Guides
Guides for health systems.
Research based guides for ministries of health, hospitals, laboratories, pharmacies and clinicians on choosing, implementing and running health information systems. Each guide is sourced, reviewed and kept current under Moana’s editorial standards.
Electronic health records
What an EHR is, how it differs from other systems, and how to choose and budget for one.
- What is an electronic health record (EHR)? A guide for health systemsA definition of the electronic health record, its core functions, the evidence on benefits, and what ministries and hospitals should expect from one.10 min read
- EHR vs EMR vs HIS vs HMIS: which system should a ministry procure?How EMRs, EHRs, hospital information systems and HMIS differ, how they fit in a national architecture, and which a ministry should procure first.9 min read
- How to choose an EHR for low and middle income countries: a scorecardTen selection criteria and a weighted scorecard for evaluating an EHR in low and middle income countries, drawn from WHO guidance and published evidence.10 min read
- Total cost of ownership of an EHR in low resource settingsA line by line guide to the five year cost of an EHR in low resource settings, from hardware and power to training, support and data quality.9 min read
- Master patient index and unique health identifiers: a guideHow patient matching, duplicate prevention and national health identifiers work, the standards involved, and what ministries should require of an EHR.9 min read
Hospital care
Running the hospital on one record, from the emergency department to the ward.
- Hospital information systems for public hospitals: a complete guideThe scope, architecture, evidence and procurement questions that matter when a public or provincial hospital replaces paper with a hospital information system.10 min read
- Digitising the emergency department: triage, registration and flowTriage scales, registration at the door, time stamps and crowding evidence: what an emergency department needs from a digital system in a public hospital.9 min read
- Bed management systems: occupancy, ward visibility and dischargeHow to measure bed occupancy correctly, why high occupancy harms patients, and how live ward visibility and early discharge planning improve patient flow.8 min read
- Maternal and newborn digital records: from labour ward to child healthHow a digital record links mother and baby at birth, supports birth notification, and follows the child through special care and immunisation.10 min read
- Clinical decision support and early warning scores in hospitalsWhat decision support and early warning scores can do in resource limited hospitals, what the evidence shows, and the safeguards for clinicians.10 min read
Laboratory, pharmacy and imaging
Diagnostics and medicines: quality, safety, supply and reporting.
- What a Laboratory Information System Should Do: A Buyer's GuideThe functions a laboratory information system must perform across the testing process, and a checklist for buyers aligned to ISO 15189.10 min read
- Critical Value Reporting in the Laboratory: Closing the LoopHow to define critical values, notify the right clinician within a set time, record read back and escalation, and measure the process.8 min read
- Laboratory Quality Control: Westgard Rules and Levey Jennings ChartsA practical explanation of Levey Jennings charts, the Westgard multirule, Sigma metrics, and how a laboratory information system enforces QC.8 min read
- Pharmacy Management Systems and Medication Safety in HospitalsThe evidence on preventable medication harm and the functions a hospital pharmacy system needs from prescribing to administration and recall.8 min read
- Medicine Supply Chain Visibility: From Warehouse to Health FacilityWhy medicines run out at facilities while stock sits in warehouses, what a logistics information system must record, and how ministries close the gap.10 min read
- PACS and Teleradiology for Hospitals Without a RadiologistWhat a PACS does, how DICOM and teleradiology let a hospital without a radiologist get studies reported, and what to measure and ask before buying.9 min read
National health systems
Surveillance, reporting and research built on routine care.
- Digital health infrastructure in Pacific Island countriesEHR coverage, connectivity, workforce and governance in Pacific Island countries, and the design choices that hold up across dispersed island health systems.9 min read
- Building a national health information system on routine careThe architecture, standards and sequencing for a national health information system in which the clinical record feeds every report and registry.9 min read
- Disease surveillance from the clinical record: IDSR and syndromicHow a ministry can drive IDSR, syndromic, case based and laboratory surveillance from coded clinical records, and meet IHR timeliness expectations.8 min read
- Traceable national health reporting: from encounters to HMISWhy tallied HMIS returns drift from the registers behind them, and how computed reporting from encounters makes every national figure traceable.8 min read
- Clinical trial recruitment from routine health recordsThe evidence on screening health records for trial eligibility, and the governance, consent and privacy controls that make it acceptable to ethics committees.8 min read
Standards, security and data
The standards that let systems exchange data, and the governance that keeps it safe.
- FHIR R4 explained for ministries of health: what to requireA briefing on HL7 FHIR R4 for national programmes: resources, profiles, SMART on FHIR, bulk export, and what to write into a tender.10 min read
- HL7 v2, FHIR, DICOM and IHE: which health standard does whatHow HL7 v2 messaging, FHIR APIs, DICOM imaging and IHE profiles divide the work of interoperability, with a worked radiology example.9 min read
- ICD 10, ICD 11, SNOMED CT and LOINC: roles and licensing explainedHow ICD, SNOMED CT and LOINC divide the work of coding a health record, what ICD 11 changes, and how each terminology is licensed.9 min read
- Health data sovereignty: who owns patient data and where it livesOwnership, custody, hosting and cross border transfer of health data, the state of national law, and the contract clauses that keep a ministry in control.9 min read
- Health data security and privacy: a guide for hospitals and ministriesAccess control, audit, break glass access, encryption, consent and two factor sign in, set against the evidence on ransomware attacks on hospitals.10 min read
Implementation
From workflow mapping to go live, training and scale.
- Designing health information systems for unreliable connectivityThe evidence on connectivity and power in health facilities, and the architecture that keeps clinical work safe when the network drops.10 min read
- Implementing an EHR in a hospital: from workflow mapping to go liveA phase by phase method for implementing an EHR in a public hospital, from governance and workflow mapping to go live and stabilisation.10 min read
- Training clinicians on a new EHR: a strategy for low resource settingsA practical training strategy for a new EHR where staff are scarce, built on role based training, super users and observed competency.9 min read
- Scalable health information systems for small island developing statesHow small island states can build one national health information system that scales from the referral hospital to the outer island clinic.9 min read
Looking for a definition? See the glossary of digital health terms.