برنامه های آموزشی انفورماتیک پزشکی برای حمایت از سیستم اطلاعات مدیریت خدمات بهداشتی درمانی رومانیایی

The Health Management Information System (HMIS) project initiated by the Romanian Ministry of Health as a component of the healthcare reform is aiming to ensure the technical, functional and operative support for: (i) a better overview of the population health status, of the medical care needs and of the Health System performances; (ii) the improvement of the resource allocation and consumption; and (iii) reform support. This system is supposed to assure a better information flow from the lower to the upper levels of the healthcare network by help of a modern IT support. In the first development stage the system is planned to link the Ministry of Health with the 41 District Health Authorities (DHAs) and with more than 200 pilot health units. The implementation of such a large system raises serious problems of acceptability and a thorough training programme for both technical staff and end users must be considered in order to face this challenge.

In the developed countries the computing equipment entered gradually in the daily life of different categories of professionals. In Romania this process has completely different characteristics due to the needs for reconstruction. A massive amount of computers were introduced by means of short term programmes into various fields of activity. This assault of the electronic machines might and sometimes it even does, induce adverse reactions. The main question the authors had in mind when they started to design the training programme to support HMIS was ‘How to make people understand that computers are not intruders in their professional lives?’ In designing the training programme the authors took into consideration the objectives of the training programme and the influencing factors.

Although confronted with many difficulties in the healthcare reform compared with other countries there are several similarities regarding the problems encountered and the way they are approached. In a paper published in 1995 J.E. Herring remarked the role of training in creating the skills level of the information managers in National Health Service (NHS). In his comments regarding the up to date responsibilities of the information managers in NHS, J.E. Herring stressed the importance of the IS/IT advice and training as required to ensure that the maximum outcome is obtained from the information resources [4]. When developed the HMIS training programme the project co-ordination team considered also the problem of maximum outcome obtained from the information resources. The four steps strategy prepared and launched by the Ministry of Health to train the information users revealed several advantages: • The improvement of links with the higher education definitely is a remarkable advantage allowing the know how transfer from university to industry and enabling the development of the interdisciplinary fields. • The new created training capacities polarised the interest of different bodies and professionals that helped the training process with innovative ideas and material support. • The semi-centralised manner in which the training campaigned was organised allowed the fructifying of a free market offer in a centrally controlled plan aiming to meet the needs of the HMIS.