1. 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-

2. Outline
Brief Introduction
Objective
Major Features

3. 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

4. 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

5. 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

6. 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

7. 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.

8. 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 (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

9. … 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.

10. … 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

11. … 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

12. Works with Paper Based Reporting

13. ….HMIS report flow and the heath data warehouse

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

15. Data Analysis Tools
Not real cases. For demonstration only.

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

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

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

22. Thank You