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Health Information System 1- Trans for 1st year MedTech
Students
BS in Medical Laboratory Science (Central Philippine University)
Studocu is not sponsored or endorsed by any college or university
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Formal Education
• Conventional classroom setup
• Structured methods of learning
• Takes place in a fixed period in which learners
complete each level by acquiring the required
competencies in preparation for higher
learning.
Informal Education
• Anything learned independently outside the
conventional classroom setup
• Not restricted in a certain location
• Integrated with the surroundings
• Involves students’ behavior skills through
interaction and exploration on a daily basis
Talks about the Future
Talks about the present
leading to the future
Where do you aim to be?
Where do you want to
be?
What makes you different?
How will you get where
you want to be
Time
Question
LESSON 1: VISION, MISSION, CORE VALUES, AND
OBJECTIVES OF THE INSTITUTION
Educational institution
• Place where learners of different ages gain
education
• From preschool to tertiary level
• Carry out educational activities that engage
students with carious learning environments
and spaces
Value Statement (Core Values)
• List of fundamental doctrines that guide and
direct the educational institution
• Guides decision making and provides a
yardstick for any action
• Shape the standard structure
• Sets the moral standards
Objectives
• Achieved within or at the end of the course or
lesson
• SMART - Specific, Measurable, Attainable,
Realistic, and Time Bound
• CHED Memorandum Order No 14 of 2006
“Policies, Standards, and Guidelines for Medical
Technology Education”
Vision Statement
• Conveys the desired end of an academic
institution
• Clear memorable, and concise
• Ave 14 words to 26 words
Mission Statement
• The intention of an institution’s existence
• 5 to 20 words
Function
Inspires to give the best
Shapes your
understanding of why
you are in the institution
It defines the key measure
of the institution’s success
Dev statement
Comparison Between Mission and Vision Statement
Vision
Mission
When do we want to
reach success? (Future
time)
Where do we want to go
forward? (Towards the
end goal)
How do we want to do
it? (Method of action)
What do we do today?
(specific actions)
For whom do we do it?
Why do we do what we do?
(Purpose)
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LESSON 2: HEALTH SYSTEM
Health System
• Combination of resources, organization,
financing, and management that culminate in
the delivery of health services to the population
• “All the organizations, institution, resources,
and people whose primary purpose is to
improve” (WHO)
• Well-performing health system provides direct
health-improving activities.
Goals and Functions of a Health System
1. Improving the health of the population
• Overarching goal of a health system
• Population must be protected from existing and
emerging health risk
• Intensive preparations for resilience to
impending but still unknown health risks must
abe executed
• Strive for equity in health
• Disparities are mostly reduced when it is
recognized and dealt with action.
2. Improving the responsiveness of the health
system
• Refers to providing satisfactory health services
and engaging people as active partners
• Embodies values in the delivery of health
services
• Responsive health systems maximize people’s
autonomy and control, allowing them to make
choices and placing them at the center of the
health system
3. Providing fair health financing
• It provides social and financial risk protection
in health
4 Vital Health System Functions
1. Health service provision
2. Health service inputs
3. Stewardship
4. Health financing
a. Revenue collection
• Earned from payments for health care services
• Include general taxation, direct household outof-pocket expenditures, mandatory payroll,
mandatory or voluntary risk-rated
contributions, donor financing
b. Risk pooling
•
•
A form of risk management which aims to spread
financial risk from an individual to all pool
members
Core function of health insurance companies
• Bismarck Model
- Named after the Prussian Chancellor,
Otto von Bismarck
- Covers everybody, thus collecting no
profit.
- Considered a multi-payer model with tight
regulation fiving the government the costcontrol clout
• Beveridge Model
- Named after William Beveride
- health care is provided and funded by the
government through tax payments
- Doctors may be government or private
employees who collect their professional
fees from the government
- Gov’t in control of health care service →
low cost per capita
c. Strategic purchasing
- Risk pooling organizations use collected
funds and pooled financial resources to
finance health care service for the
members.
WHO Health System Framework of 2000
Building Blocks
Outcomes
Service
Quality
delivery
Leadership and
Safety
Improved
governance
efficiency
Financing
➔
Social and
financial risk
protection
Health
Access
Improved level
products,
and equity of
vaccines, and
health
technology
Health
Coverage
Responsiveness
workforce
Information
Building Blocks
1. Service Delivery
• Timely delivery of quality and cost–effective
personal and non- personal health services
2. Leadership and Governance
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•
•
•
•
Ensuring effective stewardship of the entire
health system
Monitoring of accountability of health agencies,
proper system design, and appropriate
regulation of health systems
3. Financing
Takes care of the funding for health care
services for people to not worry about not
being able to pay for the services.
4. Health products, vaccine, and technology
5. Health workforce
6. Information
Refers to HIS
The Philippine Health System
Historical Background
1979: Adoption of Primary Health Care Strategy (LOI
949) promoted participatory management of the local
health care system
1982: Reorganization of DOH (EO 851) - integrated the
components Of health care delivery into its field
operations
coverage and access to quality health care for all
Filipinos
Leadership and Governance
Department of Health (DOH)
Tasks of DOH
1. To provide the appropriate direction for the
nation’s health care industry
2. The development of plans, guidelines and
standards for the health sector
3. Capacity building
4. Advisory services for disease prevention
5. Control of medical supplies and vaccines
DOH is bound to:
1. develop policies and programs for the health
sector,
2. provide technical assistance to its partners,
3. encourage performance of the partners in the
priority health programs,
1988: The Generics Act (RA 6675) — ushered the
writing of prescriptions using the generic name of the
drug
4. develop and enforce policies and standards,
1991: Local Government Code (RA 7160) - transferred
the responsibility of providing health service to the
local government units
6. provide specialized and tertiary level care.
5. design programs for large segments of the
population, and
1995: National Health Insurance Act (RA 7875) —
instituted a national health insurance mechanism for
financial protection with priority given to the poor
1999: Health Sector Reform Agenda - ordered the
major organizational restructuring of the DOH to
improve the way health care is delivered, regulated,
and financed
2005: FOURmula One (Fl) for Health - adopted an
operational framework to undertake reforms with
speed, precision, and effective coordination and to
improve the Philippine health system
2008•. Universally Accessible Cheaper and Quality
Medicines Act (RA 9502) — promoted and ensured
access to affordable quality drugs and medicines for
all
2010: Kalusugang Pangkalahatan or Universal Health
Care (AO 2010-0036) — provide universal health
DOH 3-tiered system
1. Tertiary hospitals at the national and regional
levels
2. The provincial and district hospitals and city
and municipal health centers
3. The barangay health centers
Direction of the Philippine Health Sector
1. The Philippine Health Agenda 2016-2022 (DOH
AO 2016-0038)
• “All for Health Towards Health for All”
• Expanded scope of Universal Health Care
(UHC)
Population- and individual-level interventions
for all life stages that promote health and
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2.
•
3.
•
1.
2.
3.
4.
wellness, prevent and treat triple burden
disease, delay complications, rehabilitation,
and provide palliation for both the well and the
sick
The Philippine Development Plan 2017-2022
4 medium-term plans to translate the vision of
a “metatag, maginhawa, at panatag na buhay”
for the Filipinos and the country
NEDA AmBisyion Natin 2040
Collective long-term plan envisions better life
for the Filipinos and the country by formulating
policies and implementing programs and
projects
4 Focused Areas
Building a prosperous, predominantly middle –
class society where no one is poor
Promoting a long and healthy life
Becoming smarter and more innovative
Building a high-trust society
4. Sustainable Development Goals 2030 (the 2030
Agenda)
No Poverty
Reduced Inequality
Zero Hunger
Sustainable Cities and
Communities
Good Health and WellResponsible
being
Consumption and
Production
Quality Education
Climate Action
Gender Equality
Life Below Water
Clean Water and
Life on Land
Sanitation
Affordable and Clean
Peace and Justice
Energy
Strong Institutions
Decent Work and
Partnerships to achieve
Economic Growth
the Goal
Industry, Innovation and
Infrastructure
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LESSON 3: PRIMARY HEALTH CARE AND THE
PHILIPPINE HEALTH CARE DELIVERY YSTEM
Health Care
1. Health care system – Organized plan of health
services
2. Health care delivery – the rendering of health
care services
3. Health care delivery system – Network of
health facilities and personnel which carries
out the task of rendering health care to the
people.
Primary Health Care (PHC)
• Deals with social policy which targets health equity
• Has the essential elements and objectives that
ensure attainable better health service for all
5 Key elements of WHO
1. Universal coverage to reduce exclusion and
social disparities in health
2. Service delivery organized around people’s
needs and expectations
3. public policy that integrates health into all
sectors
4. leadership that enhances collaborative models
of policy dialogue
5. Increase stakeholder participation
Essential ELEMENTS of Primary Health Care
1. Education concerning prevailing health
problems and the methods of identifying,
preventing, and controlling them
2. Locally endemic disease prevention and
Other elements of primary health care include;
1.
Expanded options of immunization
2. Reproductive health needs
3. Provision of essential technologies for health
4. Health promotion
5. Prevention and control of non-communicable
diseases
6. Food safety and provision of selected food
supplements
Principles of Primary Health Care
1.
Improve the level of health care of the
community
2. Promote favorable population growth structure
3. Reduce the morbidity and mortality rates,
especially among infants and children
4. Reduce prevalence of preventable,
communicable, and other diseases
5. Improve basic sanitation
6. Extend essential health services especially to
the underserved sectors
7. Develop the capability of the community to
become self-reliant
8. Encourage the contribution of other sectors to
the social and economic development of the
community
9. Provide equitable distribution of health care
control
3. Expanded-program of immunization against
10. Ensure community participation and monitor
adequacy and distribution of health workers
major infectious diseases
4. Maternal and child health care including family
who are supported locally and at the referral
levels
planning
5. Essential drugs arrangement
6. Nutritional food supplement, an adequate
supply of safe, and basic nutrition
7. Treatment of communicable and non-
11. Recognize that the formal health sector needs
other sectors in the promotion of health (multisectoral approach)
12. Use the appropriate technology Which are
communicable disease and promotion of
accessible, feasible, affordable, and culturally
mental health
acceptable to the community
8. Safe water and sanitation
Management of Primary Health Care
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1.
2.
3.
4.
5.
1.
2.
3.
4.
Functions in the Process of Management
Planning- Setting priorities and determining
performance target
Organizing – Designing the organization or the
specific division, unit or service
Staffing – Acquiring and retaining human
resources, and developing maintaining the
workforce
Controlling – monitoring staff activities and
performance and taking the appropriate
actions for corrective actions
Directing – initiating action in the organization
Management Principles in Relation to
Organizing
Authority, Responsibility, and Accountability
a. Authority – to issue orders, make
decisions, and allocate resources
b. Responsibility – To perform the
assigned tasks and activities
c. Accountability – Reporting and
justification of task outcomes
Types of Authority
a. Line authority
• issue orders to their subordinates and
responsible for the results
• Have total authority over those who report
directly to them
b. Functional Authority
• Authorities that have power over specific
processes, practices, policies, or other
matters in relation to activities undertaken
by persons under in other department
c. Staff Authority
• Provision of advice and other services (to
assist) to line managers
• Advisory authority given to specialist in
their areas of expertise
Centralization, Decentralization, and
Formalization
a. Centralization – The top of the
organization is responsible for planning
and decision-making
b. Decentralization – Planning and
decision–making is delegated to the
lower branch of the organization
c. Formalization – written documentation
provided for the direct control to the
employees
Staffing
The Philippine Health Care System
• Complex set of organization interacting to provide
an array of health services
The Department of Health Mandate EO no.119, Sec 3
• The DOH (formerly known as Ministry of Health)
• Has the responsibility to create, plan, implement,
and systematize nation health policies, advocacies,
and programs
Vision
A global leader for attaining better health
outcomes, competitive and responsible health care
system, and equitable health financing
Mission
To guarantee equitable, sustainable and quality
health for all Filipinos, especially the poor, and to lead
the quest for excellence in health
Levels of Health Care Facilities
1. Primary Level of Health Care Facilities
2. Secondary level of Health Care Facilities
3. Tertiary level of Health Care Facilities
•
•
•
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•
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•
•
•
•
Levels of Primary Health Care Workers
1. Grassroot or Village Health Workers
Initial links of the community to health care
Provide preventive health care measures and
simple curatives
Encourage programs/activities to improve the
socioeconomic level of the community
Volunteers, community health workers, or
traditional birth attendants
2. Intermediate Level of Health workers
1st source of professional health care
Attend to health problems that is beyond the
competency of the village workers
Provide supervision, training, supplies, and
services that provide support to front-line health
workers
3. First-Line Hospital Personnel
Serve as the backup health service providers
In close contact with the other two health workers
Physicians with specialty, nurses, dentist,
pharmacists, and other health professionals
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LESSON 4 OVERVIEW OF HEALTH INFORMATICS
Health Informatics
• Application of both tech and system in the
healthcare system
• Use of HIS reduces cost and increase quality of
healthcare
• Combination of elements in HIS improves the
provision of quality, effective and efficient services
• Huge amount of routine data in health care became
perplexing to process and analyze.
• Making sense of the large amount of data while
ensuring that the processes are valid and secure is
a challenge for health informatics
Health Information Technology (HIT)
The area of IT involving the design development,
creation use, and maintenance of information systems
for the health care industry.
Automated and interoperable health care information
systems are expected to improve medical care, lower
costs, increase efficiency, reduce error, and improve
patient
satisfaction
while
also
optimizing
reimbursement of ambulatory and in-patient health
care providers
To provide innovation to health care delivery and
connection among users and stakeholders in the ehealth market.
Health Care Software Systems
Electronic Health Record Patient’s official health
(HER) or Electronic
record in digital form
Medical Record (EMR)
Personal Health Record
person’s self-maintained
(PHR)
HR
Health Information
The health data
Exchange (HIE)
clearinghouse (Idk what
this)
HITECH Act of 2009
Use and Implementation
of EHR systems
Medicare Access and
Value-based
Children’s Health
reimbursement system
Insurance Plan
Reauthorization Act
(MACRA)
Picture Archiving and
help manage and store
Communication Systems the patient’s medical
(PACS) &
images
Vendor Neutral Archives
(VNA)
Health Information Ecosystems (Health
Interoperability Ecosystem)
As a composition of individuals, systems, and
processes that share, exchange, and access all forms
of health information, including discrete, narrative, and
multimedia (defined by Health Information and
Management Systems Society)
Provides an information infrastructure that
uses technical standards, policies, and protocols of
enable seamless and secure capture, discovery,
exchange, and utilization of health information
Health Informatics in the Cloud
Advantages of Cloud Technology
1. Integrated and Efficient Patient Care
• Single access point for patient information
• Physicians can spend more time deciding and
performing patent treatment
2. Better Data Management
• Meaningful data mining (examining databases in
order to generate new information)
• More mined data, more opportunities to identify
trends in diseases and crisis
Disadvantage of Cloud Technology
1. Potential Risk to Personnel Information
• Vulnerable to data breaches
• EMR may be subject to theft or other violations of
privacy and confidentiality
2. Cloud Setup Seems Too Complicated and
Confusing (Cumbersome)
•
Health Informatics in the Philippines
• Is the application of both technology and systems
in a health care setting.
• Community Health Information Tracking System
(CHITS)
• An electronic medical record (EMR)
• Released under the general public License
• Developed through the collaboration of the
information and Communication Technology
community and health workers
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• For use in the PH health centers in
disadvantaged areas
• A linux, Apache, MySQL, PHP-based system
released under the general public license (GPL)
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LESSON 5 HEALTH INFORMATION SYSTEMS
General Difference
Health
Informatics
Health Info
Technology
Health info
System
The application of both tech and
system in a health care setting
Focuses on the tools
Records, coding, documentation,
and administration of patient
and ancillary service
Health information Flow(?)
Handwritten →Computer-based →Integrated Health
Record →HER→HIS→HIM/HMIS
6 major Components of Information Technology
Hardware
Software
Data
People
Process
Telecommunication
(Not really sure about this part from
components to telecommunication)
Components
• Hardware
• Software
• People
Process
• Information/report
• Data collection
Telecommunication (Internet provider)
Information System Components
Technology Organization People
Knowledge
History of information Technology
7th
Johannes Gutenberg & Blaise Pascal
Century
Ability to record, process and
dissemination and reach info and
knowledge
1951
UNIVAC 1 First computer for info
processing
1954
GE Inc.
1970
Personal Computer
1991
WWW by Time Berners Lee
Health Information System
• Systems that capture, store, manage, and
transmit health-related info
• Sourced from individuals or activities of health
institution
• Well-functioning HIS is very useful in
policymaking and decision making of health
institutions and becomes the basis in creating
program action.
• Sustainable, user friendly, and economical
• Mechanism which keeps track of all data
related to the patient
• Includes:
→ Disease surveillance
systems
→ Hospital patient
admin systems (PAS)
→ District level routine
info system
→ Human resource
management info
system (HRMIS)
→ Lab info systems
(LIS)
Effects of Absence of HIS
1. Longer time of info retrieval
2. Interchanging of data and results
3. Lost results
4. Confidentiality loss of results
Roles and Function of Health Information Systems
1. Easier access to Files
2. Better Control
3. Easier Update
4. Improved Communications
Functions of HIS
• Captures, stores, and manages data
• Encompasses district level routine information
systems, disease surveillance systems and
laboratory info system, hospital patient
administration system, and HRMIS
• Collect process report and use health in and
knowledge to influence policy and decisionmaking, program action individual and public
health outcome and research
At Policy level
• Should become sustainable
• not over burden health deliver staffs
• not too expensive to run
• Employees need feedback on how the routine
data they collect can be utilized and also needs
….(wla ko na tapos copy)
• Acts as a mechanism to keep track of
everything related to patients
Components of Health Information Systems
Framework and Standards for Country Health
Information Systems by the Health Metrics Network
(HMN)
1.
Health
Information
Systems
Resources
2. Indicators
3. Data Source
Categorization of HIS
Inputs
HIS resources
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4. Data Management
5. Information Products
6. Dissemination and
Use
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Process Formed from Indicators, Data Sources,
and Data management
Outputs • Transformation of data into info
• Can be then used for decision-making
and to the dissemination and use of such
info
Different Data Sources for Health Information Systems
1.
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Demographic Data
Basic data about the patient
Educational background and employment
2.
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Administrative Data
Diagnostic Test or out-patient procedures
Kind of practitioner
Physician’s specialty
Nature of institution
Charges and payments
3.
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Health Risk Information
Lifestyle and behavior
Family medical history
Other genetic factors
Used to evaluate the patient’s propensity for
different diseases
4. Health Status
• How the current lifestyle leads to a certain
future health status
• One’s perception of his or her health in
comparison with that of his or her peers
• Includes the physical func, mental and
emotional well-bing, cognitive func, and social
func.
5. Patient medical History
• Past medical encounters (admissions,
pregnancy, surgical procedures, etc)
• Family History
6. Current Medical Management
7. Outcome Data
• Measure of the aftereffects of health care and
of various health problems (like diseases).
• Show the health care events
• Measures of satisfaction with care
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LESSON 6: HEALTH MANAGEMENT INFORMATION
SYSTEM
 Health management information system (HMIS)
o Specially designed to assist in the management
and planning of health programs, as opposed to
delivery of care
o Health component of HMIS refers to clinical
studies to understand medical terminologies,
clinical procedures and data processes
o Management refers to the principles that help
administer the health care enterprise
o Information system refers to the ability to
analyze and implement applications for efficient
and effective transfer of patient information
 HMIS is a set of integrated components and
procedures organized with the objective of
generating information that will improve health
care management decisions at all levels of the
health system.
o It is a routine monitoring system that evaluates
the process with the intention of providing
warning signals through the use of indicators
 HMIS is used by the health unit in-charge and the
Health Unit Management Committee
 HMIS was developed within the framework of the
following concepts:
o The information collected is relevant to the
policies and goals of the health care institution,
and to the responsibilities of the health
professionals at the level of collection.
o The information collected is functional as it is to
be used immediately for management and
should not wait for feedback from higher levels.
o Information collected is integrated for there is
one set of forms and no duplication of reporting.
o The information is collected on a routine from
every health unit.
 Roles of HMIS
o Provide quality information to support decisionmaking at all levels of the health care system in
any medical institution.
o Aims to aid in the setting of performance targets
at all levels of health service delivery and to
assist in assessing performance at all levels of
the health sector.
o HMIS needs to be complete, consistent, clear,
simple, cost-effective, accessible and
confidential.
 Functions of HMIS
- Can be used in planning, epidemic
prediction and detection, designing
interventions, monitoring and resource
allocation
- 3 fundamental information-processing phase: data
input, data management, data output
o Data input
▪ Data acquisition – generation and collection of data
through the input of standard coded formats to assist
in the faster mechanical reading and capturing of
data
▪ Data verification – data authentication and validation.
o Data management
▪ Data storage – preservation and archiving of data.
▪ Data classification – also called data organization
which sets the efficiency of the system.
▪ Data computation – requires various forms of data
manipulation and data transformation. Allows data
analysis, synthesis, and evaluation.
▪ Data update – facilitates new and changing
information requires constant monitoring.
o Data output
▪ Data retrieval – process of data transfer and data
distribution. The transfer process considers the
duration of transmittal of required data from the
source to the appropriate end-user.
▪ Data presentation – reporting of the interpretation of
the information produced by the system. Summary
tables and statistical reports are expected but the
use of visuals is encouraged especially for high level
managerial decision making because they provide a
better intuitive perspective of the data trend.
 List of functions HMIS
1. Client data
- Information of the client, which are related to
his or her transactions, reports and other
information such as client billing data, clinical
data, etc.
2. Scheduling
- Distribute resources to areas that need them
3. Authorization tracking
- Monitoring of the authorized personnel and
their use of the authorized units.
4. Billing
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Notification of the charges for the patient and
other related documents such as compliant
electronic entity
5. Accounts receivable management
- Customers are properly notified about their bill
and will settle it accordingly
- Tracking aging of unpaid services, tracking
reasons for denials, and aged receivable report
by payer source.
6. Reporting
- Reports issue by the entity which could be
basic reports or report writer.
7. Medical record
- Electronic health record (HER), a collection of
digital information about a patient.
8. Compliance
- Procedure that should be followed for the
improvement of the condition of the patient or
the service provided such as treatment plan
and progress note.
9. Financial data
- Information relating to the performance of the
entity collected for administering purpose.
- Financial reports, general ledger, payroll, and
accounts payable.
the overall design of the computer
software used in the collection of
information.
 PRISM Framework
- Performance of Routine Information Systems
Management (PRISM)
- Defines the various components of the RHIS
and their linkage to produce better quality and
continuous use of information, leading to better
health system performance and consequently,
better health outcomes.
o Behavioral determinants
▪ Knowledge, skills, attitudes,
values and motivation of the
people who collect and use data
o Organizational determinants
▪ Information culture, structure,
resources, roles and
responsibilities of the health
system and key contributors at
each level
o Technical determinants
▪ Data collection processes,
systems, forms and methods.
 Determinants of HMIS Performance Area
o Behavioral determinants
▪ The data collector and users of the
HMIS need to have confidence,
motivation and competence to
perform HMIS tasks in order to
improve the routine health
information system (RHIS) process.
o Organizational determinants
▪ The important factors that affect the
development of the RHIS process
are the structure of the health
institution resources, procedures,
support services, and the culture
within the organization.
o Technical determinants
▪ Involves the overall design used in
the collection of information. It
comprises the complexity of the
reporting forms, the procedure set
forward in the collection of data, and
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LESSON 7: HMIS MONITORING AND EVALUATION
HMIS Monitoring and Evaluation
• Continuous monitoring and evaluation is necessary
for HMIS to effectively assist in planning and
management of a national health strategy
• Monitoring and evaluation are complimentary by
definition and function
• There is not M&E without health programs in the
community
Monitoring
• The collection, analysis, and use of info gathered
from programs for the purpose of learning from
the acquired experiences, accounting the
resources used both internal and external, and
obtaining results and making decisions.
3 corresponding functions to the purposes of
monitoring
→ (Learning) Learning from the acquired
experiences,
→ (Monitoring) Accounting the resources used
(internal and external),
→ (Steering) And obtaining results and making
decisions
•
•
•
•
•
Evaluation
The systematic assessment of completed
programs or policies
The objective is to gauge the effectiveness of the
program so that adjustments can be made in areas
that need improvement
Both a learning function and a monitoring function
Learning function
o The lesson learned need to be incorporated
into future proposal
Monitoring function
o The concerned parties review the
implementation of policy based on the
objectives and resources
Purpose of M&E
To assess the effect of an integrated service
delivery.
Appropriate indicators, data collection systems,
and data analysis to support decision-making→
help guide the successful implementation of
integrated services and measure the effects on
both service delivery and use of services
M&E Framework
•
Strengthening of a common country platform for
the M&E HSS is the core of the framework
M&E of health system strengthening(HSS)
• General framework of M&E that was developed by
various global partners and countries
• Derived from the Paris Declaration and
International Health Partnership (IHP+)
4 components of the M&E Framework
• Indicator Domain
• Data Collection
• Analysis and
• Communication &
Synthesis
Use
o Intended for achieving great health impact
For monitoring medical services…
• Indicators are tracked to assess processes and
results associated with the various indicator
domains
→ The strength and weaknesses implementation are
provided and can be used for troubleshooting in
the system
In terms of outcomes and impact indicators…
• The changes may not be directly caused by the
service delivery efforts for there are other factors
to consider that influences the changes.
• These data are still useful in understanding the
current health status and context within a country
M&E Plan
• Addresses the components of the framework
• Establishes the foundation for regular reviews
during the implementation of the plan for the
national level
• Local M&E system generate information for global
monitoring based on the health sectoring review
processes
• Health sector review processes are considered as
key factors in monitoring the progress and
performance of the entire system
•
•
•
•
Framework-implementation strategies
The framework should…
Be localized
Address the needs for multiple users and
purposes
Facilitate the identification of indicators and data
sources
Be able to use the M&E in disease-specific
programs
M&E and HMIS Indicators
Indicator
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•
•
•
a variable which measures the value of the change
(in units) that can be compared to past and future
units
Focus is on a single aspect of a program such as
input, output, outcome, impact
HMIS uses various indicators to monitor key
aspects of health performance
USAID’s 5 Indicator Categories (Key Performance
Area)
• Reproductive
• Immunization • Disease
Health
Prevention
and Control
• Resource
• Data Quality
Utilization
Key Indicators by Categories
Reproductive Health
1. Family planning acceptance rate
2. Antenatal care coverage
3. Proportion of deliveries attended by skilled health
personnel
4. Proportion of deliveries attended by HEWs
Immunization
5. DPT-3 (Pentavalent-3) coverage (>1 child)
6. Measles Immunization coverage (>1 child)
Disease Prevention and Control
7. Malaria case fatality rate among patients under 5
years of age
8. New malaria cases per 1,000 population
9. New pneumonia cases among children under 5 per
1,000 population of<5 yrs
10. TB case detection rate
11. TB cure rate
12. Clients receiving VCT services
13. PMTCT treatment completion rate
14. PLWHA currently on ART
Resource Utilization
15. Trace drug availability (in stock)
16. OPD attendance per capita
17. In-patient admission rate
18. Average length of stay (in-patient)
Data Quality
19. Bed occupancy rate
20. Reporting completeness rate
21. Reporting timeliness rate
HMIS Indicators and Health Programs
• HMIS is a source of routine data necessary for
monitoring different aspects of various health
programs implemented in a country.
•
HMIS indicators should be carefully selected to
meet the essential information necessary for
monitoring the performance of various health
programs and services and to present an overview
of available health resources
5 Components of Health Programs (LOGIC MODEL)
Inputs:
Definition: Resources used during project activities to
product outputs
Question: What do you put in?
Example: People, space, materials, knowledge, skills
Activities:
Definition: The processes, tools, events, technology,
and/or actions that
objectives
are carried out to achieve the
Question: What are you doing?
Example: Teaching good hygiene practices, teaching
how to make soap, demonstrating new gardening
techniques, home educating on good nutrition
Outputs:
Definition: The direct result of the activities of a
project. Outputs may be goods, infrastructure,
services or people reached by services.
Questions: Who came? How many came? What was
developed?
Example: 8 women, 14 girls under 15, 10 boys under 15
attended. 8 hand-washing stations were produced, 25
bars of soap were made, 35 trees were planted
Outcomes:
Definition: Changes in specific knowledge, attitudes,
behaviors, or conditions that result from project
activities
Questions: What changed? Of the number who
participated, how many showed change?
Example A month later, six women were using the
hygiene practices they learned in their homes.
Impact(Goal/Objective):
Definition: The long-term, cumulative effect of an
intervention or interventions (e.g., the long term
results stemming from participants’ activities over the
life of a project).
Questions: What is the long-term effect?
Example: Community members, especially children
under 5, are not contracting hygiene- and sanitationrelated illnesses (like chronic diarrhea) as often as
they once did; community members are able to work
more consistently and students are performing more
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effectively in school because they aren’t out sick as
often.
•
•
Maternal Survival Intervention
The fifth millennium development goal targets to
reduce the maternal mortality ratio by 75% and to
achieve universal access to reproductive health.
Packaging of health facility-oriented interventions
is highly effective and has high coverage of the
intended target group
MSI Indicators
1. Pregnancy care
3. Postpartum care
intervention
2. Intrapartum care
4. Interpartum
period
Child Mortality and Child Survival Interventions
Top 10 leading causes of child mortality
1. Pneumonia
5. Septicemia 9. Meningitis
2. Diarrhea and
6. Accidental
10.
Pulmonar
Gastroenteriti
drowning
y and heart
s
and
disease
submersion
3. Congenital
7. Chronic
Anomalies
lower
respiratory
diseases
4.Other
8.Dengue
Diseases of
Fever and
the nervous
denguesystem
hemorrhagi
c fever
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•
•
•
•
•
1. Child 21
Or the Philippine Strategic Framework for Plan
Development for Children 2000 to 2025
Serves as a framework for policymaking and
program planning
As a roadmap for intervention aimed at
safeguarding the welfare of Filipino children
2. Children’s Health 2025 (Subdocument of Child
21)
Focuses on the development of Filipino children
and the protection of their rights
3. Integrated Management of Childhood Illness
Is a strategy that aims to lower child mortality
caused by common illness
4. Enhanced Child Growth
Aimed to improve the health and nutrition of
Filipino children
Stop TB Program(STP)
Dramatically reduce the global burden of
tuberculosis by 2015
One of the main objectives is to achieve universal
access to high-quality care for all people with TB
Reduce the prevalence of and death by 50%
compared with the 1990 baseline by 2050
•
•
•
•
STP Indicators
TB patients on DOTS
•
•
TB case Detection
HIV-TB co-infection
•
•
TB treatment
outcome
HIV+ new TB patients
enrolled in DOTS
Immunization
PENTA
DPT
HIB
OPV
HEP
B
diphtheria, Pertussis and Tetanus
Hemophilus Influenza type B
oral polio vaccine
Hepatitis B
MMP (Mumps, Measles and Rubella)
Infection
Type of Virus
Measles
Rubeola Virus
German measles
Rubella Virus
Mumps
Mumps rubella Virus
Other Acronyms (Sorry, I know it is messy :< )
IPV
Inactivated Polio Vaccine
BCG
Bacillus Calmette Guerin (for prevention of
TB)
CDC
Center of Disease Control and Prevention
MSDS Material Safety Data Sheet
DOTS Directly Observed Treatment Short Course
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LESSON 8: HMIS DATA QUALITY
Data Quality
• Can affect operational cost, customer satisfaction,
company reputation, and the strategic decisions of
management
• The overall utility of a dataset(s) as a function of its
ability to be processed easily and analyzed for a
database, data warehouse, or data analytics
system
• Signifies the data’s appropriateness to serve its
purpose in a given context
• High data quality contains most/all the aspects of
data quality
Aspects of Data Quality
• Accuracy
• Consistency
• Accessibility
• Completeness
• Presentability
• Relevance
• Reliability
Lot Quality Assurance Sampling (LQAS)
• A tool that allows the use of small random
samples to distinguish between different groups of
data elements (or lots) with high and low quality
and classify health or administrative geographical
areas.
• A methodology that provides real-time planning
and management information
• Adopted as the tool for measuring health
indicators
• District Health Information System (DHIS) data
quality assurance– Adopted the concept and
application of LQAS in its context
• survey will measure access, quality, use, health
seeking behavior, perception of health services,
performance of health providers and facilitate
governance.
❖ methodology based on small sample surveys will
be more cost effective than cluster sampling
surveys while providing statistically robust
estimates.
4. Determine the level of acceptable error.
5. Determine the sample size and decision rule
for acceptable errors to declare an area as
performing "below expectations."
6. Identify the number of errors observed
(mismatched data elements will be reliably
determined if the facility is performing above
or below expectations).
Routine Data Quality Assessment (RDQA)
• Simplified version of Data Quality Audit (DQA)
• DQA tool which allows programs and projects to
verify and assess the quality of their reported data.
• Programs and projects to assess the quality of
their data and strengthen their data management
and reporting systems.
❖ Generally, the quality of reported data is dependent
on the underlying data management and reporting
systems; stronger systems should produce better
quality data.
RDQA Objectives
1. VERIFY RAPIDLY 1) the quality of reported data for
key indicators at selected sites; and 2) the ability of
data‐ management systems to collect, manage and
report quality data.
2. IMPLEMENT corrective measures with action
plans for strengthening the data management and
reporting system and improving data quality.
3. MONITOR
capacity
improvements
and
performance of the data management and reporting
system to produce quality data.
Steps in applying LQAS
1. Define the service to be assessed (e.g,. DQA of
DHIS).
2. Identify the unit of interest (e.g., a supervisory
area, facility, hospital, a district)
3. Define the higher and lower thresholds of
performance based on prior information about
the expected performance of the region of
interest.
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2. Generalized “Cleansing” – Modification of data
3.
4.
5.
Development Implementation Plan
• Tool that illustrates how a project is expected to
progress at a high level
• Ensure that the development team is working to
deliver and complete task on time
• Ensuring the efficient flow of communication
between those who are involved in the project
• Minimize issues that would delay delivery of the
project
• Validates the estimation and schedule of the
project plan
1.
2.
3.
4.
5.
Key Steps of Implementation Plan
Define goals/objectives – “What do you want to
accomplish”
Schedule milestones – Outline the deadlines and
timelines
Allocate resources – Determine whether you have
sufficient resources, and decide how you will
procure those missing
Designate team member responsibilities – Create
a general team plan with overall roles that each
team member will play
Define metrics for success – measurement for
success
Data Quality Tools
• Analyzes info and identifies incomplete or
incorrect data
• The maintaining the process enhances the
reliability and integrity of the info being used by the
organization
Data Cleansing – the process in which could range
from removing abnormalities to merge repeated info
1.
Functions/Uses of Data Quality Tools
Parsing and standardization –
Decomposition/breakdown of fields
into
component parts and formatting the values into
consistent layouts based on industry standards
and patterns and user- defined business rules
6.
•
•
•
values to meet
domain restrictions, constraints
on integrity, or other rules that define data quality
Matching – Identification and merging of related
entries
Profiling – Capture statistics or metadata to
determine the data
quality and identify data
quality issues
Monitoring – Deployment of controls to ensure
conformity of data to
business rules
Enrichment – Enhancement of the values of the
data by using
related attributes from external
sources
Application/Scope of Data Quality Tools
First generation of data quality tools - was
characterized by dedicated data cleansing tools
designed to address normalization and
reduplication
Last 10 years - it was observed that there is a
generalization of Extraction, Transform, Load (ETL)
tools → Allow the optimization of the alimentation
process
Recently – Data Quality Management (DQM) →
integrates, profiling, parsing, standardization,
cleansing, and matching processes
Root Cause Analysis
• A systematic problem-solving method that
identifies the root causes of problems or events in
order to effectively address problems
• Aim is to improve the product’s quality and
services
Techniques in Root Cause Analysis
NOTE: this portion contains a lot of additional info for
better understanding
1. Failure Mode and Effects Analysis
• Aims to find various modes/ways of failure or in
which something might fail within a system and
analyze/study the effects of the failures, then find
solutions for the failures.
• Failures are prioritized according to how serious
their consequences are, how frequently they occur,
and how easily they can be detected.
• The purpose of the FMEA is to take actions to
eliminate or reduce failures, starting with the
highest-priority ones.
• USED WHEN: There is a new product/process/
programs or when there are changes or updates in
a product/organization/processes/programs and
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when a problem is reported through customer
feedback (but not necessarily the customers in
other cases)
https://asq.org/quality-resources/fishbone
•
https://asq.org/quality-resources/fmea
•
•
•
•
2. Pareto Analysis
statistical technique in decision-making used for
the selection of a limited number of tasks that
produce significant overall effect.
Lays down the potential causes in a bar graph and
tracks the collective percentage in a line graph to
the top of the table
Uses the Pareto principle (20% of the work creates
80% of the results)
USED WHEN: there are multiple potential causes to
a problem
https://www.projectsmart.co.uk/pareto-analysis-stepby-step.php
•
•
•
•
3. Fault Tree Analysis (FTA)
It is a top-down, deductive analysis which visually
depicts a failure path or failure chain
Uses Boolean logic to determine the root cause of
an undesirable event
Undesired results at the top and potential causes
are listed down
USED IN: risk and safety analysis.
https://quality-one.com/fta/
•
•
•
•
•
4. Current Reality Tree (CRT)
It is a down-top, inductive analysis to determine
the effects/results of the problem
Problems are listed down followed by the potential
cause/s of the problem and the results/effects are
listed at the top
USED WHEN: The root causes of multiple problems
need to be analyzed all at once
5. Fishbone Diagram (Ishikawa or cause-andeffect diagram)
Looks like a fishbone as it shows the categorized
causes and sub-causes of a problem
USED WHEN: in identifying and grouping possible
causes into categories.
6 Major categories of causes
• Methods • Equipment
• People
• Material • Measureme • Environme
s
nt
nt
•
6. Kepner-Tregoe Technique
Breaks down a problem to its root cause by
assessing a situation using priorities and orders of
concern for specific issues
The idea is not to find a perfect solution but rather
the best possible choice, based on actually
achieving the outcome with minimal negative
consequences
4 basic steps
Situation Appraisal – used to clarify the situation,
outline concerns and choose a direction
2. Problem analysis – the problem is defined, and its
root cause is determined
3. Decision analysis – Alternatives are identified, and
a risk analysis is done for each alternative
4. Potential Problem analysis – the best of the
alternatives is further scrutinized against potential
problems and negative consequences and actions
are proposed to minimize the risk
1.
https://www.decision-makingconfidence.com/kepner-tregoe-decision-making.html
7. Rapid Problem Resolution (RPR)
• Deals with failures, incorrect output and
performance issues
3 RPR Principles
• An investigation is focused on a single symptom
• Definitive diagnostic data is captured for instances
of that symptom
• The diagnostic data is always captured for a real
problem in a live environment
3 RPR Phases
1. Discover – Data gathering and analysis of the
findings
2. Investigate – Creation of a diagnostic plan and
identification of the root cause through careful
analysis of the diagnostic data
3. Fix – fixing the problem and monitoring to confirm
and validate that the correct root cause was
identified
• USED WHEN: diagnosing of ongoing and recurring
problems
12manage.com/myview.asp?KN=3136
Sustaining a Culture of Information Use
Information Culture
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•
is determined by the ff variables: mission, history,
leadership, employee traits, industry, and national
culture
•
•
•
•
It can also be shaped by cognitive and epistemic
expectations
Affects the outcomes of information use
In order to have sense of information attitudes and
values, managers should consider taking the
pulse/rhythm of information of their own
organizations
Management play an important role in sustaining a
culture of information and should continuously
work on maintaining and improving the quality of
data information used in daily operation
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LESSON 9: HOSPITAL INFORMATION SYSTEM
Hospital Information System (intro in the 1960s)
Definition: Is a computer system structured to manage
all the records of health care providers to make
available information and reports useful to health care
personnel in doing their job more efficiently
•
Offer support 24/7 to facilitate easier usage of the
system by health care professionals
Radiology Information Systems (RIS)
Can provide billing services and appointment
scheduling aside from reporting and database storage
In the past: it was mainly for billing and inventory
Today: system is integrated with other financial,
scientific, and administrative programs
Should be: affordable, scalable, and centered on the
needs of patients and medical personnel, and
adaptable to rapid technological changes.
Customizable to the needs of the departments
Function: Gather, process, retrieve patient info, and
provide hospital stakeholders with relevant
information through reports for better decisionmaking. (NOT HIS FUNCTIONS but general functions)
•
•
•
•
Has applications built to address the needs of the
various departments of health facilities.
Provides enhanced integrity of facts, minimization
of transcription error and duplication of records,
and shorter TAT for reports
Advancement and new developments will be
rendered useless if the system is not user-friendly
and training is inadequate
A person can access different HIS as long as the
person is affiliated to the HIS or has the
permission to do so.
HIS for Different Departments
Nursing Information System (NIS)
Function: Handling of personnel schedules, accurate
patient charting, and better clinical data integration
•
•
•
To obtain cost-effective staffing and show staffing
levels
Patient charting applications allow better analysis
of critical signs
Useful in designing the patients’ care plan since
the medical info integration function allows nurses
to collect and examine retrieved medical records
Physician Information System (PIS)
Function: to improve the practice of physicians
• EMRs and EHRs are some programs where PIS is
deployed and extensively used
Pharmacy Information System (PIS)
Function: Help monitor the utilization of medicines in
health institutions and provide information to identify
drug interactions which helps in administering the
appropriate drugs
Selecting a Hospital Information System
Total cost of package
HIS is available for all sizes and budgets for hardware
and software
Web-based system
Available in the internet, authorized personnel can
access the info, data sharing between hospital is
possible, and can facilitate access to info from other
health facilities upon request
Implementation and support
Provides ample training and assistance to the users of
the system. Consider HIS provides that offer 24/7
support
HIS Providers in the Philippines
BizBox (1994)
Company’s goal is to improve work efficiency in health
care institutions through software systems, and to
produce advanced solutions for netter patient care.
KCCI Medsys (Kaiser-dela Cruz Consulting, Inc.)
• Specializes in application development for
hospitals, industrial clinics, and medical-related
educational institutions
• MEDSYS for hospitals and MEDSCO for schools
Comlogik (1999)
• PH-based software development company with a
vision to be a global technology company
• Led the way in developing innovative applications
HIS Functions
Help Desk
Clients are provided with info and guidelines
associated with a company’s or institution’s products
and service without any hassle
Scheduling
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Managers and employees can effectively discuss their
scheduling preferences anywhere through scheduling
software.
•
Patient Registration
• Patient registration form records the name, age
gender, marital status, and other relevant
information regarding the patient. (Demographic
•
•
Data)
•
•
Realization of expected business benefits and
financial returns
Cooperation and responsiveness of the supplier to
the organization’s needs
No contract disputes or surprises
Satisfactory delivery of services to both parties
Package Deal Designer
Post-diagnostic package deal
Information are used for record keeping and
account management purpose
Admission
• Admissions counselor will call him or her to
gather preliminary information, offer vital info
concerning the hospital stay, and answer
questions if there are any
• Other routine test can also be carried out on the
day of admission
❖ The point at which a person enters hospital as a
patient (inpatient to be specific)
Discharge
• Releasing of patient from the health facility by
the person authorized to release the patient
• Details services needed to be administered
after the hospital stay to ensure the fully
recovery of the patient
Transfer
• The movement of an individual outside of the
hospital premises at the instruction of any
authorized hospital personnel.
• DOES NOT encompass movement of the deceased,
or leaves the facility without authorized
permission
Billing
• Shows all records pertaining to the invoices,
payments, and the current balance of a patient’s
account.
• It is a good practice to generate the billing
statement on a regular basis so that the institution
could keep track of its collectables.
Contract Management
• As the process of managing contract creation,
execution, and analysis to maximize the
operational and financial performance of an
organization while reducing financial risk
• A very time-consuming element of business, which
facilitates the need for an effective and automated
contract management system
Contract management Strategy
Posting diagnostic medical packages for in-patients,
out-patients, and emergencies requires the same
process; difference is that for emergencies.
REPORTING
Laboratory Reporting
Administrative Data or clerical Information
Date when report was
Test report date
printed
Name and address of
Patient name and
the laboratory location
identification number or a
where the test was
unique patient identifier
performed
and identification number
Name of doctor or
legally authorized
person ordering the
test(s)
Info about specimen and the test itself which
makes the lab report more meaningful
Test results
Critical results
Condition of specimen
Abnormal test results
Name of the test
Interpretation of results
performed
Laboratory accession
number
Reference intervals (or
reference ranges)
Medications, health
supplements, etc. taken
by the patient
Date and time of
specimen collection
Specimen source (if
applicable)
Deviations from test
preparation procedures
Units of measurement
(for quantitative results)
Radiology Reporting
An official medical document that provides the details
of the requested radiology examination and the
procedure conducted by the radiologist
The main objective of the report is to address the
queries in the request
The findings should take into account both positive and
negative findings
Basic Sections of Radiology Report
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• Administrative • Patient
info
identification
• Imaging
• Comparisons
technique
• signature of radiologist
• Clinical history
•
• Summary or
impression
•
Cardiology Reporting
Contain important medical information based on the
test results of the patient which are set against past
medical records
Transthoracic echocardiography (TTE) report
components
A good management reporting system enhances
the capability of an institution to be more
responsive, efficient, and effective in decisionmaking which affects the performance of the
institution as a whole
Offer a single holistic view which highlights high
value sources and eradicates the lack of visibility
in reviewing the performance of the institution
In-Built Tally Interface
Tally.ERP9 – a software that provides simplified
solutions to operations in health institutions such as
registration, accounting, inventory management, tax
management, among other
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC178109
4/
Cardiology information system (CIS) or Cardiovascular
information system (CVIS)
❖ a system that provide dynamic reporting (images,
informatics, measurements, etc) that are
structured in a template-type format for efficiency
and consistent delivery of patient report
• vascular sonography reports are accurately
created with only a few clicks
• reports could include ultrasonic ultrasound and
diagrams
Materials Management System
Materials management
• Primarily concerned with planning, identifying,
purchasing, storing, receiving, and distributing
materials.
• To guarantee that the right and sufficient materials
are in the right location when needed
• Utilize barcodes and RFID tags with precise
identification numbers assigned for each inventory
object to enable accurate tracking and control
• Automatic stock management also assist health
care institutions in figuring out whether
merchandise has been recalled or damaged and
should not be given to patients
• Accountable for receiving materials, retaining
central stock, and delivering supplies within the
institution
Management Reporting
• A platform for reporting and controlling info
valuable to the institution
• Provide non-monetary info which enables the
management to have an oversight of its operations
• Data redundancy and data quality issues are
minimized
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LESSON 10: LABORATORY INFORMATION
MANAGEMENT SYSTEM
Laboratory Information Management System (LIMS)
• Is designed to help process information in medical
research by reducing manual tasks and
procedures
→ To improve the efficiency of the department’s
services and laboratory operations
•
•
Mode of lab error →Clerical error which could lead
to misidentification or possible error results
Useful for pharmaceutical laboratories, biobanks
and genomic testing centers and laboratory
Functional Requirements and Features of LIMS
Sample Management
• Accurate and detailed records are necessary to
make sure that samples are not lost or mixed up.
LIMS recorded and stored information:
o Who the sample was taken from?
(Demographic Data)
o What is the sample taken?
o Who is working with it?
o Who handles the sample?
o Where does it go next?
o How do you store these samples? (Samples
may vary in storing procedure and
requirements)
o When does it need to move?
•
•
•
•
A record should show whether the sample meets
the acceptable values
Regular samples are stored for 3 days only,
samples with special request or significant value
could be kept for a longer period
Regular samples are kept more than 3 days if
there are certain delays
RFID or barcodes in recording and updating logs
and track the chain of custody of the sample
Workflow Management
Used to automate records and workflows which saves
time
Reporting
The most frequently used instrument, the average
handling time of sample, and list of backlogs are
useful in data analysis and formulation of
recommendation for future policymaking
EHR
•
•
It is capable of handling patient records and billing
info
Helps in managing clinical laboratory procedures
Mobile
Accepted use of smartphones in the laboratory
Enterprise Resource Planning (ERP)
• Solution is useful in current supplies, calculating
storage capacity, and managing locations
❖ Is a process used to manage and integrate the
important parts of the businesses (can also be
used for laboratories)
❖ Help implement resource planning by integrating
all the processes needed to run their companies
(or lab) with a single system
Core Components of LIMS
• Electronic laboratory
notebook
• Sample management
programs
• Record management
software
• Best practice and
compliance database
• Client tracking
applications
• ERP Software
• Workflow tools
• Process execution
• Applications to interface
with analytical
instruments or data
systems
Laboratory Standards
Occupational Exposure to Hazardous Chemicals in
laboratories Standards (by Occupational Safety and
Health Administration (OSHA))
•
It specifies the mandatory requirements of a
CHP
Laboratory – a workplace where hazardous chemicals
are used and stores small quantities of hazardous
chemicals
Lab conditions that should be met when using
hazardous chemicals:
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The manipulations of chemicals should be on
"laboratory scale" only and can be handled by one
person.
There is the use of multiple chemicals and
procedures.
The procedures should not simulate any
production process.
Protective laboratory tools are available and
proper practices are followed to minimize
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potential exposure to harmful chemicals.
Any hazardous use of chemicals which does not
meet this definition is regulated under other
standards. Examples are
chemicals used in the maintenance of the
laboratory building,
production for commercial sale, and"
testing of a product for quality control.
Chemical Hygiene Plan (CHP)
Discuss all aspects of the laboratory standards
should be formulated if the standards apply
Address the proper purchase, storage, handling,
and disposal of the chemicals used in the facility
CHP Elements (Summarized)
Establishment of
Monitoring of the work
standard operating
environment
procedures (SOP)
Statement of plan
Designation of personnel
LIMS Application
Patient Registration
• When a patient arrives at the hospital, the
admission clerk will take some basic info and will
guide him or her to a registration window
• Done before taking sample/s from the patient
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Billing
Process of generating statement of accounts or
billing statements of in-patients. out-patients, and
emergencies
Contract Management
To manage the bill and payment aspects of their
activities and to create statistical and billing
reports on a par with the laboratory and
management needs
Provide parameters for a flexible price schedule
and enable heightened attention on customer
needs
Automate billing processing, hasten collections,
and offer marketing tools
Accounts Receivables
• Can easily extract information which was already
available from the invoicing and contract
management procedures
❖ Money owned by the company (for providing goods
or service) that the customers haven’t paid
• generate specific or complete accounts receivable
reports,
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monitor balances for reconciliation and audit
purposes,
export data to other accounting systems, and
customize reports according to specifications.
Worklist and Workflow
• Assists laboratories in setting priorities of current
workloads based on analyst and instruments
availability
• Allows the user to track a sample, a batch of
samples, or numerous batches through their
lifecycle
• Queuing – done by sample or by workflow which is
a block of repetitive procedures in a certain
process
• Allowing users to plan workload schedules and
assignments, and employee information and
training.
• Ultimately, the worklist and workflow functions
operate to facilitate more efficient laboratory
processes
Quality Control
To verify whether the instrument is working within
prescribed parameters
Types of Result: Patient Result and Quality Control
result
Results can be: Qualitative or Quantitative or Semi-
Quantitative
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Enables users to set standards about the relevant
range of patient test results or to extract test
result information for the purpose of quality
assurance.
Outliers and deviations can be flagged, and
appropriate warning signals can notify users about
issues which might involve the quality of the
samples or the equipment currently in use
Levey Jennings chart – designed to detect, reduce, and
correct deficiencies in a laboratory’s internal
analytical process prior to the release of the patient
results
Barcode -generation, Printing, and Reading
• Enable a fast and easy method to identify tubes,
samples, documents, and many others
• Can be customized to suit the organization’s or
classification needs
In-built Bi-directional Interfaces with Equipment
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A two-way communication between the
information system and the clinical instrument is
required
Minimizes the time spent in programing the order
into the analyzer to enhance productivity, and the
elimination of errors usually committed in the
manual process ensures accuracy
Machines also have the random access testing
feature and barcode label scanning for specimen
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LESSON 11: OTHER HOSPITAL INFORMATION
SYSTEMS
Cardiology Information system
•
Mainly focused on the storage and retrieval of
cardiology-centric images
❖ Receives an order with patient demographics from
other information management systems
❖ Images are profiled based on the order and stored
for further distribution, viewing, and long-term
archiving
❖ The information used by cardiologist for the
diagnosis and treatment of illnesses varies from
personal notes, to signals, images, and reports
from investigations and procedures
Benefits of CIS (EFE)
1.
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Ease of Access while Maintaining Data Security
Consolidates multiple types of patient’s cardiology
info
Eliminates the need for doctors to request
different imaging results from different
department
2. Flexibility in the Workflow
•
Asses ad wide array of info without having to leave
the patient’s bedside and offer mobility to
physicians and nurses
3. Enhanced Comparability
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Comparability enables health care professionals to
make more informed decisions on their patient’s
treatment
Retrieval of past data is convenient
Benefits of CIS (ERVE)
1.
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Editing, viewing, storing Multi-modal
Cardiology Data
Different types of data (CT, MRI, PET, SPECT, AND
angiography) may be managed on a single
platform
•
A network system used in managing imagery and
associated data in the radiology department
❖ The system tracks the orders and billing
information of the requesting department
❖ Uses PACS for the storage and management of
medical images and VNA to manage image
archives and for record-keeping and billing within
a HIS
❖ Integrated in referring to the doctor’s HER system
❖ Allows faster processing of payments
❖ Permits reports to be easily generated and sent to
the requesting department
Functions of RIS (PPRIBS)
• Patient Management
Tracks the patient’s entire workflow and can add
images and generate reports to EHRs
• Patient Tracking
Tracing the patient’s radiology history starting
from admission to discharge and coordinating it
with his or her past, present and future
appointments
• Results Reporting
it is possible through the statistical reports
generated by RIS
• Image Tracking
RIS-PACS systems managed by radiology
departments cover the entire clinical workflow of
the medical enterprise
• Billing
Made convenient through the system’s financial
record keeping and processing of E-payments and
automated claims
• Scheduling
Allows staff to schedule appointments for inpatients and out-patients
2. Remote Access
•
The use of networks and integrated information
systems and modern technology offers flexibility to
CIS
3. Visualization and Reporting Capability
•
Visual real-time info retrieval is possible anytime
and anywhere making reporting an ease and
consistent
4. EHR Integration
•
Enhancement of the quality of services by offering
a more comprehensive view of the patient care
spectrum
Radiology Information System
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