Beyond classifications: entities of knowledge exchange

The perspectives of families, and especially parents of children with special health care needs, need to be better understood by the government agencies, health care providers, associations, and information systems vendors that are integrating child health information systems. To date, research on children with special health care needs has not included the perspectives of parents on integrated child health information systems. Interviews were conducted with a limited number of parents of children with special health care needs and a young adult with special health care needs about their perspectives on integrated health information systems needs. The interviews revealed common themes: (1) parents have experienced the benefits of information technology for health care purposes, (2) parents believe integrated health information systems could help to coordinate their children's health care, (3) parents believe information technology can help improve accuracy and timeliness of information, (4) parents of children with special health care needs believe their children's health information should be available to those who need it, but safeguards must be in place, (5) parents believe health information systems can improve health care, but it is not the highest priority health care issue for them, and (6) parents believe that their involvement in issues related to children with special health care needs, including information technology, is critical. Parents of children with special health care needs hold strong opinions about their children's health care, including health information systems. Parents need to be central to discussions about development of integrated child health information systems if we are to develop information systems that serve the needs of children with special health care needs and their families.

BackgroundThe Sars-CoV-2 pandemic exacerbates existing inequalities across health care systems globally, both within countries and between countries. It also highlights, like no other crisis before, existing weaknesses in health information systems (HIS). This article summarizes these key challenges for HIS in times of a pandemic and beyond, with a focus on European countries. It builds on the experiences of a large consortium representing HIS experts in key positions in national public health or similar institutes across Europe.MethodsData were collected in bi-weekly conference calls organized by the InfAct project between February and June 2020. Emerging themes were clustered and analysed around a WHO framework for health information systems (HIS). We analyse strengths of HIS at two levels: (i) dealing with health information directly, and (ii) dealing with other parts of information systems that allow for a holistic assessment of the pandemic (including health-related aspects).ResultsThe analysis highlights the need for capacity-building in HIS before a pandemic hits, the relevance of going beyond health information only related to health care but taking a broader perspective (e.g. on vulnerable groups), the need for strong reporting systems on staffing numbers and in primary care. Further, data linkage emerges as a crucial precondition to identify unmet needs for essential health care services in a timely manner. Finally, room for innovation and digitalisation is key to be able to react flexibly in times of crisis. Trust for health information stakeholders is another important factor to create strong HIS.ConclusionsThe strengths and shortcomings of European HIS that have been observed during the COVID-19 crisis highlight the need for strong HIS beyond the crisis. The experiences reported leave as a central message that successful reactions to the pandemic are (also) grounded in strong HIS that ultimately not only benefit the health of the population but also create a number of economic and psycho-social benefits. Strong data reporting schemes may also support fine-tuning of containment measures during a pandemic as well as transition phases.

In some developing countries health agencies and donors do not know how many people are dying or what the causes of death are. But with increased donor demands for transparency and performance measurement, countries are having to provide reliable health information and efforts are under way to help them. Countries that do not generate reliable health information or evidence lack the basis for making sound policy-decisions. "So you have a weak (health) sector with weak information. Therefore management decisions are often not rational; you don't provide enough information to get more resources, so it is vicious circle," said Bernhard Schwartlander, director of strategic information and evaluation at the Global Fund to Fight AIDS, Tuberculosis and Malaria. Schwartlander said that more than 90% of low-income countries do not have a well-functioning health information system, which is vital for generating basic health data. A health information system is essentially a collection of health statistics from various sources, used to derive information about health status, health care, provision and use of services, and the impact on a population's health. Until the 1990s, health information related mainly to clinical data and disease control and surveillance. Since then it has expanded to include population health data to determine major public health problems. The first aim of a health information system is to identify health issues, said Chris Scott, a development economist at the London School of Economics. It can also be used to inform health programme design and policy choice; it can help to forecast future health scenarios--as in the case of HIV/AIDS in Africa--and to monitor and evaluate the implementation of health policies, Scott said. For many low-income countries the problem is that even a rudimentary health information system costs too much. "As a result, decision-makers are unable to identify problems and needs and track progress, evaluate the impact of interventions and make evidence-based decisions on health policy, programme design, and resource allocation", according to a report by WHO's Health Metrics Network. This network is a new global partnership, hosted by WHO, that aims to tackle the health information bottleneck in low-income countries and help those countries build or consolidate their fledgling health information systems. "Health Metrics Network will work with countries to assess the current status, identify gaps, and develop a national plan for improving the health information system," said interim executive secretary Carla AbouZahr. The idea is that efforts to strengthen health information systems within countries would be financed by resources in the countries themselves, for example through multilateral development partners such as the World Bank, bilateral donors and global health initiatives such as the Global Fund and the Global Alliance for Vaccines and Immunization (GAVI). AbouZahr said that the Health Metrics Network hoped to sign agreements by October with a number of low- and middle-income countries to develop health information systems. Helping countries build and sustain health informations systems is a challenge. Scott said one way to address this would be for WHO to promote health information systems that are appropriate to the infrastructure, technological capacity and budgets of health ministries. In the poorest countries, it might be helpful to design and implement a simple pencil-and-paper-based health information system which contains data understood by and, therefore, more likely to be used by policy-makers at different levels, he added. "Launching directly a nationwide, computer-based health information system which is vulnerable to power failures, software crashes and inadequate IT skills of health staff is a high-risk strategy," Scott said. There may be a case in large federal states for experimenting with different types of health information systems in different parts of the country to see which one functions best in which set of circumstances, Scott said. …

BackgroundAs the world approaches the final five years to achieve the Sustainable Development Goals (SDGs), a global polycrisis threatens progress on health and well-being. Populations experiencing vulnerabilities, particularly women, girls, and adolescents in low- and middle-income countries, shoulder a disproportionate burden. Universal access to sexual and reproductive health (SRH) services has seen mixed progress. In particular, adolescents are facing heightened risks such as early marriage, unintended pregnancies, and limited access to SRH services, compounded by gender norms and fragile contexts. Integrated, community-driven, and gender-transformative approaches are urgently needed, as are robust health data and information systems. However, fragmented systems suffer from poor data quality and underrepresentation of marginalized groups. Digital innovations hold promise for addressing these gaps but must be adapted to local contexts.Bridging the Know-Do GapThis supplement presents findings from the Cedar Cohort, an initiative supported by the International Development Research Centre across West Africa and the Middle East (2017–2023). The cohort's 16 implementation research projects explored SRH services for adolescents and health information systems, emphasizing gender equality, human rights, and knowledge translation.The articles are organized around three themes: (1) adopting contextual approaches rooted in local communities and their context-specific needs, (2) advancing gender equality and inclusion and (3) harnessing the transformational potential of data and information systems. Authored by LMIC-based researchers, the supplement provides concrete findings and localized insights into the transformative change possible when high-quality research is combined with an understanding of social, economic, political, and cultural factors at the individual, organizational, structural and systems levels.ConclusionThe collection of research projects featured in this supplement enriches our understanding of designing and implementing effective initiatives to improve health outcomes for women, children and adolescents. The findings emphasize that no singular solution exists for the multifaceted SRH challenges that continue to evolve. The projects in the Cedar Cohort offer critical insights into designing and scaling SRH interventions that are locally relevant, inclusive, and impactful. The current polycrisis necessitates a re-evaluation of global strategies, and the findings from the research projects in this supplement provide indications of ways forward.

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This paper describes an empirical qualitative analysis of how knowledge and data generated through traditional health practices, specifically by traditional birth attendants, with respect to maternal and child health, define and control data quality in health information system. The aim is to gain an understanding of how knowledge and data crosses the boundary between traditional and modern sectors with varying practices, and how the existing mechanisms linking the two sectors can be strengthened. Using an interpretative approach, this research provides the health informatics and information systems community with an understanding of how bridging the divide between scientific and indigenious knowledge can improve data quality in a context where two different sectors exist; each utilising different types of knowledge. Concepts from community of practice theory were employed as the framework for analysis. We recommend that boundary crossing of knowledge and data between the two health sectors must be tailored from histrorical, cultural and modern perspectives, with an emphasis on: i) utilizing the historical‐cultural means of capturing data through chiefs and ii) the modern mechanisms of utilising health surveillance assistants as the link.

The District Health Information System (DHIS) is an information system that is hosted in the Khomas regional office of the Ministry of Health and Social Services (MoHSS) in Namibia. Parallel to the DHIS, the MoHSS runs silo information systems in the 14 regions of Namibia which were donated by non-governmental organisations in addition to a regional DHIS. The DHIS and silo systems currently work in isolation from one another, hence this study is on finding a framework to enable semantic interoperability of data in these heterogeneous health information systems (HIS) so that the DHIS and these silo systems in the Namibian public hospitals can act as an integrated platform to share and exchange health- related information with each other. Thus, a protocol called Interlink protocol is developed in this research to enable integration. The DHIS and silo- interfaced system that will be developed in this research should be able to link or connect all the public hospitals in Namibia to the central database at the MoHSS for health information feed. The system would allow public hospitals to interlink with each other through a technology integrated platform. The study therefore seeks to interface DHIS and silo systems at a data level. The aim of this research therefore is to design and develop a framework for data semantic interoperability of DHIS and these other health information silo systems so that they can exchange health data and information.

The growth of the foreign population residing in Spain makes it necessary to avail of better information on the level of health. In the health information and research systems, no uniform criteria currently exist for the nomenclature of origin-related variables. This study poses a consensus on the definitions of immigrant and foreigner. Employing the Delphi methodology, 66 experts in immigration from different disciplines were invited to take part in the study using a two-round questionnaire with suggested definitions, terms and variables, including in the second round the percentages of responses and the comments made by the participants in the first. The suggestions regarding which an 80% consensus was reached were put into a final document which was approved in the third round. A total of 57 people accepted the invitation, 44 having completed at least one round and 33 having completed all three. Some of the most important aspects regarding which a consensus was reached were: the term "immigrant" denotes the individual who comes to a country where he/she was not born to take up residency, one not being an immigrant on a lifelong basis. Those individuals born in another country who have arrived in Spain less than 5-10 years ago can be considered immigrants; and immigrated people are all those individuals born in another country. Socioeconomic variables, gender, administrative status and country of origin should also be taken into consideration. The children of immigrated individuals who are born in Spain must not be considered individuals who are born in Spain must not be considered. To properly define the inmigrating and immigrated population categories, the health studies and information systems must include country of birth, year of arrival and nationality.

Background How does your Health Information System (HIS) measure up to others in the EU? How can you empower national HIS players with an objective peer-reviewed HIS assessment? Nine InfAct partners engaged in a capacity building exercise where experts in rotating groups of three countries performed peer assessments of each other’s national HIS. Using a WHO Europe adapted and refined tool, assessors analysed the HIS of a country (data collection, processing, analysis, dissemination and use) and exchanged practices in an intensive 2-day schedule of interviews with established key stakeholders. Objectives The aim of the peer assessment is three-fold: to test the feasibility of a peer-review HIS assessment, to map heath information inequalities across EU MSs, and to strengthen the knowledge of HIS players. Results Two cycles are now complete and the feedback is overwhelmingly positive - from assessors and hosts alike. So far, the HIS assessment has been a major success in its ability to systematically and concisely analyse a HIS. It identifies gaps in the HIS through desk review and interviews, and provides a SWOT analysis and SMART recommendations to address these gaps. Additionally, this exercise has shown the ability to increase stakeholders’ awareness of their role in their national HIS, and to build new networks within and between MSs. The exercise is also perceived as an opportunity for cross-fertilisation of ideas and exploration of methodologies on how to address specific challenges. This will stimulate actions to improve national HISs, and will lead to the identification of good practices which can then be used by other EU countries. Conclusions By bringing together key HIS stakeholders from different countries and stimulating the improvement of HIS and the exchange of good practices, InfAct contributes to capacity building in the EU, which in turn may lead to the reduction of health information inequalities between countries.

In the last half-century the world has witnessed dramatic gains in health status. These are occurring in developing countries now but started in Europe and other wealthier countries around the global in the late 19th century and early 20thcentury. These improvements were partly attributed to increasing in education and income of the population which resulted in more hygienic living conditions and nutrition later in the 20th, expansion of health and public health services by governments and biomedical innovations. Sub-Saharan Africa still carries most of the global burden of disease with low life expectancy at birth with majority of deaths occurring to children under the age of 5 years. Infectious diseases are the major contributors to the disease burden in sub-Saharan Africa that affect the poorest in addition to noncommunicable diseases. The health system is a major determinant in reversing
\nthis burden in sub-Saharan Africa. Health systems in sub-Saharan Africa are weak and need to cope with simultaneous communicable and noncommunicable epidemics. Health information systems play a significant role in steering health system strengthening and documenting progress as it provides reliable information on health determinants, health system performance and population health status. Despite its importance, health information systems in many developing countries are weak, fragmented and often focused exclusively on disease-specific programme
\nareas. Integration of health information systems will provide the basis for public health professionals to look at the health system from different viewpoints.
\nEnterprise architecture (EA) is a management tool that provides means for aligning information systems with organisation’s mission, goals and objectives. EA is used to develop a comprehensive description of all of the key elements and relationships of an organization and its alignment with an organization’s mission, goals, and strategic objectives with information systems. EA can be used as a method for designing health information systems in terms of a well defined set of building blocks, and showing how the building blocks fit together and how they communicate with each other. This research aims to study the potential of EA as a strategic methodology that can be used to systematically gather and document health information system
\nrequirements to design a unified comprehensive health information system that integrates data from diverse sources at all levels of the health system for localised evidence-based decision making and health systems strengthening.
\nThis research used qualitative method to collect primary and secondary data. Primary research data was collected through in-depth interviews with key stakeholders and observation and discussions in workshops and meetings. Secondary research include desk research by searching for published and unpublished research outputs, white papers, reports, user manuals and training materials.
\nGathering and documenting requirements and processes that facilitate systematic design and development of health information systems that are usable, integrated, interoperable and sustainable are practices neglected by Ministries of Health and donor partners in health systems strengthening. In response, this thesis presents original studies on the potential use of an EA approach to strengthen health information systems in low income countries.
\nEA is a systems science approach that is widely used in software design in developed countries.
\nIt is common to see, in developing countries, the application of EA to be focusing on developing eHealth or HIS architecture in silos with little attention paid its application in the context of the health system. This thesis shows developing countries would benefit more from EA by applying it to simplify the complexity of the health system through guiding a systems thinking approach to describe processes, personnel, information systems, data and sub-systems their alignment and
\nhow they are all intended to complement health systems goals and strategic direction. In the process of developing EA developing countries should use the opportunity to reassess the current processes, indicators and data usage and take a decision to either eliminate processes that are no longer required or rationalise them.
\nDeveloping countries has realised the potential of ICT in improving healthcare delivery and availability of information for evidence decision making. Despite this realisation many HISs in developing countries are chaotic characterised by silo systems unable to communicate with each other. EA approach facilitates the design of integrated HISs by describing HIS in a more systemic holistic way.
\n
\nZusammenfassung
\nIn den letzten fünfzig Jahren hat sich der Gesundheitszustand der Weltbevölkerung dramatisch verbessert. Während sich dieser Fortschritt heute vor allem auf Entwicklungsländer beschränkt, begann er in Europa und anderen wohlhabenden Ländern auf der ganzen Welt schon im späten 19. und frühen 20. Jahrhundert. Solche Verbesserungen sind teilweise der höheren Bildung und dem höheren Einkommen der Bevölkerung zuzuschreiben, welche hygienischere
\nLebensverhältnisse und Ernährungsgewohnheiten im 20. Jahrhundert zur Folge hatten, aber auch erweiterten Gesundheitsdiensten durch Regierungen und biomedizinischen Erfindungen. 
\nAfrika südlich der Sahara trägt nach wie vor den grössten Teil der globalen Krankheitslast mit einer tiefen Lebenserwartung bei der Geburt und der höchsten Todesfallrate bei Kindern unter 5 Jahren. Infektionskrankheiten sind neben nichtansteckenden Krankheiten Hauptbestandteil der Krankheitslast, die die ärmsten in Afrika südlich der Sahara trifft. Das Gesundheitssystem ist ein bedeutender Einflussfaktor, wenn es um die Reduktion dieser Krankheiten in Afrika südlich der
\nSahara geht. Gesundheitssysteme in Afrika südlich der Sahara sind schwach und kämpfen gleichzeitig mit Epidemien ansteckender und nichtansteckender Krankheiten. 
\nGesundheitsinformationssysteme spielen eine wichtige Rolle bei der Verbesserung der Gesundheitssysteme und helfen, den Fortschritt zu dokumentieren, da sie verlässliche Informationen zu Gesundheitsfaktoren, Effizienz des Gesundheitssystems und den Gesundheitszustand der Bevölkerung liefern. Obwohl sie so bedeutend sind, sind Gesundheitsinformationssysteme in vielen Entwicklungsländern schwach, bruchstückhaft und oft nur auf bestimmte betroffene Gebiete beschränkt. Die Vernetzung der Gesundheitsinformationssysteme würde es für Angestellte des Gesundheitswesens ermöglichen, das Gesundheitssystem von verschiedenen Blickwinkeln her zu betrachten.
\n „Enterprise architecture“ (EA) ist ein Führungsinstrument, das es ermöglicht,
\nInformationssysteme mit dem Auftrag und den Zielvereinbarungen einer Organisation zu vergleichen. EA entwickelt eine umfassende Beschreibung aller Schlüsselelemente und Beziehungen einer Organisation, um das Informationssystem auf den Auftrag und die strategischen Ziele der Organisation auszurichten. EA kann zur Entwicklung von Gesundheitsinformationssystemen mittels genau definierter Bausteine verwendet werden und zeigen wie die Bausteine zusammenpassen und miteinander in Verbindung stehen. Die vorliegende Forschungsarbeit untersucht die Möglichkeiten von EA als strategische Methode zum systematischen Sammeln und Dokumentieren von Anforderungen eines Gesundheitsinformationssystems. Dadurch soll ein umfassendes, einheitliches Gesundheitsinformationssystem entwickelt werden, das Daten von verschiedenen Quellen auf allen Stufen des Gesundheitssystems zusammenführt, um eingegrenzte, evidenzbasierte
\nEntscheidungen und die Stärkung des Gesundheitssystems zu fördern.
\nIn dieser Forschungsarbeit wurden qualitative Methoden verwendet, um primäre und sekundäre Daten zu sammeln. Primäre Daten wurden durch Tiefeninterviews mit den wichtigsten Interessenvertretern erhoben, sowie anhand von Beobachtungen und Diskussionen in Workshops und Sitzungen. Die sekundäre Datenerhebung beinhaltet Schreibtischarbeit wie die Suche nach publizierten und nicht-publizierten Forschungsergebnissen, Weissbüchern, Berichten, Bedienungsanleitungen und Schulungsunterlagen.Das Sammeln und Dokumentieren von Vorgaben und Prozessen, die das systematische Designen und Entwickeln von Gesundheits-informationssystemen, die anwendbar, umfassend, kompatibel und nachhaltig sind, vereinfachen, wird von den Gesundheitsministerien und Geberpartnern bei
\nder Stärkung der Gesundheitssysteme vernachlässigt. Die vorliegende Arbeit präsentiert Originalstudien zur möglichen Anwendung von EA, um Gesundheits-informationssysteme in einkommensschwachen Ländern zu stärken.
\nEA ist eine systematische, wissenschaftliche Herangehensweise, deren Anwendung im Softwaredesign in entwickelten Ländern weit verbreitet ist. Üblicherweise wird in
\nEntwicklungsländern EA bei der Entwicklung von eHealth oder der Architektur von
\nGesundheitsinformationssystemen in Silos angewendet, wobei der Verwendung im
\nZusammenhang mit dem Gesundheitssystem wenig Beachtung geschenkt wird. Die vorliegende Arbeit zeigt, dass Entwicklungsländer mehr von EA profitieren würden, wenn sie es zur Vereinfachung von Komplexitäten im Gesundheitssystem anwenden würden. Durch einen „Systems Thinking“-Ansatz könnten Prozesse, Personal, Informationssysteme, Daten und Subsysteme beschrieben und angepasst werden, um Ziele und strategische Richtung des Gesundheitssystems zu ergänzen. Während der Erarbeitung des EA sollten Entwicklungsländer die Gelegenheit nutzen, ihre Prozessabläufe, Indikatoren und Datenanwendungen zu überdenken,
\nund überholte Prozesse zu eliminieren oder zu rationalisieren.
\nEntwickelte Länder haben das Potential der Informations- und Kommunikations-technologie erkannt, um die Gesundheitsvorsorge und die Verfügbarkeit von Informationen fü

Health Information Systems (HIS) are being implemented in all aspects of healthcare; from administration to clinical decision support systems. Usability testing is an important aspect of any HIS implementation with much done to deliver highly usable systems. However, evidence shows that having a highly usable system is not enough. Acceptance by the clinician users is critical to ensure that the HIS implemented is used fully and correctly. A longitudinal case study of the implementation of the Community Health Information Management Enterprise System (CHIME) in NSW is used to illustrate the importance of ensuring clinician acceptance of a HIS. A mixed methods approach was used that drew on both qualitative and quantitative research methods. The implementation of CHIME was followed from the early pre-implementation stage to the post implementation stage. The usability of CHIME was tested using expert heuristic evaluation and a usability test with clinician users. Clinician acceptance of CHIME was determined using the Technology Acceptance Model (TAM). The clinician users were drawn from different community health service departments with distinctly different attitudes to information and communication technology (ICT) in healthcare. The results of this research identified that a successful implementation of a HIS is not a measure of its quality, capability and usability, but is influenced by the user’s acceptance of the HIS.Keywordshealth information systemsacceptanceusabilityinformation and communication technology

Background:Health policies in Indonesia facilitate public access to healthcare information in efforts to improve public health. These policies rely on the support of electronic healthcare information systems to provide health data and information. However, the usage of these systems faces various challenges that affect their sustainability. Objective:To determine the effect of healthcare information technology assets on the sustainability of healthcare management information systems and the role of healthcare information technology strategies as a moderating variable. Methods:This is a quantitative and explanatory research study. The sample consisted of 350 respondents, with a significance level of 0.05. Latent variables included the sustainability of healthcare management information system usage, healthcare information technology assets, and information system strategies, which also served as an intervening variable. Results:The direct effect test yielded a p-value of 0.000 (<0.05), leading to the rejection of the null hypothesis. Thus, healthcare information technology assets and healthcare information technology strategies have a positive and significant effect on the sustainability of healthcare management information system usage. The indirect effect test yielded a p-value of 0.003 (<0.05), also leading to the rejection of the null hypothesis. These results indicate that the healthcare information technology strategies variable moderates the effect of healthcare information technology assets on the sustainability of healthcare management information system usage. Conclusion:Healthcare information technology strategies strengthen the effect of healthcare information technology assets on the sustainability of healthcare management information system usage. Keywords:Health Policy; Health Information Systems; Information Technology; Indonesia

BackgroundA Health Information System (HIS) assessment is an evaluation of the functioning of the main elements that compose a national HIS. Assessors from nine countries performed peer assessments of each other’s national HIS in the Joint Action on Health Information (InfAct). The aim of this study is to evaluate the advantages and disadvantages of the InfAct peer assessment methodology as well as the different steps involved in this assessment process.MethodsEach peer assessment included a preparatory desk report, a country visit with semi-structured interviews with local stakeholders, a final report and a follow-up stakeholder meeting. A qualitative content analysis of the peer HIS assessment was performed based on 12 semi-structured interviews.ResultsThe main advantage of the assessments is its informal atmosphere, high degree of objectiveness and its networking opportunities. Disadvantages are its informal request format and setting for recommendation uptake. The peer assessment helped the assessors to broaden their understanding of the assessed and their own HISs, to gain knowledge on how to carry out an HIS assessment and to practice their organization, communication, reporting and negotiation skills. All steps of the HIS assessment are essential and each contributes to the enriching experience of the participants.ConclusionThe InfAct peer HIS assessment methodology strengthened capacity in national HISs by building up the knowledge and expertise in participating countries and as such addressed health information inequalities. This study confirms the value and relatively easy to implement methodology, and therefore recommends its wide and more systematic application across Europe.

The rapid evolution of health information systems (Health IS) research has led to many significantcontributions. However, while the Health IS subset of information systems (IS) scholarship hasconsiderably grown over the past two decades, this growth hasled to questions regarding the currentintellectual structure of this area of inquiry. In an effort to more fully understand how Health ISresearchhas contributed to the IS discipline, and what this may mean for future Health IS researchin the IS domain, we conduct an in-depth evaluation of Health IS research published in mainstreamIS journals. We apply citation analysis, latent semantic analysis (LSA), and social network analysis(SNA) to ourdata setof Health IS articles in order to: (1) identify Health IS research themes andthematic shifts, (2)determine which Health IS research themes are cohesive (versus disparate), (3)identify which Health IS research themes are central (versus peripheral), (4) clarify networks ofresearchers (i.e., thought leaders) contributing to these research themes, and(5) provide insights intothe connection of Health ISresearchto its reference disciplines. Overall, we contribute a systematicdescription and explanation of the intellectual structure ofHealth ISresearchand highlight how theexisting intellectual structure of Health ISresearchprovides opportunities for future research.

Introduction:National Health Information System plays an important role in ensuring timely and reliable access to Health information, which is essential for strategic and operational decisions that improve health, quality and effectiveness of health care. In other words, using the National Health information system you can improve the quality of health data, information and knowledge used to support decision making at all levels and areas of the health sector. Since full identification of the components of this system – for better planning and management influential factors of performanceseems necessary, therefore, in this study different attitudes towards components of this system are explored comparatively.Methods:This is a descriptive and comparative kind of study. The society includes printed and electronic documents containing components of the national health information system in three parts: input, process and output. In this context, search for information using library resources and internet search were conducted, and data analysis was expressed using comparative tables and qualitative data.Results:The findings showed that there are three different perspectives presenting the components of national health information system Lippeveld and Sauerborn and Bodart model in 2000, Health Metrics Network (HMN) model from World Health Organization in 2008, and Gattini’s 2009 model. All three models outlined above in the input (resources and structure) require components of management and leadership, planning and design programs, supply of staff, software and hardware facilities and equipment. Plus, in the “process” section from three models, we pointed up the actions ensuring the quality of health information system, and in output section, except for Lippeveld Model, two other models consider information products and use and distribution of information as components of the national health information system.Conclusion:the results showed that all the three models have had a brief discussion about the components of health information in input section. But Lippeveld model has overlooked the components of national health information in process and output sections. Therefore, it seems that the health measurement model of network has a comprehensive presentation for the components of health system in all three sections-input, process and output.