Table 4 Recommendations for designing and implementing the core components of a health information system during an emergency

Overall

Use the inputs and outputs from Table 2 as a framework to design the HIS

Create an overall plan of which system components will be needed, including priorities and thinking through contingencies

Incorporate feasible evaluations (e.g. user questionnaires, comparison of records) into system planning from start if possible

Create communication channels with other organizations to share HIS components throughout the emergency

Data collection tools

Investigate whether adaptable tools already exist through other organizations or in similar emergencies

Pre-plan as many tools (e.g. forms, databases) as possible, and treat them as a unit

Include error reduction techniques from the beginning (e.g. check digits)

Communication of data

Identify range of approaches that will allow data communication with speed, accuracy, and confidentiality

Test different methods early and make sure they are working for all relevant parties

Think unconventionally (e.g. plasticized paper) if needed

Coordination amongst relevant parties

Maintain communication between HIS and other relevant departments throughout the emergency

Try to hire staff in leadership roles who can stay involved for a long period to minimize turnover

Pre-plan handover strategies, including overlap timing between outgoing/incoming staff and written handover notes

Staff training

Create tools in advance that are easy-to-use and easily updated (e.g. simple PowerPoint slides) for training sessions

Allow time for staff to become familiar with the data collection tools

Ensure that training includes “do”s and “don’t”s for high-quality data collection based on tools in use

Develop a plan for training, including training schedules, frequency of refresher trainings, and easy accessibility to HIS staff outside of regular training

Make easy-to-access tools (e.g. laminated, annotated forms in the clinicians station) available in addition to training sessions

Ensure training is done in as many languages as necessary for staff to be fully trained

Data management

Make and use databases for data digitization as early as possible

Perform digitization in as close to real-time as possible

Hire staff according to planned double entry during digitization if possible

Ensure that all patient data are securely stored, and develop a plan in advance for what will happen to the patient records after the emergency ends

Data analysis/ reporting

Develop templates and analysis scripts for reports to internal and external actors

Ensure that one master database is used for analyses