National guidelines and standards for health facilities

The Integrated Health Facility Electronic Management System (iHFeMS) document describes minimum requirements, standards and guidelines for successful implementation and use of the iHFeMS in Tanzania private and public Health facilities. This guideline will address some of the key challenges experienced by health facilities implementing Health facility management systems and other related electronic systems that include a lack of proper governance, diverse scope of functionalities, and lack of standards hampering data exchange and information sharing.

The iHFeMS implementation guideline is applauded as a useful guide to the next steps for Tanzania in its eHealth journey. The document is easy to understand and therefore will help to lead Tanzania towards providing quality healthcare by making management of Health facility more efficient and more effective. 

The next figure illustrates the element of the guideline.

Guidelines

According to the guidelines the first step is to analyse health facility business processes, reengineering the processes.

Health facility business process reengineering involves critical analysis and redesign of workflows and work practices of existing business processes within the Health facility setting in order to maximize the value of the computerization process.

The following tasks are:

  • Functional requirements capture the intended behavior of the iHFeMS expressed as services, tasks or functions
    the system is required to perform.
  • Non-functional requirements: Non-functional requirements define the overall qualities or attributes of the resulting system that place restrictions or conditions on the system being developed, the development process, and specify external constraints that the system must meet. The non-functional requirements usually impact many parts of the system, and they may be related to one or many features e.g. how long can the system be down and how easy should it be to restart it, or if data becomes corrupt how does a user fix it and which users can do so. There are for example security requirements and system requirements.
  • General constraints and risks: Each requirement listed above pose a number of risk(s), which may cause minimal or big impact. This part addresses the risks that cannot be accepted and propose mitigation strategies. Risks can be for example in registration of illegal employee, privacy of alert information, security of the system and so for.
  • Standards and Information Exchange: It is required that the iHFeMS be able to share and exchange information with other systems in the health sector. This is important because of several reasons; increased efficiency through
    decreasing entry of duplicate data, decreased errors in medical information through the same mechanism, increased availability of health information promoting better decision making and improved continuity of patient care. The integration and information sharing between health systems requires systems to be interoperable. The interoperability is achieved through standardization process that requires the creation, acceptance and implementation of clinical data standards to ensure that data in one system are available and meaningful in another system
  • Infrastructure and Human resource requirements: Deployment and implementation of the iHFeMS requires adequate and reliable computing infrastructure and human resource necessary to provide both technical and manage the operation of the iHFeMS from inception to operations.
  • ImplementingMeeting the above-mentioned requirements alone does not guarantee successful implementation and use of the iHFeMS in a Health facility. It requires:
  • Planning: The implementation of the iHFeMS requires careful planning to ensure that the implementation proceeds in comprehensive, cost-effective and timely ways.
  • Deployment: Installation of Computing Infrastructure, Software Configuration and Installation, Technical documentation, Training, Trial-run/Deployment Approach, Trial-run to Production, Quality Assurance During iHFeMS Implementation
  • Maintenance and support: Maintenance and support of the iHFeMS operations is an essential ingredient in making its adoption successful and thus achieve the intended organizational goals. Maintenance aims at retaining the system in the working state; with support of the ICT Team to enable users achieve their objectives. Furthermore maintenance
    includes both preventive and incidental maintenance.
  • Monitoring and evaluation: Monitoring and evaluation is vital to ensure successful implementation and smooth operation of iHFeMS. As part of M & E, quality assurance exercise should run throughout the life cycle of the project especially during procurement of the iHFeMS and implementation process to ensure compliance with the national iHFeMS standards and guidelines. Furthermore, it is necessary to track and evaluate the implementation and functioning of the system in order to understand how well the implementation objectives have been met and the effect of iHFeMS in the day-to-day Health facility operations

·     The guidelines and standards are available on the
website of the Ministry of Health, Community development, Gender, Elderly and
Children:

·     The ministry Guidelines website: Guidelines (moh.go.tz)

National guidelines and standards for health facilities (2016): Guidelines_and_Standards_for_Integrated_Health_Facility_MoH

 

·     The ministry Strategic plans: Strategic Plans (moh.go.tz)