09 Health Information Management
09 Health Information Management
PST 05209
Health Information
Management
ii
Table of Contents
Background .................................................................................................................................... iv
Acknowledgment ........................................................................................................................... vi
Introduction .................................................................................................................................. viii
Abbreviations/Acronyms ................................................................................................................ x
Session 1: Organization of Health Related Data Using Computer Packages ................................. 1
Session 2: Creation of Table from Health Data Using Spreadsheet ............................................. 17
Session 3: Creation of Table from Health Data Using Spreadsheet ............................................. 29
Session 4: Creation of Chart from Health Data Using Spreadsheet ............................................. 54
Session 5: Creation of Histogram from Health Data Using Spreadsheet ..................................... 66
Session 6: Report and Presentation of Health Related Information Using Computer Packages .. 75
Session 7: Computer Applications for Data Backup, Information Searching and Learning ........ 82
Session 8: Utilization of Computer Packages in Ordering, Invoicing, Dispensing, Selling and
Inventory Management ............................................................................................................... 100
Session 9: Components of Health Management Information System ........................................ 108
Session 10: Utilization of HMIS (MTUHA) Database in Capturing and Managing
Pharmaceutical Data ................................................................................................................... 115
Session 11: Analysis of Data Using HMIS/MTUHA Database (PRACTICAL) ....................... 132
Session 12: Management of Pharmaceutical Information in Vertical Program ......................... 139
Session 13: Networking Programmes in Dissemination of Pharmaceutical Information........... 144
iii
Background
There is currently an ever-increasing demand for pharmaceutical personnel in Tanzania.
This is due to expanding investment in public and private pharmaceutical sector. Shortage of
trained pharmaceutical human resource contributes to poor quality of pharmaceutical
services and low access to medicines in the country (GIZ, 2012).
CSSC prepared a Multi-actor Partnership (MAP) project proposal on how to sustain and
strengthen health care in Tanzania through improvement of pharmaceutical training and an
inter-institutional coordination of actors. This will harmonize and improve access to quality
pharmaceutical service in Tanzania.
The project has a various key stakeholders like; CSSC, NACTE, PC, TCU, CEDHA and
Pharmaceutical Training Institutions (PTIs). Through this project, few PTIs will receive
infrastructural improvements to increase the quantitative and qualitative capacities (CUHAS,
RUCU and KSP). Furthermore this project will train Pharmaceutical tutors from different
PTIs on teaching and assessment methods in Tanzania and thus improved health delivery
through increased qualified human resource.
It was also observed that in the previous stakeholder’s meetings there was a need for the
development of training manuals and assessment plans for NTA Level 5 & 6, in order to
support the establishment and implementation of the curriculum in PTIs. During MAP kick-
off workshop done in February 2018, Stakeholders agreed that there was a need for
development of the said manuals and it was among the highest priority in Pharmacy
education in Tanzania. Therefore this project aims at developing facilitator’s guide and
assessment plans for NTA Level 5 & 6.
Pharmacy Council, CSSC and action medeor developed the Terms of Reference and selected
a qualified service provider with experience in material development to develop the
mentioned training manuals and assessment plan. Centre for Educational Development in
Health Arusha (CEDHA) was selected and offered a contract to develop Facilitators guide for
NTA level 5 & 6 and assessment plan.
Centre for Educational Development in Health Arusha (CEDHA) was offered a leading role
with the instructions to include experts who have developed teaching materials for NTA
Level 4. These experts are primarily experienced pharmaceutical and non-pharmaceutical
tutors.
The mode of operation used by CEDHA to develop facilitators guide and assessment plan
was participatory approach which included a number of activities through various workshops
such as planning, and orientation of material development. After these preliminary
workshops, experts developed materials individually and in-groups. Thereafter, developed
iv
draft materials were reviewed, edited and formatted and draft one was finalized and shared to
stakeholders for inputs.
Finally, CEDHA submitted the finalized Facilitator’s guides and assessment plans for NTA
level 5 and 6 to CSSC for endorsement, printing, dissemination and sharing with relevant
authorities.
There are 11 modules for NTA level 5 making 11 facilitator guides including one practicum
guide.
v
Acknowledgment
The development of standardized training materials of a competence-based curriculum for
pharmaceutical sciences has been accomplished through involvement of different
stakeholders.
Special thanks go to the Pharmacy Council for spearheading the harmonization of training
materials in the pharmacy after noticing that training institutions in Tanzania were using
different curricula and train their students differently.
I would also like to extend my gratitude to Christian Social Service Commission (CSSC) for
their tireless efforts to mobilize funds from development partners (German Ministry of Industry
and action medeor). It is through the implementation of the Multi-Actors Partnership (MAP)
project, CSSC has been able to provide the financial and technical support needed during the
development of this training material.
Many thanks go to the Centre for Educational Development in Health Arusha (CEDHA)
experts on health material development and training who coordinated the development of
these module sessions particularly Ms. Diana H. Gamuya for her commitment in coordinating
and facilitating the planning and development to its completion.
Particular acknowledgements are sent to Mr. Dickson Mtalitinya and Members from the
secretariat of National Council for Technical Education (NACTE) for facilitating and
providing their expertise to the success of this work.
It will be unfair if I will not recognize the efforts and contributions of all CEDHA supportive
staff that made this process a success; accountant, secretary, drivers and printers
Finally, I very much appreciate the contributions of the tutors and content experts
representing PTIs, hospitals, and other health training institutions. Their participation in
meetings and workshops, and their input in the development of this training
manual/facilitators guide have been invaluable.
vi
Dr. Peter Sala CEDHA
Mr. Amani Phillip HKMU
Mr. John M. Bitoro CUHAS
Mr. Omary Mejjah CUHAS
Mr. Karol Marwa CUHAS
Mr. Raphael Matinde CUHAS
Mr. Rajabu I. Amiri MUHAS
Mr. Peter Njalale MUHAS
Ms. Tumaini H. Lyombe MUHAS
Mr. Mdoe Ibrahim TCHRT
Mr. Kolonjoi Olekiyapi KSP
Ms. Dilisi J. Makawia KSP
Mr. Richard P. Mmassy KSP
Mr. Nemes Uisso RAS-KLM
Mr. Gaspar Baltazary RuCU
Mr. Goodluck Mdugi RuCU
Mr. Godfrey A. Pharaoh SIBS
Mr. Joel M.Selestine SIBS
Mr. Jimmy M. Mulee SIBS
vii
Introduction
Module Overview
This module content is a guide for tutors of Pharmaceutical schools for training of students.
The session contents are based on sub-enabling outcomes and their related tasks of the
curriculum for Technician Course in Pharmaceutical Sciences. The module sub-enabling
outcomes and their related tasks are as indicated in the in the Technician Certificate in
Pharmaceutical Sciences (NTA Level 5) Curriculum
Target Audience
This module is intended for use primarily by tutors of pharmaceutical schools. The module’s
sessions give guidance on the time, activities and provide information on how to teach the
session. The sessions include different activities, which focus on increasing students’
knowledge, skills and attitudes.
viii
Instructions for Use and Facilitators Preparation
Tutors are expected to use the module as a guide to train students in the classroom and
skills laboratory
The contents of the modules are the basis for teaching and learning dispensing.
Use the session contents as a guide
The tutors are therefore advised to read each session and the relevant handouts and
worksheets as preparation before facilitating the session
Tutors need to prepare all the resources, as indicated in the resource section or any other
item, for an effective teaching and learning process
Plan a schedule (timetable) of the training activities
Facilitators are expected to be innovative to make the teaching and learning process
effective
Read the sessions before facilitation; make sure you understand the contents in order to
clarify points during facilitation
Time allocated is estimated, but you are advised to follow the time as much as possible,
and adjust as needed
Use session activities and exercises suggested in the sessions as a guide
Always involve students in their own learning. When students are involved, they learn
more effectively
Facilitators are encouraged to use real life examples to make learning more realistic
Make use of appropriate reference materials and teaching resources available locally
ix
Abbreviations/Acronyms
x
Session 1: Organization of Health Related Data Using
Computer Packages
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Explain concepts of electronic data storage and arrangement
Demonstrate electronic filing and application of security to electronic data
Explain the methods of summarizing data
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD projector
Antivirus disc
Peripheral storage devices
Worksheet 1.1: The difficulties in patient registration process
1
SESSION OVERVIEW
Step Time Activity/Method Step Title
SESSION CONTENTS
2
Data storage
o Data storage is the recording (storing) of information (data) in a storage medium.
o Handwriting, phonographic recording, magnetic tape, and optical discs are all
examples of storage media.
Electronic data storage is the means of storing soft data information in given format
like Music, Video, Document or Pictures in a device which could be a flash disk or
rather a hard disk drive
Electronic data storage requires electrical power to store and retrieve data.
Data stored in a digital machine-readable medium is sometimes called digital data.
Computer data storage is one of the core functions of a general purpose computer.
Electronic documents can be stored in much less space than paper documents.
Barcodes and magnetic ink character recognition (MICR) are two ways of
recording machine-readable data on paper.
Three common types data storage are: hard drive, USB flash drive and memory card.
3
The best example of non-volatile memory and storage is a computer hard
drive, flash memory, and ROM.
o A hard drive is a secondary storage device that consists of one or more platters to
which data is written using a magnetic head, all inside of an air-sealed casing.
o A typical hard drive is only slightly larger than a human hand and can hold over
100 GB of data.
Memory card
o A memory card is a type of storage device that is used for storing media and data
files.
o It provides a permanent and non-volatile medium to store data and files from the
attached device.
o Memory cards are commonly used in small, portable devices, such as cameras and
phones.
o The most common type of data that’s being stored on a memory card include
videos, pictures, audio and other types of file formats.
o Some of the most popular forms of memory cards are:
Secure Digital (SD) card
CompactFlash (CF) card
Smart Media
Memory Stick
Multi Media Card (MMC)
In the healthcare system, data are store in the electronic systems, and these systems
are called electronic health records (EHR) and electronic medical records (EMR)
4
o It contains a patient’s medical history, diagnoses, medications, treatment plans,
immunization dates, allergies, radiology images, and laboratory and test results in
electronic format.
o It is health information that is created and managed by authorized providers in a
digital format capable of being shared with other providers across more than one
health care organization.
Retrieval
o Paper Based System
During normal business hours requests for thinned or discharged health records
should be coordinated through the HIM staff.
It is recommended that a process be in place to track the locations and holders
of the health record.
This can be accomplished through a record check out system.
A reasonable length of time should be identified for which a record can be
checked out.
5
Because evening and night shift staff may have to complete deficient discharge
records or have access to an overflow record, the supervisor should have keys to
access the department and be trained in retrieval, the sign-out process, and other
security measures.
Department procedures should track who has keys to the department and
documentation of their training on filing and retrieval procedures.
Filing
o Paper based system
Filing of all documents that should be part of the complete health records are
added to the discharge record, preferably prior to completion.
As with the addition of any document to the record, care should be taken to
verify the resident name prior to inserting the document in the record.
o Hybrid system
The facility policies and procedures should determine which parts of the record
will be paper based and which parts are stored in a data repository.
This policy should also determine whether or not additional documents should
be added as paper based documents or scanned into the data repository.
If documents are added to the electronic portion of the record after this has been
completed, these should be added as addendums.
o Electronic record
The facility policies and procedures should allow for the capture of additional
material for the electronic record through a system of scanning to the file.
If the record has been determined to be complete and additional paperwork is
discovered, these documents should be added as addendums.
The electronic system should be able to separate the active from the inactive
record within the data base
6
Information security risk assessment is an on-going process of discovering,
correcting and preventing security problems.
The risk assessment is an integral part of a risk management process designed to
provide appropriate levels of security for information systems.
Security risk assessments must be performed annually to meet the criteria of the
meaningful use of an HER
o Encrypt data
Encryption is the process of encoding a message or information in such a way
that only authorized parties can access it and those who are not authorized
cannot.
Patient data should be encrypted whenever possible
Antivirus programs and firewalls to defend the privacy and security of data
should be installed in the system
Use password to protect data from being accessed with unauthorized persons
o Authenticate users
Authentication is the process of recognizing a user’s identity.
Authentication process can be described in two distinct phases: identification
and actual authentication.
Identification phase provides a user identity to the security system and this
identity is provided in the form of a user ID.
An actual user can be mapped to other abstract user object in the system, and
therefore be granted rights and permissions to the user and user must give
evidence to prove his identity to the system.
The process of determining claimed user identity by checking user-provided
evidence is called authentication and the evidence which is provided by the user
during process of authentication is called a credential.
7
It is a security-relevant chronological record, set of records, destination and
source of records that provide documentary evidence of the sequence of
activities that have affected at any time a specific operation, procedure, or event.
It documents what resources were accessed; audit log entries usually include
destination and source addresses, timestamp and user login information.
EHRs have audit logs that record which user did what in the EHR and when.
Most of hospitals that practices EHR were using their audit logs or another
feature designed to prevent people from tampering with the logs to erase the
signs of an intruder.
EHR practices need software that automatically scans their audit logs to detect
anomalies that might indicate a cyber-attack, such as an unfamiliar user or a
known user logging on at an unusual time of the day.
8
Table 1: Number of patients admitted at Mount Meru hospital in the year 2011
NUMBER OF PATIENTS
AGE
Below 35 1,280
35-55 1,160
Above 55 300
Total 2,740
Line graph
o A line graph is a graphical tool used to present and compare two variables.
o One variable is represented at X axis and other at Y axis.
o The points given are plotted and are joined together by straight lines.
4000
patients per year
Number of
3000
2000
1000
0
Emergency
Maternity
Surgery
Cardiac
Intensive
Care
Care
9
Multiple bar chart
o A two or more sets of inter-related data are represented.
o Multiple bar diagram facilities comparison between more than one phenomena.
14000
12000
10000
NO. Clients
8000 Male
6000 Female
4000
2000
0
1991 1992 1993 1994 1995
Years
120
100
Quantity in 100 gms
80
Glimepiride
Glyburide
60
Glipizide
Chlorpromide
40
20
0
1991 1992 1993 1994
Years
10
Figure 5: Inpatient cases at Medical ward-MNH 1991-1994
INPATIENT CASES IN HUNDRED AT MEDICAL WARD-MNH
FROM 1991-1994
100%
90%
Number of Cases in %
80%
70%
60% MTA
50% HIV/AIDS
40% Malaria
30%
20%
10%
0%
1991 1992 1993 1994
Years
Pie chart
o Pie chart is named so, due to its similarity with pie and its slices.
o Pie chart is a circular chart which is divided into sectors.
o Each sector corresponds to different values of a data.
o In pie charts, the percentage of each number is calculated and then obtained
percentages are plotted at pie chart.
Figure 6: Hospital Patients by Unit
Hospital Patients by Unit
Cardiac
Care
12%
Emergenc
Surgery y
53% 25%
Intensive
Care
Maternity 4%
6%
Histogram
o A bar graph that displays the data from a frequency distribution
o Horizontal Scale (x-axis) is labeled using CLASS BOUNDARIES or
MIDPOINTS
o Vertical Scale (y-axis) is labeled using frequency
o Bars are contiguous (No gaps)
11
Figure 7: Time to complete blood transfusion
Time to Complete Blood Transfusion
30
Fr 25
eq
ue 20
nc
y 15 Frequenc y
10
Minutes
Frequency polygon
o It presented by using Line graph rather than a bar graph.
o It uses class midpoints rather than class boundaries on x-axis
Figure 8: Frequency polygon for Blood pressure data
18
16
14
12
Frequency
10
0
92.5 106.5 120.5 134.5 148.5 162.5 176.5 190.5 204.5 218.5
Systolic Pressure
Ogive
o Line graph (rather than a bar graph)
o Uses class boundaries on x-axis
o Uses cumulative frequencies (total as you go) rather than individual class
frequencies
o Used to visually represent how many values are below a specified upper class
boundary
12
Figure 9: Blood Pressure of fifty subjects
60
Cummulative Frequency
50
40
30
20
10
0
99.5 127.5 155.5 183.5 211.5
Systolic Pressure
13
STEP 8: Assignment (05 minutes)
ALLOW group to work for three days and submit the task after scheduled time.
CONDUCT general discussion by asking groups to present one of these questions for not
less than 5 minutes.
14
References
Embrey, M. A. (2013). MDS-3: Managing access to medicines and health technologies.
Sterling, VA: Kumarian Press.
United Republic of Tanzania Ministry of Health and Social Welfare, Strategy for
Development and Implementation of an Integrated Logistics System for Essential
Health Commodities: Government printers, Dar es Salaam
USAID | DELIVER PROJECT, Task Order 1. 2011. Tanzania: 2020 Supply Chain
Modeling—Forecasting Demand from 2020–2024. Arlington, Va.
Gartee R. (2011). Electronic Health Records + MEDCIN CD: Understanding and Using
Computerizing Medical Records. 2nd Ed. Pearson. USA
Gerda Koch. (2000). Basic allied health statistics and analysis. 2nd Ed. Thomson Delmar
learning. USA.
Pietka E et al. (2016). Information Technology in Medicine. 1st Ed. Springer International
Publishing. USA.
Thanki S. (2018). Medical Imaging and Its Security in Telemedicine Applications. 1st Ed.
Springer International Publisher. USA.
15
Worksheet 1.1: The difficulties in patient registration
process
Instructions: This is a take home exercise that should be done by all students
individually.
Finished work should be collected and handed over to the tutor. Time for collection will
be discussed and agreed in class.
16
Session 2: Creation of Table from Health Data Using
Spreadsheet
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Explain the structure of Microsoft Excel spreadsheet
Use Microsoft Excel procedures to open spreadsheet
Use Microsoft Excel procedures to formatting data
Use Microsoft Excel procedures to create borders
Use Microsoft Excel procedures to print a table
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD projector
Network
Worksheet 2.1
17
SESSION OVERVIEW
Step Time Activity/Method Content
SESSION CONTENTS
18
Microsoft Excel Ribbon
The ribbon provides shortcuts to commands in Excel.
A command is an action that the user performs.
An example of a command is creating a new document, printing a documenting.
Ribbon tabs
o The tabs are used to group similar commands together. The home tab is used for
basic commands such as formatting the data to make it more presentable, sorting
and finding specific data within the spreadsheet.
Ribbon bar
o The bars are used to group similar commands together. As an example, the
Alignment ribbon bar is used to group all the commands that are used to align
data together.
19
Worksheet and Workbook
A worksheet is a collection of rows and columns.
o When a row and a column meet, they form a cell.
o Cells are used to record data.
o Each cell is uniquely identified using a cell address.
o Columns are usually labelled with letters while rows are usually numbers.
20
Add, Subtract, Multiply, divided in Excel
Create a folder on computer in my documents folder and name it HIM Excel.
Open Excel.
Enter the data in the worksheet.
Perform the calculations using the respective arithmetic operators.
When performing calculations in Excel, start with the equal (=) sign.
Start with the one for addition.
Write the following formula in E2 Excel (Result column)
= C2+D2
o "=" tells Excel to evaluate whatever follows after the equal sign
o "C2" is the cell address of the first number given by C representing the column
letter and 2 representing the row number
o "D2" is the cell address of the second number given by D representing the
column letter and 2 representing the row number
Highlight the cells that have the column names by dragging them.
Click on the bold button represented by B command.
The workbook should now appear as follows.
21
Procedures for align data to the left
22
Follow drop down menu below
23
STEP 6: The Procedures for Printing a Table From Spreadsheet (20
minutes)
Procedure for setting print area, print view, printing and page layout
The print area is the part of the worksheet that used to print out on paper.
The quick and easy way of doing it is by using the following shortcut commands
Ctrl + P
24
Press Esc button to exit print preview mode
ALLOW group to work for one day and present the task after scheduled time.
CONDUCT general discussion by asking groups to present one of the tasks for not less
than 5 minutes.
25
References
International Council on Archives (1999), Managing Public Sector Records,
Understanding computers an over view for records and archives: International
Records Management Trust London
Gartee R. (2011). Electronic Health Records + MEDCIN CD: Understanding and Using
Computerizing Medical Records. 2nd Ed. Pearson. USA
Gerda Koch. (2000). Basic allied health statistics and analysis. 2nd Ed. Thomson Delmar
learning. USA.
Held B. (2010). Microsoft Excel Functions & Formulas. Wordware Publishing, Inc.
26
Worksheet 2.1: Microsoft Excel Spreadsheet
Instructions: This is a take home exercise that should be done by all students
individually.
Finished work should be sent and handed over to the tutor. Time for collection and
sending will be discussed and agreed in class.
Create a spreadsheet like the one below. Enter all the numbers.
Change the formatting of the numbers to dollars.
Make the grid around the cells visible.
Insert the title ―Monthly Budget‖ center and merge it.
o Change the font to Baker Signet, size 18.
o Make the text white and the fill black.
Insert the subtitle ―January 2005 – June 2005.‖
o Change the font to Baker Signet, size 10
o Make text white and fill black.
o Center and merge it.
Total the expenses at the bottom of each month.
o Widen columns if necessary so numbers can be seen.
Put a dark border around the edges of the document.
Change the amount for gasoline in June from 60 to 70 shillings.
Figure out the average for each row. You must know the formula on your own!
Center and bold the headings (months and average)
o Bold the headings in column A.
o Change the font to BakerSignet.
Add a header with your name, period, and FINAL PART A.
Print
27
28
Session 3: Creation of Table from Health Data Using
Spreadsheet
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Explain Microsoft Excel formula
Use Microsoft Excel formulas to analyse data in a table
Explain Microsoft excel function (function wizard)
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD projector
SESSION OVERVIEW
Step Time Activity/Method Content
29
SESSION CONTENTS
=A2 * D2 / 2
WHERE,
"=" tells Excel that this is a formula, and it should evaluate it.
"A2" * D2" makes reference to cell addresses A2 and D2 then multiplies the values
found in these cell addresses.
"/" is the division arithmetic operator
"2" is a discrete value
30
STEP 3: The Analysis of Data Using Microsoft Excel Formulas (50
minutes)
=C4*D4
WHERE,
"C4*D4" uses the arithmetic operator multiplication (*) to multiply the value of the
cell address C4 and D4.
31
The worksheet should look as follows.
Auto select cell address and apply the same formula to other rows.
32
Mistakes to avoid when working with formulas in Excel
Take advantage of data validation to specify the type of data that should be
accepted by a cell, such as numbers only.
o To work with the correct cell, addresses referenced in the formulas; press F2 on the
keyboard.
33
o When working with many rows use serial numbers for all the rows and have a
record count at the bottom of the sheet.
Compare the serial number count with the record total to ensure formulas are
included to all rows.
34
SUMIF formula = SUMIF (A2:A7,“Items wanted”, D2:D7)
o The Sum IF gives the total number of any items for selected ranges.
o For instance here we want to calculate only the total sales amount for software
items, to do that we will apply the formula as =SUMIF (A2:A7, “software”,
D2:D7).
o Here A2 and A7 defines the range for software and same way we can find sales
amount for hardware. (A2:A7, “hardware”, D2:D7).
Software
Hardware
35
o The total sale amount of hard-ware and soft-ware in the table are as follows:
o The total number of cells that has value greater than 3000.
36
Concatenate Function: =CONCATENATE(C4,Text, D4, Text,…)
o Concatenate function is used in excel to connect different segment or text to
display as a single sentence.
o For example, here we want to display text as ―NewYork has the highest sale of
12000 dollars‖
o For that we will use the formula =CONCATENATE(C4,‖has the highest sale
of‖,D4,dollar‖).
37
INT Formula: INT (this number)
o Int formula is used to remove integer from the number like we have demonstrated
over here in below example.
38
Factorial Formula= FACT(number)
o Factorial formula will return the factorial of the number.
o To know the factorial number for 3, we use this formula.
o We can use this formula to know the probability for any number
o Here we will have factor 3=3x2x1.
3!
Results of 3!= 6
VLookup Formula = VLookup (value, range, and get me value in the column, is
my list sorted)
o VLookup formula is used when we know the detail of any object or person and,
retain other formation based on that detail.
39
o For example here we have an example of the keyboard, where we know the retail
price of the keyboard but we don’t know how much total sale it made in
California by selling keyboard.
o To know that we will use =VLookup(20,D2:D7,2,False).
o This formula will give us the total sale amount based on the retail price.
o While applying this formula we have to ensure that whatever we are placing as
ref, must be unique, for example looking for any particular employee with its ID
number it should not be allotted to others otherwise it will show an error.
D7 and not E7
40
o This function is used when we want to refer whether the following condition met
is correct or incorrect.
o Here we have used ―good‖ as any sales made greater than 2000 should be
remarked as good.
o Likewise, we can set this as ―bad‖, ―correct‖ or ―incorrect‖.
o Below table shows when we applied our formula it highlighted cell as ―good‖.
https://career.guru99.com/wp-content/uploads/2014/10/if_function_formula_1.png
41
o AVERAGE for calculating the average of a given range of numbers
o COUNT for counting the number of items in a given range
= E4 + E5 + E6 + E7 + E8
=SUM (E4:E8)
o As we can see from the above function used to get the sum of a range of cells, it is
much more efficient to use a function to get the sum than using the formula which
will have to reference a lot of cells.
Common functions
S/N FUNCTION CATEGORY DESCRIPTION USAGE
42
04 AVERAGE Statistical Calculates the average =AVERAGE(E4:E8)
value in a range of
cells
Numeric functions
S/N FUNCTION CATEGORY DESCRIPTION USAGE
43
1 ISNUMBER Information Returns true if the =ISNUMBER(A3)
supplied value is numeric
and false if it is not
numeric
44
1 DATE Date & Time Returns the number that =DATE(2015,2,4)
represents the date in
excel code
VLOOKUP function
The VLOOKUP function is used to perform a vertical look up in the left most column
and return a value in the same row from a column that you specify.
The home supplies budget has a serial number column that uniquely identifies each
item in the budget.
Suppose we have the item serial number, and we would like to know the item
description, we can use the VLOOKUP function.
Here is how the VLOOKUP function would be used.
45
=VLOOKUP (C12, A4:B8, 2, FALSE)
WHERE,
46
Computation of Mean using Excel functions
First, open a new spreadsheet.
Click on a blank cell where you will paste a function to calculate the mean, median or
mode.
Using the series fill function, enter the series of integer values 1 to 10 in cells A6 to
A15.
Next click on the function wizard button.
From the drop down list Or select a category,
select Statistical.
Click on Average to highlight it, then on OK.
Using the mouse, highlight the cells containing the
data range just entered or you can select data by
first clicking the collapse icons.
47
These are the collapse icons and are used in
selecting ranges in many Excel dialogues.
Click OK.
The value of the mean will now appear in the blank cell you selected in step 2.
Mode
The syntax for this computation is:
=Mode (Range)
Median
The syntax for this computation is:
=Median (Range)
Mean
There is a built in Excel function that returns the mean as its value
= Average (Range)
Range
The range of a sample is the largest score minus the smallest score.
This can be calculated using the Excel Formula
= (Max(A1:A10)-(Min(A1:A10)
Variance
The variance in a population is calculated as follows.
We won’t build this equation ourselves in Excel during this session.
48
The population variance:
x x
2
S 2
N
x x
2
S 2
N 1
This formula depends upon first calculating X and N which we have already seen
above.
The Excel function to calculate the variance for a population is:
= varp(range)
You can access both from the function wizard or use them by typing formulae in
cells.
49
This means that the function returns a set of values rather than just one value.
To enter an array function, the range that the array is to occupy must first be
selected and the function must be entered by pressing Shift+Ctrl+Enter
instead of just Enter or using the mouse.
With this range selected, the following function is keyed into the Formula bar:
=FREQUENCY(C4:C17,E8:E17)
Press Shift+Ctrl+Enter.
The array is now filled with data.
This data shows that no student scored below 30, 1 student scored between 30 and 39,
3 between 40 and 49, 1 between 50 and 59, 3 between 60 and 69, 1 between 70 and
79, 3 between 80 and 89, and 2 scored between 90 and 100.
If any of the results are changed, the data in the No. In Range column will be
updated automatically.
50
STEP 6: Evaluation (5 minutes)
What order of operations used to evaluate formulas in Excel?
What are the useful functions in Excel?
What is the pivot table?
ACTIVITY:
ALLOW group to work for three days and submit the task after scheduled time.
CONDUCT general discussion by asking groups to present one of these questions for not
less than 5 minutes.
51
References
Gartee R. (2011). Electronic Health Records + MEDCIN CD: Understanding and Using
Computerizing Medical Records. 2nd Ed. Pearson. USA
Gerda Koch. (2000). Basic allied health statistics and analysis. 2nd Ed. Thomson Delmar
learning. USA.
Pietka E et al. (2016). Information Technology in Medicine. 1st Ed. Springer International
Publishing. USA.
Held B. (2010). Microsoft Excel Functions & Formulas. Wordware Publishing, Inc.
52
Worksheet 3.1: The measures of central tendency and
dispersion Excel formula and functions
Instructions: This is a take home exercise that should be done by all students
individually.
Finished work should be collected in hardcopy and softcopy format and handed over to
the tutor. Time for collection will be discussed and agreed in class.
Consumable and non-consumable medical items at Kasulu district hospital 2008 annual
report.
REQUIRED:
A. Use formula to compute the following in the spreadsheet:
Mode for non-consumable
Median for consumable
Standard deviation for non-consumable
Mean for consumable
53
Session 4: Creation of Chart from Health Data Using
Spreadsheet
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Define a chart as applied in Ms Excel
Explain types of Ms Excel charts
Create a chart using Ms Excel principles
Format data using condition formatting
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard marker
Computer and LCD projector
Worksheet 3.1: The Microsoft Excel charts
SESSION OVERVIEW
Step Time Activity/Method Content
54
SESSION CONTENTS
Chart
A chart is a visual representative of data in both columns and rows.
Charts are usually used to analyse trends and patterns in data sets.
For example, the district hospital pharmacist have been recorded the malaria drugs
inventory figures in Excel for the past three years; using charts, the pharmacist can
easily tell which year had the most consumption of Malaria drugs and which year had
the least.
Charts are used to compare set targets against actual achievements.
Use the following data for chart practice.
55
The following table shows some of the most commonly used charts
56
4 Line When user
chart want to
visualize
trends over
a period of
time i.e.
months,
days, years,
etc.
57
To get the desired chart the user should follow the following steps
58
When you select the chart, the ribbon activates the following tabs:
Try to apply the different chart styles, and other options presented in your chart.
Conditional Formatting
Conditional formatting refers to formatting that is only applied when the specified
condition is true.
Let's say we want to easily fetch the sales figures greater than 30; we can use
conditional formatting to highlight all the sales figures that are greater than 30.
59
Procedures for conditional Formatting
The user get the following dialogue window when click on ―Greater Than‖
60
The final result should look as follows
61
STEP 8: Assignment (5 minutes)
ALLOW group to work for three days and submit the task after scheduled time.
CONDUCT general discussion by asking groups to present one of these questions for not
less than 5 minutes.
62
References
Gartee R. (2011). Electronic Health Records + MEDCIN CD: Understanding and Using
Computerizing Medical Records. 2nd Ed. Pearson. USA
Held B. (2010). Microsoft Excel Functions & Formulas. Wordware Publishing, Inc.
63
Worksheet 3.1: The Microsoft Excel charts
Instructions: This is a take home exercise that should be done by all students
individually.
Finished work should be collected in hardcopy and softcopy format and handed over to
the tutor. Time for collection will be discussed and agreed in class.
Required:
This graph will show the total amount of money spent on each category over a six
month period.
To do this, you must total the amount spent on each item in column I.
Do not include the average in your equation.
64
Next, highlight the expenses (house payment, gasoline, etc).
Hold down the CTRL key and highlight your new totals.
Create a pie chart.
Go to data labels and show the percentages.
Cut and paste all the information you need and the graph to a new sheet.
Graph 2: Bar Chart
This will be a bar chart for income and expenses.
Below your total column, type Income in A12. Enter the income for each month. They
are as follows:
January: 2,000
February: 2,100
March: 2,000
April: 1,900
May: 2,500
June: 2,200
June
May
April
Income
March Expenses
February
January
65
Session 5: Creation of Histogram from Health Data
Using Spreadsheet
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Define Histogram
Explain Histogram data used in Ms Excel
Create Histogram using Ms Excel
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD projector
Worksheet 3.1: The Microsoft Excel histogram
SESSION OVERVIEW
Step Time Activity/Method Content
66
SESSION CONTENTS
ASK students to pair up and buzz on the following question for 2 minutes:
What is histogram?
ALLOW few pairs to respond and let other pairs to add on points not mentioned
67
A data point is included in a particular bin if the number is greater than the lowest
bound and equal to or less than the greatest bound for the data bin.
If the user omits the bin range, Excel creates a set of evenly distributed bins between
the minimum and maximum values of the input data.
The output of the histogram analysis is displayed on a new worksheet or in a new
workbook and shows a histogram table and a column chart that reflects the data in the
histogram table.
First, enter the bin numbers (upper levels) in the range C3:C7.
NOTE: If you can't find the Data Analysis button; click here to load the Analysis
ToolPak add-in.
68
Select Histogram and click OK.
Click OK.
69
Click the legend on the right side and press Delete.
Properly label your bins.
To remove the space between the bars, right click a bar, click Format Data Series and
change the Gap Width to 0%.
To add borders, right click a bar, click Format Data Series, click the Fill & Line icon,
click Border and select a colour.
Result:
70
STEP 5: Key Points (5 minutes)
The omission of bin range in the Ms Excel creates a set of evenly distributed bins
between the minimum and maximum values of the input data that results to
histogram.
The output of the histogram analysis is displayed on a new worksheet or in a new
workbook and shows a histogram table and a column chart that reflects the data in the
histogram table
ALLOW group to work for three days and submit the task after scheduled time.
CONDUCT general discussion by asking groups to present one of these questions for not
less than 5 minutes.
71
References
MoHSW, Strengthening Health Information System, Government printers, Dar es
Salaam
Gartee R. (2011). Electronic Health Records + MEDCIN CD: Understanding and Using
Computerizing Medical Records. 2nd Ed. Pearson. USA
Gerda Koch. (2000). Basic allied health statistics and analysis. 2nd Ed. Thomson Delmar
learning. USA.
Thanki S. (2018). Medical Imaging and Its Security in Telemedicine Applications. 1st
Ed. Springer International Publisher. USA.
Held B. (2010). Microsoft Excel Functions & Formulas. Wordware Publishing, Inc.
72
Worksheet 3.1: The Microsoft Excel histogram
Instructions: This is a take home exercise that should be done by all students
individually.
Finished work should be collected in hardcopy and softcopy format and handed over to
the tutor. Time for collection will be discussed and agreed in class.
TASK 1
Data: 1,2,2,3,3,3,3,4,4,5,6
73
TASK 2
Consider the set {3, 11, 12, 19, 22, 23, 24, 25, 27, 29, 35, 36, 37, 45, 49} and use Shodor
histogram activity to create the following:
74
Session 6: Report and Presentation of Health Related
Information Using Computer Packages
Prerequisites
None
Learning Tasks
By the end of this session students are expected to be able to:
Define report
Explain principles of good report writing
Describe methodology of report writing
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD projector
SESSION OVERVIEW
Step Time Activity/Method Content
75
SESSION CONTENTS
ASK students to pair up and buzz on the following question for 2 minutes:
What is a report?
ALLOW few pairs to respond and let other pairs to add on points not mentioned
Report
o The report is a practical document that describes deals or analyses a situation such
that the reader can take specific actions about the situation.
o The report as a whole asks if there is a problem.
o The conclusion draws the various elements of this question together, typically
acknowledging that there is a problem and breaking it down into its component
parts.
o The recommendations suggest the range of options available to solve the problem.
Types of report
o Factual report: gathering information that explain or define a situation
o Instructional report: gathering information that explain a problem and offer a
range of solutions
o Persuasive report: gathering information that explain a problem and recommend a
solution.
76
STEP 3: Basic Principles of Good Report Writing (45 minutes)
Accuracy
o Report factual information, for example ―I saw.‖
o Report information gained from the physical senses, for example, sight, smell,
taste, auditory, and touch.
o Be aware of feelings that may destroy objective descriptions. Strong feelings can
cause the writer to seek evidence to support her feelings and reject evidence that
does not support them.
o Make distinctions between fact and hearsay, fact and opinion, and fact and
conclusions.
o Be clear about the meaning of words; avoid jargon.
o Clarify all abbreviations, such as SOB for shortness of breath.
o Proofread the report and rewrite as needed.
Completeness
o Completeness is achieved by reporting all the facts discovered during the course
of an investigation or data collection.
o Information that appears irrelevant to the investigator may be relevant to the
reviewer.
o In most cases, the only information the reader will have will be the information in
the report.
o Partially stated facts can be misleading and misinterpreted.
o Explain why certain information is lacking or incomplete.
o Provide a detailed explanation of the possible source of additional information
and undeveloped leads.
Conciseness
o Avoid unrelated, extraneous, incidental, and nonessential information and detail.
o Pay attention to grammar.
o Avoid adjectives, wit, sarcasm, flowery expressions, and repetition. A report is
not a literary or creative writing exercise.
o Use singleness of thought and purpose. A good report will give the reader a clear
idea or picture of the investigation or the information collected.
o Use headings, paragraphing, sentence structure, indentations, underlining, and
capitalization to emphasize and give weight and/or visibility to information the
investigator deems more important.
Impartiality/Objectivity
77
o The investigator is a fact finder. Report the material and evidentiary facts without
addition or subtraction.
o Do not conceal or withhold information.
o Do not assume.
o Do not conclude.
o Maintain an unbiased and open mind about the case.
o Avoid formulating preconceived ideas about the guilt of the accused.
o Avoid becoming emotionally involved in the process of seeking information.
78
Appendices
▼
Glossary
79
STEP 7: Take Home Assignment (5minutes)
Activity: Take Home Assignment
ALLOW group to work for three days and submit the task after scheduled time.
CONDUCT general discussion by asking groups to present one of these questions for not
less than 5 minutes.
80
References
Embrey, M. A. (2013). MDS-3: Managing access to medicines and health technologies.
Sterling, VA: Kumarian Press.
United Republic of Tanzania Ministry of Health and Social Welfare, Strategy for
Development and Implementation of an Integrated Logistics System for Essential
Health Commodities: Government printers, Dar es Salaam
USAID | DELIVER PROJECT, Task Order 1. 2011. Tanzania: 2020 Supply Chain
Modeling—Forecasting Demand from 2020–2024. Arlington, Va
81
Session 7: Computer Applications for Data Backup,
Information Searching and Learning
Prerequisites
None
Learning Tasks
By the end of this session, students are expected to be able to:
Define data back up
Describe importance of backing up data
Explain causes of data loss
Define computer virus
Classify different type of computer viruses
Describe the importance of computer antiviruses
Demonstrate techniques in searching information on the internet
Resources Needed
Flip charts, marker pens, and masking tape
Black/white board and chalk/whiteboard markers
Computer and LCD projector
Internet
82
SESSION OVERVIEW
Step Time Activity/Method Step titles
Presentation
4 20 minutes Causes of Data Loss
Presentation
5 05 minutes Definition of Computer Virus
SESSION CONTENT
83
WRITE their responses on the board/flip chart.
Data backup
A data backup is the result of copying or archiving files and folders for the purpose of
being able to restore them in case of data loss.
Data backup have two distinct reasons:
o To recover data after its loss, by data deletion or corruption.
Data loss can be a common experience of computer users
o To recover data from an earlier time, according to a user-defined data
retention policy typically configured within a backup application for how long
copies of data are required.
Magnetic tape has long been the most commonly used medium for bulk data storage,
backup, archiving, and interchange.
Hard disk: Hard disks have been improving for many years, making them more
competitive with magnetic tape as a bulk storage medium.
Optical storage: Recordable CDs, DVDs, and Blu-ray Discs are commonly used with
personal computers to store data.
SSD/Solid state storage: flash memory, thumb drives, USB flash
drives, CompactFlash, SmartMedia, Memory Stick, Secure Digital cards are very
convenient for backing up low data volumes.
Cloud backup: Backing up via the Internet to a remote location can protect against
events such as fires, floods, or earthquakes which could destroy locally-stored backups.
On-line backup storage is the most accessible type of data storage, which can begin
restore in milliseconds of time.
Near-line storage is less accessible and less expensive than on-line storage, but still
useful for backup data storage.
Off-line storage requires some direct human action to provide access to the storage
media: for example inserting a tape into a tape drive or plugging in a cable.
o Off-site data protection: To protect against a disaster or other site-specific problem,
many people choose to send backup media to an off-site vault.
o The vault can be as simple as a system administrator's home office or as
sophisticated as a disaster-hardened, temperature-controlled, high-security bunker
with facilities for backup media storage.
84
Backup site: Some organizations have their own data recovery centers that are
equipped for data storage.
85
o Inexpensive DVD or tape cartridges are a sure way to archive the programs and data
while still keeping them accessible when needed.
o It can enable to put off buying a larger disk.
86
Viruses and damaging malware
o There are numerous new viruses which attack computers every day.
o Being connected to worldwide network has many advantages; however, it opens
computers to many serious risks.
o Damages may differ greatly but the majority of viruses affects operational software,
misuses Internet connection and damages stored data.
o There are many different types of viruses and, often, data loss is just a side effect of
some larger damage done to operational system.
o The most dangerous are the attacks targeted to steal and damage business data.
Imagine the value of client databases, technical inventions, patient health
information essential for treatment and medication or financial transactions'
history of the health organization are destructed/ damaged with viruses.
Power failures
o There are two adversary effects of power failures.
When you are halfway through writing a long article and you have not saved it
yet, then in case of power going out you lose your data.
Another, even deeper problem may arise when power failures affect operation
systems or hardware of computers; shutting computer down suddenly without
proper shutdown procedures may cause problems with rebooting operation system
later, these operation system problems cause chain reaction and data might not be
accessible any more.
o Sudden changes in voltage may damage many different computer parts.
Most problems can be solved by changing power supply unit but there are also a
great possibility for damaging other hardware elements of computer, e.g. hard
drives and other parts which are very sensitive to changes in voltage and strong
magnetic fields.
o Having automatic backups enables to recover from any accidents caused by power
failures.
87
Theft of computer
o It is a real tragedy to lose both computer and data at the same time.
o There is always the danger of burglars breaking the offices and stealing electronic
devices.
o While traveling passengers leave the laptop in a bus/car, airport, conference centers,
coffee shops or any other crowded place.
o New computers cost some money, but very often the data saved to hard disks is even
more expensive.
o Even if there is no particular monetary value involved, personal memories, family
pictures or other heirlooms are certainly important and very valuable to any person
who use computer.
o Losing computer may be less painful, if a computer user use proper data backup
strategy and keep data in safe storage.
Spilling coffee, and other water damages
o Since laptop usage has been growing during past few years, the damages caused by
spilling drinks on to the computers have become more often as well.
o Average laptop does not have extra covers to protect internal parts from getting
soaked.
o Liquids cause short circuit of important electronic components and they are really
hard to recover afterwards.
o Hard drives are usually placed in protective case and may be still used after getting a
little wet.
o However, harder soaking makes hard drives inaccessible.
o Another risk of the same category is dropping computer into water.
o If the computer is completely immersed into water, it is really hard to fix anything
afterwards.
o Maybe visiting a repairman really quickly can save some parts of the computer
appliances otherwise it will be a useless computer.
o Also, if computer was not switched on at the moment of falling into water, the
damage may be less severe.
o Water accidents usually cause the loss of data saved to the hard drive.
88
o The safest practice against fire is to make regular backups and keep them in other
(different) locations.
A virus refers to a man-made computer program or code that is loaded onto a user's
computer without their knowledge and run without the user's approval.
A computer virus attaches itself to a program or file enabling it to spread from one
computer to another, leaving infections as it travels.
Like a human virus, a computer virus can range in severity: some may cause only
mildly annoying effects while others can damage the computer hardware, software and
files.
Almost all viruses are attached to an executable file, which means the virus may exist
on the computer but it actually cannot infect the computer unless the user run or open
the malicious program.
It is important to note that a virus cannot be spread without a human action, such as
running an infected program to keep it going.
Because a virus is spread by human action, people will unknowingly continue the
spread of a computer virus by sharing infecting files or sending emails with viruses
as attachments in the email.
NOTE: Virus attaches to an executable file that requires human action to spread.
89
Worm
A worm is similar to a virus by design and is considered to be a sub-class of a virus.
Worms spread from computer to computer, but unlike a virus, it has the capability to
travel without any human action.
A worm takes advantage of file or information transport features in the system, which is
what allows it to travel unaided.
The biggest danger with a worm is its capability to replicate itself in the system, rather
than the computer to send out a single worm, it could send out hundreds or thousands of
copies of itself, creating a huge devastating effect.
One example is a worm sends a copy of itself to everyone listed in the sent e-mail
address book.
o Then, the worm replicates and sends itself out to everyone listed in each of the
receiver's address book, and the manifest continues on down the line.
o Due to the copying nature of a worm and its capability to travel across networks the
end result in most cases is that the worm consumes too much system memory and
network bandwidth, causing Web servers, network servers and individual computers
to stop responding.
o In recent worm attacks such as Blaster Worm, the worm has been designed to tunnel
into the computer system and allow malicious users to control the computer
remotely.
NOTE: Worm can replicate itself on system and does not require human action to
spread.
Trojan horse
A Trojan Horse is full of as much trickery as the mythological Trojan Horse it was
named after.
The Trojan Horse, at first glance will appear to be useful software but will actually do
damage once installed or run in the computer.
Those on the receiving end of a Trojan Horse are usually tricked into opening them
because they appear to be receiving legitimate software or files from a legitimate
source.
When a Trojan is activated in the computer, the results can vary.
Some Trojans are designed to be more annoying than malicious, like changing
the desktop, adding silly active desktop icons or they can cause serious damage by
deleting files and destroying information in the system.
90
Trojans are also known to create a backdoor in the computer that gives malicious users
access to the system, possibly allowing confidential or personal information to be
compromised.
Unlike viruses and worms, Trojans do not reproduce by infecting other files; they self-
replicate.
NOTE: Trojan Horse appears useful but damages system, and it requires human action
to run, but do not self-replicate.
Blended Threat
Added into the mix, we also have what is called a blended threat.
A blended threat is a more sophisticated attack that bundles some of the worst aspects
of viruses, worms, Trojan horses and malicious code into one single threat.
Blended threats can use server and Internet vulnerabilities to initiate, then transmit and
also spread an attack.
91
STEP 7: Importance of Computer Antiviruses (15 Minutes)
Antivirus Software
Antivirus Software is data security utility which is installed in a computer system/PC
with a purpose of protection from viruses, spyware, malware, rootkits, Trojans, phishing
attacks, spam attack and other online cyber threats.
Antivirus software is the "policeman" at the gate of a computer system.
It protects the computer from incoming threats and seeks out, destroys and warns of
possible threats to the system.
New viruses are coming out all the time; it is the job of the antivirus software to keep
up with the latest threats.
This is achieved by daily updates of the antivirus database definitions, which counteract
the latest threats to provide constant protection.
Two-Way Firewall
92
o Antivirus Software provides two-way firewall protection which puts a check in
every incoming and outgoing data/mail through the internet and blocks the same if it
finds something suspicious during transmission.
93
Figure 10: Google Search
With the Google’s Chrome browser, type the search content right into the same box
Enter search term in the omnibox, for example a ―car‖.
Using a toolbar, as you type, you may see words begin to appear below the toolbar’s
search box.
These are suggestions that Google thinks may match what you’re interested in.
Google calls this ―Google Suggest‖ or ―Autocomplete.‖
94
You can ignore the suggestions, but if one seems useful, select it to save some typing.
95
Figure 13: Search results
Click on this, and you’ll make a preview of the page for that listing appear:
96
Step 6: Refine the Google Search
Google doesn’t know exactly what you want, when you enter a search, so the results
you get are its best guess.
There are ways you can help it make better guesses.
For one, Google provides a variety of ways to refine your searches, to narrow them
down.
For examples: search for DVD players:
97
STEP 11: Take HomeAssignment (05 minutes)
Activity: Take Home Assignment
ALLOW group to work for three days and submit the task after scheduled time.
CONDUCT general discussion by asking groups to present one of these questions for not
less than 5 minutes.
98
References
Embrey, M. A. (2013). MDS-3: Managing access to medicines and health technologies.
Sterling, VA: Kumarian Press.
Couglas J.D. (2003). The Backup Book: Disaster Recovery from Desktop Data Center.
3rd Ed. Network Frontiers, LLC. US.
Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
Publisher. USA.
Miller M. (2009). The Complete Idiot`s Guide to Search Engine Optimization. Alpha
Books Publisher. US.
99
Session 8: Utilization of Computer Packages in
Ordering, Invoicing, Dispensing, Selling and Inventory
Management
Total Session Time: 120 minutes
Prerequisites
None
Learning Tasks
By the end of this session, students are expected to be able to:
List common inventory management applications
Demonstrate procedures for electronic ordering
Demonstrate procedures for electronic invoicing
Demonstrate procedures for electronic dispensing
Demonstrate procedures for electronic selling
Carry out inventory management functions using computer (PRACTICAL)
Resources Needed
Flipcharts, marker pens, masking tape
Black/whiteboard and chalk/white board marker
Computer and LCD projector
100
SESSION OVERVIEW
Step Time Activity/Method Steps Title
101
SESSION CONTENTS
102
o Zoho Inventory
Popular inventory management solution for small and large companies, used to
automate their order and inventory management, and to keep track of delivery in
order to make smarter business decisions. It also includes a powerful analytic and
reporting kit, and out-of-the-box features such as inventory replenishment for
avoiding stock-outs.
o Cin7
A complete, automated point-of-sales package and inventory management suite
created to cater to the needs different business sizes and industries. Completely
cloud-based, this platform offers top-of-the-line features that let you sell and
distribute your products more quickly and efficiently.
o TradeGecko
A top-listed inventory specialists’ choice for cloud based and automated delivery
of asset management services. Ideal for multi-channel and multiregional
wholesalers and distributors who find it handy to manage sales, supply chains,
and customer relationships from a single location.
o Brightpearl
Another recommended multi-channel retail management system that is a solid
TradeGecko alternative and helps businesses handle orders, inventory, customer
data, accounting and reporting. It offers an advanced sales management kit, and
integrates with all popular marketplaces and payment gateways.
o SellerCloud
An eCommerce and inventory management solution used to manage the full
scope of multi-channel selling. From inventory and warehouse management,
publishing listing to marketplaces, to order processing and shipping, as well as
accounting integration, this Zoho Inventory alternative does all the work needed.
o Logiwa
A cloud-based warehouse management software that caters specifically to small
and medium-sized businesses in the retail and e-commerce industries, giving them
a user-friendly platform that comes with all the core capabilities and features to
address their complex needs and requirements.
103
STEP 4: Demonstrate Procedures for Electronic Ordering and
Invoicing (30minutes)
104
o Click on product group button, select product group and click search. Select your
product then click ok.
o Click save option or submit option.
o Click on approve for order and for confirmation order will go to a new status.
Electronic Invoicing
e-Invoicing
o This is an act of electronically exchanging of the invoice document between
supplier and a buyer in an integrated electronic format.
Electronic Dispensing
o A good example is that of an Electronic Dispensing Tool (EDL) for which is a
software program that helps pharmacy staff efficiently manage both patients and
their antiretroviral.
o it contains fields in which you fill relevant data that is used to monitor patient
adherence, trace dispensing history, show therapy regimen and status changes also
appointment keeping, inventory management, and early indicators of HIV
medicine resistance to antiretroviral.
o After a patient is identified it takes less time to attend to them.
Electronic Selling
o Also referred to as e-commerce is the buying and selling of goods and services
over an electronic network, primarily the internet.
o Types of transactions that occur
Business to business (B2B)
Consumer to consumer (C2C)
Business to Consumer (B2C)
Consumer to Business (C2B)
105
STEP 6: Key Points (5 minutes)
Computer application software’s are employed to conduct various activities that are
carried out in a pharmaceutical environment.
Activities like ordering, selling, sending invoice, dispensing as well as making
payments can be achieved through the use of search software.
Examples of software’s/applications that can be used in ordering, selling, sending
invoice and dispensing are (e-LMIS, Logiwa, Seller Cloud and TradeGecko.
ALLOW group to work for three days and submit the task after scheduled time.
CONDUCT general discussion by asking groups to present one of these questions for not
less than 5 minutes.
106
References
United Republic of Tanzania Ministry of Health and Social Welfare, Strategy for
Development and Implementation of an Integrated Logistics System for Essential
Health Commodities: Government printers, Dar es Salaam
GNU. (2016). DHIS 2 User Manual. DHIS2 Documentation Team. Free Software
Foundation. Available at: www.gnu.org . accessed : 11.09.2018
MOHCDGEC. (2016). National Guideline for Health Data Quality Assessment. Dar es
salaam. Tanzania
107
Session 9: Components of Health Management
Information System
Total Session Time: 120 minutes
Prerequisites
None
Learning Tasks
Resources Needed
Flipcharts, marker pens, masking tape
Black/whiteboard and chalk/white board markers
Computer and LCD projector
SESSION OVERVIEW
Step Time Activity/Method Steps Title
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7 05 minutes Presentation Evaluation
SESSION CONTENT
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o Health determinants: socioeconomic factors, environmental factors, behavioral
factors, genetic factors and the contextual environments within which the health
system operates.
o Inputs to the health system and related processes: policy and organization,
health infrastructure, facilities and equipment, costs, human and financial
resources and health information systems.
o The performance or outputs of the health system: availability, accessibility,
quality and use of health information and services, responsiveness of the system to
user needs, and financial risk protection.
o Health outcomes: mortality, morbidity, disease outbreaks, health status, disability
and wellbeing.
o Health inequities: determinants, coverage of use of services, and health outcomes,
and including key stratifies such as sex, socioeconomic status, ethnic group and
geographical location.
A good health information system brings together all relevant partners to ensure that
users of health information have access to reliable, authoritative, usable,
understandable and comparative data.
There is clear value in defining what constitutes a health information system and how
its components interact with one another to produce better information for better
decisions and better health.
HMIS is build-up with six components and these components are further grouped into
three elements which are: inputs, processes, and outputs.
Inputs refer to resources.
Processes touch on how indicators and data sources are selected and data are collected
and managed.
Outputs deal with the production, dissemination, and use of information.
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o Indicators. A core set of indicators and related targets for the three domains of
health information is the basis for a plan and strategy for a health information
system.
Indicators need to encompass determinants of health; health system inputs,
outputs, and outcomes; and health status.
Planning
o In order to utilize limited resources adequately one needs to plan.
o How can one know that project A needs more funding than project B, it is only
through an adequate health information system that can be able to determine this.
o Allocation of human and non-human resources in health sector needs data.
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o Formulation of health policies in health sector needs accurate and adequate data
from health facilities and communities.
Coordinating
o In order to coordinate activities carried out by various national health programmes
and Non-Governmental organization, there is a need of having a Health
Information System.
o Through HIS, the Ministry of health can be able to determine if the programmes
and Non- Governmental Organization `s are performing their roles as expected.
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What is Health Information Management (HIM)?
What is a Health Management Information System (HMIS)
ALLOW group to work for two days and submit the task after scheduled
time.
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References
Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
Publisher. USA.
Wager A.K. (2013). Health Care Information Systems: A Practical Approach for Health
Care Management. 3rd Ed. Wiley Brand Publishers, US.
WHO. (2008). Assessing the National Health Information System: An Assessment tool-
Vesrion 4.00. Switzerland.
Winter A. (2011). Health Information Systems. Springer Publisher. New York City.
Wodon A. (2011). Health Information System. 2nd Ed. Editions L`Harmattan Publisher.
Paris, France.
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Session 10: Utilization of HMIS (MTUHA) Database in
Capturing and Managing Pharmaceutical Data
Total Session Time: 120 minutes
Prerequisites
None
Learning Tasks
By the end of this session, students are expected to be able to:
Define HMIS/MTUHA Database
List commonly used HMIS/MTUHA tools
Capture and process data using (HMIS) MTUHA database software (PRACTICAL)-
DHIS 2 Software
Generate reports from HMIS/MTUHA database (PRACTICAL)- DHIS 2 Software
Resources Needed
Flipcharts, marker pens, masking tape
Black/whiteboard and chalk/white board markers
Online DHIS2
HMIS Registers
SESSION OVERVIEW
Step Time Activity/Method Steps Title
Brainstorm
2 05 minutes Definition of HMIS (MTUHA)
Presentation
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7 05 minutes Presentation Evaluation
SESSION CONTENT
STEP 1: Presentation of Session Title and Learning Tasks (5
minutes)
HMIS Database is a system designed to collect facility based health and health related
data, compile, store and retrieve for data analysis to produce report which in turn
inform service providers, health managers, decision markers/policy makers and the
public to make informed decision on health planning, monitoring and evaluation and
provision of services at all levels of health care delivery.
HMIS in Swahili is called MTUHA which stands for ―Mfumo wa Taarifa za
Uendeshaji wa Huduma za Afya‖.
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o Monthly report forms
HMIS Guideline
o This is Book No. 1. It is used as an instruction manual and reference to other
books/registers, i.e., Books No. 2–16.
o Each facility should have at least one copy.
o The HMIS Programme will ascertain that each division in each health service
delivery facility obtains at least one copy.
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HMIS/MTUHA Departmental registers used to collect data at hospital level:
o Laboratory register
o Physiotherapy register
o Mortuary register
Currently HMIS/MTUHA has added other registers which are yet to be numbered,
these are:
o Malaria laboratory investigation register
o Dispensing register
o Monthly Tracer medicine register
o Death notification form/register
DHIS 2 Software
DHIS2 provides a powerful set of tools for data collection, validation, reporting and
analysis, but the contents of the database.
o For example:-
What to collect,
Who should collect it
On what format; it depends on the context of use
The Tanzania HMIS/MTUHA database software is called DHIS 2
DHIS 2 is platform independent
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DHIS 2 can run on both on-line (with the internet) and offline (without the internet)
modes.
Input: DHIS provides user-friendly interface to enter data. Data entry forms mimic
the paper tools.
Processes: DHIS automatically computes sums, indicators and checks validity of the
data.
Output: Provide different tools for reporting – both for routine reports and analysis,
also user can create and save their reports
Accessing DHIS 2 Software for data entry process
Each user need the following to access DHIS2
o Device e.g. laptop
o Internet access
o Internet browser e.g. Google chrome, Firefox
o URL: https://dhis.moh.go.tz/
o DHIS2 account (username and password)
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Figure 12: Application Navigation Menu
Navigations
There are two types of Application Menu
National TB and Leprosy Control Program (NTLP) forms integrated into DHIS 2
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Quarterly Summary Forms
o LEP 07 Case Notification Report
o LEP 09 Results of Treatment
o TB 07 Case Notification Report
o TB 09 Results of Treatment
Annual Summary Forms
o LEP 10 Report on Presentation of Disabilities
DHIS 2 Applications
Aggregate Data Entry
Events Capture Data Entry
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Reports
Data Visualizer
GIS / Maps
Pivot Tables
Messaging & Interpretation
Administrative Features
o Organization unit management
o Data element & Indicator Management
o Dataset Management
o Users and Roles Management
o Data administration
o Settings
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Figure 15: Logging Out
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Figure 16: Ministry of Health Organization Units
Organization units DHIS 2 Data Access
MoHSW
Region 1 Region 2
Dispensary
Facility 1 Hospital1 Facility 2
1
Data elements
Explains what we collect and analyse
o For example, "Malaria new cases", "Total Population", "1st ANC visits",
"Measles doses given―; Idadi ya Wajawazito Waliotegemewa wa umri chini ya
miaka 20 (ANC form)
Sometimes referred to as Indicators in other contexts
o In DHIS 2 data elements and indicators are not the same
It describes the raw data, e.g. the counts and not the coverage
It can be further disaggregated using categories, e.g. "Measles doses given" + <1y /
>1y.
Routine Data Element: is data that is collected at regular intervals through
mechanisms designed to meet predictable information needs: Such as Total OPD
cases / total delivery in a month.
Semi-permanent Data Element: is data that changes at after relatively longer
intervals of time (say annually) as compared with routine health data. For example,
data on population in a district.
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For example, "Malaria new cases" + <5y + Male
o A data element can be linked to one category combination
o A data value is linked to a category option combination
Data
element
group
Data
element
Figure 18: The link between DHIS 2 Data element and Data collection form
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DHIS 2 Data Set
Data set is a collection of data elements into a logical data collection tool
In DHIS2 it acts as a transformation of the paper based forms into digital forms
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Select ―WHERE‖ organization unit
Select form (data set) to fill data
Reports
o Data set report: summaries of data entered for the given form/data set and
selected period
o Apps > Reports > data set report > Data set > Define organization unit (where) >
Define period (when)
o Reporting rate summary: summaries of number of forms submitted and count
of ones submitted on time for each data set
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Figure 20: Period Selection
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Examples of Indicators
Birth by skilled attendant
o Type: Percentage (factor=100)
o Numerator: ―Skilled birth attendants‖
o Denominator: ‖Total Deliveries‖
Measles coverage under 1 year
o Type: Percentage (factor=100)
o Numerator: ―Measles doses given <1 year‖
o Denominator: ‖Population <1 year‖25/11/2014
ALLOW group to work for three days and submit the task after scheduled
time.
129
SUMMARIZE the activity using training guidelines.
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References
Embrey, M. A. (2013). MDS-3: Managing access to medicines and health technologies.
Sterling, VA: Kumarian Press.
Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
Publisher. USA.
GNU. (2016). DHIS 2 User Manual. DHIS2 Documentation Team. Free Software
Foundation. Available at: www.gnu.org . accessed : 11.09.2018
MoHCDGEC. (2016). National Guideline for Health Data Quality Assessment. Dar es
salaam. Tanzania
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Session 11: Analysis of Data Using HMIS/MTUHA
Database (PRACTICAL)
Total Session Time: 120 minutes
Prerequisites
None
Learning Tasks
By the end of this session, students are expected to be able to:
Establish trends of pharmaceutical services from HMIS/MTUHA database
Identify pharmaceutical services problems from analysed data
Prepare reports
Resources Needed
Flipcharts, marker pens, masking tape
Black/whiteboard and chalk/white board markers
Computer and LCD projector
Online DHIS2
HMIS Registers
SESSION OVERVIEW
Step Time Activity/Method Steps Title
Prepare Reports
4 50 minutes Presentation
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SESSION CONTENT
LMIS
A LMIS is a system that is used to collect, organizes, and present logistics data
gathered from all levels of the health system.
An LMIS enables logisticians to collect the data needed to make informed
decisions that will ultimately improve product availability and patient
treatment.
One immediate decision that is made based on logistics data is the quantities of
products that should be resupplied to health facilities.
An LMIS provides data needed to operate a supply chain.
o It collects data about health products such as quantities consumed, stock on
hand, losses and adjustment.
o It collects data from stores, dispensing records area.
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Features and functionality of LMIS in relation to pharmaceutical services
Requisitions and Ordering
o Create, authorize, approve report and requisitions, both regular, based on
configured processing periods, and emergency.
o Supports offline data capture on key screens.
o Executes complex and configurable approval hierarchies.
o Calculates order amounts based on average consumption and max policies.
o Complex data validations to support quality data capture.
o Generate orders for external fulfillment based on approved requisitions.
Stock Management
o Record transactions and view electronic stock cards (supports lot info)
o Perform physical inventory & adjustments
o Track ins/outs of stock – send and receive stock
DHIS 2
it is used for Capturing, managing, and analysing of data
Highly flexible and configurable platform with a wide variety of use cases
Free and open source software
Extensible through Web APIs and other applications
DHIS 2 Features
GIS
Pivot tables
Charts
Routine data
Events
Tracking
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Linking HMIS and LMIS in Tanzania
HMIS LMIS
System used DHIS 2 eLMIS
Data collected Services (Patient, Product used for that
cases) service
Where data comes Services records Stores and dispensing
from records area
Frequency of data Monthly Quarterly
reporting from
facilities
Who enters data District HMIS focal District pharmacist
electronically in the person
system
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STEP 4: Prepare Reports (50minutes)
LMIS data compared with service data in HMIS, the sample dashboard graph
with sample data
National level dashboard
o Consumption data has been pulled into DHIS2 and dashboards developed
to compare cases of PPH and retained placenta and consumption of
oxytocin, ergometrine, and misoprostal.
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STEP 5: Key Points (05 minutes)
To understand trends that occurs during data collection.
Analyse data for interpretation.
Generate reports from analysed data.
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References
GNU. (2016). DHIS 2 User Manual. DHIS2 Documentation Team. Free Software
Foundation. Available at: www.gnu.org . accessed : 11.09.2018
MOHCDGEC. (2016). National Guideline for Health Data Quality Assessment. Dar es
salaam. Tanzania
Couglas J.D. (2003). The Backup Book: Disaster Recovery from Desktop Data Center.
3rd Ed. Network Frontiers, LLC. US.
Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
Publisher. USA.
138
Session 12: Management of Pharmaceutical
Information in Vertical Program
Prerequisites
None
Learning Tasks
By the end of this session, students are expected to be able to:
Define the term vertical programme
Mention vertical programme existing in the country
Explain the importance of pharmaceutical information management in vertical
programmes
Resources Needed
Flipcharts, marker pens, masking tape
Black/whiteboard and chalk/white board markers
Computer and LCD Projector
SESSION OVERVIEW
Step Time Activity/Method Steps Title
139
SESSION CONTENT
Vertical programme
A vertical programme is a programme which targets one particular disease.
A vertical program might focus on malaria from the bottom where members of
community leave and go on up to the level where planners, evaluators and decision
makers making decision of a particular case.
Vertical programme deals with removing the places where mosquitoes breed,
protecting the houses where the people live, educating people about how to avoid
malaria, establishing clinics where malaria can be diagnosed and treated, and finally,
finding medications to cure the disease, and so on.
It is one system all focused on the same disease.
It's vertical because it goes from the ground; where people who have the disease leave,
up to the level where the doctors and scientists try to develop new cures.
A horizontal program might focus on all tropical diseases, or in fact all diseases.
A horizontal approach might consist of equipping a clinic to treat every kind of disease
and health problem in the region.
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STEP 3: The Vertical Programmes Existing in the Country (10
Minutes)
Tanzania vertical health programmes:
Reproductive Health Program
National Aids Control Program
National Immunization Program
National TB / Leprosy Program
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o Increased funding for HIV/AIDS, tuberculosis, and immunization programs has
contributed to the need for accurate and timely information on a variety of
parameters that affect the ability to conduct accurate quantification, procurement
planning, budgeting, resource mobilization and program management.
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References
Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
Publisher. USA.
143
Session 13: Networking Programmes in Dissemination
of Pharmaceutical Information
Total Session Time: 60 minutes
Prerequisites
None
Learning Tasks
By the end of this session, students are expected to be able to:
Explain the importance of networking in dissemination of pharmaceutical information
Explain the networking programmes used in dissemination of pharmaceutical
information
Disseminate pharmaceutical information (PRACTICAL)
Resources Needed
Flipcharts, marker pens, masking tape
Black/whiteboard and chalk/white board markers
Computer and LCD projector
SESSION OVERVIEW
Step Time Activity/Method Steps Title
144
SESSION CONTENT
STEP 1: Presentation of Session Title and Learning Tasks (5
minutes)
Networking
A network, in computing, is a group of two or more devices that can communicate.
A network is comprised of a number of different computer systems connected by
physical and/or wireless connections.
The scale can range from a single PC sharing out basic peripherals to massive data
centers located around the World, to the Internet itself.
All networks allow computers and/or individuals to share information and resources.
Computer networks serve a number of purposes, some of which include:
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The following are the benefits of pharmaceutical networking technology in healthcare
industry:
o It improves the pharmacists work, especially in acquisition of consumable and non-
consumable medical materials, deliveries of pharmaceutical materials, stock and
inventory control.
o It gives them more time to help the customers in the service area.
o It reduces client waiting time, pharmaceutical expenditure and the manpower
requirement for any kind of pharmaceutical work.
o It facilitates sharing of information with other service area within the health facility
Networking computers helps to run business operations efficiently
o They make it easier to handle the business tasks such as recording drugs, requesting
consumable and non-consumable medical items, tracking and paying drugs and
medication bills from insurance company, client/patients and other service user.
o It helps to improve patient safety, provide quality of care, monitoring efficacy and
safety of medicine in use.
o It gives updates of prices and other pharmaceutical product information online.
o It is used in online and e-prescribing of medication.
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The encrypted connection helps ensure that sensitive data is safely transmitted.
It prevents unauthorized people from eavesdropping on the traffic and allows
the user to conduct work remotely.
Health Level Seven (HL7) allows computer systems to send and receive
pharmaceutical information to each other in secure way.
o Pharmacies, physician office, health care sites and facilities can exchange
pharmaceutical information through this information exchange standards.
The following are Health information systems (HIS) used to disseminating/ sharing
pharmaceutical information through networking system:
o Pharmacy information system
o Computerized Physician Order Entry (CPOE) system
Pharmacy information system (PIS)
o The PIS is system that supports the distribution and management of drugs,
identifying the type of intervention, determining the amount of inventory,
reporting and managing of costs, and improving the accessibility of information.
o The PIS helps clinical decision-making by alerting users about clinically
important drug-drug interactions, drug allergies, and drug doses; it also evaluates
patterns of drug use as well as other possible side effects of drugs.
o The PIS may operate as a separate and individual system or as part of a hospital
information system (HIS), paired with the Computerized Physician Order Entry
(CPOE) system.
Computer physician order entry (CPOE) system
o CPOE is the process of a medical professional entering medication orders or
other physician instructions electronically instead of on paper charts.
o A primary benefit of CPOE is that it can help reduce errors related to poor
handwriting or transcription of medication orders.
o CPOE systems allow providers electronically to specify medication orders as well
as laboratory, admission, radiology, referral, and procedure orders.
o CPOE systems and Clinical Decision Support (CDS) system can improve
medication safety and quality of care and reduce costs of care.
HL 7 and system interoperability facilitates data sharing/ dissemination from
pharmacies, physician office, health facilities to users which is the ministry of health.
The system that is used to disseminate pharmaceutical information to ministry of
health is DHIS 2 Software.
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STEP 4: Key Points (5 minutes)
Networking software helps in sharing pharmaceutical information within and outside
of the hospital setup.
PIS and CPOE systems are pharmaceutical systems used to sharing information.
HL 7 and interoperability facilitates data sharing from the source to users through
networking system.
ALLOW group to work for t 1 day and submit the task after scheduled
time.
CONDUCT each group to present how they handled the activity for not
less than 5 minutes.
148
References
MoHSW, Strengthening Health Information System, Government printers, Dar es
Salaam
Couglas J.D. (2003). The Backup Book: Disaster Recovery from Desktop Data Center.
3rd Ed. Network Frontiers, LLC. US.
Davis A. (2014). Health Information Technology. 3rd Ed. Elsevier Health Science
Publisher. USA.
Miller M. (2009). The Complete Idiot`s Guide to Search Engine Optimization. Alpha
Books Publisher. US.
Dixon E. Brian, Zafar A. (2009). Inpatient Computerized Provider Order Entry (CPOE).
ARRQ National Resources Center for Health Information Technology. USA
Wager K.A, Lee F.W, Glaser J. P. (2009). Managing health care information systems: a
practical approach for health care executives. 2nd ed. San Francisco (CA): Jossey-
Bass.
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