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Part I: Policy and economic issues Part II: Pharmaceutical management Part III: Management support systems
Planning and administration
Organization and management
Information management
48 Monitoring and evaluation
49 Pharmaceutical management information systems
50 Computers in pharmaceutical management
Human resources management
chapter 49
Pharmaceutical management information systems
Summary 49.2 illustrations
49.1 Importance of a pharmaceutical management Figure 49-1 The information systems pyramid 49.4
information system 49.2 Figure 49-2 Flow of documents in a basic supply system
Definition of a pharmaceutical management information PMIS 49.8
system • Functions of a pharmaceutical management Figure 49-3 PMIS information stages 49.15
information system • Data and information • Figure 49-4 Graph styles 49.16
The information systems pyramid Table 49-1 Information users and information needs 49.5
49.2 Meeting the information needs of users with different Table 49-2 Forms and records for a basic supply system
requirements 49.5 PMIS 49.9
49.3 Typical components of a pharmaceutical Table 49-3 Proposed PMIS indicators for building a
management information system 49.5 pharmaceutical supply system in Namibia: rational
use of medicines and quality of care 49.11
Record-keeping documents • Data compilation/aggregation Table 49-4 Improving recording and reporting
tools • Data-reporting forms • Feedback reports accuracy 49.12
49.4 Steps in designing or revising a pharmaceutical boxes
management information system 49.7 Box 49-1 Steps in designing or revising a PMIS 49.10
49.5 Key issues in designing or revising a pharmaceutical Box 49-2 Job description for a pharmaceutical management
management information system 49.10 information officer in Kenya 49.14
49.6 Implementing a pharmaceutical management Box 49-3 Example of information interpretation and
information system 49.13 use 49.17
49.7 From information to action 49.15 country studies
Processing data • Presenting information • Interpreting CS 49-1 Using the Electronic Dispensing Tool to manage
information • Taking action pharmaceutical information at different levels of the
References and further readings 49.17 health care system 49.6
Assessment guide 49.19 CS 49-2 Building a data management information system for
MDR-TB surveillance in Brazil 49.13
annex
Annex 49-1 Sample annual EMP status report 49.20
copyright © management sciences for health 2012
49.2 INFoRMATIoN MANAGEMENT
suMMary
The planning process for a new or revised pharmaceu- other issues to consider include—
tical supply system should include a pharmaceutical • Selection of indicators to monitor system perfor-
management information system (PMIS). The PMIS is mance and intended results (discussed in Chapter 48)
an organized system for collecting, processing, reporting, • Integration of the PMIS with other data collection
and using information for decision making. Information systems
for each subsystem is collected by means of— • Computerization at appropriate levels
• Record-keeping documents, a combination of regis- A successful PMIS requires effective use of the infor-
ters, ledgers, and filing systems that typically are not mation generated, which includes—
circulated
• Information reporting forms, such as periodic status • Efficient data processing to reduce large amounts of
reports, that transmit data to other departments or data to a manageable number of key indicators, often
levels for use in making management decisions in summary tables
• Feedback reports, also called analytical reports, that • Presentation of information in graphic form to sim-
are usually provided to the units that collected the plify interpretation
data • Interpretation of information to identify trends and
Design or revision of a PMIS should be based on the potential problems
differing information needs of users at each level of the • Appropriate use of technology (for example, e-mail,
system and should build on existing forms, reports, and websites) to present and share information with a
procedures as much as possible. Any forms should be wider audience in less time
designed through a participatory process and field-tested • Action in response to both positive and negative
with staff who will use them. results
• Effective mechanisms to provide and receive feed-
back
49.1 Importance of a pharmaceutical responsibility. They are unable to analyze and use many
management information system of these data for improved decision making. Many factors
affect the usability of these data, including data quality
A good PMIS provides the necessary information to make and quantity (for example, missing or incomplete data or
sound decisions in the pharmaceutical sector. Effective too much data to analyze effectively) or a manager’s lack
pharmaceutical management requires policy makers, pro- of analytical skill. Therefore, many managers find them-
gram managers, and health care providers to monitor selves making decisions based not on information but on
information related to patient adherence, drug resistance, intuition.
availability of medicines and laboratory supplies, patient This chapter focuses on the practical aspects of organiz-
safety, postmarket intelligence, product registration, prod- ing and managing a routine pharmaceutical management
uct quality, financing and program management, among information system. It should be read in conjunction with
other issues. Chapters 48 and 50. Chapter 48 puts information manage-
Coordinating the elements of a pharmaceutical supply ment into the broader context of monitoring and evaluating
system requires relevant, accurate, and timely informa- program performance against long-term goals and objec-
tion. Increased funding for HIV/AIDS, tuberculosis, and tives and against medium-term workplans and targets.
malaria programs has contributed to the need for accu- Chapter 50 presents a variety of tools for analyzing data pro-
rate and timely information on a variety of parameters duced by the PMIS.
that affect the ability to conduct accurate quantification,
procurement planning, budgeting, resource mobilization, Definition of a pharmaceutical management
and program management. In addition, multiple donors information system
require different data reports, complicating program man-
agement. Because a pharmaceutical supply system uses The PMIS integrates pharmaceutical data collection and
many forms and other documents, managers often feel the processing and presentation of information that helps
as if they are buried under mountains of data and that staff at all levels of a country’s health system make evidence-
filling in the forms and producing reports ends their based decisions to manage pharmaceutical services.
49 / Pharmaceutical management information systems 49.3
Incoming EMP
Reports Headquarters
We can’t use the data
because because
THE BAD DATA CYCLE
Return for Feedback Reports
Headquarters from Headquarters
Those who collect data
never see the results
The data are so bad
because
The features that distinguish a PMIS from a logistics man- sector, not just activities related to procurement and
agement information system include— inventory management
• The ability to triangulate consumption data with clini-
• The incorporation of patient-specific data in addition cal and patient-specific data
to product-centered data
• A focus on decision making for pharmaceutical ser- Functions of a pharmaceutical management
vices, not just resupply information system
• Information on outcomes related to medicine use,
such as adherence, adverse drug reactions, and An effective PMIS is able to synthesize the large volume of
pharmaco vigilance, that affect pharmaceutical policy data generated by pharmaceutical management operations.
and selection decisions, including individualized treat- It then processes the data into information for use in plan-
ment options ning activities, estimating demand, allocating resources, and
• overarching information about the pharmaceutical monitoring and evaluating pharmaceutical management
sector, such as a summary of available professionals/ operations. This information is often in the form of a few key
personnel, outlets, legislation status, and distribution indicators. Indicators should be targeted toward staff at all
of personnel and facilities levels so that they can monitor both their own performance
• Varied data sources from the whole pharmaceutical and that of the units for which they are responsible.
49.4 INFoRMATIoN MANAGEMENT
Another important function of a PMIS is to improve Figure 49-1 The information systems pyramid
accountability. Much of the recording and reporting in a
PMIS is intended to create an audit trail for products as they
enter or leave a pharmaceutical supply system.
Data and information
Periodic Queries Executive Strategic Planning
An understanding of the distinction between data and Level
information is necessary to appreciate how a management
information system functions. Data represent real-world
observations or measurements. Data, in and of themselves, Scheduled and Management Management
often have little value and take on meaning only after they On-Demand Information Systems Control
are processed into a more usable form. Information is a Reports
meaningful aggregation of data that can be interpreted for
a specific use. In other words, information is processed data Transaction Operational Systems Operational
that contains sufficient context to make it meaningful. The Data ➤ Selection ➤ Organization Control
tools in Chapter 40 are intended primarily to aggregate data ➤ Procurement ➤ Financial Management
into useful information. ➤ Distribution ➤ Information Management
For example, data from a health center reveal that 3,000 ➤ Use ➤ Personnel Management
co-trimoxazole tablets were distributed last month. Is this
consumption level abnormal? Without analysis, this ques-
tion would be difficult to answer. The data can be converted procurement, personnel, financial management, or stock
to information by comparing the 3,000 tablets distributed control (see the sample report format in Annex 49-1).
with the number distributed the previous month, say 1,000. Information provided by the MIS helps managers answer
This interpretation could then be expressed as a 300 percent questions such as the following—
increase in co-trimoxazole distribution. But information is
indicative, not prescriptive. The manager must analyze the • How do expenditures compare with the budget at a
complete context and make decisions. given level of operation?
In a PMIS, data are routinely collected on a common set of • How effective is the inventory control system in elimi-
indicators, usually expressed as proportions or rates. Some nating stockouts and cutting stock losses?
of these indicators measure performance toward objectives, • What is the delivery performance over the last period?
whereas others may measure process efficiency. • Are the trends generally favorable, or are indicators
worsening?
The information systems pyramid
Information at this level may demonstrate reduced accu-
Viewing information systems as a pyramid may be helpful racy because errors might be introduced during the consoli-
(Figure 49-1). At the base of the pyramid are operational dation of data, so a certain level of variation is normal.
systems. These include subsystems—procurement, distri- The highest level of the information systems pyramid is
bution, financial management, medicine use—that handle the executive level. At this level, the system further summa-
data at the transactional level. Every item that moves in and rizes management information for use in strategic planning
out of inventory must be tracked, and decisions must be and policy making. The executive level of the MIS typically
made about how much to supply to a health facility, when to generates program-wide information on how effective the
re order, and how much to bill. This level is characterized by organization is in accomplishing its mission. Systems at this
a high volume of data that must be recorded and processed, level track a limited number of indicators, less frequently.
usually daily and at the time of transaction. Data recording They provide users with the tools, such as total cost analysis
accuracy is very important at this level because every unit of and price comparison analysis (see Chapter 40), to perform
medicine matters. periodic queries on data at every information-system level,
The next level of the pyramid is formed by management either to investigate the causes of problems or to perform
information systems (MIS). These systems typically pro- “what if” analyses to test the effect of changes in strategy.
vide summaries of operational data on a periodic basis (for Some of the strategic questions that can be answered with
example, monthly or quarterly) to help managers of spe- executive-level information include the following—
cific departments monitor the performance of their units.
Annual reports often summarize information on key indi- • Should the transport and delivery function be con-
cators from many different operational subsystems, such as tracted out?
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