1. Overview/Importance of HMIS
Health Management Information Systems, the Private Sector, and HIV/AIDS: a discussion of implementation and outcomes.
Video Conference, World Bank Offices, Washington, D.C.
18 January 2006
Xenophon M. Santas
Global AIDS Program, Informatics Team
Centers for Disease Control and Prevention

2. The Emergency Plan
A multi-agency $15 billion U.S. initiative to provide HIV care, treatment, and prevention services to HIV affected populations in the developing world
HMIS committee – draws expertise from USAID, CDC, HRSA, Census Bureau, DoD, and Peace Corps
Includes technical expertise from private partners
Works closely with counterparts at WHO and UNAIDS

3. Health Management Information Systems (HMIS)
Key component of strategic information systems
Definition: “targeted monitoring, evaluation, and surveillance data used to answer key questions about
The state of the epidemic
The delivery and process of prevention, care, and treatment services
The effectiveness of these services
Capacity needed to improve programs, meet planning and reporting requirements, and reach goals for impacting the epidemic

4. Strategic Information Key Components
HIV/AIDS surveillance
Population-based bio-behavioral surveys and facility surveys
Health Management Information Systems for facility-based reporting
Program-level monitoring and reporting (non-facility based)
Targeted evaluation studies

5. Components of an Information System
Organizational
Human resources
Communications infrastructure
Protocols and training
Supervision
Quality control
Analysis and feedback
Paper-based data collection forms
Electronic databases
Hardware and software
Technological

6. Examples of Information Systems Supporting HIV Programs
Pharmacy management
Laboratory management
Logistics/supply chain management
Program monitoring (OVC, palliative care)
Facility-based patients systems (e.g., ART)
Vital statistics registries
Facility-based surveys (e.g., ANC clinics)
Population-based surveys
National notifiable disease reporting systems

7. Strategic Information Data Flow
President’s Emergency Plan Countries
United States
Surveys
(BSS, AIS,
Country
etc.)
Specific
U.S. in -
country
Survey Results
Offices
(e.g., MACRO)
Embassy
USAID
CDC
CRIS+ or
other
system
D.C.
Headquarters
System
Washington, D.C.
Facility-
based service
providers
Ministries of
Health
Other services
(OVC
, peer -
CRIS+ or
Other
education,
other
Databases
etc.)
system
(e.g. BuCen)

8. Traditional HMIS Partners
International Organizations (WHO, UNAIDS)
National Governments (MOH, NAC)
Donors
Provincial governments
NGO’s
Local universities/schools of medicine
U.S./European universities
Private partners

9. PEPFAR HMIS Subcommittee Goals (1)
Provide assistance in the collection of Emergency Plan core indicators
Improve capacity to collect client-level and clinical service information that will assist in daily management of individual patient care
Improve capacity to collect facility-, district- and country-level information that will assist with clinic and program management
Develop strategies for better data collection and program monitoring from non-facility-based care or prevention activities, such as OVC services.

10. PEPFAR HMIS Activities (1)
Minimum data set for use in monitoring ART produced by WHO, with input from HMIS subcommittee
Concept Paper: Developing Facility-based Management Information Systems, May 2004
Protocol: Assessment of Health Information Systems developed to describe methods for evaluating and assessing country health management information systems, and to aid in obtaining comparable descriptions of these systems ( under the “PEPFAR” tab)
Describes background, framework, objectives, team composition, and methodology
Four data collection forms:
A. HIV/AIDS program inventory
B. National HIS overview
C. National and sub-National Infrastructure Assessment
D. Facility Assessment
Translations available in French and Portuguese

11. PEPFAR HMIS Activities (2)
HMIS assessments conducted/initiated
Haiti
Côte d’Ivoire
Mozambique
Tanzania
Nigeria
Uganda
Antiretroviral Therapy (ART) Software Inventory (
New Technology White Paper

12. PEPFAR HMIS Activities (3)
Software Tool Enhancements
HRSA’s CareWare patient care and management software
Pharmacy module for tracking prescriptions and dispensing invoices; inventory and prescription adherence reports
Language translator
Flexible forms creator that allows user to select certain fields of interest and place them on a form in the order of interest.
Regimen builder and tracker
PEPFAR reports
HL7 export for “transportable” core data
Study and produce a feasibility report on integrating biometric patient identifier system with CareWare (e.g., thumbprint reader).
Technical assistance and training
Collaboration with CDC-Uganda, Track 1 (and other) grantees.
Output data to CDC PMTCT aggregate reporting system
CDC’s Epi-Info data analysis tool

13. PEPFAR HMIS Activities (4)
ART Facility-Level Systems and Electronic Medical Records (EMR). Support development of
Electronic standards for information systems to be used in the monitoring of clinical care (including ART)
Guidelines for security and confidentiality of patient data (joint activity with WHO)
A standardized Health Level Seven (HL7) message to facilitate secure electronic transmission and exchange of data across data systems
Publish specifications for electronic systems that support the care of HIV infected patients

14. PEPFAR HMIS Activities (5)
Enhanced support/management of Graphical Information Systems (GIS) activities
Support routine production of maps.
Develop/enhance an Emergency Plan web site, both password-protected and for public access
Support to WHO for their HealthMapper and Service Availability Mapping (SAM) projects
Develop and maintain an inventory of laboratory information systems (LISs) suitable for use in both focus and non-focus countries

15. PEPFAR HMIS Activities (6)
Develop specifications/requirements for in-country program monitoring and evaluation data systems
Visit at least three countries with extensive U.S. government presence
Develop and document recommendations
Support UNAID’s Country Response Information System (CRIS) for enhanced/better management of U.S. mission-specific data