Case Study: Integrating HR Information Systems

Health care decision-makers need reliable, high-quality information in order to make effective, evidence-based decisions. This critical information includes reports and analyses of the current health workforce in the country. A human resources information system (HRIS) collects the human resources for health (HRH) data. The HRIS generates reports that display or aggregate the HRH data in various ways to aid analysis or to answer key HR policy and management questions.

Other types of health-related resources are also useful for aiding decision-making. Too often, though, these resources are scattered and difficult to access. The problem is aggravated when the resources are published by a variety of sources in many different formats, including paper and electronic files. Developing a knowledge management (KM) system provides a single point of access for these resources to be collected, organized and made easily searchable. When the KM system is made available online, remote offices are relieved of the burden of maintaining their own collection of resources. It is also important to ensure that health planners outside the central level have access to the collection so that their decision-making does not suffer by comparison.

Management of the KM system is an important consideration. Since it supports decision-making, the system must be updated regularly to provide accurate information and remove outdated or incorrect materials. Furthermore, a process should be put in place to evaluate the quality and applicability of resources. In the best case, inaccurate or unfounded reports are a nuisance and weaken trust in the reliability of the collection as a whole. In the worst case, poor information may be used to make inefficient, expensive or harmful health policy decisions.

Addressing Health Information Needs in Uganda

The Ministry of Health (MOH) identified several HRH and other health information needs within the country. Each of the four health professional councils in the country had implemented iHRIS Qualify to address the need for data about health worker education, registration and deployment. At the central and district levels, iHRIS Manage was installed to enable the MOH to better track job placement and vacancy information. These systems improved access to health worker information to better inform health policy and planning decisions in Uganda.

Despite the improved reporting, only those directly involved with the iHRIS software at the central level had access to the reports. Health decision-makers, both at the policy and provider level, needed these reports as well as additional information to make effective health decisions. The MOH had a simple digital library in place, but software limitations kept it from meeting the needs of the decision-makers. The software could only be used from a single desktop computer at the MOH Library, which was not connected to a network. The proprietary software only supported PDF-format documents, and storage space was limited to the desktop's hard drive. Finally, the system was vulnerable to any computer failures because there were no backups or dedicated maintenance.

Developing a Knowledge Management System

The Capacity Project's goal was to help the MOH develop an electronic KM system that would meet user needs. The system was called the Knowledge Management Portal, or KM Portal, since it would serve as a gateway to different types of HRH information.

The MOH wanted to design a KM system that would fulfill the following parameters:

  • Information must be easy to find, use and share
  • Information should be available over the Internet to encourage accessibility
  • Sensitive information should be limited to internal access by the MOH and should be secure
  • Information should be reviewed regularly to assure accuracy and quality.

The Capacity Project linked the following HR information resources to the KM Portal:

  • MOH Resource Center, including an new digital library system
  • HRH Global Resource Center, a digital library of HRH resources developed by the Capacity Project (www.hrhresourcecenter.org)
  • HRH Action Framework, an HRH planning aid (www.capacityproject.org/framework)
  • District websites with contacts for district personnel
  • Static versions of standard HRIS reports.

The MOH decided to use a combination of Open Source software programs to develop the KM Portal in order to customize the system to meet specific needs and to avoid costs associated with using proprietary software. The developers created a customized search tool for searching multiple sites linked to the Portal and standard user access levels in order to protect sensitive information. Along with developing the new KM system, the MOH librarians instituted a process for reviewing and updating the resources in the new digital library.

Uganda Knowledge Management Portal Home Page (screen shot)

Figure 1. The Knowledge Management Portal implemented in Uganda.

Interoperability: Making HRIS Reports Available on the KM Portal

The HR information systems implemented in Uganda's four health professional councils and at the Ministry of Health are valuable sources of information about health workers deployed throughout the country. Data and reports from these systems can be very useful for health planning at different levels. However, access to the HRIS is restricted for reasons of confidentiality. Although the HRIS software was designed to be straightforward and easy to use, the system does require some training to create and view reports.

In order to allow health planners at all levels to access the country-level HRIS reports while ensuring that access to the HRIS itself remained restricted, we developed a mini-database of the HRIS data. This database generates static reports that are updated monthly to ensure timeliness. We selected the reports based on their relevance and usefulness to health planners who would not typically have access to the full HRIS. This solution enabled health planners to quickly and easily obtain up-to-date information specific to the current Ugandan health workforce, without requiring training on the HRIS software or compromising the security of the country's HR data.

Conclusion

  • By leveraging several Open Source software projects, the Capacity Project was able to quickly develop and implement a KM system for the MOH in Uganda that provided access to a large collection of resources for health workers and decision-makers across the country. These resources included standard reports of health worker data drawn from the various HRIS installed in Uganda.
  • When the Capacity Project put this system in place and demonstrated its capabilities for the KM workers, their excitement was palpable. They recognized that the new system's ability to read and use a variety of document formats meant that much less time needed to be spent on manually converting files. That the KM server resided in the MOH's professional hosting facility instead of on a desktop computer in the library ensured that any technical issues could be dealt with immediately.
  • The Capacity Project technical staff observed the KM system being used and documents being added on a monthly basis through the end of 2008. The Open Source nature of the KM system and its new location in a hosted, networked environment increased the accessibility and reliability of the health care resource collection maintained by MOH Library.