HIS in AsiaPacific 2004

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Health Information Systems in the Pacific Island
Countries (PICs) Issues, Challenges and
Opportunities
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Presentation at the WHO SEARO/ WPRO Consultation
on Strengthening Health Information System in
Asia and the Pacific, Bangkok, 13-15 December 2004

• Presented by Dr Salanieta T Saketa, Fiji
• 13th December 2004.

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Issues in the Pacific for HIS

• Diverse in terms of level of HIS development,
  population size and infrastructure development
• Lack of skilled workforce in HIS
• Similarities in health systems
• Oceans of data and drops of information
• Data quality and integrity
• Strategic planning for HIS
• Use of HI as a management tool to improve health
  care delivery

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Diversity

• Vast ocean with many islands
• Volcanic to coral atolls
• Population range from 5million to
• less than 20,000
• Varied government commitment
• to HIS development
• IT infrastructure development is
• varied
• Differing HIS systems in place

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Workforce for HIS

• Staff strength and skills lacking
• No clear career structure
• Lack of leadership
• Lack of commitment
• High turnover with loss of corporate memory

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Health systems

• System similarities related to colonisation
  linkages (British, US, French, NZ)
• Strength in networking and support possibilities
• Common training institutions
• Healthy competitiveness in health care system
  development

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Use of health information

• Mismatch between supply and demand
• Overwhelming data collection with limited
  analysis and feedback
• Capacity for analysis often lacking
• Culture of information use maybe lacking
• Resources limited to enable free flow of
  information

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Data quality and integrity

• Checking systems ill-defined
• Capacity to validate information maybe lacking
• Lack of clear procedures and guidelines
• Coordination and consolidation of various data
  sources
• Centralised systems with limited delegation of
  responsibilities and authority

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Strategic Planning for HIS

• Few countries have a Strategic Plan for HIS in
  place
• Leading to lack of monitoring and evaluation of
  the system
• Poor prioritisation of resources
• Success of organisational performance dependent
  on use of information for planning

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Evidence-based decision making

• Nurturing of culture of information use
• Demand for information by management at every
  level
• Timeliness of available high quality information
• Information use in management and in clinical
  settings

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Challenges

• Leadership
• Political/Financial commitment
• Identification of roles and responsibilities
• Manpower (brain drain)
• Level of management awareness of health
  information
• Geography
• Support system
• Telecommunication infrastructure

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Opportunities

• Health reform
• Improvement and decentralisation of HIS
• Regional network
• Collaboration and support
• Monitoring and Evaluation of
• Performance in MDGs
• Open Learning Centres

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Fiji Health Information System
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Issues in Fiji Health Information System

• Complex with extensive data collection processes
• Minimal information feedback
• Public health information well documented
• Varied and poor medical record filing procedures
• Centralised system
• Capacity and skills of staff

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Fiji Health Management Reform Patient
Information System (PATIS)
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Objectives of PATIS

• Improve patient services and outcomes
• Assist health service administration
• Collect information for timely public health
  surveillance and health programme monitoring

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Fuctionality

• Software developed on Access database
• Registers all persons who have been serviced at
  hospital, health centre and nursing stations
• Person registered within their locality
• Local area networks linking into wide area
  networks

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Coverage of PATIS

• Piloted in 2001 in Northern division
• All 3 major hospitals with 2 subdivisional
  hospitals on line
• Rollout limited by funds and staffing capacity
• Rollout also dependent on infrastructure
  availablity

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Summary

• HIS in Pacific Island Countries
• Issues
• Challenges
• Opportunities
• Issues in Fiji HIS
• PATIS

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• Thank You
• Vinaka vakalevu

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References

• Websites
• www.spc.int/phs
• WHO website
• Documents
• Discussion Paper A Pacific Health information
  Network in the Context of Health Reform- AusAID
• Evaluation of the Fiji Health Information System-
  AusHealth International
• Samoa Health Information System Project
  Review-AusAID
• Fiji Patient Information System (PATIS)-
  AusHealth Insternational
• Fiji Management Information Plan- AusAID
• Evaluation of PATIS pilot- Dr S Saketa
• Evaluation of Fiji HIS- Dr Y C Chong, WHO