Electronic Health Management Information System (eHMIS) to build Strategic Information in the Ethiopian Health Sector (WEAE0704) Dr. Wuleta Lemma1,Assistant Professor, Director of Center for Global Health Equity, Tulane University USA Hiwot Tesfaye1 ,Head of Health Informatics Systems Deployment- Tulane University Ethiopia Program Abigail Belete2 ,Head of Software Development Informatics-

Outline Brief Introduction Objective Major Features

Brief Introduction: About Ethiopia health infrastructure Primary Health Care Unit (HC + 5HP) District Hospital= 56 Regional /Zonal Hospital=34 Specialized/ referral Hospital = 15 Woreda Level (Woreda Health Office)=811 Zonal Level (Zonal Health Dept.)=72 Regional Level (Regional Health Bureau)=11 Federal level (Federal Ministry of Health) Health Centers = 2,142 Kebele ~ 15,000 Health Post = 14,192 5Million Pop 1Million Pop 250,000 Pop 25,000 Pop 5,000 Pop *Health and Health Related Indicators 2001 and 2002 Federal Democratic Republic of Ethiopia Ministry of Health

Brief Introduction : About the HMIS Standardize Indicators & definitions Disease list for reporting & case definitions Client / patient flow & data elements Recording & Reporting forms Procedure manual Information use guidelines: Simplify Reduce data burden Streamline data management procedures Integrate Data channel Client / patient information at facility * HMIS/M&E Technical Documentation ,Manual January 2008 Federal Ministry of Health

Brief Introduction: About HMIS 19 /46 HIV/AIDS Related Indicators * HMIS/M&E Technical Documentation ,Manual (Indicator Definitions Area1), January 2008 Federal Ministry of Health

Brief Introduction: About HMIS HMIS captures much of its service and disease surveillance data from client/patient records that health professionals maintain for care and follow up. HMIS reports contain the data required to calculate the indicators used for monitoring and evaluation of the health system

Objective of Electronic Health Information System The Initiation to Implement EHR system at facility and higher levels by FMOH in collaboration with Tulane and CDC has created good opportunity to establish automated electronic report distributions within the different levels of the health system using e-HMIS module e-HMIS insures data completeness, validity, timeliness, ease of data/report compilation and promotes information use at all levels. e-HMIS system architecture employs Health Data Warehouse concept.

e-HMIS Module Major Features Produce all types of HMIS reports at health facility, Woreda Health office, zonal health Department, Regional health Bureau and Federal Ministry of Health on monthly , quarterly and annual bases. Sending and receiving HMIS reports electronically through secure e-mail (by means of any available communication infrastructures including CDMA, GPRS, PSTN-Dialup, Broadband, etc) and other removable media (such as USB flash disk, CD/DVD). Provides data validation, completeness and timeliness. Provide data analysis tools such as indicators computation tools and charts

… e-HMIS Module Major Features Provides easy and instant performance monitoring reports and chart. Supports automated data abstraction from site that has fully implemented Smartcare –EMR. Supports multi-point data encoding.

… e-HMIS Module Major Features: Reports Diseases reports OPD (out patient department) disease report IPD (in patient department) diseases report OPD and IPD diseases report aggregation at woreda health office and higher levels Service delivery reports Quarterly service delivery report at health facilities Annual service delivery report at health facilities Service delivery report aggregation at woreda and higher levels Other reports Top ten diseases Key Indicators Report Status User defined adhoc reports

… e-HMIS Module Major Features: Reports Disease Surveillance features Tracks twenty diseases cases Data validation and completeness Vertical data integration and secure communications Works with the Paper-based reporting system GIS – based data analysis User defined queries and charts * HMIS/M&E Technical Documentation ,Manual (Disease Classification for National Reporting and Case Definitions Area 2), January 2008 Federal Ministry of Health

Works with Paper Based Reporting

….HMIS report flow and the heath data warehouse

e-HMIS Module: Secured Communications Reports are encrypted and compressed for electronic transfers (flash disk/CD/email). Encrypted report ready for transfer Clear report Secured Email transfer (through SSL) Decrypted report ready for import

Data Analysis Tools Not real cases. For demonstration only.

GIS –based data Analysis Full integration with GIS mapping More analysis tools such as user defined reports and charts

GIS –based data Analysis Includes 1-1 Km grid assigned with unique tag to identify disease occurrence

Next steps Additional Features SDMX and Indicator repositories Scale up to cover more than 800 Woreda’s in Ethiopia by the end of 2012

Thank You