[lshifaa]

Definitely agree with Sam. That is the ideal approach to be followed but some times due to some political reasons or Health Ministries structural reasons the HIS architectural approach becomes difficult to maintain that is why we adopted Data Warehousing in our country for fragmented information systems which are out of our control. This Data Warehousing is one of types of information systems which are categorized based on Distributed Databases Criteria as follows:

1. Monolithic Information system : Fully integrated
2. Distributed Information System: Fully interoperable
3. Cooperative Information System and P2P Information System: Goes to Data Warehouse.

We in our country have three types of information systems such as {Distributed, Cooperative and P2P } that is why we adopted Data Warehousing.

Dr.Lutfullah Shifaa
MIS Manager
HMIS department
Afghanistan

[lshifaa]

We been able to maintain MFL for public sectors and we are working to manage a MFL for private sector too. Same as other countries in Afghanistan we have problems of donor driven system development and you know this kind of process generates fragmentation but in spit of the donors influences we could manage to have a MFL at least for public sectors.
The processes for HFs registration we maintain here in our country are as follow:
1. We developed standard registration form
2. Registration forms are being filled by implementer.
3. Registration forms are being approved by Provincial Health Office.
4. Approved registration forms then sends to HMIS department.
5. HMIS department recorded in MFL databases and give it a unique id.
6. Then implementer can access all information on a HF from MFL database.

We kept Unique ids for staff in health facilities for recording in HRMIS system too.

Maintaining unique ids for patients to be recorded in EMR requires governmental approach like Social Security Card ID and it goes beyond ministry of health . well, there can be some vertical approaches like

1.Giving unique ids for patients plus health registration card , but here is the problem we found in our country like patients don’t keep the IDs so one patient is being recorded many times overtime.

2. Search patients in EMR with FirstName, LastName or phone number, its works to some extent but still not a solid record keeping.
The main reason we have not been able to maintain a good EMR is we don’t have the required infrastructure in our country.

Dr.Lutfullah Shifaa
MIS Manager
HMIS department
Afghanistan

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