The 6 th Asia Pacific Network meeting of WHO FIC Thailand, July, 2013

Subsystems of HIS Epidemiological surveillance system Routine service reporting system Program-specific reporting systems Administrative and resource management reporting systems Vital or Civil Registration Systems Population based surveys

Routine Service Reporting System Public Health ReportingHospital Reporting

Department of Health Planning MCH/UHC/Station HU/RHC District/Township Health Department State/Regional Health Department Sub Rural Health Center Data Flow

Data Flow and Feedback DHP Teaching Hospitals General Hospitals with Specialist services 200-Bedded Hospitals 150-Bedded Hospitals 100-Bedded Hospitals 50-Bedded Hospitals 25-Bedded Hospitals 16-Bedded Hospitals Specialist Hospitals States/Region Health Department Hospital Form I,II, III & OPD Hospital Form I, III Station Hospitals

Hospital report forms Monthly hospital return Monthly general inpatient summary Hospital inpatient daily record Outpatient report form

PART A. NO. OF BEDS: (1) SANCTIONED BEDS (2) AVAILABLE BEDS AT END OF MONTH PART B. IN-PATIENT ACTIVITIES:PART C. OUT-PATIENT ACTIVITIES SR. NO. SPECIALIT Y NO. OF PATIENTS BEGINNIN G OF MONTH ADMIS- SIONS DURIN G MONTH TOTAL UNDER CARE (3+4) DISCH- ARGES DEATH S TOTAL DISCH- ARGES (6+7) PATIENT DAYS SR. NO. SPECIALIT Y NEW CASES OLD CASES TOTAL ATTEN- DANCE S TOTAL MONTHLY HOSPITAL RETURN (ADMINISTRATIVE) FORM I (TO BE COMPLETED AND POSTED NOT LATER THAN THE 7 TH OF EACH MONTH) (REVISE/2013) NAME OF HOSPITAL TOWNSHIP REGION/STATE MONTH YEAR

PART D. OBSTETRIC SERVICES:PART E. SURGICAL ACTIVITIES: 1NO. OF WOMEN DELIVERED1GENERAL ANAESTHESIA 2NO. ADMITTED FOR PUERPERIAL CARE2SPINAL ANAESTHESIA 3NO. OF ABORTIONS3LOCAL ANAESTHESIA 4NO. OF LIVEBIRTHS4OTHER ANAESTHESIA 5NO. OF STILLBIRTHS PART F. DEATHSPART G. MISCELLANEOUS ACTIVITIESTOTAL F-1 IN-PATIENT DEATHS: (TOTAL NO.) F-2 NEWBORN DEATHS (TOTAL NO.) 1.POLICE CASES 2.PATIENTS BROUGHT IN DEAD IN-PATIENT DEATHS: (WITHIN 48 HOURS OF ADMISSION) NOTE: Newborn deaths refer to babies who were born in hospital and died before being discharged with or without their mothers. 3.AUTOPSIES PERFORMED NOTE: Inpatient deaths refer to patients who were admitted to hospital and died before being discharged. PART H. MANPOWER: MaleFemale 1NO. OF SPECIALISTS 2NO. OF DOCTORS 3NO. OF DENTAL SURGEONS 4NO. OF NURSES 5NO. OF MEDICAL TECHNICIANS TOTAL * Part H December Report Part H Signature …………………………………… Name - ……………………………………… Designation …………………………………… Hospital ……………………………………

SR. No. AD MIS SIO N NU MB ER SE X AGEDATE OFPRINCIPAL/ DISCHARGE DIAGNOSIS (OR) NATURE OF INJURY BY SITE CO- MORBIDITY/OTHER COMPLICATION (OR) EXTERNAL CAUSES OF INJURY (INCLUDING PLACE OF OCCURRENCE & ACTIVITY) OPERATI ONS PERFOR MED TYPE OF DISCHA RGE STATUS YMDADMISS ION D/M/Y DISCH ARGE D/M/Y (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) 1 CODE CODE 11 CODE 12 CODE MONTHLY GENERAL IN-PATIENT SUMMARY FORM II (REVISE/2013) NAME OF HOSPITAL TOWNSHIP REGION/STATE MONTH YEAR

Date PART (A) Patients admitted to HospitalPART (B)PART (C) No. of Patients in Hospital (Previous Day) Admis- sion Transfers in from other wards Total (Cols ) Disch- arges Death * Trans - fer Out to other wards Total (Cols ) No. of Patients in Hospital (End of Day) (Cols. 5-9) Babies born in Hospital Patients admitted and discharged on the same day LiveStillDeath of new born (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) Tot. HOSPITAL DAILY RECORD (IN - PATIENT) FORM III (Revise/2013) (To be completed and posted not later than the 7 th of each month)Month Name of Hospital Speciality(**) Township Region/State

OPD Form

Hospital report forms Standardized Hospital report forms for all Hospitals

ICD-10

Use of ICD( International Statistical Classification of Diseases and Related Health Problems) in Myanmar ICD ICD ICD ICD 10 Translation Chapter XIX, XX

Data from Private Health Sector Permission from higher level Initialization phase Start from 2013 January Private hospitals Develop data collection form and manual

Standardized Report Forms Form I - Private Hospital Monthly Report Form (Administrative) Form II - Private Hospital Monthly In- Patient Summary Training –

Standardized Report Form I- front

Standardized Report Form I-back

Standardized Report Form II

Available information Hospital administrative information – Average number of out-patients per day – Average number of In-patients per day – Average duration of stay (in days) – Bed occupancy rate – Turnover interval – Hospital Death Rate Causes of Hospitalization – Leading cause of Morbidity and mortality

Training ******* Medical record technician

Training of Medical Record Technicians on ICD-10 and CAMRS ( – )

Workshop on International Statistical Classification of Diseases (ICD-10) and Computer Assisted Medical Record System(CAMRS) Nay Pyi Taw ( )to ( )

Workshop on International Statistical Classification of Diseases (ICD-10) and Computer Assisted Medical Record System(CAMRS) Nay Pyi Taw ( )to ( ) Group Work

Utilization of Health Information Selection of project sites Resource allocation including budget and logistics distribution Planning, Implementation, monitoring and evaluation of health services Country presentation on workshop, seminars and meetings

Points for consideration in improvement of Hospital Information System Lack of written Health information Policy Inadequate infrastructure Shortage of manpower Low capacity of human resources especially in information management No Career development for medical record technicians Supplies and equipment – Inadequate ICD -10 Books, Computer, File cover, filing rack

Points for consideration in improvement of Hospital Information System (Cont:) Still use in paper recording and reporting from various level except central and region/state Poor favourable working environment Low utilization of data and information to actions Lack of motivation in strengthening of health information

Areas need to be strengthened Strengthen organization set up and infrastructure Capacity building of human resources on modeling method and advanced data analysis, presentation and interpretation Provision of supplies and equipments for electronic health record system

Areas need to be strengthened (Cont:) Systematic monitoring, supervision and feedback Encourage in utilization of information to actions Establish unique logistic management information system and human resource management information system Cooperation, coordination and collaboration with indispensible partners

Future Plan Training of Medical Record Technicians Supervision and Monitoring on performance of medical record technicians Advocacy to authorities for career development of medical record technicians Paramedic degree for medical record technicians in collaboration with Department of Medical Science Training of ICD-10 to medical doctor Include ICD-10 in pre-service curriculum of medical doctors Verbal autopsy on cause of death