8/6/2019 Green Book- HMIS
1/28
Primary Care Informatics
Information Systems in Healthcare
Dr. Shariq Khoja; MBBS. MSc. PhD (e-Health)Assistant Professor
Department of CHS & Medical Directors OfficeAga Khan University, Karachi. Pakistan
8/6/2019 Green Book- HMIS
2/28
Primary Care Informatics
Roadmap
Existing Information system for Primary care
in PakistanConcept of PCI and its componentsHow PCI could benefitWould PCI system work for Pakistan.?What could be the structure of PCI inPakistan
8/6/2019 Green Book- HMIS
3/28
Primary Care Informatics
Current situation
F irst point of contact(BHU, RHC,
health workers, physicians offices
LHWs
TBAs
Vaccinators
District
Province
National
Laboratories Radiology
PharmaciesOther
providers
TB
CP
MC p
8/6/2019 Green Book- HMIS
4/28
Primary Care Informatics
Current situationRole of Primary Care Provider Care (Cure??) Provider Expert / Storehouse of Information Information Administrator Information Source / Channel
Implementer of health programs Isolated component of a Disintegrated
Patient Care System
8/6/2019 Green Book- HMIS
5/28
Primary Care Informatics
Current situation
Role of a client in health care
Care (Cure??) receiver Amateur / learner Information provider Information Source Receiver of health programs Sufferer of a Disintegrated Patient Care
System
8/6/2019 Green Book- HMIS
6/28
Primary Care Informatics
Definitions
eelectronic
elitist, exclusive, exhausting, ephemeral, andexasperating
vs
ethics, equity, efficiency, empowerment,encouragement, education, enhancement of quality,evidence-based decisions, extension of the scope of
health care, and enablement of information exchangeand communication in standardized ways
8/6/2019 Green Book- HMIS
7/28
Primary Care Informatics
Definitions
e-Health:
consumer-centered model of healthcare wherestakeholders collaborate using ICTs includingInternet technologies to manage health,arrange, deliver, and account for care, and
manage the healthcare system. (OntarioHospitals e-Health Council)
8/6/2019 Green Book- HMIS
8/28
Primary Care Informatics
Definitions
Telehealth is the use of information and
communication technology(ICT ) to deliver healthservices, expertise andinformation over distance
e-Health
Health InformaticsTelehealth
Health Informatics dealswith the storage, retrieval
and optimal use of biomedical information,data and knowledge for problem solving anddecision-making
8/6/2019 Green Book- HMIS
9/28
Primary Care Informatics
DefinitionsHI= Collection of Health Information
+
Conversion of information into knowledge
Primary care describes the health servicesthat play a central role in the local community,such as family doctors (GPs), pharmacists,dentists and midwives.
8/6/2019 Green Book- HMIS
10/28
Primary Care Informatics
DefinitionsPrimary Care Informatics
T he scientific study of data,information and knowledge , and how they can be modelled, processed or harnessed to promote health and
develop patient-centred primary medical care.
Simon de Lusignan, Primary Care Informatics, LONDON SW17 0RE. 8th July 2002
8/6/2019 Green Book- HMIS
11/28
Primary Care Informatics
Definitions
People MachinesMethods
Data Collection, Process, Transmission & Dissemination
8/6/2019 Green Book- HMIS
12/28
Primary Care Informatics
Evolution
Physiciansmemory
EMR/EHR History &Physical exam
Organized data
8/6/2019 Green Book- HMIS
13/28
Primary Care Informatics
Why??Need of organization and integration
Advancements in ICT
T echnical Infrastructure deployment inhealthcare institutions
Powerful networked PCs and serversGovernment programsWHO initiatives
8/6/2019 Green Book- HMIS
14/28
Primary Care Informatics
Uses3 Rs of Primary Care Informatics:
Repository (collect-store)Collection, flow (interfacing), and organization(Clinical data repositories)Completeness and Accuracy
Reporting (display)Clinical data, integration, admin info
Research (analysis)Intelligent analysis of data for patient andpopulation
8/6/2019 Green Book- HMIS
15/28
Primary Care Informatics
Components
Patient
Provider EMR
8/6/2019 Green Book- HMIS
16/28
Primary Care Informatics
Components
Patient
Provider EMR
Decision Support
8/6/2019 Green Book- HMIS
17/28
Primary Care Informatics
Components
Patient
Provider EMR
Decision SupportLinks to lab &
imaging
Alerts
Entry of orders &data communications
support
KnowledgeResources
Patient access toknowledge,
Communications& EMR data
8/6/2019 Green Book- HMIS
18/28
Primary Care Informatics
Why???
If it aint break - Dont fix it
8/6/2019 Green Book- HMIS
19/28
Primary Care Informatics
BenefitsBetter / highest quality of health care(not possible with poor, incomplete or missing information)Enhancing quality by includingknowledge resources, practiceguidelines (minimizing variationbetween individual practice and optimalpractices)
8/6/2019 Green Book- HMIS
20/28
Primary Care Informatics
BenefitsAvoiding errors in practiceImproving service to the patients, andimprove their satisfaction with careControlling costs by avoiding: Rework Ordering duplicate tests Inappropriate diagnosis and treatment measures Medical errors
8/6/2019 Green Book- HMIS
21/28
Primary Care Informatics
ChallengesLack of education, training & supportLack of information exchange
Lack of a reasonable business caseLack of a common data model & CodingschemeLack of a drug database & drug decisionsupportLack of a decision support frameworkLack of quality
8/6/2019 Green Book- HMIS
22/28
Primary Care Informatics
Lack of Quality
8/6/2019 Green Book- HMIS
23/28
Primary Care Informatics
EvaluationWhy? Goals & Benefits Objectives Processes Indicators
8/6/2019 Green Book- HMIS
24/28
Primary Care Informatics
Relevance
Would Primary Care Informatics systemwork for Pakistan.?
8/6/2019 Green Book- HMIS
25/28
Primary Care Informatics
Relevance
F irst point of contact(BHU, RHC,
health workers, physicians offices
LHWs
TBAs
Vaccinators
District
Province
National
Laboratories Radiology
PharmaciesOther
providers
TB
CP
MC p
8/6/2019 Green Book- HMIS
26/28
Primary Care Informatics
Relevance
F irst point of contact(BHU, RHC,
health workers, physicians offices
LHWs
TBAs
Vaccinators
District
Province
National
Laboratories Radiology
PharmaciesOther
providers
TB
CP
MC p
Patient
8/6/2019 Green Book- HMIS
27/28
Primary Care Informatics
Relevance
F irst point of contact(BHU, RHC,
health workers, physicians offices
LHWs
TBAs
Vaccinators
District
Province
National
Laboratories Radiology
PharmaciesOther
providers
TB
CP
MC p
Patient
8/6/2019 Green Book- HMIS
28/28
Primary Care Informatics
Next stepsT he direction is clear, the pace uncertain
Determining the structure of PCI mostappropriate for PakistanExpanding knowledge among physicians,
other care providers and managersMoving towards complete, widespreadimplementation of EMR