CURRENT SITUATION OF HEALTH INFORMATION SYSTEM

IN MYANMAR

The 6th Asia Pacific Network meeting of WHO FICThailand, 18-19 July, 2013

Subsystems of HIS

• Epidemiological surveillance system• Routine service reporting system• Program-specific reporting systems• Administrative and resource management

reporting systems• Vital or Civil Registration Systems• Population based surveys

Routine Service Reporting System

Public Health Reporting

Hospital Reporting

Department of Health Planning

MCH/UHC/Station HU/RHC

District/Township Health Department

State/Regional Health Department

Sub Rural Health Center

Data Flow

Data Flow and Feedback

DHP

Teaching Hospitals

General Hospitals with Specialist services

200-Bedded Hospitals

150-Bedded Hospitals

100-Bedded Hospitals

50-Bedded Hospitals

25-Bedded Hospitals

16-Bedded Hospitals

Specialist Hospitals

States/Region Health Department

Hospital Form I,II, III & OPD

Hospital Form I, III

Station Hospitals

Hospital report forms

• Monthly hospital return• Monthly general inpatient summary• Hospital inpatient daily record

• Outpatient report form

PART A. NO. OF BEDS:

(1) SANCTIONED BEDS ------------------------------ (2) AVAILABLE BEDS AT END OF MONTH ------------------------------

PART B. IN-PATIENT ACTIVITIES: PART C. OUT-PATIENT ACTIVITIESSR.NO.

SPECIALITY

NO. OFPATIENTSBEGINNIN

GOF MONTH

ADMIS-SIONSDURIN

GMONTH

TOTALUNDERCARE(3+4)

DISCH-

ARGES

DEATHS

TOTALDISCH

-ARGES

(6+7)

PATIENTDAYS

SR.NO.

SPECIALITY

NEWCASES

OLDCASES

TOTALATTEN-DANCE

S

1 2 3 4 5 6 7 8 9 1 2 3 4 5

TOTAL TOTAL

MONTHLY HOSPITAL RETURN (ADMINISTRATIVE) FORM I(TO BE COMPLETED AND POSTED NOT LATER THAN THE 7TH OF EACH MONTH) (REVISE/2013)

NAME OF HOSPITAL ---------------------------- TOWNSHIP -------------------------- REGION/STATE ------------------------- MONTH ----------- YEAR ---------

PART D. OBSTETRIC SERVICES: PART E. SURGICAL ACTIVITIES:

1 NO. OF WOMEN DELIVERED 1 GENERAL ANAESTHESIA

2 NO. ADMITTED FOR PUERPERIAL CARE 2 SPINAL ANAESTHESIA

3 NO. OF ABORTIONS 3 LOCAL ANAESTHESIA

4 NO. OF LIVEBIRTHS 4 OTHER ANAESTHESIA

5 NO. OF STILLBIRTHS

PART F. DEATHS PART G. MISCELLANEOUS ACTIVITIES TOTAL

F-1 IN-PATIENT DEATHS: (TOTAL NO.)

F-2 NEWBORN DEATHS (TOTAL NO.)

1. POLICE CASES2. PATIENTS BROUGHT IN DEAD

IN-PATIENT DEATHS:(WITHIN 48 HOURS OF ADMISSION)

NOTE: Newborn deaths refer to babies who were born in hospital and died before being discharged with or without their mothers.

3. AUTOPSIES PERFORMED

NOTE: Inpatient deaths refer to patients who were admitted to hospital and died before being discharged.

PART H. MANPOWER:Male Female

1 NO. OF SPECIALISTS2 NO. OF DOCTORS3 NO. OF DENTAL SURGEONS4 NO. OF NURSES5 NO. OF MEDICAL

TECHNICIANSTOTAL

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Signature ……………………………………

Name -……………………………………… Designation

……………………………………Hospital

……………………………………

SR.

No.

ADMISSION

NUMBER

SEX

AGE DATE OF PRINCIPAL/ DISCHARGE DIAGNOSIS

(OR)

NATURE OF INJURY BY SITE

CO-MORBIDITY/OTHER

COMPLICATION (OR)EXTERNAL CAUSES OF

INJURY (INCLUDING PLACE

OF OCCURRENCE & ACTIVITY)

OPERATIONS

PERFORMED

TYPE

OF DISCHA

RGE

DISCHARGE

STATUSY M D ADMISS

IOND/M/Y

DISCHARGED/M/Y

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11)1

CODE

2CODE

3CODE

4CODE

5CODE

6CODE

7CODE

8CODE

9CODE

10CODE

11CODE

12CODE

MONTHLY GENERAL IN-PATIENT SUMMARY FORM II (REVISE/2013)NAME OF HOSPITAL ------------------------ TOWNSHIP ------------------------ REGION/STATE ---------------------- MONTH ------------------- YEAR ---------

Date

PART (A) Patients admitted to Hospital PART (B) PART (C)No. of

Patients inHospital(Previous

Day)

Admis-sion

Transfersin fromotherwards

Total(Cols.

2+3+4)

Disch-arges

Death*

Trans-fer

Out to other wards

Total(Cols.6+7+8)

No. of Patients in Hospital(End of

Day)(Cols. 5-9)

Babies born inHospital

Patients admitted

and discharged

on the same day

Live Still Death of

new born

(1) (2) (3) (4) (5) (6) (7) (8) (9) (10) (11) (12) (13) (14)123456789

10111213141516171819202122232425262728293031

Tot.

HOSPITAL DAILY RECORD (IN - PATIENT) FORM III (Revise/2013)(To be completed and posted not later than the 7th of each month)Month ............................ 20 ..........Name of Hospital .................................. Speciality(**)........................Township ...........................Region/State............................

OPD Form

Standardized Hospital report forms for all Hospitals

Manual for Hospital Form

I, II & III

Manual for OPD

ICD-10

Use of ICD( International Statistical Classification of Diseases and Related Health Problems)

in Myanmar

1962- ICD 71968- ICD 81979- ICD 91996- ICD 10

Translation------------ Chapter XIX, XX

Data from Private Health Sector

• Permission from higher level• Initialization phase• Start from 2013 January• Private hospitals • Develop data collection form and manual

Standardized Report Forms

• Form I - Private Hospital Monthly Report Form (Administrative)

• Form II - Private Hospital Monthly In-Patient Summary

• Training – 27.4.2013 -28.4.2013

Standardized Report Form I- front

Standardized Report Form I-back

Standardized Report Form II

Available information

• Hospital administrative information– Average number of out-patients per day – Average number of In-patients per day– Average duration of stay (in days) – Bed occupancy rate – Turnover interval – Hospital Death Rate

• Causes of Hospitalization– Leading cause of Morbidity and mortality

Strengthening of Hospital information System

Training *******Medical record

technician

Training of Medical Record Technicians on ICD-10 and CAMRS

(6.5.2013 – 21.5.2013)

Workshop on International Statistical Classification of Diseases (ICD-10) and

Computer Assisted Medical Record System(CAMRS)Nay Pyi Taw (28-5-

2013)to (31-5-2013)

Workshop on International Statistical Classification of Diseases (ICD-10) and

Computer Assisted Medical Record System(CAMRS)Nay Pyi Taw (28-5-

2013)to (31-5-2013)

Group Work

Utilization of Health Information

• Selection of project sites• Resource allocation including budget and

logistics distribution• Planning, Implementation, monitoring and

evaluation of health services• Country presentation on workshop, seminars

and meetings

Points for consideration in improvement of Hospital Information System

• Lack of written Health information Policy• Inadequate infrastructure• Shortage of manpower• Low capacity of human resources especially in

information management• No Career development for medical record

technicians• Supplies and equipment – Inadequate ICD -10

Books , Computer, File cover, filing rack

Points for consideration in improvement of Hospital Information System (Cont:)

• Still use in paper recording and reporting from various level except central and region/state

• Poor favourable working environment• Low utilization of data and information to

actions• Lack of motivation in strengthening of health

information

Areas need to be strengthened

• Strengthen organization set up and infrastructure

• Capacity building of human resources on modeling method and advanced data analysis, presentation and interpretation

• Provision of supplies and equipments for electronic health record system

Areas need to be strengthened (Cont:)

• Systematic monitoring, supervision and feedback

• Encourage in utilization of information to actions

• Establish unique logistic management information system and human resource management information system

• Cooperation, coordination and collaboration with indispensible partners

Future Plan

• Training of Medical Record Technicians • Supervision and Monitoring on performance of

medical record technicians• Advocacy to authorities for career development of

medical record technicians• Paramedic degree for medical record technicians in

collaboration with Department of Medical Science• Training of ICD-10 to medical doctor • Include ICD-10 in pre-service curriculum of medical

doctors• Verbal autopsy on cause of death

Thank you