CHAPTER ONE
1. INTRODUCTION
1.10 OPERATIONAL DEFINITIONS OF KEY TERMS
In this study the terms used are defined as follows:
1.10.1 Data
Duffy and Assad (1989:7) state "data are text, images and numbers in their raw form. Once processed and presented in aparticular situation, they may become information". In this study, the term data relates to the above definition, that is, data are facts; they are raw materials that can be used to create information.
1.10.2 Information
The term information and data are used interchangeably. TheOxford Advanced Learner's Dictionary(19S9:64)defines information as, "... facts, told, heard, or discovered (about somebody, something); give, pass on, receive, obtain, seek, find, collect, etc. information (on/about, somebody/something). TheAmerican Heritage College Dictionary(1993) defines information as "". a collection of facts or data: statistical information". Duffy and Assad (1989:7) state that"
information is data that has been processed and presented in such away that they are relevant in adecision-making situation".
From another perspective, Montviloff (1990:7) provides a more elaborate definition of information:
Information is some meaningful message transmitted from source to users. In this process information may be stored in information products and systems organized for the purpose of providing amemory in numerical, textual, sound and image forms. Information may also be communicated through interpersonal channels. The source may be documentary material, institutions or people.
The definition of Montviloff provides greater meaning for this study. However, in the present work, information refers to ideas, facts and data that have been processed, organised and disseminated to the potential user, for decision- making.
1.10.3 Knowledge
Hawes and Hawes (1982: 126) define knowledge as the aggregate of facts, information and principles that an individual has acquired through learning and experience; formal education seeks to raise the level of knowledge systematically.
Therefore, knowledge may be described as the know-how to perform certain tasks and functions.
Probst, Raub and Ramhardt (1998:24) provide a more detailed definition of knowledge, which has been adopted for this thesis:
Knowledge is the whole body of cognitions and skills which individuals use to solve problems.
It includes both theories and practical, everyday rules and instructions for action. Knowledge is based on data and information, but, unlike these, it is always bound to persons. It is constructed by individuals, and represents their beliefs about casual relationships.
Knowledge encompasses both tacit and explicit knowledge (Padley 1999). Tacit knowledge is developed and internalized by the knower over a long period of time and incorporates so much accrued and embedded learning that its rules may be impossible to separate from how an individual acts (Davenport and Prusak 1998). Explicit knowledge is codified and expressed as information in databases, books and policy manuals.
1.10.4 Information accessibility
The Harrods Librarian's Glossary (1995) defines the term access along three levels:
1. A devise or method whereby a document may be found 2. Permission and opportunity to use a document
3. The approach to any means of storing information, e.g. the index, bibliography, catalogue, computer terminal.
Saracevic and Wood (1981 :42), on the concept of accessibility of information, note that:
... in order to be used, information must be not only available some place or the other, it must be directly, intellectually and physically accessible to users as well. To make the available information also accessible, information systems must:
• Intellectually process such information, analyse, index, classify, organise...
• File, format, or package the information ...
• Disseminate the information: circulate, provide selective dissemination of information (SDI) services, answer questions, etc.
For the purpose of this study, information accessibility relates closely to all of the above points. That is, the extent to which health information is made available to the potential users; medical doctors and nurses, as well as the methods used to provide or disseminate health information.
1.10.5 Information availability
Culnan (1985), quoted in Mukangara (2000: 15), states "that a person's information gathering behaviour is afunction of the information discovered to be available". In this study, the phrase "information availability" refers to health information and resources being accessible and relevant for use by potential users.
1.10.6 Information management (IM)
Davenport and Prusak (1998) defines IM as a structured set of activities that comprise the way an organization captures, processes, uses and disseminates data and codified information, to produce reliable information and make it available whenever a need arises to facilitate decision-making.
Fairer-Wessels (1993:35-37) refers to information management as:
the management of the information process. It is the interaction of members ofthe organisation with information resources and supporting technologies to assist the activities, for decision- making and analytical purposes with the emphasis on the value of the information used. IM is a process that uses techniques to effectively and efficiently manage information resources and assets from internal and external sources for decision-making in order to achieve the aims and objectives of the organisation.
The United States Office of Management and Budget (1994:37907) has provided a similar but more elaborate definition:
the planning, bUdgeting, manipulating and controlling of information throughout its cycle, "that is from its creation or receipt, through its processing, distribution, storage, retrieval, use and ultimate disposition".
Information management in the present study relates to all of the above, that is the overall management and control of the investment in information within any organisation. Information management is a prerequisite to the availability and accessibility of health information for decision-making and, above all, better health care delivery.
1.10.7 Information and communication technologies (leTs)
The term ICTs is also referred to as information technology (IT). The first recorded use of the term information technologywas by Leavit and Whistler in 1958, in theHarvard Business Review(XXXVI41/1): "The new technology does not have a single established name. We shall call it information technology" (Keary 2000:868). Harrods Librarians' Glossary (1995:357) provides a description of ICTs, as follows:
ICTs are currently used to replace the older "IT" and the briefly fashionable "C&IT" is used to express the combination of computing hardware and software with the capabilities of communications networks that provides new opportunities for teaching, learning and training through the delivery of digital content. The expression is used particularly in an educational context.
Easingwood's description is useful in defining ICTs:
the recent change in terminology from IT to ICT reflects a subtle yet distinct change in approach to what the use of the new technologies really means. The former term suggested that there was aone-way flow of information, with the user being apassive recipient of material displayed on the screen. The adding of the word "communication" implies a more dynamic interaction between the user and the world of information contained beyond the computer screen. As aresult, the computer has evolved from being ateaching machine, atool to support learning and ultimately into ameans of instigating communication from alocal to aglobal scale (Easingwood 2000:45).
Feather and Sturges (1997:220) define ICTs:
as the electronic technologies for collecting, storing, processing and communicating information. There are two main categories: those which process information, such as computer systems; and those which disseminate information, such as telecommunication systems. The term can generally be understood to describe systems that combine both.
Senn (1997:14) defines IT as comprising three interlocking components namely, computers, communication networks and know-how. According to Senn:
• Computers are electronic systems that are being instructed to accept, process, store and present data and
information.
• Communication networks are sets of stations, consisting of programs and information that are linked together as a system that transmits and receives data and information.
• Know-how is the validity of an information technology and depends on the knowledge of the users.
For the purpose of the study, the term information and communication technologies (ICTs) is an umbrella term used to describe complex hardware and software, lined by avast array of technical protocols. In this study, the term ICTs refer to the use of computer(s) and computer auxiliaries, such as CD-ROM facilities and electronic databases, and the Internet facilities and/or resources to capture, retrieve and disseminate health information.
1.10.8 Health
Committees of Professional Development (2000) describe health as everything from birth to death and wellness to illness. It also includes a state of complete physical, mental and social wellbeing.
1.10.9 Health information
Dixon (2002) defines health information as all the data and information related to a person's medical condition. It comprises all data, both internal and external (clinical, epidemiological, demographic, financial, research, reference, and coded), and includes the patient's medical history and physical examination, reports of X-ray and other laboratory tests, diagnosis and treatment plans, reimbursement information, allied health notes, medications, doctors notes/orders and nurses' notes generated by a hospital or health care facility.
1.10.10 Health information management (HIM)
"Health information management is the continuum of practice concerned with health-related information and the management of the information system to collect, store, process, retrieve, analyse and disseminate information related to the research, planning, provision, financing, and evaluation of health care services" (Weber State University 2000).
1.10.11 Decision-makers
In government, decision-makers are top officials within the executive and legislative branches, as well as the bureaucracy (including planners, administrators, and managers). In particular, decision-makers are those who are responsible for the formulation, implementation and administration of government policies and programmes.
In this study, decision-makers refer to the Minister of Public Health and his immediate subordinates, the Directors of hospitals, the Provincial Delegates of Public Health, the District Officers of Health, nurses and medical doctors, and the Executive members of the Management Committees of the hospitals.
1.10.12 Health information management functions
The HIM functions are to design and to manage health information systems. They include the organisation, analysis and technical evaluation of all health records, according to established standards, to assist in resolving problems that affect the care and treatment of patients. Health information management functions comprise identifying, evaluating, compiling, maintaining and using various types of administrative and health information and statistics from internal and external sources (Weber State University 2000).
1.10.13 Health Information Manager
Weber State University (2000) defines a health information manager as an individual who performs tasks related to health information management and the systems used to collect, store, process, retrieve, analyse, disseminate and communicate that information, regardless of the physical medium in which information is maintained.
In addition, he or she accesses the uses of information and identifies what information is available and where there are inconsistencies, gaps and duplication in health data sources. He or she ensures that the health information resources are effectively and efficiently managed, to help the organization fulfil its mission and achieve its goals and objectives.