Health Information System Development Plan for Egypt: Phase 1—HIS 2000, Technical Report No. 40
The Egyptian Ministry of Health and Population operates one of the largest rural health care systems in the world, accounting for roughly 20 percent of outpatient visits in the country. Other health care providers, including the Health Insurance Organization, Curative Care Organization, the new Family Health Fund, and the private sector account for most visits. Health sector reform is intended to decrease the role of the Ministry as a provider, while strengthening its role as a regulator. By late 1999 the Ministry still operated a core health information system (HIS) designed from the bottom up and covering only facilities operated by the Ministry. This system operated on an increasingly obsolete computing platform and lacked the capacity to incorporate data from other health care providers. This report was developed to outline broad strategy, create a common vision for developing a new core health information system, and describe specific technical development tasks in detail. The new information system must be designed from the top down based on information demand. This should focus development on clear data collection and processing priorities, eliminate collection of unused data, and produce an efficient and relevant system. Information demand is being generated and defined by developing and testing an Executive Information System (EIS), beginning with a very limited set of key indicators and drawing data from the existing HIS. The list of indicators will change and expand as demand broadens. As the EIS develops, the core HIS database will be redesigned on a new technical platform. The new design and technical platform should scale easily to accommodate data from other health care providers. Redesign will begin with the common dimensions of time, provider, facility, location, and higher order classifications of these dimensions. As information demand is defined through EIS development, the required data elements will be added to the new HIS design. The resulting system should streamline data collection and processing, incorporate data flows from other health care providers, and eliminate unused data elements. This report describes long-term and short-term objectives. It includes a detailed technical assessment of existing HIS implementations, and technical alternatives for the computing platform. The strategy described in this report focuses on structural and technical improvements to the core information system database and data handling components. The report recognizes the significance of incorporating data from other health sector providers, but does not describe how this will be done. Specific technical development tasks and task teams are described in detail. The report includes a suggested development timeline, an inventory of existing related software applications, an inventory of current coding systems, an example framework for specifying field validation, and an example data collection and processing schedule.