Value Added Article: Quality Issues in The Health Management Information System | Category – Health | Source – EPW

Relevance: GS Paper III (Science & Tech.)


Economic and Political Weekly


With the growing importance of health in the global agenda, the Health Management Information System (HMIS) has emerged as one of the key activities that require accelerated efforts to meet international as well as country-specific health needs.

Understanding HMIS

  • The HMIS is an improved and user-friendly programme geared towards the use of information for planning and action.
  • It is a process of collection, compilation, reporting, analysis, and the use of information for the purposes of management and problem-solving of healthcare services.

HMIS in Bihar

  • The HMIS was formally launched in Bihar in October 2008 to receive uninterrupted health-related information from different facilities in the state.
  • The purpose of employing the HMIS was to promote evidence-based decisions in planning, implementing, and evaluation of health programmes.

Significance of HMIS

  • Several interventions, including the launch of the NRHM, have increased the demand for data on population and health for use in both micro-level planning and programme implementation. HMIS takes care of all the health-related data needs.
  • In addition to the health system and health programmes, the use of the HMIS has also increased in hospitals.
  • It has been envisaged to not only help administrators have better monitoring and control of the functioning of hospitals, but also assist medical staff to improve health services with readily referenced patient data.
  • The HMIS has also enabled provisioning of better care to patients by automating all the major functional areas and other activities of hospitals .
  • Health-related data helps the healthcare system derive the level of insight and trends needed to personalise treatment, foster effective communication between patients and physicians, and improve the overall quality of treatment of patient care.
  • The HMIS has the potential to improve the health status of a population as it not only helps to take evidence-based decisions, but is also useful in planning health services, monitoring health programmes, and evaluating health programmes and health systems.

Limitations of HMIS

  • The role of health information systems is to generate, analyse, and disseminate such data, but, in practice, health information systems rarely function systematically.
  • Furthermore, it may not be practical to collect specific information on all aspects to answer a specific research question.
  • There are other limitations to the HMIS, such as the reliability, validity, and accuracy of the data in the system. These limitations can be attributed to the weaknesses in the system as well as the attitude of the staff who are handling the HMIS.
  • The state has been lagging behind in achieving quality HMIS data, for which a correctness and consistency of data is must.

Quality concern in HMIS

  • The first factor that affects the quality of HMIS data is timely reporting, since it is an important parameter of the HMIS.
  • The second factor that affects the quality of data in the HMIS is the shortage of stationery at the health sub-centre and PHC levels.
  • The third factor that affects the quality of HMIS data is the accuracy of data. Information entered into the HMIS needs to be correct and valid.
  • Fourth, it has been found that sometimes the same information is being recorded in more than one recording register in different formats, which can lead to mismatch between data from different sources.
  • Fifth, there are some issues related to the regular updation of the list of health facilities and upgradation of software.
  • The sixth issue is with the use of HMIS data. Currently, HMIS data is not used extensively by the higher authorities. Unless HMIS data is used by the higher authorities, feedback cannot be given on the quality of data.
  • Seventh, it has been observed that healthcare staff are not concerned about the use of the HMIS. Most of the front-line workers fail to realise the importance of HMIS data .
  • Eighth, the understanding of these data elements vary from the staff of one facility to the other, between lower-level staff and higher-level staff and between those who record data and those who enter data.
  • Ninth, some other quality-related issues such as outliers and validation errors exist in HMIS data.
  • In addition to the above, the state faces regular shortage of trained HMIS staff who look after HMIS work at different levels.

Way forward

  • Clinical and non-clinical staff should be made more aware about health information systems.
  • Until the quality of data is ensured, its use in health planning and monitoring will be doubtful.
  • If HMIS data is not used regularly for programme planning, monitoring, and evaluation, the quality of the database will decline further.
  • To present accurate and consistent information through HMIS data, it is crucial that the data must be the best possible representation of the health services provided to the people. Thus, staff entrusted with data collection and entry need regular orientation and feedback to improve their interpretation of certain data elements and fields.
  • The government should promote the utilisation of data in planning, budgeting, and monitoring of health programmes to improve the quality of data.
  • The government should organise regular review meetings based on HMIS data at different levels and provide feedback to health workers.