Building Effective Health Information Systems

What do I know about Health Information Systems (HIS)?

Welcome to Building Effective Health Information Systems (HIS). Assess your prior knowledge by completing a short assessment on each topic in this training. Use these pre-tests as a guide to help you tailor your learning. After going through each module, you will have the opportunity to complete a post-test to assess what you have learned. You will also receive information about other relevant modules that may be useful to you. Facility managers and regional and national level stakeholders will benefit from all of the modules. Frontline healthcare providers may wish to focus on the general introductions to HIS, data use and quality, and interoperability. IT professionals will benefit from the modules on system structure and data management.

Learning Activities

Module 1: Introduction to Health Information Systems (HIS)
Instructions: Assess your current knowledge on the topic: Introduction to Health Information Systems (HIS) with a short pre-test. Click or tap the correct answer(s), then tap the Show My Score button to reveal the correct answers and additional information.
1Information literacy can be described as the:
1. Ability to access, evaluate, organize, and use information from a variety of sources
2. Ability to use computer hardware and software applications
3. Knowledge of how information systems work
4. Knowledge of how basic computer systems work
2Computer literacy can be described as the:
1. Ability to access, evaluate, organize and use information from a variety of sources
2. Ability to use computer hardware and software applications
3. Knowledge of how information systems work
4. Knowledge of basic information resources are accessed
3Examples of institution-based data sources include:
1. Censuses, individual records, service records
2. Population surveys, vaccine registers, resource records
3. Individual records, service records, resource records
4. Censuses, civil registration, population surveys
4When trying to locate the information you need in an electronic information source, you would use a strategy called:
1. Narrow domain searches
2. Boolean searches
3. Universal searches
4. Wide domain searches
5Once you have located the information you need from a source, you would then evaluate it for:
1. Redundancy, relevance, rationalization, reliance, and complexity
2. Availability, answerability, reusability, usability, and flexibility
3. Accuracy, authority, objectivity, currency, and coverage
4. Scope, source, time, output, and ownership
6Data is usually defined as:
1. The beginning of a database
2. A thing without meaningful relation to anything else
3. The things within a database
4. A beginning to understanding a problem
7Information is usually defined as:
1. Formatted, filtered, organized, structured, interpreted, summarized data
2. Rules, procedures and protocols that guide decisions and actions
3. Intuition and expertise that creates a new view on a situation
4. A necessary part of any database
8The ultimate goal to health information management is to:
1. Apply management tools
2. Create computer systems
3. Design health-related systems
4. Improve healthcare outcomes
9Systems form a complex whole from:
1. Open, proprietary, or web-based elements
2. Interacting, interrelated, or interdependent elements
3. Independent, unrelated, or reacting sources
4. Foundational, important, or recognized sources
10Processes that support effective health information systems include:
1. Resources and data sources
2. Indicators, data sources, and data management
3. Legislative, regulatory, and planning frameworks
4. Information products
My score:

Thank you for completing the pre-test. If you scored 0% – 60% on this test, we recommend you complete Module 1: Introduction to Health Information Systems.

Module 1: Introduction to Health Information Systems is most useful for frontline healthcare workers who are new to using electronic information systems, facility managers, IT support staff, trainers and supervisors, and regional and national level officers tasked with monitoring and receiving facility-level data.

After completing Module 1, frontline healthcare workers may wish to learn more by completing Module 3: Using EMR Data for Decision Making, Module 4: Improving and Maintaining the Quality of EMR System Data, and Module 7: Introduction to Interoperability at the Facility Level.

After completing Module 1, facility managers and regional and national level officers can learn more by completing Module 2: Health Information Systems: Data Management Concepts Module 3: Using EMR Data for Decision Making, Module 4: Improving and Maintaining the Quality of EMR System Data, Module 5: Logic Models and System Classification, Module 6: Overview of System Architecture, Module 7: Introduction to Interoperability at the Facility Level, and Module 8: Introduction to Planning for Interoperable Systems.

After completing Module 1, IT support staff can learn more about information systems in the healthcare setting by completing Module 2: Health Information Systems: Data Management Concepts, Module 5: Logic Models and System Classification, Module 6: Overview of System Architecture, Module 7: Introduction to Interoperability at the Facility Level, and Module 8: Introduction to Planning for Interoperable Systems.
Module 2: Health Information Systems: Data Management Concepts
Instructions: Assess your current knowledge on the topic: Health Information Systems: Data Management Concepts with a short pre-test. Click or tap the correct answer(s), then tap the Show My Score button to reveal the correct answers and additional information.
1Qualitative data:
1. Provides additional numbers and data points
2. Is expressed as words indicating a grouping or categorization
3. Creates additional codes to the database
4. Uses existing data and code
2A problem with aggregate data is that it is:
1. Only used for reporting
2. Difficult to disaggregate
3. Too specific to be of use
4. Very expensive to do
3For efficient data management, your facility must have:
1. Statistician
2. Organized structures
3. Form box
4. Strategic plan
4Four elements of a database are:
1. Field, row, column and table
2. Spreadsheet, column, checksum and input screen
3. Scope, risk, cost, and time
4. Flow, charter, task and spreadsheet
5A data dictionary is essential to a well-constructed database because it:
1. Keeps the data more relevant
2. Produces better data quality
3. Provides clear definitions for the data
4. Creates an easy personnel management tool
6Storing data includes both:
1. Back-up and recovery management
2. Dissemination and architecture management
3. Disaggregation and organizational management
4. Benchmarking and gap management
7A query is a way to:
1. Efficiently organize data in a database
2. Relate groups of fields
3. Identify records in a table
4. Retrieve information from a database
8Data quality during data capture can be managed by:
1. Single point of entry
2. Fields that accept certain values
3. Statisticians
4. Strategic Plans
9Electronic entry can occur:
1. At time of care and at point of entry
2. When exchanging data with another system
3. During data quality assessments
4. At time of care, at point of care, or after time of care
10The three phases of data management are:
1. Save, Secure, Archive
2. Capture, Store, Retrieve
3. Collect, Save, Analyze
4. Record, Store, Retrieve
My score:

Thank you for completing the pre-test. If you scored 0% – 60% on this test, we recommend you complete Module 2: Health Information Systems: Data Management Concepts.

Module 2: Health Information Systems: Data Management Concepts is most useful for facility managers, IT support staff, and regional and national level officers tasked with monitoring and receiving facility-level data. Other modules related to this content include Module 1: Introduction to Health Information Systems, Module 4: Improving and Maintaining the Quality of EMR System Data, Module 6: Overview of System Architecture, Module 7: Introduction to Interoperability at the Facility Level, and Module 8: Introduction to Planning for Interoperable Systems.
Module 3: Using EMR Data for Decision Making
Instructions: Assess your current knowledge on the topic: Using EMR Data for Decision Making with a short pre-test. Click or tap the correct answer(s), then tap the Show My Score button to reveal the correct answers and additional information.
1Which of the following is an example of clinical or public health decisions that can be made using data?
1. Starting patients on IPT treatment
2. Directing community team's outreach activities
3. Scheduling supervision visits
4. Updating ART treatment guidelines
2What level of the health system makes decisions about resource management? Choose all that apply.
1. Province
2. Facility
3. County
4. Region
5. National
3Put the different steps of the decision making process into the correct order:
1) 2) 3) 4) 5)
4The National TB and Leprosy Program's decision to institute the 5 I's of managing and controlling TB in co-infected patients was based on the technical working group's intuition.
1. True
2. False
5Fill in the blank.

EMR systems support evidence-based decision making by increasing to data.

6Fill in the blank.

Comparing the number of people immunized in one month to monthly targets is an example of turning data into .
7How does evidence-based decision making improve service delivery?
1. It relies on clinical experience and expertise
2. It captures the social context for decision making
3. It gives more confidence that solutions will address the problem
4. It ensures that others will agree with the decision
My score:

Thank you for completing the pre-test. If you scored 0% – 60% on this test, we recommend you complete Module 3: Using EMR Data for Decision Making.

Module 3: Using EMR Data for Decision Making is most useful for frontline healthcare workers, facility managers, trainers and supervisors, and regional and national level officers tasked with monitoring and receiving facility-level data. Other modules related to this content include Module 1: Introduction to Health Information Systems and Module 4: Improving and Maintaining the Quality of EMR System Data.
Module 4: Improving and Maintaining the Quality of EMR System Data
Instructions: Assess your current knowledge on the topic: Improving and Maintaining the Quality of EMR System Data with a short pre-test. Click or tap the correct answer(s), then tap the Show My Score button to reveal the correct answers and additional information.
1Which of the following data quality issues will lead to increasing patient numbers in EMR system reports? Choose all that apply.
1. Deactivating active patients
2. Creating a duplicate patient record
3. Failing to record a patient as a transfer in
4. Enrolling patients in the wrong programme
5. These all lead to higher patient numbers in the system
2During a supportive supervision visit at Wanjohi Health Centre, the data clerk reported that he had entered all the legacy data into the EMR system. To make sure that all the patients were entered into the system, the data clerk would enter at most one visit for the patient per quarter and skip any additional visit where the patient is seen more than once in 3 months. What aspect of data quality is affected by this action?
1. Timeliness
2. Security
3. Integrity
4. Reliability
5. Completeness
6. Confidentiality
3The KenyaEMR system has inbuilt data validation checks at the user interface; the EMR system detects and disallows invalid data at the point of entry.
1. True
2. False
4Data entry personnel who notice illegible or implausible values on patient encounter forms should:
1. Make the correction themselves based on their assessment of the values provided
2. Seek clarification from the provider
3. Leave the field blank
5Which of the following are ways that an EMR system promotes data quality? Choose all that apply.
1. Compares data from a paper register with the data entered into the EMR system
2. Uses unique patient identifiers
3. Identifies and flags questionable data
4. Permits patient look-up to avoid duplicate records for the same patient
5. Records patient weight
6. Captures data in structured formats
7. Alerts users when mandatory fields are not filled
6Possible data errors in KenyaEMR include (choose all that apply):
1. Creating a new record for a patient who already exists in the system
2. Entering an estimated age when the patient's exact date of birth is unknown
3. Failing to record the results of a TB screening
4. Switching digits, e.g. CD4 value of 156 vs. 516 for laboratory result
5. Using a clinic identification number, which is different from the patient's national ID number
My score:

Thank you for completing the pre-test. If you scored 0% – 60% on this test, we recommend you complete Module 4: Improving and Maintaining the Quality of EMR System Data.

Module 4: Improving and Maintaining the Quality of EMR System Data is most useful for frontline healthcare workers who use EMR systems, facility managers, data managers, trainers and supervisors, and regional and national level officers tasked with monitoring and receiving facility-level data. Other modules related to this content include Module 1: Introduction to Health Information Systems, Module 2: Health Information Systems: Data Management Concepts, and Module 3: Using EMR Data for Decision Making.
Module 5: Logic Models and System Classification
Instructions: Assess your current knowledge on the topic: Logic Models and Systems Classification with a short pre-test. Click or tap the correct answer(s), then tap the Show My Score button to reveal the correct answers and additional information.
1In creating a logic model you would include:
1. Data, information, technology, and timelines
2. Models, systems, technologies, and architectures
3. Inputs, activities, outputs, and outcomes
4. Sources, costs, milestones, and determinates
2Chose one response. The difference between proprietary and public system models can be described as:
1. How many components are in the system
2. Where the system was implemented
3. How the system interacts with its environment
4. Who owns the system
3Choose all that apply. Factors to consider when selecting a system include:
1. Available infrastructure (electricity, internet)
2. Funding
3. Celebrity endorsements of the system
4. At what levels the system will be used (facility, regional, national, etc.)
5. The country of origin of the system
4Information products, such as data visualizations and monthly reports that highlight data of value and aid in decision making, are an example of a/an:
1. Input
2. Output
3. Activity
4. Outcome
5What is one disadvantage of free, open-source software?
1. It is often developed in a community that may or may not be responsive to a particular stakeholder’s needs
2. It goes through a transparent process of peer review
3. It has no licensing fee in order to use it
4. It can be modified by anyone who obtains the source code
My score:

Thank you for completing the pre-test. If you scored 0% - 60% on this test, we recommend that you complete Module 5: Logic Models and Systems Classification.

Module 5: Logic Models and Systems Classification is most useful for facility managers, IT support staff, and system planners as it provides information on the purpose of information systems, information system components, and different kinds of systems available in the healthcare setting. Other modules related to this content include Module 1: Introduction to Health Information Systems, Module 2: Health Information Systems: Data Management Concepts, Module 6: Overview of System Architecture, Module 7: Introduction to Interoperability at the Facility Level, and Module 8: Introduction to Planning for Interoperable Systems.
Module 6: Overview of System Architecture
Instructions: Assess your current knowledge on the topic: Overview of System Architecture with a short pre-test. Click or tap the correct answer(s), then tap the Show My Score button to reveal the correct answers and additional information.
1Match the system with its correct objective.
Electronic Medical Record: Laboratory Information System: Billing/Invoicing System: Human Resources Information System: Equipment Management System: Supply Inventory System:
2Choose the system architecture that completes the following sentence:

A contains all the entered data, no matter where it is entered.
1. Federated system
2. De-centralized system
3. Centralized system
4. Stand-alone system
3Complete the sentence: A federated system . Choose all that apply.
1. Requires strong governance protocols to ensure data security
2. Is a blend of centralized and de-centralized systems
3. Is simple to troubleshoot when a user encounters a problem
4. Can share data from multiple information systems and store the data together in one place
4What is the value of an architecture?
1. Allows you to swap component applications or systems
2. Helps manage behavior change
3. Allows you to respond to changes in technology
4. Permits upgrading specific workflows as needed
5. None of the above
6. All of the above
5What is the major advantage of a centralized system?
1. Strong security measures and protocols are necessary to protect the information that moves between system components.
2. It is more vulnerable because if the central repository breaks down, the entire system is unusable.
3. Each stakeholder can share core information and address their individual needs without losing their autonomy.
4. It is easier to implement and to troubleshoot problems since everyone is using the same thing.
My score:

Thank you for completing the pre-test. If you scored 0% - 60% on this test, we recommend that you complete Module 6: Overview of System Architecture.

Module 6: Overview of System Architecture is most useful for facility managers, IT support staff, and system planners as it provides information on the purpose of information systems, information system components, and different kinds of systems available in the healthcare setting. Other modules related to this content include Module 1: Introduction to Health Information Systems, Module 2: Health Information Systems: Data Management Concepts, Module 5: Logic Models and System Classification, Module 7: Introduction to Interoperability at the Facility Level, and Module 8: Introduction to Planning for Interoperable Systems.
Module 7: Introduction to Interoperability at the Facility Level
Instructions: Assess your current knowledge on the topic: Introduction to Interoperability at the Facility Level with a short pre-test. Click or tap the correct answer(s), then tap the Show My Score button to reveal the correct answers and additional information.
1The three kinds of interoperability are:
1. Human-mediated, foundational, and semantic
2. Point-to-point, standard, and structural
3. Human-mediated, point-to-point, standardized
4. Foundational, structural, and semantic
2Structural interoperability is .
1. The ability to exchange data and maintain the original meaning and context of it
2. The ability to exchange data in a way that it can be fully used by the receiving system
3. The exchange of information between two or more systems
4. The architecture of an interoperable system network
3Complete the sentence: Bahmni integrated hospital system is .
1. A lab information system and electronic medical record in one
2. A centralized health information system
3. Simple to troubleshoot when a user encounters a problem
4. A standardized, semantic interoperable health information system
4Choose all that apply. Benefits of interoperable systems include .
1. Standardized data
2. More disease outbreaks
3. Automatic links between stocks of medication and/or supplies and use
4. Less time required for clinical visits
5. Cost savings on communication of information
6. Reduced human error in documentation and transmission of orders, results, and reports
7. Greater need for trained IT personnel
5Choose all that apply. With regard to interoperable systems at the health facility level, it is the role of the frontline healthcare worker to .
1. Make sure you receive training in the systems you are expected to use
2. Never share system IDs or passwords with anyone else
3. Advocate for internet service infrastructure at the national level
4. Troubleshoot by trying the easiest solutions before contacting IT support
5. Encrypt sensitive patient data
6. Be thorough and detailed when reporting issues encountered when using a system
My score:

Thank you for completing the pre-test. If you scored 0% - 60% on this test, we recommend that you complete Module 7: Introduction to Interoperability at the Facility Level again.

Module 7: Introduction to Interoperability at the Facility Level is appropriate for frontline health workers who use electronic information systems, facility managers, regional and national level officers, and IT support staff. Other modules related to this content include Module 6: Overview of System Architecture and Module 8: Introduction to Planning for Interoperable Systems.