Health Informatics

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Browsing Health Informatics by Author "Addisse Mesfin (PhD)"

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    Assessment of Hmis Design and Implementation in Ethiopia: The Case of Selcted Public Health Facilities in Addis Ababa Health Bureau
    (Addis Ababa University, 2012-06) Kitanbo Messay; Addisse Mesfin (PhD); Abebe Ermias (PhD)
    Background: To facilitate informed local decision-making it is necessary to implement health management information system to timely and accurately provide each level of the health sector with the necessary information. In the interests of improving health sectors, the Ethiopian government has engaged in the sector reform, including a process of decentralizing decision-making and budgetary power to the district levels. Objectives: The purpose of this study was to assess HMIS Design and Implementation in selected Public Health facilities of Addis Ababa Health Bureau, Ethiopia. The study attempted to determine the status of HMIS implementation and the use of HMIS generated information for health care delivery planning and decision making at different level of the health sector. Methodology: In this study, a cross-sectional study was conducted at Addis Ababa, Ethiopia from December to June 2012. The research methods used were both qualitative and quantitative. The sample size of the study was 258. Data was collected through open and closed-ended questionnaires, observation and analysis of certain documents, and secondary data from selected reports of facilities obtained from Addis Ababa health bureau. SPSS version16 software was used to analyze quantitative data. Correlation was used as a statistical method to identify the association between selected variables and quality of HMIS data and Pearson’s correlation coefficient with two tailed test of significance was used to determine the strength of association. Results: The general implementation of HMIS in the study area covered all (100%) of health facilities and administrative units. Availability of adequate HMIS unit staff at health facilities was not up to the need of health facilities. The use of HMIS generated information for health care delivery planning and decision making in the study area was found to be 78%. The major identified problems related with the design of the current system used for HMIS were; Prevention Mother To Child Transmission (PMTCT) and Volunteer Counseling and Testing (VCT) for 1 to 4 age was not included, the analysis part of the existing system doesn’t include further statistical analysis it only show charts, blank space for unregistered diseases was not available, the recently included HMIS indicators for some disease were not included, and problem of registration by the professionals due to inconveniency of the HMIS formats.The study also identified the major problems of the current HMIS data collection and reporting tools. It was found that data collection tools at Outpatient Department (OPD) and Antiretroviral Therapy (ART) were not quite adequate, work burden on the professionals due to most of the tools had similar attributes, data collection using tally sheets was not suitable for professionals, and the line spacing of data collection tools was not suitable were reported as the major problems of the existing HMIS data collection and reporting tools. Knowledge of HMIS concept, frequency of training and accountability of concerned bodies has a statistically significant association with quality of HMIS data. The finding of the study also identified that duration of supervision and availability of HMIS focal person did not have a statistically significant association with quality of HMIS data. Conclusions: The study concludes that; health facilities need to be furnished with adequate HMIS resources, and qualified human resources required at HMIS unit. The design of the existing system used for HMIS and the data collection tools needs to be modified and customized to support the needs of the professionals by incorporating the problems identified by this research. Duration of supervision, followed by availability of HMIS focal person, did not result into a significant improvement of the quality of HMIS data, thus guideline for capacity building program of the staff have to be developed by following the strength of association identified by this and other related studies with quality of HMIS data. Keywords Health Management Information system, Implementation, Design, Data quality
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    Assessment of Knowledge Sharing Practices of Health Care Professionals in Hospitals Under Addis Ababa Health Bureau
    (Addis Ababa University, 2011-06) Yalew Tirualem; Addisse Mesfin (PhD)
    Background: - Knowledge is the most important strategic resource in organizations, and its management is critical to organizational success. Knowledge sharing is a social interaction culture, involving the exchange of employee knowledge, experiences, and skills through organization. However there is no previous study that assesses the knowledge sharing practice in AA. Therefore the purpose of this study is to assess the knowledge-sharing practices and identify factors that affect knowledge sharing practices among health professionals. Objective: -To investigate the level and factors associated with knowledge-sharing practice among health care professionals in public hospitals of Addis Ababa. Methods:-A cross-sectional study with both quantitative and qualitative methods was conducted among 5 hospitals under Addis Ababa Health Bureau from May to June 2011 G.C. Total of 318 respondents were selected using simple random sampling technique. The data were collected using self administered structured questionnaire and to supplement the quantitative study in-depth interviews were also conducted. The data were entered and cleaned using Epinfo version 3.5.1 and analyzed using SPSS version 16. Frequencies and percentages were used to describe the study population and Logistic regression with 95% confidence interval was used to assess the presence and degree of association between dependent and independent variables. Result: - The study revealed that 50.3% of the respondents were engaged in active knowledge sharing practice. More than half (57.2%) of the respondents were not satisfied with their job, and 69% of participants report the absence of motivational schema in their health institutes. Over all 72% of respondents are willing to share their knowledge. The factors that were independent predictors of knowledge sharing were job satisfaction, very high level of motivation, extrinsic motivation, use of communication channel and the presence of knowledge sharing opportunity. Those respondents who were satisfied with their job were more likely to share their knowledge than the others with the odds ratio, AOR[95%CI] 1.73[1.00-2.98], who had high level of motivation were more likely to share their knowledge than the others with the odds ratio, AOR[95%CI] 3.38[1.04-11.00], and those respondents who were extrinsically motivated were more likely to share their knowledge than the others with the odds ratio, AOR[95%CI] 1.75[1.02-2.99].The respondents who used communication channels were more likely to share their knowledge than the others with the odds ratio , AOR[95%CI] 3.05[1.71-5.45] and who had knowledge sharing opportunity were more likely to share their knowledge than the others with the odds ratio, AOR[95%CI] 2.89[1.70-4.90]. Conclusion and Recommendation: - From this study most of the respondents were aware of the importance of knowledge sharing but only half of respondents were engaged on active knowledge sharing practice, and the factors that were independent predictors of knowledge sharing were job satisfaction, high level of motivation, extrinsic motivation, use of communication channel, the presence of knowledge sharing opportunity. So stake holders (AAHB, the hospitals) should device a way for strengthen knowledge sharing practice through improving all the hinderers of knowledge sharing.
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    Assessment of the New Health Management Information System Implementation in Public Health Facilities and Institutions in Addis Ababa
    (Addis Ababa University, 2010-06) Alemu Tilahun; Addisse Mesfin (PhD)
    Background: Health Management Information System (HMIS) supports informed strategic decision making through the production of quality data and information for action that helps mangers and health workers plan and manage the health service system. HMIS is one of the major ’core’ activities given due attention even though the ongoing ‘businessprocess re-engineering’ in HMIS program has resulted several measures to be taken. Objective: To assess the new HMIS implementation status in Addis Ababa. Methods: A cross–sectional, descriptive study was conducted. Purposive sampling was used. Structured questionnaire, in-depth interview and observation were made between March and April 2010. Both HMN and PRISM frameworks were used to evaluate the results. Result: There were 220 respondents and among them, 80% were clinician health workers. The majority of respondents (94.5%) did not participate in the designing efforts of the new HMIS and one hundred fifty one (68.6%) respondents are currently involving in the HMIS activities. There is no incentive (93.6%).Two hundred and eleven (95.9%) respondents use HMIS for reporting purpose. Implementation lacks ownership (91.4%), coordination and leadership (85%), strategy and policy (63.3%), motivation (92.7%), shared responsibility among stack holders (57.7%) and not considered as the extension of the previous HIS(92.%). Conclusion: large numbers of respondents currently participate in the manual based HMIS activities through a well designed data collection and reporting formats. A short period on job-training, absence of incentive, motivation and lack of management support lead to poor information use culture that is limited mainly for a send-report purpose. HMIS Implementation suffered from ownership, follow-up, communication and leadership. Recommendation: HMIS should be a core activity furnished with appropriate human, material and financial resources. Improved data processing and management should be accompanied by Skilled and trained health workers with appropriate ICT use. Management shall support, facilitate and motivate information use culture. HMIS implementation in Addis Ababa should have ownership, follow up, coordination, cooperation and communication among stack holders. Key words: HMIS, HIS, Data Quality, Information Use, Implementation status.
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    Factors Affecting the Implementation of Electronic Health Management Information System (Ehmis) in Public Hospitals Addis Ababa
    (Addis Ababa University, 2013-09) Akmel Mubarek; Kebede Gashaw (PhD); Addisse Mesfin (PhD)
    Background:Electronic health management information system software has been developed along with the national paper based health management information system reporting formats. Electronic health management information system is a home –grown solution developed by Ethiopian information technology experts taking advantage of international expertise made available by John Snow Inc. Electronic health management information system has been developed to suit particularly the Ethiopian health information system with ability to meet any future changes or information needs they evolve. Objective of the Study: To identify possible factors affecting the implementation ofelectronic health management information system in the public hospitals Addis Ababa. Methodology:This study was conducted in Addis Ababa from December, 2012-june, 2013 in eight public hospitals who have implemented electronic health management information system. Datawere conducted by self-administer and in-depth interviews of the stakeholders i.e. the electronic health management information system and planning head of the hospitals respectively in the surveystudy design by using qualitative method. Observational check list was also made by the investigator to supplement this qualitative finding. Result:All of eight institutions answered that there was the legislatives, regulatory and planning framework concerning the electronic health management information system and adequate organized staffs. And the studyidentified those hindering factors for the electronic health management information system implementation, i.e. lack of adequate training, finance, knowledge/skill, material resources and lack of attitude. Also the study found that adequate knowledge/skill, training, information technology infrastructure, finance, and adequate material resources are used to facilitate the implementation of this system.The attitudes of staffs toward the electronic health management information system implementation were medium. Conclusion and Recommendation: The findings of the study answered the research objective i.e. it was able to explore factors that hinderor facilitate the implementation of eHMIS system in eight public hospitals Addis Ababa. The e-HMIS-Developers and Decision makers at FMOHs/ higher officials must give special attention to sustainable the eHMIS system in the future and the FMoH have to assign the concerned eHMIS staffs for the implementations ofeHMIS system.
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    Investigating Electro Medical Record (Smart Care Software) Implementation in A Health Care Facility: A Guiding Framework for Adama Hospital Medical College
    (Addis Ababa University, 2015-06) Alemayehu Dilarg; Beshah Tibebe (PhD); Addisse Mesfin (PhD)
    Background: In Ethiopia, electro medical record (smart care software) was introduced in 2007/2008 in collaboration with the smart care teams’ of Zambia and United States as part of HMIS reform. The smart care software has become a necessary tool in health care for improving patient quality care and enhancing quality health management information system. However due to several factors; lack of optimal knowledge on computer usage by health professionals and their commitment there are gaps to implementing electro medical record (EMR). Objective: The aim of this project is to investigate electro medical record (smart care software) implementation in a health care facility a guiding framework for Adama Hospital medical college. Methodology: Cross sectional study design with qualitative and quantitative approaches was conducted on 177 EMR users at Adama hospital from January 01, 2015- April 30, 2015. In this study, personal observation on documents related to EMR, interview and questionnaires were used as data collection tools. The data were collected by investigator. Quantitative data were coded and analyzed using SPSS statistically software version 16. The opinion of respondent were recorded, summarized, analyzed and presented in a readable product in comparison form related study conducted in different area. Multiple regressions were used to identify factors contributing to electro medical record (EMR) implementation. Electro medical record (EMR) implementation success and failure were measured based on twelve nationally stated benefits: legibility of record, safer data, patient data confidentiality, continuous data processing, always up to date, simultaneous remote access to patient data, integration with other information resources, incorporation of electronic data, greater range of data output modalities, flexible data layout, assisted search, and tailored paper output. Meanwhile a guiding framework was designed and evaluated based on experts’ opinion.Result: According to the investigation made on EMR implementation success or failure based the twelve nationally stated benefits. Parameters as success were; legibility of record (91.5%), safer data (77.4%), patient data confidentiality (78.5%), continuous data processing (57.6%) and always up to date (53.1%). However the following seven parameters that should have been expected as benefits were found as failures. These include simultaneous remote access to patient data (100%), integration with other information resources (100%), incorporation of electronic data (100%), greater range of data output modalities (100%), flexible data layout (41.8%), assisted search (24.9%) and tailored paper output (24.3%) In this study, attitudes of users towards EMR usage (α= .001), variation in number of training days among users (α = .001) , exchange of electronic information via networking between departments (α = .010), experience variation on using the smart care software among users (α = .001), disparity of the expectation drown by users during the training period and its contradiction on actual working environment (α = .005),were found statistically significant causes for failures EMR usage at Adama hospital. Discussion and Recommendation: The system was initially implemented in twenty seven service areas. However gradually the implementation was limited only to six departments and currently was functional only in two departments. In this study the overall EMR usage success and failure rates was 41.7 % and 58.3 respectively. This indicates that more remained to be done on EMR implementation success at Adama Hospital. Based on major study findings made a guiding framework is proposed. In this framework inputs introduced from the study findings are system quality, user involvement, human resources, integration, capacity building, perceived usefulness, incentive, perceived easy for use, technical support, monitoring and evaluation, user promotion, interoperability, innovative leadership, and website. Overall this guiding framework is expected to bridge the existing gap in EMR implementation at Adama hospital. Key words: EMR, Smart care Software, Success, Failure and a guiding framework.
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    Prospects of Mhealth on Improving Non Communicable Chronic Disease Management in Addis Ababa: The Case of Public Hospitals Owned By Addis Ababa City Administration Health Bureau
    (Addis Ababa University, 2013-06) Lulie Gashaw; Teferra Solomon (PhD); Addisse Mesfin (PhD)
    Introduction: Mobile Health is not a new technology today, but is a novel approach for Ethiopia, and in fact, has more profound impact on the country due to unmet demands for health and unprecedented health related challenges. Mobile Health could potentially reduce waiting times for patients, reduce the cost of the health system‟s operations, improve interdepartmental, inter-clinical communication and collaboration, improve Health Management Information System, improve self health management and enhance better resource allocation for the Chronic Disease care sector. Objective: This study explores the prospects of Mobile Health on improving Non Communicable Chronic Disease Management in Addis Ababa Health Bureau Owned Hospitals in order to highlight the current status of mHealth, level of mHealth knowledge and the attitudes towards mHealth among the healthcare providers, other professionals and patients in Ethiopia. Methodology: The study follows a descriptive cross – sectional study employing quantitative methods using self administered questionnaire and qualitative method using a key informant interview between the months of March and May 2013. A total of 403 respondents consisting of IT professionals, health professionals and patients are involved to depict the prospect of mHealth on improving non communicable chronic disease management in Addis Ababa. Qualitative data is collected by key informant interview supported by questionnaire held. Data analysis is done using Statistical Package for Social Sciences (SPSS) Version 20. Results: The study reveals that healthcare providers, patients and other professionals in the health facilities had low mHealth knowledge level. The health facilities are not sufficiently furnished for implementing mHealth. However, health institutes‟ professionals have positive attitude towards mHealth and its application for non communicable chronic disease management. Based on the findings I have developed mHealth prototype which can improve non communicable chronic disease management. Conclusions and Recommendations: The findings indicate there needs to train professionals and establish policy framework about mHealth. It is, therefore, recommended that Addis Ababa City Administration Health Bureau and Ministry of Health should allocate sufficient resources to implement mHealth.Keywords eHealth, Mobile Health, Chronic Disease, Non Communicable Chronic Disease, Chronic Disease Management, Mobile Technologies, Prototype, Information and Communication Technology.
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    Revitalizing the Smartcard System of Surgery Inpatient Department in Saint Paul Hospital Millennium Medical College
    (Addis Ababa University, 2014-06) Kassahun Yeshimebet; Teferi Dereje (PhD); Addisse Mesfin (PhD)
    Introduction:-Medical records are a collection of information about a patient's health care and are essential for present and future continuation of care. While EMR systems can improve completeness and availability of medical record information, Ethiopia lacks the needed information because of different barriers for the implementation and widespread utilization of electronic medical record system. Objectives:- To identify barriers and propose solution for initiation of the SmartCare system of surgery inpatient department in Saint Paul Hospital Millennium Medical College Methodology: - The project used descriptive study design with quantitative and qualitative methods. The tools used for data collection were structured questionnaire and semi structured interview. Pre tested questioner was administered to 42 health professionals and interview was conducted (3) higher management officials and (1) information communication technology department head. Result: - From identified barriers lack of awareness, disconnection of the SmartCare system, non- integration of other information systems, incapability of the system to generate report and ICT supporting staff shortage were the major ones. After barriers identified possible solutions were proposed and interventions made. Conclusion: - The absence of continuous training resulted in a large number of new respondents with knowledge gap. Data incompleteness reflected the negative impact of paper based system and it also indicates the requirement of the paper based system to be replaced by electronic medical records system. Initiation and commitment of the hospital management obtained to made interventions. Based on the proposed solution baseline assessment made to reinstall wireless connection and incorporate those relocated and new opened clinical areas and the awareness buildup training on the benefits of the SmartCare system was given. After the training awareness and attitude change was illustrated among the trainees.