Presentations Day 1 - Session 1 - Presentation 06 - Sri Lanka

8/8/2019 Presentations Day 1 - Session 1 - Presentation 06 - Sri Lanka

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Health InformationHealth InformationSystem in Sri LankaSystem in Sri Lanka

Dr Sunil SenanayakeDr Sunil Senanayake

MBBS, MSc, MDMBBS, MSc, MDDirector/Health InformationDirector/Health Information

by



Information System

Components of National HMIS:

±Hospital Information System

±Preventive Health Information System±Disease Surveillance System

±Population Census

±Surveys±Other special surveys (NCD Risk Factor

Survey)



Sources of Information

Hospital Information System:

±Clinical Data

±Diagnosis of diseases (Using ICD-10)±Procedures performed

±Cancer Registry

±Cause of Death (Hospital deaths)±Hospital facilities

±Hospital services



Sources of Information ctd«

Preventive Health InformationSystem:

±Maternal, Child Health and FP data

±Food Sanitation, Environmental & Occupational Health data

±Nutrition data

±School Health data

±Immunization data

±Data from Disease Control Programmes



Sources of Information ctd«

Disease Surveillance System:

±Mainly Communicable Diseases

±Monitoring of disease trends±Leading causes of Hospitalization

Ischaemic Heart Diseases

Hypertension and complicationsCancers

Diseases of elderly



Sources of Information ctd..

Population Census:

National Census:±Started in 1881

±Every ten years (except 1991)

±Wide range of information




Surveys:

1. Demographic and Health Survey:±Started in 1973

±Every five years

±Support Health Information±Confirm Health Information




Surveys: ctd«

2.Household Income Survey:±Nutritional status

±Energy consumption

±Common Health Problems±Expenditure pattern




Surveys: ctd«

3. Nutrition Survey:±Nutritional status

±Nutritional disorders

±Energy consumption±Vitamin deficiencies

±Micro-nutrient deficiencies




Surveys: ctd«

4. Other Special Surveys (NCD RFSurvey):

±NCD Risk Factor Survey±Injury Surveillance




Other Sources Health Related Data:

±Alcohol and Drug Information Centre

±National Dangerous Drugs Control Board & Police Narcotic Bureau

±Non Governmental Agencies

±Sri Lanka Customs

±Trade and Commerce Ministry

Food, tobacco, alcohol etc (imports & sales)



In the past «««««..In the past «««««..

-Well established health infrastructure

-Very good preventive health care service

-Eradication of diseases

-One of the world best EPI programmes

-Better health Indicators for theinvestment

-Model for low cost health services-- Among many other things «...

Some of the remarkable achievements .



Recent past ««.Recent past ««.

-Health for all by 2000

-Primary Health care approach

-MCH and FP-Immunization

-Health Education

-Disease prevention-Healthy environment etc««



Future problems ««.Future problems ««.

Changing demography

Changing disease pattern

Changing life styles High expectation of people

Equity

Responsiveness Technological advances etc««



Our strategies ««««.Our strategies ««««.

-Improve ambulatory care

-Concentrate on Non Communicable Diseases

-Integrated Disease Surveillance

-Rehabilitation in the community-Promote healthy lifestyles

-Ensure equity

-Exploit IT-Better dialogues between clinicians, publichealth personnel, researchers & planners



Issues

There are many Issues: (Hospital)(Hospital)

±Manual Record keeping system

±Only inpatient data±Only from Government Hospitals

±ICD10 at Hospital but aggregated

groups are transmitted to the centre±Doctors do not concern about writingof diagnoses



Issues ctd«

There are many Issues: (Hospital) ctd«(Hospital) ctd«

±Inadequate human resources

±Untrained coders±Patient record formats

±No established Medical Record Departmentsin some hospitals

±No unique ID

±Repeated admissions counted as new cases

±Use of IT is minimal



Issues ctd«

There are many Issues: (Public Health)(Public Health)

±Total system is manual

±Behind time

±Processing is difficult

±No/weak data from

Estate sector

Occupational healthNutrition surveillance

Health education

NCDs



Issues ctd«

There are many Issues: (Other)(Other)

±Poor Financial Information

±No unit cost system±No Disease burden study

±No routine NCD surveillance system

±HIS policy has not been laid down



Challenges

Hospital System:

±Re-designing the hospital record

keeping system±Changing of record keeping formats

±Adaptation of ICD 10 at all hospitals

±Transmitting of data by ICD 10 4digit level



Challenges ctd..

Hospital System: ctd..

±Changing of attitudes of doctors

±Introduction of ICD 10 to basiccurriculums

±Introduction of IT to hospitals (EPR)

±Development of IT Networks in

hospitals±Training of users

±Quality of Medical Records



Challenges ctd..

Public Health System:

±Introducing IT at lowest possiblelevel

±Development of suitable software

±Development of routine NCD,nutrition and occupational diseasesurveillance systems

±Integration of disease surveillancesystems



Challenges ctd..

Other Systems:

±Introduce a Unit cost system

±Updating of Human ResourceInformation System

±Mapping of Health Facilities (GIS)

±Convincing Policy makers anddecision makers on investment in ITin Health



Challenges ctd..

The biggest challenge is ³getThe biggest challenge is ³getdecision makers and policy makersdecision makers and policy makers

to use information for decision andto use information for decision and

policy making.´policy making.´

Therefore ³evidence based decisionTherefore ³evidence based decision

making culture´ has to be promotedmaking culture´ has to be promotedamong them.among them.



Challenges ctd..

Information dissemination wouldInformation dissemination wouldbe one of the strategies that couldbe one of the strategies that could

be adopted to overcome thisbe adopted to overcome thissituation.situation.



Dissemination of Information

Annual Health Bulletin

Annual Administrative report

Weekly Epidemiology Bulletin

Quarterly Epidemiology Bulletin

Annual Family Health Report

Census reports

DHS reports

Survey reports

Health Ministry Website



Current status of IT Facilities

IT Facilities available:IT Facilities available:

±Ministry of Health has a Local Area Network with adedicated e-mail service and Internet services.

±All the Provincial Health Offices and most of theDistrict Offices are connected to the LAN of theMinistry of Health via dial-up lines for electronic

data transfer.

±Network will be expanded to MOH Offices andlarge hospitals by end of 2005.



Opportunities

Millennium Development Goals

Health sector master plan

WB assisted Health SectorDevelopment project

E-Sri Lanka project

Government budget monitoringmechanism



Thank You!Thank You!

Dr Sunil Senanayake

[email protected]@hotmail.com

Documents

Presentations Day 1 - Session 1 - Presentation 06 - Sri Lanka