What is a Health Information System?

Learn what a health information system is, benefits, best practices, and more in Data Protection 101,
our series on the fundamentals of information security.

A health information system (HIS) refers to a system designed to manage healthcare data. This includes
systems that collect, store, manage and transmit a patient’s electronic medical record (EMR), a
hospital’s operational management or a system supporting healthcare policy decisions.

Health information systems also include those systems that handle data related to the activities of
providers and health organizations. As an integrated effort, these may be leveraged to improve patient
outcomes, inform research, and influence policy-making and decision-making. Because health
information systems commonly access, process, or maintain large volumes of sensitive data, security is a
primary concern.

Health information technology (HIT) involves the development of health information systems.

EXAMPLES OF HEALTH INFORMATION SYSTEMS

Health information systems can be used by everyone in healthcare from patients to clinicians to public
health officials. They collect data and compile it in a way that can be used to make healthcare decisions.

Examples of health information systems include:

Electronic Medical Record (EMR) and Electronic Health Record (EHR)

These two terms are almost used interchangeably. The electronic medical record replaces the paper
version of a patient’s medical history. The electronic health record includes more health data, test
results, and treatments. It also is designed to share data with other electronic health records so other
healthcare providers can access a patient’s healthcare data.

Practice Management Software

Practice management software helps healthcare providers manage daily operations such as scheduling
and billing. Healthcare providers, from small practices to hospitals, use practice management systems to
automate many of the administrative tasks.

Master Patient Index (MPI)

A master patient index connects separate patient records across databases. The index has a record for
each patient that is registered at a healthcare organization and indexes all other records for that patient.
MPIs are used to reduce duplicate patient records and inaccurate patient information that can lead to
claim denials.

Patient Portals

Patient portals allow patients to access their personal health data such as appointment information,
medications and lab results over an internet connection. Some patient portals allow active
communication with their physicians, prescription refill requests, and the ability to schedule
appointments.

Remote Patient Monitoring (RPM)

Also known as telehealth, remote patient monitoring allows medical sensors to send patient data to
healthcare professionals. It frequently monitors blood glucose levels and blood pressure for patients
with chronic conditions. The data is used to detect medical events that require intervention and can
possibly become part of a larger population health study.

Clinical Decision Support (CDS)

Clinical decision support systems analyze data from various clinical and administrative systems to help
healthcare providers make clinical decisions. The data can help prepare diagnoses or predict medical
events — such as drug interactions. These tools filter data and information to help clinicians care for
individual patients.

BENEFITS OF HEALTH INFORMATION SYSTEMS

Health information systems tend to target efficiency and data management. The main drivers of health
information systems are:
Data analytics: The healthcare industry constantly produces data. Health information systems help
gather, compile and analyze health data to help manage population health and reduce healthcare costs.
Then the healthcare data analysis can improve patient care.

Collaborative care: Patients often need to treatments from different healthcare providers. Health
information systems — such as health information exchanges (HIEs) — allow healthcare facilities to
access common health records.

Cost control: Using digital networks to exchange healthcare data creates efficiencies and cost savings.
When regional markets use health information exchanges to share data, healthcare providers see
reduced costs. On a smaller scale, hospitals aim for the same efficiencies with electronic health records.

Population health management: Health information systems can aggregate patient data, analyze it and
identify trends in populations. The technology also works in reverse. Clinical decision support systems
can use big data to help diagnose individual patients and treat them.

BEST PRACTICES FOR HEALTH INFORMATION SYSTEMS

Security is the primary health information system concern. All networks are vulnerable, but healthcare
providers are desirable targets for cybercriminals. The Health Insurance Portability and Accountability
Act (HIPAA) regulates the protection of individual healthcare information. To help keep systems secure
companies should:

Train employees

Encrypt data

Back up data

Monitor usage

Buy insurance

Access vendor vulnerability

Utilize multifactor autentication

Besides security, it’s useful to focus on patients. Use health information systems to increase
convenience and access for patients. Consumers are used to retail systems and have high expectations
for customer service.

Remember the clinical staff is probably the best resource for health information system decisions. Top-
down decision making doesn’t often lead to seamless technology integration. Involve clinicians in
deciding how health information systems can be used and which technologies will be best.
WHERE TO FIND OUT MORE ABOUT HEALTH INFORMATION SYSTEMS

Visit the following resources for more insights on health information systems:

Healthcare Information and Management Systems Society (HIMSS)

American Health Information Management Association (AHIMA)

Health Information Systems: Toolkit on monitoring health systems strengthening (World Health
Organization 2008 draft report)

Connecting Public Health Information Systems and Health Information Exchange Organizations (The
Office of the National Coordinator for Health Information Technology)

Technology And Rising Health Care Costs (Forbes)

Health Information System Strengthening: Standards and Best Practices for Data Sources (Measure
Evaluation)

Tags: Data Protection 101, Healthcare

Health Information System in Primary Health Care: The Challenges and Barriers from Local Providers’
Perspective of an Area in Iran

Vahid Yazdi-Feyzabadi,1,2 Mozhgan Emami,3 and Mohammad Hossein Mehrolhassani3

Author information Article notes Copyright and License information Disclaimer

This article has been cited by other articles in PMC.

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Abstract

Background:

Health information system (HIS) has been utilized for collecting, processing, storing, and transferring the
required information for planning and decision-making at different levels of health sector to provide
quality services. In this study, in order to provide high-quality HIS, primary health care (PHC) providers’
perspective on current challenges and barriers were investigated.

Methods:

This study was carried out with a qualitative approach using semi-structured audiotaped focus group
discussions (FGDs). One FGD was conducted with 13 Behvarz and health technicians as front-line
workers and the other with 16 personnel including physicians, statisticians, and health professionals
working in health centers of the PHC network in KUMS. The discussions were transcribed and then
analyzed using the framework analysis method.
Results:

The identified organizational challenges were categorized into two groups: HIS structure and the current
model of PHC in urban areas. Furthermore, the structural challenges were classified into HIS
management structure (information systems resources, including human, supplies, and organizational
rules) and information process.

Conclusions:

The HIS works effectively and efficiently when there are a consistency and integrity between the human,
supplies, and process aspects. Hence, multifaceted interventions including strengthening the
organizational culture to use the information in decisions, eliminating infrastructural obstacles,
appointing qualified staff and more investment for service delivery at urban areas are the most
fundamental requirements of high-quality HIS in PHC.

Keywords: Health information system, Health service provision, Primary health care

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INTRODUCTION

Developing countries are faced with a wide variety of health-related challenges including the limited
resources and capabilities[1] and the health systems that address those challenges, have inevitably
moved into maximizing the value of scarce resources and finding ways to make health systems functions
as efficiently as possible.[2,3]

In order to ensure a more responsible use of the financial and human resource investments, public
health professionals are increasingly expected to engage in evidence-informed decision making,[4]
which is critically dependent on the timely availability of sound and accurate data and information.[5]
This information not only is required for health policy makers to make more effective decisions,[6] but
also it can be used by health front-line providers to improve the quality and efficiency of health
initiatives.[7] Obviously, data and information provide knowledge and developing and managing the
knowledge will provide power to construct effective interventions.[8]

Availability of accurate and timely information and understanding of how to use them effectively in the
health system are critical components for evidence-informed decision making,[9] which are provided by
the health information systems (HIS).[10]
Health information system is not a separate and independent component of the health system, and it
should be designed according to the service delivery system.[11] HIS is utilized for collecting, processing,
storing, retrieving, and transferring the required information.[12] HIS aims to improve the processes of
data handling in order to extract useful information for health planning, decision-making, and resource
allocation through different sources to provide quality services.[13,14] To this end, many attempts have
been accomplished by the health sector and donors concerning the design, development and
implementation of computerized HIS in countries.[3,15] The lure of this promise is magnified in
developing countries given the existing conditions and inefficiencies.[3]

The HIS is a functional entity within the framework of the comprehensive health system to improve the
health of the population. In this regard, the HIS structure should allow the generation of necessary
information for use in decision-making at each level of the health system with a given amount of
resources.[16] The HIS structure is grouped into two components of information process and HIS
management structure. Information process involves the components of gathering, transferring,
processing and analyzing the data, and presenting information for use in management decisions. The
information management structure encompasses components like the information systems resources
such as human (managers, statisticians, epidemiologists, etc.), supplies (telephones, computers, report
forms and financial resources), which are utilized in a way that produce high-quality and timely
information for decision-making, and a set of organizational rules, which are necessary to ensure the
optimal use of HIS resources.[17]

One of the main strategies to achieve universal health coverage and reduce the gap between health
outcomes in urban and rural areas is the implementation of primary health care (PHC),[18] which is
known as the first level of service[19] delivery for past two decades.[20]

The public sector is main provider of PHC services across the country and services such as prenatal care
and vaccination are provided free of charge in public facilities,[20] On the other hand, demographic and
epidemiological transition that is underway in health sector have a significant impact on the pattern of
morbidity and mortality in the near and distant future, especially as it affects the emergence of chronic
non-communicable diseases. Hence, the kind and nature of the services to meet new needs have been
changed.[21] For these reasons, it is necessary to pay more attention to HIS to suit new needs and
evidence-based decisions.[22]

Several studies have attempted to evaluate the HIS with various methods.[22,23] Some of these
evaluations were more focused on technical issues and clinical processes and stakeholders’ views on the
state of the HIS have been less analyzed.[24,25,26,27,28,29] Furthermore, although some studies
conducted in Iran have presented overall evidence regarding the functioning of the HIS in PHC, but have
more focused on the successes and have less provided more detailed evidence about the challenges and
inefficiencies.[30,31] Since changing environment such as growing developments in the technological,
social, and cultural contexts lead any system toward organizational changes and achieving better future
to survive and adapt to it,[32] this paper addressed the challenges and obstacles of high quality health
management information systems (HMIS) at the PHC system in district levels in Kerman University of
Medical Sciences (KUMS) to achieve a reliable evidence system for decisions.

What is a Health Information System?

EMR Interoperability

Last Updated on March 28, 2019

In the simplest terms, a health information system (HIS) is a system that captures, stores, transmits, or
otherwise manages health data or activities. These systems are used to collect, process, use, and report
health information. In turn, information from a health information system can be used to drive policy-
and decision-making, research, and ultimately health outcomes. Here’s what you need to know about
the key components of a HIS, the various types, and benefits of HIS.

Key Components of a Health Information System

Health information systems consist of six key components, including:

Resources – the legislative, regulatory, and planning frameworks required for system functionality. This
includes personnel, financing, logistics support, information and communications technology (ICT), and
mechanisms for coordinating both within and between the six components.

Indicators – a complete set of indicators and relevant targets, including inputs, outputs, and outcomes,
determinants of health, and health status indicators.

Data sources – including both population-based and institution-based data sources.

Data management – collection and storage, QA, processing and flow, and compilation and analysis.

Information products – data which has been analyzed and presented as actionable information.

Dissemination and use – the process of making data available to decision-makers and facilitating the use
of that information.

Types of Health Information Systems

Health Information Systems is a broad category that encompasses several specific types of systems.
Here’s a look at some of the most common HIS types.

Strategic or Operational Systems

Strategic or operational systems are typically used for information classification. Provisions are made for
information systems based on the type of information they’re handling. A pyramid classification system
allows organizations to assess the spread of digitization. Because operational systems are generally
developed before executive information systems or management information systems, this is easily
achieved. The ability to evaluate dependencies can help to identify system deficiencies, as well. For
example, a properly configured information system should pull data from a clinical system rather than
require nurses and clinicians to collect and document data manually.

Clinical and Administrative Systems for Managing Patient Information on an Administrative Level

Clinical systems are dependent on administrative data. The foundation of an integrated HIS is a master
index developed around the most basic patient information with links to different clinical systems, and
the clinical system contains the electronic patient record (EPR), diagnostic data, outcomes, and
processing.

Electronic Health Record and Patient Health Record

Open EHR aims to enable semantic interoperability for health information systems between various EHR
systems in a non-proprietary format to prevent vendor lock-in. Knowledge concepts are stored outside
the EHR as archetypes, which support the recording of clinical information. Archetype building blocks
include instructions, evaluations, observations, and actions, and information built using these building
blocks is stored in the EHR.

Subject- and Task-Based Systems

Subject-based systems are related to patients or healthcare professionals in any type of healthcare
organization. Task-based systems, on the other hand, are associated with particular tasks such as
admission or discharge. Subject-based systems are often preferred, as they reduce data duplication. In a
task-based system, the same subject could be related to various tasks, with basic information such as
the patient’s ID being duplicated across each task. In a subject-based system, this basic information is
entered only once and flows with the subject through various tasks. For example, an EHR is a subject-
based system.

Financial and Clinical Health Information Systems

These systems provide easy access to patient financial information, such as costs and payors, and they
also aid in monitoring patient usage of different departments or services. Financial systems typically
include invoicing capabilities as well as tools for following up on non-payments.

Decision Support Systems

Decision support systems convert data to clinically relevant information and present it in actionable
form to clinicians, aiding in adherence to regulatory guidelines and best practices. These systems can
give results for several data manipulations to mimic cognitive processing. For example, a decision
support system may provide a list of medications for a particular condition appropriate for the patient’s
demographics, such as the patient’s age and weight, as well as any comorbidities. Decision support
systems can also facilitate next steps in the workflow, such as submitting a prescription to the pharmacy
and scheduling a follow-up appointment for the patient.

Examples of Health Information Systems

Examples of Health Information SystemsThere are many specific health information systems, most of
which can be classified as one of the types discussed above. Specific examples include:

Master Patient Index (MPI)

Medical billing software

Patient portals

Health Information Exchange (HIE)

Activity Based Costing (ABC)

Patient Reported Outcomes (PRO)

Remote Patient Monitoring (RPM)

Scheduling software

e-Prescribing software

Laboratory information systems

Hospital Patient Administration Systems (PAS)

Human Resource Management Information Systems (HRMIS)

As you can see, health information systems run the gamut from high-level administrative systems to
those that manage detailed, patient-specific information.

Benefits of Health Information Systems

The healthcare industry relies on a massive amount of data to make decisions about patient care,
facilitate the delivery of care, and handle the many complex administrative tasks that go on behind the
scenes. Health information systems are valuable tools that aid clinicians and administrative personnel in
ensuring a seamless patient experience from end-to-end. Other benefits include:
Data analytics – HIS help to gather and analyze data to manage population health and reduce healthcare
costs.

Supports collaborative care – HIS facilitates the sharing of PHI between providers and organizations,
making it possible for patients to receive coordinated care from multiple providers while improving care
delivery and patient outcomes.

Cost control – By sharing information, HIS can eliminate duplicate testing and procedures, reduce time
demands on staff (such as for sending paper copies of patient records), and reduce costly human errors.

Population health management – Aggregating patient data can help to identify patterns and trends,
predict or prevent outbreaks, identify at-risk populations, and more.

Clinical decision support – Integrating a patient’s individual data and medical history with broader
population data and research improves both diagnostics and treatment.

Challenges of Health Information Systems

Health information systems must be both user-friendly – otherwise, staff simply won’t use them – and
cost-effective to run. They should also be able to use and interpret health data. However, achieving
these goals has been challenging in the past, leading the industry to aim for interoperability – which is
crucial for maximizing the benefits of HIS.

Interoperability improves both the quality and use of health information, but traditional integration
techniques are costly and time-consuming to implement. That’s why more healthcare organizations are
turning to API solutions like Emissary®. APIs make interoperability more practical, cost-effective, and
user-friendly, allowing for the seamless integration of a variety of disparate systems to eliminate silos
and streamline the flow and management of data between systems. Learn more about Sansoro Health’s
integration solutions and how our solutions can remove the painful, lengthy barriers of application
integration to start getting more value from your HIS.

HEALTHCARE

Safeguard PHI. Stop Ransomware. Deliver Security Education in Real-time.

HERE’S THE CHALLENGE

Healthcare has the unenviable task of balancing protection of large amounts of personal and medical
data with the need for quick access and easy movement by and to care providers, insurers, partners and
other affiliates. With recent ransomware attacks in hospitals, healthcare CISOs now understand
compliance does not equal security; new controls are needed.

In addition, insider misuse is a major issue for the healthcare industry. It is the leading industry where
employees or practitioners are the predominant threat actors in data breaches.

HERE’S THE SOLUTION

More than 120 healthcare organizations trust Digital Guardian to balance patient care and data security.

Digital Guardian enables healthcare organizations to effectively discover, monitor and control PHI,
whether on the network, in use on desktops or laptops, at rest in databases and on network servers - or
stored in the cloud. Automated and flexible controls prevent a data breach without negatively impacting
practitioners or patient outcomes. Real-time prompts enhance security awareness at the point of risk,
reducing insider misuse of sensitive data.

SOLUTION BENEFITS

SEE WHAT DATA TO PROTECT

Digital Guardian with its deepest visibility into data, user and system events, can identify and tag
sensitive data in real-time even before you develop formal policies. We accurately identify PHI using our
Database Record Matching fingerprinting technology.

UNDERSTAND WHEN DATA IS AT RISK

Digital Guardian Analytics and Reporting Cloud uses a big data cloud services architecture and
innovative UI to aggregate and analyze millions of system, user and data events and turn all that data
into human digestible intelligence. Analysts can detect and respond to threats – both insider and
outsider – faster and more efficiently.

ENFORCE AND EDUCATE: FLEXIBLE & AUTOMATED CONTROLS

Our behavior-based rules automatically prompt users to prevent actions that violate policies and put
data at risk. Users are educated in real-time with positive reinforcement on the appropriate handling of
regulated data via display prompts that request justification. Illegal downloads or exfiltration can be
blocked or contained before the data is gone.

DATA TYPES WE PROTECT

HOSPITALS

Personal health Information (PHI)

Patient Financial Information Including Payment Card Industry (PCI) Data

HEALTHCARE IT

Patient Care Data

Personal Health Information (PHI)

Personally Identifiable Information (PII)

HEALTHCARE ANALYTICS

Claims & Cost Data

Unstructured Data Such as R&D Data, Clinical Data, Patient Behavior & Sentiment Data
BENEFITS MANAGEMENT & INSURANCE

Personal Health Information (PHI)

Claims Data

Patient Care Data

DOH, DOST to improve access to health information

Philippine Health Information Exchange, a project of DOH and DOST will allow easy access to health
information across the country

MANILA, Philippines – Inaccessibility of health care services and information, especially those in rural
areas, is one of the perennial problems of the country’s health sector.

To address this, the Department of Health (DOH) partnered with the Department of Science and
Technology (DOST) to create a platform that will allow better access to health services, facilties and
information.

The two agencies introduced the Philippine Health Information Exchange, a system that basically allows
easy access to health information from the national to the barangay level, during an e-health forum held
Saturday, July 26.

The forum, which was part of the 2014 National Science and Technology Week at the SMX Convention
Center in Pasay City, also served as a venue to discuss possible ways to improve the health sector of the
country through technology.

Health information at your fingertips

The Philippine Health Information Exchange will store health-related data in the country and can be
viewed by authorized health care providers.

Health Secretary Enrique Ona explained that having a centralized health information will help policy
makers and health managers formulate better health programs.

Meanwhile, DOH Usec Teodoro Herbosa believes that having a system for shared information will be
helpful especially to patients living in rural areas who do not have access to health services.
“It will provide a single unified view of patients’ data records across and between facilities, whether
hospitals or clinics, to an interface that is accessible anywhere and anytime. Maybe even in your
smartphones,” Herbosa added.

Advantages

One of the main concepts of the Philippine Health Information Exchange is having a standard for all
health data.

“What the country has at the moment are independent information systems that are unfortunately still
subpar to developing international standards,” Ona said.

Herbosa said having the Philippine Health Information Exchange will:

eliminate double counting very high maternal mortality records that might be inaccurate

prevent under reporting that may result to budget allocated incorrectly

assure reliability of data and avoid using obsolete data

avoid double data collection by different agencies

standardize data to allow ease of sharing and analysis

improve the completeness of data because of the exchanges among different health facilities

Another project in the health sector is the RxBox, a portable telehealth device equipped with sensors
that allows patients to consult with health care specialists by simply measuring their vital signs and then
transmitting them through a wireless connection.

Others, the android run e-tablet and e-hatid, which allow real-time access to health information for
LGUs and health specialists, are also part of the initiatives in the health sector.

"Having these smarter technologies for better healthcare services and the capability to connect health
information, we can now guarantee that our health specialists, policy makers and stakeholders will be
smarter in formulating policies, and programs for the benefit of Mang Juan and Aling Maria," Science &
Technology Secretary Mario Montejo said.

Privacy issues
Having a system that will house all health information in the country, privacy becomes one of the
concerns of people.

Ona assured that the system will only consist of information such as the number of people having a
particular disease and their age, among other things and will not reveal their identity.

"We’ve also created a group that [would] also create our standards for privacy in terms of sharing of
patient information and patient health data," Herbosa added.

Call for ideas

Among the other issues raised during the panel discussion were internet connectivity in rural areas,
disasters and other factors that may affect the system.

Advertisement

Ona also encouraged stakeholders, policy makers and students to give ideas on how the Philippine
Health Informaton Exchange can be institutionalized and what necessary incentives are needed for both
the public and private sector to develop it. – Rappler.com