few and too generalized for managing.

A good HIS can:

• Monitoring
• Rewards medical professional for providing good care
• Identifies medical professionals that need additional training
• Competing to "beat the numbers"

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