NCD Malaysia 2002, volume 1, No.2
9
INTRODUCTION
I
nformation support is essential in the de
velopment and provision of any service.
The Malaysian Health Development has
been captured by a sound Health Information
System in the country that was developed
through the years, from pre-independence days.
HEALTH MANAGEMENT INFORMATION
SYSTEM (HMIS)
Health Management Information System
(HMIS) is use in assisting for the effective planning,
development, co-ordination and evaluation
of the individual programme. It is a decision
support system for health management
and a system that links information to managerial
concern.
An information system is necessary because
managers at different levels of management
require information in order to assess achievement,
monitor the existing programme as well
as plan for future development including evaluation
of resource allocation. The information
system will also provide a feedback on accomplishments
of norms and targets set and
whether resources have been fruitfully utilized.
HEALTH MANAGEMENT INFORMATION
SYSTEM (HMIS), MEDICAL CARE
(IMPLEMENTATION OF ICD-10), MALAYSIAN
EXPERIENCE
LAILANOR IBRAHIM1
This feedback will appear in the form of information
which can be stored in a computer file,
recorded in a register or reported in a monthly,
quarterly or annual report .
System Framework
The system framework of HMIS consists of
subsystems such as Medical Care, Dental Care,
Financial and various other subsystems.
This integration of the various information
systems within the HMIS facilities will enable
managers and planners at the National Level
to monitor and evaluate the performance of the
total health care delivery of the nation in a comprehensive
manner.
Reporting
In the HMIS reporting system the regular
reports will be transmitted periodically up to the
various managerial levels. Data generation will
be done at the district level, in some cases the
sub district level, where the data will be compiled
or aggregated and transmitted to next
higher level for further compilation. Information
required on an ad hoc basis or annually will
be processed at MOH level (IDS Unit) and annual
reports will be produced for use by differ-
1
Head of Information
and Documentation
System Unit (IDS),
Ministry of Health,
Malaysia
ABSTRACTS
Information support is essential in the development
and provision of any service. Health Management Information
System (HMIS) is responsible in assisting
for the effective planning, development, co-ordination
and evaluation of the individual programme. HMIS
is a decision support system for health management
and a system that links information to managerial concern.
The Medical Care Information System (MCIS)
which is the component of the HMIS was started by
Ministry of Health (MOH) in 1980 in manual form, and
in 1990 the software was developed in which the discharges
diagnosis was coded as in the classifications
used as in the International Classification of Diseases,
ninth revision (ICD-9) and implemented in all MOH
hospitals. The core output of the system is a set of
indicators to be used in monitoring and evaluating the
inpatients services namely a) Performance indicators
such as admissions, deliveries etc. b) utilization indicators
e.g Laboratory test per day, bed occupancy rates
(BOR) etc. and Evaluation Indicators such as average
length of stay (ALOS), death rates, 10 principal causes
of admission and 10 principal causes of death in the
hospital can be obtained from the system. In 1998,
MOH had developed a new software for the MCIS with
International Statistical Classification of Diseases and
Health related problems, tenth revision (ICD-10) coding
incorporated. The software with ICD-10 was implemented
nationwide in all MOH hospitals in 1999.
All the outputs from all MOH hospitals can be transferred
to Information and Documentation System
Unit (IDS) through file transfer protocol (FTP)
through the HMIS Phase II online networking that has
been layout in the year 2000. For standardization of
information and indicators, similar data collection
could be implemented to all private hospitals.
Keyword: Health Management Information Sysrem (HMIS), Medical Care, IDS 10
Health Management Information System (HMIS), Medical Care (Implementation of ICD-10), Malaysian Experience
NCD Malaysia 2002, volume 1, No.2
10
ent levels of management .
System Description
The system capabilities shall be able to :
a) generate all the data necessary for
measurement of performance which will
form the basis of management at different
operational levels.
b) Generate all routine reports for circulation
to subscribed users on a timely
basis.
c) Interface with the other information
subsystem users on a timely basis.
d) Interface with the other information
subsystems to be able to generate integrated
reports for multifunctional
purpose.
e) Flexible enough to allow for and accom
modate any additional requirement that
may be necessary over a period of time.
f) For reports, the following constitute the
scope of data to be gathered by the
system:-
00ttendance's by types of activities.
00ontinuity of care given by types of
activities.
00utput/Workload by operational
area.
All data will be captured in the basic documents
and will appear in the form of information
provided in the reporting formats.
For the outputs, the core of the system is a
set of indicators to be used in the monitoring
and evaluation of programmes. The type of indicators
cover the three main areas, i.e. performance,
utilization and evaluation indicators.
Processing
IDS Unit of MOH will be responsible for the
processing and dissemination of information
generated. All basic documents will be filled up
at the operational level units and subsequently
periodical reports will be prepared and sent up
either for management use or for further aggregation.
Information required on an annual basis
and which involves a number of variables
would be processed directly by computer from
basic documents. This mode of processing is
imperative because of the high volume of information
expected to be generated.
a) Users
Generally speaking, the system will be utilized
by the internal sector composed of
National Programme Directors/Managers,
State Directors/Managers, District
Health Officer and supervisory staff at the
operational level. The internal sector will
utilize the information for health policy
formulation, planning, budgeting, monitoring
research and evaluation purposes.
External agencies - Information generated
by this system will not only benefit
to MOH, but also useful to external agen
cies like Statistics Department, Economic
Planning Unit, and others.
b) Evaluation
The information system can be evaluated
over regular intervals for the timeliness
of information generated, the appropri
ateness of the forms used, and proper utilization
of information generated.
c) Monitoring of HMIS
The programme under HMIS were:-
00Public Health (Family Health,
Communicable Disease Control,
Food Quality Control and Rural Environmental
Sanitation)
00edical Care
00ental Care
HMIS MEDICAL CARE (INPATIENT
SERVICES)
The Medical Care Information System
(MCIS) which is the component of the HMIS to
fulfill the following objectives:-
a) To provide timely and relevant management
oriented information to managers
at various level of the Ministry for the
management of the medical care health
programme.
b) To assists the programme planners and
managers in determining the future requirements
and evaluating past perform-
ances.
Health Management Information System (HMIS), Medical Care (Implementation of ICD-10), Malaysian Experience
NCD Malaysia 2002, volume 1, No.2
11
c) To facilitate the development of norms
and standards for the management of the
medical care health programmes.
d) To serve as a basis for monitoring the im
provement and effectiveness of the medical
care delivery system.
Inputs - All then data will be captured in the
basic documents and will appear in the form of
information as provided in the reporting forms.
Basic Document of inpatients are as follows:-
00dmission Register
(PD 101)
00elivery Register
(PD 102)
00aily Ward Census
(PD 103)
00aily Inpatient
(PD 104A)
Census for Hospital
00aily Inpatient
(PD 104B)
Census By Discipline
00eath Register
(PD 105)
Periodical Reports for the inpatients are as
follows:-
00eekly report on Death
(PD 201)
00onthly/Annual Report on
Admission by Sex, Ethnic,
Age Group
(PD 202)
00nnual Report of Admission
by Admission Category
(PD 204)
00onthly/Annual Report on
Admission for Maternity Unit (PD 205)
00onthly/Annual Report on Morbidity
and Mortality of Inpatients (PD 206)
00onthly/Annual Report on Operation
done by Discipline
(PD 207)
00early census on Hospital Bed (PD 209)
00onthly/Yearly for uses of
Hospital Bed
(PD 211)
In 1998, MOH had developed a new software
for the MCIS with International Statistical Classification
of Diseases and Health related problems,
tenth revision (ICD-10) coding incorporated
. The software with ICD-10 was implemented
nationwide in all MOH hospitals in
1999. All the outputs from all MOH hospitals
can be transferred to Information and Documentation
System Unit (IDS) through file transfer
protocol (FTP) through the HMIS Phase II
online networking that has been layout in the
year 2000.
CONCLUSIONS
In conclusion, in order to make the plan for
the HMIS project a success, it will need both the
commitment and support from public and private
sector top level management. Only then can
the vision the target of having IDS to become
the only source of data on Health Management
Information System in Malaysia for the future
become a reality.
REFERENCES
1. World Health Organisation (1999), WHO cooperation
in strenghtening National Health Information
System.
2. S.K Lwanga, S.A Sapire (1995), Rapid Assesment
of National Health Information System (HIS) Including
Epidemiological Surveillance
3. Ministry of Health Malaysia, Medical Care Information
System Manual. Health Management Information
System.
4. World Health Organisation (1993), ICD-10 Computer
based training packages-
Health Management Information System (HMIS), Medical Care (Implementation of ICD-10), Malaysian Experience
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