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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 ...

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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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...Part i policy and economic issues ii pharmaceutical management iii support systems planning administration organization information monitoring evaluation computers in human resources chapter summary illustrations importance of a figure the pyramid system flow documents basic supply definition pmis functions stages data graph styles table users needs meeting with different forms records for requirements typical components proposed indicators building namibia rational use medicines quality care record keeping compilation aggregation improving recording reporting tools feedback reports accuracy steps designing or revising boxes box key job description officer kenya implementing example interpretation from to action country studies processing presenting interpreting cs using electronic dispensing tool manage taking at levels references further readings health assessment guide mdr tb surveillance brazil annex sample annual emp status report copyright sciences process new revised pharmaceu o...

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