Miriam Lum On: an island journey.
Article Type: Personal account
Subject: Medical informatics (Forecasts and trends)
Medical informatics (Management)
Medical advice systems (Technology application)
Medical advice systems (Forecasts and trends)
Career development (Evaluation)
Author: On, Miriam Lum
Pub Date: 02/01/2010
Publication: Name: Health Information Management Journal Publisher: Health Information Management Association of Australia Ltd. Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2010 Health Information Management Association of Australia Ltd. ISSN: 1833-3583
Issue: Date: Feb, 2010 Source Volume: 39 Source Issue: 1
Topic: Event Code: 010 Forecasts, trends, outlooks; 200 Management dynamics Computer Subject: Market trend/market analysis; Company business management; Technology application
Product: Product Code: 9918560 Career Planning SIC Code: 7389 Business services, not elsewhere classified
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 222559417
Full Text: In the short time that I have been working as a Health Information Manager (HIM), I have enjoyed a career that is extremely diverse and rewarding. I look out of my window as the sun sets each afternoon and wonder, 'How on earth did I get here?' Sometimes my job finds me in the back of a truck visiting health centres in Vanuatu to review data collection methods. At other times, my job has me discussing malaria elimination indicators. On other days, you will see me frantically writing reports on health information systems in Fiji.

We all know that there is a current shortage of skilled health information workers and a pressing need for health information management skills in Australia. But beyond our shores, the Asia Pacific region is in desperate need as basic health information practices remain inadequate in many health systems, in particular those in developing countries (Ashraf 2005; Krickeberg 2007). With only a short time before the Millennium Development Goals (MDGs) are due to be achieved (United Nations 2009), there is a growing global awareness of the need for better health information to monitor and manage progress towards these goals. Furthermore, in most developing countries, vertical disease-specific programs and donor requirements have led to a fragmentation of demand for health information.

Having been trained as a HIM in the Australian context, I have had to expand my thinking beyond the medical records department and hospital-based data to national and global arenas. The globally agreed objective of a health information system is to 'to ensure the production, analysis, dissemination and use of reliable and timely information on health determinants, health system performance and health status' (World Health Organization 2007). This can mean health information is produced from a variety of sources, for example, the civil registrar's office, census data, or from grass-roots non-government organisations (NGOs) working in communities. All in all, this means that my life as a HIM is never boring.

Even in high school I knew I wanted to work in healthcare, but where this might be I really did not know. That was until I went to a university open day at the University of Sydney's Cumberland College of Health Sciences and met Beth Reid. My mother, who was accompanying me, asked: 'Is this a degree for bossy people? Beth replied 'Yes!' and my future was sealed. My interest in working in development was actually sparked much earlier. I had wanted to work overseas from a young age and often scared my family with my grand plans to travel. I spent a gap year working for an NGO in the Pacific and in my final year at university I decided to do my practical placement in Tonga on their health information system strengthening project. It was a great eye opener and helped to solidify my future plans. I graduated from the University of Sydney and immediately started my Masters in International Public Health in 2005.

I had been working as a Medical Records Officer and Coder in a number of private hospitals throughout my undergraduate training, and knew I needed more experience in a larger hospital environment, and so when I graduated I took a position at the Randwick Campus of Prince of Wales Hospital, Sydney Children's Hospital and the Royal Hospital for Women as the Operations Manager for the Medical Record Department. Here I learnt how to work under pressure, on a large-scale patient administration system (PAS) implementation and the integration of three medical record departments. While I loved my job at the hospital, I yearned for a new adventure and to apply my international health theory.

As an Australian Youth Ambassador for Development, (1) I arrived in Fiji in September 2006 to work with the Ministry of Health at the Colonial War Memorial Hospital in Suva. I was there specifically to work with the system administrators of PATIS, which is the Fijian national patient administration system, to train clinical and management staff on its value and in analysis for reporting and use for making evidenced-based decisions. This was during a rather 'hot' political period in Fiji's history and I was evacuated in December 2006. A political coup took place at the same time as the Ministry of Health held its inaugural health information management conference. Postcoup, I had the option of not returning but I felt the islands calling... and so returned. Fiji is resilient. Its health information staff work tirelessly to make a difference and I knew I wanted to invest in their development. My time in Fiji was a dazzling mix of curries, cocktails, hiking across rivers, and snorkeling in crystal blue water. Better than all of that was meeting my future husband.

At the close of 2007, I had to make a decision on my future. I chose to move in a new direction and apply my recently acquired knowledge in Canberra. I took a position at the Australian Institute of Health and Welfare (AIHW) in the Metadata Infrastructure Services Unit to work with METeOR, Australia's online metadata registry for the health, welfare and housing sectors data standards. The AIHW also provided a great opportunity to work on e-health and classification issues.

The Health Information Systems (HIS) Knowledge Hub was established in April 2008 at the School of Population Health at the University of Queensland, as one of the four Knowledge Hubs for Health funded by AusAID to provide improved health knowledge and expertise to inform policy dialogue at national, regional and international levels, and to provide guidance to AusAID on how to ensure better health outcomes from its bilateral aid programs. I joined the HIS Knowledge Hub as a Research Officer and have now returned to my islands. It has been a hectic first year of work for the Hub, while also having to learn how to be an academic. One of the highlights has been the establishment of the Pacific Health Information Network as a group that provides networking, support, information sharing and training for health information professionals in the Pacific region. In September 2009, a meeting of the network was attended by representatives of 12 Pacific Island countries in the region, all of whom gave presentations on their countries' health information systems.

I would like to encourage more young people to consider health information as a valid career path to start them on a journey that has many potential roads to be travelled. My own career has changed rapidly and my island journey continues. I know that my journey to date is only the beginning of many more diverse and interesting roads that my HIM training will open up for me, and I look forward to planning the next stage of my career with many interesting options available to me.


Ashraf, H. (2005). Countries need better information to receive development aid. Bulletin of the World Health Organization 83(8): 565-566.

Krickeberg, K. (2007). Principles of health information systems in developing countries. Health Information Management Journal 36(3): 8-20.

United Nations (2009). UN to review progress on the millennium development goals. Available at: http://www.un.org/ millenniumgoals/ (accessed 16 December 2009).

World Health Organization. (2007). Everybody's business: Strengthening health systems to improve health outcomes: A framework for action. Available at: http://www.searo.who.int/ LinkFiles/Health_Systems_EverybodyBusinessHSS.pdf (accessed 20 January 2010).

Miriam Lum On

Research Officer

Health Information Systems Knowledge Hub

School of Population Health

University of Queensland

Herston QLD 4006


Tel: +61 7 3365 5405

Email: m.bluhdorn@uq.edu.au

(1) Further information on the Australian Youth Ambassador for Development Program available at: http://www.ayad.com.au (accessed 16 December 2009). The AYAD program aims to strengthen mutual understanding between Australia and the countries of the Asia-Pacific region and make a positive contribution to development.
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