Automating indicator data reporting from health facility EMR to a national aggregate data system in Kenya: An Interoperability field-test using OpenMRS and DHIS2

Introduction: Developing countries are increasingly strengthening national health information systems (HIS) for evidence-based decision-making. However, the inability to report indicator data automatically from electronic medical record systems (EMR) hinders this process. Data are often printed and manually re-entered into aggregate reporting systems. This affects data completeness, accuracy, reporting timeliness, and burdens staff who support routine indicator reporting from patient-level data. Method: After conducting a feasibility test to exchange indicator data from Open Medical Records System (OpenMRS) to District Health Information System version 2 (DHIS2), we conducted a field test at a health facility in Kenya. We configured a field-test DHIS2 instance, similar to the Kenya Ministry of Health (MOH) DHIS2, to receive HIV care and treatment indicator data and the KenyaEMR, a customized version of OpenMRS, to generate and transmit the data from a health facility. After training facility staff how to send data using the module, we compared completeness, accuracy and timeliness of automated indicator reporting with facility monthly reports manually entered into MOH DHIS2.Results: All 45 data values in the automated reporting process were 100% complete and accurate while in manual entry process, data completeness ranged from 66.7% to 100% and accuracy ranged from 33.3% to 95.5% for seven months (July 2013-January 2014). Manual tally and entry process required at least one person to perform each of the five reporting activities, generating data from EMR and manual entry required at least one person to perform each of the three reporting activities, while automated reporting process had one activity performed by one person. Manual tally and entry observed in October 2013 took 375 minutes. Average time to generate data and manually enter into DHIS2 was over half an hour (M=32.35 mins, SD=0.29) compared to less than a minute for automated submission (M=0.19 mins, SD=0.15).Discussion and Conclusion: The results indicate that indicator data sent electronically from OpenMRS-based EMR at a health facility to DHIS2 improves data completeness, eliminates transcription errors and delays in reporting, and reduces the reporting burden on human resources. This increases availability of quality indicator data using available resources to facilitate monitoring service delivery and measuring progress towards set goals.

Download Full-text

Measles Data Reporting in the District Health Information System: A Case Study of Gombe State

Global Journal of Health Science ◽

10.5539/gjhs.v11n11p109 ◽

2019 ◽

Vol 11 (11) ◽

pp. 109

Author(s):

Nnamdi Usifoh ◽

Toby Yak ◽

Ivy Dooga ◽

Raymond Dankoli ◽

Olufemi Ajumobi ◽

...

Keyword(s):

Information System ◽

Health Information ◽

Health Facility ◽

Health Information System ◽

Data Entry ◽

Health Facilities ◽

World Health ◽

District Health ◽

Targeted Interventions ◽

Data Entry Error

BACKGROUND: The District Health Information System (DHIS2) is a modular, cloud-based data management system designed for use in integrated health information systems. In Nigeria, it serves as the repository for routine health data, including measles. A first dose of measles is given routinely in most countries, however, for a country to include a second dose of measles in the routine immunization schedule, it must meet certain criteria set by the World Health Organization (WHO). Unfortunately, Nigeria falls into the category of countries that haven’t met the criteria. Despite this, MCV2 data can be seen on the DHIS2 platform. Data from DHIS2 also shows that Gombe State has the highest number of health facilities that reported MCV2 data at least once from 2015 to 2017. The aim of the study was to determine the reasons for the MCV2 reporting on DHIS2 platform for Gombe State. METHOD: We conducted a cross-sectional study among health workers in selected health facilities and LGA RI Officers at the LGA level in Gombe State. Health facility registers were reviewed, and data consistency was ascertained. We reviewed and conducted secondary data analysis of MCV2 data for Gombe State from January 2015 to December 2017. RESULTS: Of the 22 health facilities assessed, 14 health facilities (12 public and 2 private) reported offering MCV2 during the health facility-level interviews. At the LGA level, 5 LGAs out of the 11 LGAs reported during the LGA-level interviews that a second dose of measles is part of the RI schedule in their respective LGAs. For the 6 LGAs that reported not offering a second dose of measles as part of the RI schedule, 3 LGAs identified data entry error as the possible reason for having MCV2 data in the DHSI2 platform while the remaining 3 LGAs reported that the MCV2 data in the DHIS2 platform can be attributed to recording children who didn’t receive a first dose of measles at 9 months but received at 18–23 months as second dose of measles. CONCLUSION: Data entry error and knowledge gap on how to record measles data were identified factors responsible for MCV2 data on the DHIS2 platform. There is a need for targeted interventions towards improving the quality of RI data in Nigeria.

Download Full-text

Data cleaning process for HIV-indicator data extracted from DHIS2 national reporting system: a case study of Kenya

BMC Medical Informatics and Decision Making ◽

10.1186/s12911-020-01315-7 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Milka Bochere Gesicho ◽

Martin Chieng Were ◽

Ankica Babic

Keyword(s):

Data Cleaning ◽

National Level ◽

Voluntary Medical Male Circumcision ◽

Cleaning Process ◽

Process Data ◽

District Health ◽

Medical Male Circumcision ◽

Secondary Analyses ◽

Indicator Data ◽

Quality Issues

Abstract Background The District Health Information Software-2 (DHIS2) is widely used by countries for national-level aggregate reporting of health-data. To best leverage DHIS2 data for decision-making, countries need to ensure that data within their systems are of the highest quality. Comprehensive, systematic, and transparent data cleaning approaches form a core component of preparing DHIS2 data for analyses. Unfortunately, there is paucity of exhaustive and systematic descriptions of data cleaning processes employed on DHIS2-based data. The aim of this study was to report on methods and results of a systematic and replicable data cleaning approach applied on HIV-data gathered within DHIS2 from 2011 to 2018 in Kenya, for secondary analyses. Methods Six programmatic area reports containing HIV-indicators were extracted from DHIS2 for all care facilities in all counties in Kenya from 2011 to 2018. Data variables extracted included reporting rate, reporting timeliness, and HIV-indicator data elements per facility per year. 93,179 facility-records from 11,446 health facilities were extracted from year 2011 to 2018. Van den Broeck et al.’s framework, involving repeated cycles of a three-phase process (data screening, data diagnosis and data treatment), was employed semi-automatically within a generic five-step data-cleaning sequence, which was developed and applied in cleaning the extracted data. Various quality issues were identified, and Friedman analysis of variance conducted to examine differences in distribution of records with selected issues across eight years. Results Facility-records with no data accounted for 50.23% and were removed. Of the remaining, 0.03% had over 100% in reporting rates. Of facility-records with reporting data, 0.66% and 0.46% were retained for voluntary medical male circumcision and blood safety programmatic area reports respectively, given that few facilities submitted data or offered these services. Distribution of facility-records with selected quality issues varied significantly by programmatic area (p < 0.001). The final clean dataset obtained was suitable to be used for subsequent secondary analyses. Conclusions Comprehensive, systematic, and transparent reporting of cleaning-process is important for validity of the research studies as well as data utilization. The semi-automatic procedures used resulted in improved data quality for use in secondary analyses, which could not be secured by automated procedures solemnly.

Download Full-text

Evaluasi Sistem Informasi Manajemen Puskesmas Guna Mendukung Penerapan Sikda Generik Menggunakan Metode Hot Fit Di Kabupaten Purworejo

Jurnal Manajemen Kesehatan Indonesia ◽

10.14710/jmki.4.2.2016.129-138 ◽

2016 ◽

Vol 4 (2) ◽

pp. 129-138 ◽

Cited By ~ 1

Author(s):

Viera Juniver Thenu ◽

Eko Sediyono ◽

Cahya Tri Purnami

Keyword(s):

Information System ◽

Health Center ◽

Health Information ◽

Health Information System ◽

Health Centers ◽

Accurate Information ◽

System Quality ◽

District Health ◽

Routine Monitoring

Purworejo District Health Office (DHO) has developed Health Center Management Information System (HCMIS) to provide quick, precise, and accurate information for supporting the process of decision making and the policy of services at Health Center. However, there was still any empty forms and did not use the system. To standardize Health Information System, Ministry of Health has released a concept of Generic SIKDA. Therefore, the system applied by Purworejo DHO needs to be evaluated using the method of HOT fit. This was qualitative research using indepth interview and direct observation. Main informants were nine data operators and informants for triangulation purpose was six persons from health centers and five persons from DHO. Furthermore, data were analyzed using content analysis. The result of this research revealed that the application of HCMIS at Purworejo DHO was equal to Generic SIKDA. The system had been applied routinely but there was no a guidance book and training. Number of human resources was sufficient. However, there needed to make an implementer team of Health Information System in accordance with competency. There was no routine monitoring and current budget was not sufficient to maintain hardware to support the system. Quality of the system used was good, easy to use, and available of menu to communicate data. Unfortunately, quality of resulted information had still been inaccurate and incomplete because it did not cover data of services at Subsidiary Health Centers (SHC) and Village Health Posts (VHP). The lateness of services was related to a funding procedure. HCMIS at Purworejo DHO was equal to Generic SIKDA but it had not been used to make a decision. As a suggestion, DHO needs to conduct training, monitor, and provide hardware and a network. Meanwhile, Health Centers needs to make a commitment for applying the HCMIS maximally by SHC and VHP.

Download Full-text

Evaluasi Sistem Informasi Kesehatan di Provinsi Jawa Tengah Dalam Rangka Penguatan Sistem Informasi Kesehatan Nasional

Jurnal Manajemen Kesehatan Indonesia ◽

10.14710/jmki.4.3.2016.222-231 ◽

2016 ◽

Vol 4 (3) ◽

pp. 222-231

Author(s):

Endah Sri Lestari ◽

Sutopo Patria Jati ◽

Aris Puji Widodo

Keyword(s):

Information System ◽

Health Information ◽

Government Regulation ◽

Assessment Tool ◽

Health Information System ◽

Research Subjects ◽

District Health ◽

Central Java ◽

High Quality Information ◽

Central Java Province

Evaluasi SIK bertujuan untuk memastikan SIK berjalan secara efisien, mampu mengumpulkan informasi yang relevan dan berkualitas sebagai dasar pengambilan keputusan oleh pemangku kebijakan. Hasil penilaian SIK sangat dibutuhkan dalam meningkatkan kinerja SIK.SIK Provinsi Jawa Tengah merupakan sub sistem dari SIKNAS sehingga pengembangan SIK Provinsi Jawa Tengah akan berpengaruh terhadap penguatan SIKNAS. Tujuan dari penelitian ini adalah untuk mengevaluasi SIK di Provinsi Jawa Tengah dalam rangka Penguatan SIKNAS. Penelitian ini merupakan penelitian deskriptif evaluatif dengan pendekatan kuantitatif dan kualitatif. Subyek penelitian adalah 35 petugas SIK DKK dan enam petugas SIK Dinas Kesehatan Provinsi Jawa Tengah. Pengumpulan data kuantitatif melalui pengisian kuesioner, pengumpulan data kualitatif melalui FGD dan wawancara. Analisis data penelitian dilakukan dengan menggunakan perangkat Evaluasi SIK Provinsi yang merupakan modifikasi dari Assessment Tool HMN Versi 4.00. Modifikasi Assessment Tool HMN Versi 4.00 dilakukan dengan cara menghapus item pertanyaan yang tidak relevan dengan SIK di provinsi dan menambahkan item pertanyaan berdasarkan PP no 46/2016 tentang SIK. Hasil evaluasi terhadap tujuh komponen SIK, empat diantaranya dinilai “ada tapi tidak adekuat” yaitu komponen pengelolaan (54,7%), sumber daya (54,2%), sumber data (58%) dan manajemen data (41,3%). Sementara tiga komponen lainnya dinilai “adekuat”, yaitu komponen indikator (74,3%), produk informasi (71,3%) dan diseminasi dan penggunaan informasi (74,5%).Disimpulkan bahwa secara umum SIK Provinsi Jawa Tengah berada dalam kategori “adekuat”. Untuk meningkatkan pengelolaan SIK di Provinsi Jawa Tengah, direkomendasikan untuk membuat suatu standar tata kelola SIK sebagai acuan pengelolaan SIK di Provinsi Jawa Tengah. Evaluation of Health Information System (HIS) aimed at ascertaining the efficient implementation of HIS that could result relevant and high-quality information to be used as a basis of making a decision by a decision maker. The result of HIS assessment was needed to improve the HIS performance. HIS of Central Java Province was a sub-system of National Health Information System (NHIS) in which the development of HIS there would strengthen the NHIS. The aim of this study was to evaluate HIS in Central Java Province in order to strengthen NHIS. This was a descriptive-evaluative study using quantitative-qualitative approach. Research subjects were 35 HIS officers at District Health Office (DHO) and six HIS officers at Central Java Province Health Office. Quantitative data were collected by filling a questionnaire whereas qualitative data were collected by conducting FGD and indepth interview. Data analysis was performed using a software of Province HIS evaluation that was modified from Assessment Tool HMN version 4.00. Modification of Assessment Tool HMN version 4.00 was performed by deleting questions that were irrelevant with HIS at province and adding questions based on government regulation number 46/2016 about HIS. The results of evaluation of seven components of HIS, four of these seven components indicated “available but inadequate”, namely components of management (54.7%), resource (54.2%), data source (58%), and data management (41.3%). In contrast, three of these seven components were “adequate”, namely components of indicator (74.3%), information product (71.3%), and dissemination and use of information (74.5%). To sum up, generally HIS of Central Java Province was categorised as “adequate”. To improve HIS management in Central Java Province, a standard of HIS management needs to be made as a reference to manage HIS in Central Java Province.

Download Full-text

43 District health information system 2 (DHIS2) for injury surveillance in a resource constrained context

Injury Prevention ◽

10.1136/injuryprev-2015-041654.43 ◽

2015 ◽

Vol 21 (Suppl 2) ◽

pp. A15.3-A16

Author(s):

Achala Upendra Jayatilleke ◽

Roshan Hewapathirana ◽

Achini Silva

Keyword(s):

Information System ◽

Health Information ◽

Health Information System ◽

Injury Surveillance ◽

Resource Constrained ◽

District Health ◽

System 2

Download Full-text

District Health Information System Assessment: A Case Study in Iran

Acta Informatica Medica ◽

10.5455/aim.2012.21.30-35 ◽

2013 ◽

Vol 21 (1) ◽

pp. 30 ◽

Cited By ~ 7

Author(s):

Ahmad Raeisi ◽

Sakineh Saghaeiannejad ◽

Saeed Karimi ◽

Asghar Ehteshami ◽

Mahtab Kasaei

Keyword(s):

Information System ◽

Health Information ◽

Health Information System ◽

District Health ◽

System Assessment

Download Full-text

Perceived Usefulness, Competency and Associated Factors in using the District Health Information System Data among District Health Managers in Tanzania: Cross-Sectional Study (Preprint)

JMIR Formative Research ◽

10.2196/29469 ◽

2021 ◽

Author(s):

Daudi Simba ◽

Felix Sukums ◽

Claud Kumalija ◽

Sarah Asiimwe ◽

Sai Pothepragada ◽

...

Keyword(s):

Information System ◽

Health Information ◽

Associated Factors ◽

Health Information System ◽

Cross Sectional Study ◽

Perceived Usefulness ◽

Sectional Study ◽

District Health ◽

Cross Sectional ◽

System Data

Download Full-text

Use of mHealth Solutions for Improving Access to Adolescents' Sexual and Reproductive Health Services in Resource-Limited Settings: Lessons From Zimbabwe

Frontiers in Reproductive Health ◽

10.3389/frph.2021.656351 ◽

2021 ◽

Vol 3 ◽

Author(s):

Dominica Dhakwa ◽

Fungai H. Mudzengerere ◽

Mulamuli Mpofu ◽

Emmanuel Tachiwenyika ◽

Florence Mudokwani ◽

...

Keyword(s):

Information System ◽

Reproductive Health ◽

Health Services ◽

Health Information ◽

Adolescent Girls ◽

Young Women ◽

Health Information System ◽

Completion Rates ◽

District Health ◽

Referral Completion

Background: Gaps still exist in reducing new HIV infections among adolescent girls and young women (AGYW) aged 10–24 years. High Internet coverage and mobile phone penetration rates present opportunities for the use of mobile health (mHealth) to support access to health services. We present results of an FHI 360 and Zimbabwe Health Interventions-implemented mHealth intervention for reproductive health (RH) and HIV testing service (HTS) referral among AGYW aged 10–19 years between October 2019 and September 2020.Methods: Adolescent girls and young women referred for RH and HTS under the Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) program had automatic reminders sent to their phones to facilitate access to services through short message service (SMS) and also using a paper-based system. These data were captured in a web-based District Health Information System (DHIS) database, which captured the referral completion status of the AGYW. Data for AGYW referred for RH and HTS for the period October 2018 to September 2019 for the paper-based system and October 2018 to September 2020 for the mHealth were extracted from District Health Information System version 2 (DHIS2) database and analyzed using SPSS to generate descriptive statistics. The Chi-square test was used to assess differences in referral completion rates by age-group; marital status, district, and type of service, as well as differences between mHealth and paper-based referral completion rates within each of the groups for the variables above.Results: A total of 8,800 AGYW referred for RH and HTS, where 4,355 and 4,445 were referred through the mHealth and paper-based systems, respectively. About 95.2% (4,148/4,355) and 87.8% (3,903/4,445) referred through mHealth and the paper-based system, respectively completed referrals. The median time for referral completion was 1 day (Range = 0–9 days) for mHealth and 11 days (Range = 0–28 days) for the paper-based system. AGYW referred through mHealth were 17.995 timesmore likely to complete the referral system than those referred through the paper-based system (OR =17.995; p <0.001).Conclusion: Compared to the paper-based referral system the mHealth solution resulted in a higher, service referral completion rates and shorter turnaround time. We recommend expansion of the mHealth solution to all DREAMS supported districts to increase uptake of RH and HTS among AGYW aged 10–19 years.

Download Full-text