MODULE 5: HEALTH INFORMATION SYSTEMS

Health Information Systems hard copy of the patient's medical records becomes
 Health Information Systems (HIS), also called health optional as the systems are electronic. 
informatics, is the application of both technology and 2. Better control
systems in a health care setting. - Only authorized personnel can have access
 While health information technology focuses on tools, information and a patient's health. Doctors may be
health information systems cover the records, coding given permission to update patient information while
documentation, and administration of patient and ancillary receptionists may only have the authority to update a
services. patient's appointment. 
 Defined as a mechanism for the collection, processing, 3. Easier update
analysis and transmission of information required for - After creation of the record, patient information can be
organizing and operating health services and also research accessed and reviewed anytime and copies can be
and training. printed or released to the patient upon request. 
4. Improved communications
Objectives of Health Information System - HIS assists communication among doctors and
1. For early detection of suspected disease outbreaks to hospitals. However, medical professionals must adhere
enable timely initiation of response efforts. to regulations on patient privacy and security to ensure
2. To monitor trends in health status and identify changing that information is kept confidential and safe from
health-care priorities. unauthorized access.
- age, sex and cause-specific data allow planners to
identify priority areas and groups within the population Components of Health Information Systems
3. To provide reliable, relevant, up-to-date, adequate, timely Health metrics network (HMN), in its Framework and
and reasonably complete information for health managers. Standards for Country Health Information Systems (2008), defines
4. To provide at periodic intervals, data that will show the information systems as consisting of six components:
general performance of the health services.

Uses of Health Information System

1. Measure the health status of the people and to quantify
their health problems and medical and health care needs.
2. For local, national and international comparisons of health
status.
3. For planning, administration and effective management of Health Dissemination
Information Systems
Information
and Use
Indicators
Products
Resources
Data
Data
Management
Sources
health services and programs.

Role and Function of Health Information System

The roles that a well-implemented HIS can perform in
improving health services are as follows:
1. Easier access to files
- The systems have revolutionized the collection and
management of patient information. The need for a
1. Health information systems resources The six components of health information systems can be
- These include the framework on legislation, regulation, categorized into inputs, processes, and outputs.
planning, and resources required for the system to be  Inputs refer to the health information system resources.
fully functional (e.g. personnel, logistics support, These resources include health, institutional coordinations
financing, ICT, and component’s coordinating and leadership, health information policies, financial and
mechanism).  human resources, and infrastructures.
 The indicators, data sources, and data management form
2. Indicators the process in HIS. Core indicators are needed as bases
- The basis of the HIS plan and strategy includes for program planning, monitoring, and evaluation.
Population- and institution-based sources are also
indicators and related targets such as the determinants
essential for decision-making as they provide guide to
of health; health system inputs, outputs, and outcomes;
health service delivery. Importantly, this data must be
and the health status. 
accessible and understandable by users and
policymakers. 
3. Data resources
 Outputs refer to the transformation of data into information
- Data sources are divided into two main categories:
that can be used for decision-making and to the
o (1) population-based approaches such as civil
dissemination and use of such information.
registration, censuses, and population surveys
and
Different Data Sources for Health Information Systems
o (2) institution-based data such as individual
records, resource records, and service records.
Demographic Administrative Health Risk Health
- Occasional health surveys, research, and information
Data Data Information Status
produced by community-based organizations may not
be directly classified under the main categories, but
they may provide useful information.  Patient Medical Current Medical Outcomes
History Management Data
4. Data management
- Data management refers to the handling of data, Donaldson and Lhor (1994) explain that a comprehensive
starting from collection and storage to data flow and database for health information systems include the following:
quality assurance, processing, compilation, and data 1. Demographic data refers to the facts about the patient which
analysis.  include age and birthdate, gender, marital status, address of
residence, race, and ethnic origin. Information on educational
5. Information products background and employment is also recorded along with
- Data is transferred into useful information that serves information on immediate family members to be contacted
as evidence that provides insight crucial to shaping a during an emergency.
health action. 
2. Administrative data includes information on services such as
6. Dissemination and use diagnostic tests or out-patient procedures, kind of practitioner,
- HIS enhances the value of health information by physician specialty, nature of institution, and charges and
making it readily available to policymakers and data payments.
users. 
3. Health risk information records lifestyle and behavior (e.g., procedures, and the like. It also includes previous illnesses
use of tobacco products or engagement in strenuous activities) and family history (e.g., alcoholism or parental divorce).
of a patient and facts about his or her family's medical history
and other genetic factors. This information is used to evaluate 6. Current medical management reflects the patient’s health
the patient's propensity for different diseases. screening sessions, diagnoses, allergies (especially on
medications), current health problems, medications, diagnostic
4. Health status refers to the quality of life that a patient leads or therapeutic procedures, laboratory tests, and counseling on
which is crucial to his or her health. This shows the domains of health problems.
health which include physical functioning, mental and
emotional well-being, cognitive functioning, and social 7. Outcomes data presents the measures after effects of health
functioning. It also shows one's perception of his or her health care and of various health problems. These data usually show
in comparison with that of his or her peers. the healthcare events (e.g., readmission to hospital,
unexpected complications or side effects) and measures of
5. Patient medical history gives information on past encounters satisfaction with care. Outcomes directly reported by the
like hospital admission, pregnancies and live births, surgical patient after treatment will be most useful. 

MODULE 6: HEALTH MANAGEMENT INFORMATION SYSTEM

Health Management Information System (HMIS) 3. To assist in assessing performance at all levels of the
- an information system specially designed to assist in the health sector.
management and planning of health programs, as opposed Roles of the HMIS
to delivery of care (WHO, 2004). An HMIS needs to be complete, consistent, clear, simple,
cost-effective, accessible, and confidential (Janneh, 2002). It
Components: should be complete with all information but avoiding duplication
 health refers to clinical studies to understand medical and consistent in assigning definitions to similar information from
terminologies clinical procedures and database various sources. It should be simple to use and clear as to what
processes; is measured by the elements. The eligible users must have
 management refers to principles enhanced by finance, access and should be able to use the system with ease. The
law, and planning help administer the healthcare confidentiality of patient information and data privacy should
enterprise; and always be a top priority. While providing all these benefits, the
 information system refers to the ability to analyze and system must prove its cost-effectiveness through its operations.
implement applications for efficient and effective
transfer of patient information. Uses of the HMIS
The information from an HMIS can be used in
Objectives of the HMIS 1. Planning
1. To provide quality information to support decision-making 2. Epidemic prediction and detection
at all levels of healthcare system in any medical institution. 3. Designing interventions
2. Aims to aid in the setting of performance targets at all 4. Monitoring
levels of health service deliver. 5. Resource allocation
 a. Data retrieval pertains to processes of data
transfer and data distribution. The transfer process
Three Fundamental considers the duration of transmittal of required
Information-processing Phases data from the source to the appropriate end-user. 
Each phase comes with elements that performs specific The economics of producing the needed
functions. information is a significant criterion.
1. Data input includes data acquisition and data verification. b. Data presentation is the reporting of the
a. Data acquisition refers to the generation and interpretation of the information produced by the
collection of data through the input of standard system. Summary tables and statistical reports are
coded formats (e.g., bar codes) to assist in the expected but the use of visuals is encouraged
faster mechanical reading and capturing of data. especially for high-level managerial decision-
b. Data verification involves data authentication and making because they provide a better intuitive
validation. The authority, validity, and reliability of perspective of the data trend.
the data sources help ensure quality of gathered
data. Role and Functions of the HMIS
2. Data management, also called processing phase, Listed below are the possible functions in an HMIS with the
includes data storage, data classification, data update, and corresponding type of information that can be captured and
data computation. tracked in the system (Behavioral Health Collaboration Solutions,
a. Data storage includes preservation and archiving 2006).
of data. It is advisable that data which are no longer 1. Client data relates to all the information of the client which
actively used should be archived. At times, it is is related to his or her transactions, reports, and other
mandatory and part of legislation. information such as client billing data, clinical data, and
b. Data classification is also called data organization other client data.
which sets the efficiency of the system. Key 2. Scheduling is observed to distribute resources to areas
parameters should be used for data classification that need them. An example is linking the schedule to the
schemes for easier data search. billing of the entity.
c. Data computation requires various forms of data 3. Authorization tracking focuses on monitoring of the
manipulation and data transformation (e.g., authorized personnel and their use of the authorized units.
mathematical models, linear and non-linear 4. Billing refers to the notification of the charges for the
transformation, statistical and probabilistic patient and other related documents such as the compliant
approaches, and other data analytic processes). electronic claim.
This function allows data analysis, synthesis, and 5. Accounts receivable (A/R) management ensures that
evaluation so that data can be used not only for customers are properly notified about their bill and will
decision-making but also for other tactical and settle it accordingly. Data for A/R management include
operational use. tracking aging of unpaid services, tracking reasons for
d. Data update facilitates new and changing denials, aged receivable report by payer source.
information and requires constant monitoring. For 6. Reporting refers to reports issued by the entity which
HMIS, the mechanism for data maintenance must could be basic reports or report writer.
be in place for updating changes for manual or 7. Medical record, also called an electronic health record
automated transactions. (HER), is a collection of digital information about the
3. Data output in data retrieval and data presentation. patient. Aside from patient registration, the data could
 include assessment, treatment plan, and  Behavioral determinants – knowledge, skills, attitudes,
progress/encounter notes. values, and motivation of the people who collect and use
8. Compliance refers procedure that should be followed for data.
the improvement of the condition of the patient or the  Organizational (environmental) determinants – information
service provided such as treatment plan and progress culture, structure, resources, roles, and responsibilities of
note. the health system and key contributors at each level, and
9. Financial data refers to information relating to the  Technical determinants – data collection process, systems,
performance of the entity collected for administering forms, and methods.
purposes. These include financial reports, general ledger,
payroll, and accounts payable. 

Determinants of HMIS Performance Area

 Behavioral determinants
o 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.
 Organizational determinants
o The most important organizational factor which
affects the RHIS process is related to structure,
resource, procedure, support services and the
culture within the organization.
o Lack of funds, human resources, and management
support are other factors contribute to the PRISM Conceptual Framework
determinant of the RHIS process.
o Health workers and data collectors work in
organizations’ environments which have value,
norms, culture and practice.
 Technical determinants
o Technical factors involve the overall design used in
the collection of the information. It comprises the
complexity of the reporting forms, the procedure set
forward in the collection of data, the overall design
of the computer software used in the collection of
information.

PRISM Framework
The Performance of Routine Information Systems
Management (PRISM) is a conceptual framework that broadens
the analysis of HMIS or RHIS by including the three determinants
of HMIS performance, namely:
Technical and Organizational Factors
in the PRISM Framework
 MODULE 9: HOSPITAL INFORMATION SYSTEM

Health care plays a vital role in a society and people  They can also be used to obtain cost-effective staffing and
expect efficiency from health care providers and health institutions show staffing levels.
which face the challenge of handling the numerous patients that  Patient charting applications allow better analysis of critical
seek their services. Proper management of clinical and signs.
operational records is therefore necessary. Presently, most  Nurses could check admission information, and care plans
hospitals have shifted from tedious manual recording to the use of along with applicable nursing notes.
a hospital information system (HIS) to assist them in maintaining  Crucial information is kept and can be retrieved when
the different records of the institution. needed.
 This is also useful in designing the patients’ care plan
Hospital Information System since the medical information integration function allows
 A hospital information system (HIS) is fundamentally a nurses to collect and examine retrieved medical records.
computer system that could manage all the information to
permit health care providers to do their jobs efficiently. 2. Physician Information Systems (PIS)
 HIS was introduced in the 1960s and has evolved since  PIS are designed to improve the practiced of physicians.
then to cope with the changes and demands of the modern  Electronic medical records (EMRs) and electronic health
times. records (EHRs) are some programs where PIS is deployed
 Back then the features of HIS were used mainly for billing and extensively used.
and inventory.  Most system offer support 24/7 to facilitate easier usage of
 However, all of these have changed through time, and now the system by healthcare professionals.
it is also integrated with other financial, scientific, and
administrative programs. 3. Radiology Information System (RIS)
 RIS are capable of providing billing services and
An effective HIS additionally provides benefits including: appointment scheduling aside from reporting and database
 enhanced facts integrity storage.
 reduced transcription errors  Technological advances have made the practice of
 reduced duplication of facts entries radiology more complicated such that more hospitals turn
 optimized report turnaround times to RIS to address the commercial concerns of their
radiology departments.
HIS for different departments
1. Nursing Information Systems (NIS) 4. Pharmacy Information System (PIS)
 NIS are developed to enhance patient care by providing  PIS help monitor the utilization of medicines in health
nurses with accurate information to assist them in institutions.
performing their duties more efficiently.
 The system also handles information on medication-related
 Carries out numerous functions including the handling of complications and drug allergies of patients.
personnel schedule, accurate patient charting and better
 It provides information to identify drugs by considering the
clinical data integration.
physiological conditions of the patient (EMR Education
 Agenda packages help enhance the management of the Center, 2013)
workforce by helping managers handle overtimes and
absences.
Selecting a Hospital Information System
1. Total cost of package  KCCI MEDSYS
 HIS is available for all sizes and budgets. - Kaiser-dela Cruz Consulting, Inc. specializes in application
 For hospitals with smaller budgets providers may reduce development for hospitals industrial clinics, and medical
upfront and maintenance fees by using a design that related educational institutions in the Philippines.
requires fewer servers and hard wares. - Its products, Visual MEDSYS for hospitals and MEDSCHO
for schools, provide integrated, comprehensive, and
2. Web based system proven solutions for efficient health care practices.
 The system is available on the internet which means that
authorized personnel can access the information anywhere  COMLOGIK
and anytime. - Comlogik Business Systems, Inc. is a Philippine –based
 It also allows data sharing between hospitals. software development company that was established in
 A hospital with updated patient history in its system can 1999
facilitate access to information from other health facilities Vision: To be a global technology company.
upon request. - Comlogik led the way in developing innovative applications
like online hospital services in which patients can access
3. Implementation and support their billings and examination results, while administrators
 During the deployment or upgrade of the HIS, it is can access reports and doctors can access patients’
imperative that the vendor provides ample training and records anywhere and anytime.
assistance to the users of the system.
 Consider vendors that offer 24/7 support through HIS Functions
telephone or web services. Help Desk, Scheduling, Patient Registration
 Help desk
HIS Providers in the Philippines - Helpdesk is a useful resource meant to offer the customer
 BIZBOX or end user with information and guide associated with a
- BizBox Inc. was formulated 25 years ago. company's or institution's products and services. It
- Its very first hospital project was completed in 1994. becomes more efficient through the HIS because the
Goal: To improve work efficiency in health care institutions manual retrieval of information is no longer needed.
through software systems and to produce advanced solutions Clients are provided with information and guidelines
for better patient care. associated with the company’s or institution’s product and
- Today, it is among the top IT companies in the health care services without any hassle.
industry.  Scheduling
- Aside from being a certified Microsoft Gold Partner, it has - Managers and employees can access work schedules
also received the Independent Software Vendor (ISV) of from anywhere they are and effectively discuss their
the Year Award. scheduling preferences through the HIS. An employee
- It has fully integrated systems such as electronic health scheduling software helps save time and makes employee
records (EHR) and document management system (DMS) scheduling less difficult.
that will streamline tasks and help provide health services  Patient registration
(BizBox , 2017). - Patient registration form records the name, age, gender,
marital status, and other relevant information regarding the
patient. All this information is used for record keeping and
account management purposes. This form needs to be
 filled up whenever a patient visits a hospital or clinic to
avail of medical treatment but if the patient is unable to Billing, Contract Management, Package Deal Designer
complete the form due to the need for prompt medical  Billing
attention, the form can be filled out by a relative or - Billing statement show all the records pertaining to the
guardian. invoices, payments, and the current balance of a patient’s
account. HIS is very useful for patients who require
Admission, Discharge, Transfer Procedures frequent health care services because numerous invoices
 Admission can be combined and a lump sum payment can be made.
- Before a patient is admitted to a health facility, an It is good practice to generate the billing statement on a
admissions counselor will call him or her to gather regular basis so that the institution could keep track of its
preliminary information, offer vital information concerning collectibles. HIS lists the outstanding balances of the
the hospital stay, and answer questions if there are any. patients. Any overdue payments may be checked easily. In
Additionally, the physician may also schedule recurring addition, balances of patients who only have minimal
medical exams, such as laboratory tests or X-rays, before transactions are kept updated.
hospitalization. Other routine tests can also be carried out
on the day of admission. All this can be done more  Contract Management
efficiently through the HIS. - Goodrich (2013) defines contract management as the
process of managing contract creation, execution, and
 Discharge analysis to maximize the operational and financial
- Through the HIS, instructions that accompany a patient’s performance of an organization while reducing financial
discharge or transfer are more efficiently provided. These risk. Organizations constantly encounter pressure to
instructions may include discharge planning which details reduce costs and improve company performance. Contract
services needed to be administered after the hospital stay management proves to be a very time – consuming
to ensure the full recovery of the patient. element of business, which facilitates the need for an
effective and automated contract management system.
 Discharge Summary - When a contract management strategy is successfully
- A discharge summary is a clinical report arranged by a implemented, organizations can expect to see the
health practitioner or different health expert at the following:
conclusion of a hospital stay or series of treatments. o realization of expected business benefits and
financial returns.
 Transfer o cooperation and responsiveness of the supplier to
- The term “transfer” means movement (along with the the organization’s needs
discharge) of an individual outside of the hospital premises o no contract disputes or surprises
at the instruction of any authorized hospital personnel. o satisfactory delivery of services to both parties
This, however does not encompass movement of an
individual who (a) has been declared lifeless, or (b) leaves  Package Deal Designer
the facility without the permission of any such authorized - Posting diagnostic medical packages for in- patients, out-
person (Louisiana State University, 1993). patients, and emergencies requires the same process; the
- If the patient is transferred from the emergency room, difference is that for emergencies, this is called post-
employees must fulfill the statutory requirements for a diagnostic package deal. HIS helps in accessing
proper switch. With the HIS, patient transfer details are information regarding package deals without going through
easily accessed and processed. the hassle paperwork.
 Laboratory Reporting, Radiology Reporting, and
Cardiology Reporting
Laboratory Reporting Radiology Reporting
 Despite differences in presentation and form, all laboratory  According to the University of Virginia (2013), a radiology
reports must possess common elements as required by report is an official medical document that provides the
institutional and company policies. They may also contain details of the requested radiology examination and the
supplementary items not specially required, but which the procedure conducted by the radiologist.
laboratory chooses to report to aid in the interpretation of  A qualified physician authorized by the health care
results of medical testing (American Association for Clinical institution interprets the report.
Chemistry, 2017).  The main objective of the report is to address the queries
 For identification and filing purposes, some laboratory in the request.
reports display elements with administrative or clerical  The findings in the report should take into account both
information such as the following: positive and negative findings.
o Patient name and identification number or a unique  Important findings should be stated followed by incidental
patient identifier and identification number findings.
o Name and address of the laboratory location where  The basic sections of a radiology report enumerated in the
the test was performed American College of radiology’s practice guideline on
o Date when the report was printed communication must include the following:
o Test report date o administrative information o comparison
o Name of doctor or legally authorized person o patient identification o observations
ordering the test(s) o clinical history o summary or impression
 Information about the specimen and the test itself, such as o imaging technique o signature of the radiologist
those included below, are the other elements that make a  The length of the report is dependent on the complexity
laboratory report more meaningful: and cost of the examination.
o Specimen source (if applicable)  The main components are:
o Date and time of specimen collection 1. Patient's demographics. Name, social security
o Laboratory accession number number, etc.
o Name of the test performed 2. Relevant clinical information and ICD-9 code.
o Test results 3. Body of the report.
4. Impression (conclusion or diagnosis)
o Abnormal test results
o Critical results Cardiology Reporting
o Units of measurement (for quantitative results)  The purpose of cardiology reports is that they should
o Reference intervals (or reference range) clearly provide information about a patient for medical
o Interpretation of results records.
o Condition of the specimen  Using the cardiology information systems (CIS), vascular
o Deviations from test preparation procedures sonography reports are accurately created with only a few
o Medications, health supplements, etc. taken by the clicks.
patient  This means the results are generated more efficiently
which translates to improve patient experience.
  These systems capture the necessary data required by
management to operate more efficiently.
Material Management System – Pharmacy, Main Stores and  Data redundancy and data quality issues are minimized
Purchase  Employee headcount, customer account information,
 Material management is basically concerned with the funding and overall performance are some of the data that
planning, identifying, purchasing, storing, receiving and can be retrieved though this system.
distribution of materials.  Good management reporting system enhances the
 The purpose of material management is to guarantee that capability of an institution to be more responsive, efficient,
the right materials are in the right location, in the right and effective in decision–making which affects the
quantities when needed. performance of the institution as a whole.
 As such, the automation of an inventory or a materials  These systems offer a single holistic view which highlights
management system is necessary for a hectic health high value sources and eradicates the lack of visibility in
center to streamline the hospital supply chain. reviewing the performance of the institution (Kumar,2017).
 Computerized stock management systems include
technologies for tracking inventories and devices used In-Built Tally Interface
each day in a health care setting.  Tally.ERP9 is a software that provides simplified solution
 Generally, they utilize barcodes and RFID (radio to operations in health institutions such as registration,
frequency identification) tags with precise identification accounting, inventory management, tax management,
numbers assigned for each inventory object to enable payroll, and compliance among many others.
accurate tracking and control.  Tally is easy to learn and can be implemented with
minimum resources.
Management Reporting  It is reportedly used by over 1,000,000 entities across the
 Has become a platform for reporting and controlling globe.
information valuable to the institution.

MODULE 10: LABORATORY INFORMATION MANAGEMENT SYSTEM

Laboratory Information Management System should show whether that sample meets the
 A Laboratory Information Management System (LIMS) acceptable values.
is software designed to make labs more efficient and - LIMS records and stores the following information
effective, especially those that process massive amounts about the sample: 
of samples for research and development (R&D), o Who the sample was taken from? 
manufacturing, and medical research. o What is the sample taken? 
 The ultimate motive of a LIMS is to enhance efficiency in o Who is working with it (researcher or provider)? 
lab operations through reducing manual responsibilities. o Who handled the sample?
o Where does it go next? 
Functional Requirements and Features of LIMS o How do you store these samples?
1. Sample Management o When does it need to move? 
- Accurate and detailed records are necessary to make
sure that samples are not lost or mixed up. A record
 - LlMS automates most of these by using radio- 4. Records management software
frequency identification (RFID) or barcodes in recording 5. Applications to interface with analytical instruments or data
and updating logs and track the chain of custody of the systems
sample. 6. Workflow tools
2. Workflow Management 7. Client tracking applications
- LIMS can be used to automate records and workflows 8. Best practice compliance databases
which saves time. Existing coding methods and 9. ERP software
procedures enable the system to take part in the
decision process. Using preset rules, it can suggest Laboratory Standards
instruments needed for the procedure and assign the  Occupational Safety and Health Administration
medical laboratory technician or specialist to complete (OSHA) released an “Occupational Exposure to
the test. Hazardous Chemicals in Laboratories Standard (29 CFR
3. Reporting 1910.1450)” in 2011 to facilitate laboratory safety.
- Using LIMS, reports can be run and exported to make  Laboratory is a workplace where hazardous chemicals are
them standard and customized. Reports on the most used. It is also a facility that stores small quantities of
frequently used instrument, the average handling time hazardous chemicals which are not intended for production
of sample, and list backlogs are useful in data analysis use. On the other hand, the laboratory use of hazardous
and formulation of recommendation for future chemicals should meet the conditions listed below: 
policymaking. o The manipulation of chemicals should be on the
4. EHR “laboratory scale” only and can be handled by one
- Some LIMS have a built-in electronic health records person. 
(EHR) functionality which is capable of handling patient o There is the use of multiple chemicals and
records and billing information. A health institution procedures.
should consider this during acquisition because this o The procedures should not simulate any
feature will greatly help in managing clinical laboratory production process.
procedures. o Protective laboratory tools are available and proper
5. Mobile practices are followed to minimize potential
- Gartner’s (2016) reports that mobile LIMS offerings are exposure to harmful chemicals.
limited. But with the accepted use of smartphones in o Any hazardous use of chemicals which does not
the laboratory, it is better for LIMS to be mobile- meet this definition is regulated under other
friendly. standards. Examples are 
6. ERP  chemicals used in the maintenance of the
- A LIMS that can handle inventory functions is laboratory building, 
recommended. The enterprise resource planning  production for commercial sale, and 
(ERP) solution is especially useful in viewing current  testing of a product for quality control.
supplies, calculating storage capacity, and managing  If the Laboratory standard applies, employers must
location. develop a Chemical Hygiene Plan (CHP).
o A CHP is the laboratory’s program which addresses
Core Components of LIMS all aspects of the Laboratory standard.
1. Electronic laboratory notebooks o Primary elements of a CHP include the following:
2. Sample management programs
3. Process execution software
 1. establishment of standard operating Through integration of the LIMS, the personnel in charge of
procedure (SOP) managing accounts receivables can easily extract information
2. monitoring of the work environment which was already available from invoicing and contract
3. statement of plan on how to obtain free management procedures. Additionally, LIMS can:
medical care for work-related exposures  generate specific or complete accounts receivable reports
4. designation of personnel  monitor balances for reconciliation and audit purposes
 export data to other accounting systems
LIMS Application  customize reports according to specifications
Patient Registration
 When a patient arrives at the hospital, the admission clerk Worklist and Workflow
will take some basic information and will guide him/her to a  LIMS assists laboratories in setting priorities of current
registration window. workloads based on analyst and instrument availability.
 functions operate to facilitate more efficient laboratory
Billing processes
 The process of generating statement of accounts (SOAs)
or billing statements of in patients, out-patients and Quality Control
emergencies are the same.  Diagnostic tests executed inside the clinical laboratory may
yield two kinds of results, a patient result or a quality
Contract Management control (QC) result. The result can be quantitative (in
Common features of LIMS for invoicing and contract management: numbers), or qualitative (positive or negative), or semi-
 Customer customizable invoices including balance and quantitative (limited to a few different values).
charges history analysis, history balance, detailed  Quality Control results are used to verify whether or not
services, participation when in insurance coverage, the instrument is working within prescribed parameters,
discounts etc. confirming that patient test results are reliable.
 Different electronic formats for invoices allow interfacing to  LIMS functions enable users to set standards for the
customer electronic systems relevant range of patient test results or to extract test result
 Customizable information completion reports for customers information for the purpose of quality assurance.
 Managerial reports display laboratory billing status for
payer groups including projected return values for each Barcode-generation, printing and reading
payer group  Enables a fast and easy method to identify tubes, samples,
 Ability to change the Insurance Organization of a Patient documents and many others
per visit.  With this kind of technology, information about a tube, a
 Ability to select which Tests of a Patient’s Visit are covered specimen, or equipment within the laboratory can be found
by the Insurance Organization and which are privately – and retrieved effortlessly using a barcode scanner.
with automatic modification of the prices accordingly.
 Supervision – financial data management of the Senders. In-built bi-directional interfaces with equipment
 Reminder for amounts due from past visits.  A two-way communication between the information system
 Immediate access to the Billing Card of each Patient. and the clinical instrument is required. LIMS downloads the
 Consistency with the International Laws. test orders and specimen ID for each test. On the other
hand, the clinical instrument uploads the same information
Accounts Receivables for analysis. 
  It minimizes the time spent in programming the order into of errors usually committed in the manual process.
the analyzer and ensures accuracy due to the elimination

MODULE 11: OTHER HOSPITAL INFORMATION SYSTEM

A hospital management information system or hospital Functionalities of CIS

information system (HIS) is an element of health informatics that 1. Editing, viewing and storing multi-modal
focuses mainly on the administrational needs of hospitals. Other Cardiology Data – With the help of CIS, different types
hospital information system that will be discussed in this lesson of data, including those of computed tomography (CT),
will be Cardiology Information System (CIS) and Radiology cardiac ultrasound (echocardiography), magnetic
Information System (RIS). resonance imaging (MRI), nuclear imaging (PET and
SPECT), and angiography may be managed on a single
Cardiology Information Systems platform.
 Cardiology Information Systems (CIS) are mainly
focused on the storage and retrieval of Cardiology-centric 2. Remote Access – The use of networks and integrated
images. information systems, coupled with the availability of the
 The information used by cardiologists for the diagnosis and internet and tablets and smartphones, offers flexibility to
treatment of illnesses varies from personal notes (history, CIS.
physical examination), to signals (electrocardiograms),
images (echocardiograms, angiograms, CT, MRI), and 3. Visualization and Reporting Capabilities – Two of
reports from investigations and procedures.  the main benefits of CIS are the ease and the consistency
Benefits and Features of reporting. As a result, virtual real-time information
1. Ease of Access while Maintaining Data Security – CIS retrieval is possible anytime and anywhere with just a
consolidates multiple types of patient cardiology couple of clicks. 
information, thus eliminating the need for doctors to
request different imaging results from different
4. EHR Integration – CIS may be integrated with existing
departments. 
electronic health record systems; this results in the
enhancement of the quality of services of the health
2. Flexibility in the Workflow – Availability of mobile
professionals by offering a more comprehensive view of
technology allows cardiologists to assess a wide array of
the patient care spectrum.
information without having to leave the patient's bedside.
Having cardiological data in a single platform offers
Radiology Information System
mobility to physicians and nurses, thereby improving the
 Radiology Information System (RIS) is a networked
efficiency of providing service.
software system for managing medical imagery and
associated. The system tracks the orders and billing
3. Enhanced Comparability – CIS is an essential repository
information of the requesting department.
of cardiology imagery results thereby retrieval of past data
is convenient this comparability enables healthcare  It uses:
professionals to make more informed decisions on their  Picture Archiving and Communication System
patients’ treatment. (PACS) is a healthcare technology for short- and long-
 term storage, retrieval, management, distribution and 2. Scheduling – The system allows staff to schedule
presentation of images. appointments for in-patients and out-patients. 
 Vendor Neutral Archival (VNA) is as medical imaging
used by the healthcare professionals that stores 3. Patient Tracking – Patient tracking means tracing the
images in a standard format and interface, making patient's radiology history starting from admission to
medical imaging data accessible through different discharge and coordinating it with his or her past, present,
picture archiving and communication systems (PACS). and future appointments. 

4. Results Reporting – Results reporting is possible through

the statistical reports generated by RIS. The reports may
Advantages of using an RIS
be done for a single patient or a group of patients, as well
1. Better communication with referring doctors
as for specific procedures, depending on the needs. 
2. Faster payments
3. Improved efficiency
5. Image Tracking – RIS was traditionally used to track
Functions of RIS individual films and associated data. Nowadays, RIS-
PACS systems managed by radiology departments cover
1. Patient Management – The system tracks the patient's
the entire clinical workflow of the medical enterprise. 
entire workflow within the radiology department. It can add
images and generate reports to EHRs for easy retrieval
and viewing by the authorized radiology staff.  6. Billing – Billing is made conveniently through the system's
financial record keeping and processing of electronic
payments and automated claims.
MODULE 12: MATERIALS MANAGEMENT SYSTEM
 In HIS by BizBox, a purchase request marks the beginning
Materials Management System of the procurement process.
 The material management function of hospital materials–  Using this form, the user notifies the purchasing
that is, to ensure that services are rendered successfully department regarding the needed items and services.
from one source to an end user–covers several areas of  It contains the quantity, as well as a time frame for the
the hospital and could drastically affect the expenses of the items requested.
medical institution.  It has the authorization information needed to proceed with
 Executing this function in a manner that lessens expenses the purchase.
and ensures adequate cash flow requires effective  The requested items are then confirmed using the
management of large amount of information from several purchase order and a supplier is nominated.
sources.  Once completed, the order is sent to the supplier for
 To successfully manage such information, many hospitals processing. 
implement a form of materials management information  Finally, the items are checked during receipt of the
system (MIMS). delivery.
 The aforementioned system can be used to manage  The receiver, which is usually the Central Supplies
functions like purchasing, accounting, inventory department, uses the purchase order as basis for
management, and patient supply charges.  accepting the delivered items that should be checked for
indents and damages.
Purchasing
  Afterwards, the said items are then released to the 4. A program has to be actively managed. Once you
requesting department.  put a program in place, you then have to actually
manage it. Once you have and the program continues
Inventory to develop, the savings will become sustainable and
 Inventory is one of the biggest expenses for most medical continue to improve over time.
institutions (Johnston, 2014).
 Inventory control plays an important part in refining the
quality of health care services since lives of people are on
the line and medical costs are increasing.  Item Master Maintenance 
 Strategies in improving inventory control in health care  Since the importance of inventory control has been
facility:  recognized, the usage of a materials management system
1. Observe processes that are in place. Because brings an advantage.
assets transcend single departments, healthcare  In this system, the Inventory Item Maintenance screen has
organizations need to take a horizontal approach to many sections.
their asset management. This means observing  The upper portion contains master information. Additional
current processes and then working with each options appear after the selection of an existing item.
department an asset batches to create new processes  “Item Tab” is used for maintenance of the attributes of an
that make everything more efficient; thereby improving inventory item, such as product type, item class, item type,
the overall utilization of the equipment.  and others.
 If the balance and order activity is zero (0), items can be
2. Clean up remaining contracts. It is important to deleted using this option.
make sure that there are not too many service  Users may set the product type to group similar items for
contracts specially on equipment that has been pulled sales analysis and inventory reporting. 
out. Many hospitals have multiple service contracts on
the same piece of equipment or equipment they don't Item Indents and Issues 
even own anymore. Once the asset inventory of a  There are some instances when items are damaged either
hospital has been made efficient and normalized, the upon receipt from the supplier or during the move from the
next step is to clean up the contracts of the equipment source to another location.
that’s actually left.   Some suppliers allow return of goods that have indents or
the like, with a guarantee of replacement without any
3. Create a capital plan. Hospitals need to know the additional payments.
utilization of their assets and then ask themselves,  This applies to distribution and retail industries where the
“How many of one thing should they have?” vs “How goods for sale are fast-moving.
many do they actually need?” Creating an integrated  Normally, damaged items are moved to another
capital plan that extends out 3 to 5 years helps take warehouse for them to be monitored. 
the guesswork out of what future capital request might
be. This ensures they’re replacing the equipment they Reorder Level and Minimum and Maximum Inventory
have, not what's been taken out of inventory. Having a Ordering 
predictable plan is something more useful than having
 In a typical materials management system, reorder level
complicated plans. 
is the minimum quantity of an item that a company has in
stock, so when the stock reaches the stated minimum
 quantity, the item must then be reordered (purchase
order/production order). 
 A basic reordering method implemented in many ERPs
and other inventory management softwares is the Min/Max
inventory ordering method. The “Min” value is
representative of a stock level that prompts the reorder, Comparison of Quotations and Preferred Vendors
and the “Max” value is representative of a new targeted Purchase Quotations Preferred Vendors
stock level that follows the reorder. The main difference of - Document for requesting - Maintain list of preferred
these two – Max and Min – is often interpreted as the prices and delivery vendors from whom
economic order quantity (EOQ).  information from a vendor inventory items are usually
before the purchase order purchased
Enquiries and Quotations for Drugs, Consumables, Assets, - Random vendors - Trusted vendors
and General Items  - Allows comparison of offers - Preferred quality products
According to Webrino (2018), the following documents are and services
required in the materials management process: 
1. Enquiries - Mark the beginning of the purchasing process. Purchase Request, Orders, and Approval 
This established the relationship between the entity and Purchase Request 
the right supplier. The supplier provides information on the  A purchase request or purchase requisition is a document
availability and price of the required items. that notifies the purchasing department that certain items
  or services need to be replenished.
2. Quotations - Contain vital information regarding the  Remember that purchase request marks the beginning of
requirements which include price, delivery details, payment the procurement process.
terms, and etc. Companies usually review 2 to 3 quotations
 For enhance accountability and for documentation
before selecting the supplier.
purposes, some companies require a purchase requisition
for all purchases, but others only require them for specific
3. Orders - The buyer shows the intention to purchase the
kinds of purchases, such as those that would require
required item by issuing a purchase order. A purchase
greater capital outlay.
order is placed to signify intention to engage in commercial
operations for a specific product or service. Upon
Purchase Orders
agreement, the order becomes a contract between the
 A purchase order is a legally binding contract which shows
health care institution and the supplier. 
that the seller has already accepted the order issued by
the buyer.
4. Invoices - An invoice is also called a bill. It is a commercial
document that indicates the product, the ordered quantity,  It should contain:
and agreed price. The supplier issues this to the buyer to o information about the buyer and seller (name, address,
show the products and services that were sold or provided contact details, and etc.);
to the buyer.  o order number and order date;
o item description (quantity, unit, and total price);
5. Documents - Are statutory requirements used during o shipping information (shipping date and address);
purchase and sales transactions. These ensure smooth o billing address; and
transition and completion of the process.  o authorized signature. 
Approval Process - If no this was provided, the department should request
 The person who creates the document, either a purchase the copy from the supplier.
request or order, is the originator. - All files should be kept according to the guidelines of
 When the said originator adds document/s to the materials the entity.
management system, the system checks for any approval - This helps track partial and staggered deliveries. 
requirements.
 If the document fails to meet the approval requisites, the 4. Inspecting a Shipment
originator is notified that the document needs approval. - The personnel receiving the items should inspect the
 The document is temporarily saved as draft.  goods to ensure that the following minimum conditions
 When the approval process is launched, an internal are met:
request is immediately sent to the first approval stage. a. The received items match the requirements stated
 This request is received in the Messages/Alerts Overview in the purchase order (type, description, color, etc.).
window, and the approver can access the document. b. The quantity is correct.
 Approval can be done through a mobile phone if the c. The item has no damage, discoloration, and issues.
devices are integrated. d. The quantity per unit of measurement is accurate.
 An internal notification goes back to the originator with the (e.g. one dozen = 12 pieces)
link to the rejected document when the approver rejects e. Packing list, certifications, and other delivery
the document.  documentation are completely provided.
f. Perishable items should be in good condition and
Receiving and Tracking Items  have not reached the expiration dates.
The following policies should be followed for the proper g. The items are functioning properly.
receipt and inspection of goods (The York College, 2017):
1. Signing for Deliveries 0. Partial Deliveries
- The person who receives the delivery should inspect - When items are delivered partially without proper
the delivered items before signing the receiving notification from the supplier, the receiving personnel
document and the packing list. should advise the purchasing department for approval
- Then the document should be submitted to the and further instructions.
appropriate department for reconciliation.  - This should also be typically noted in the packing list or
the receiving document. 
2. Refusing Delivery
- The receiving department should refuse to accept any a. Tracking of Goods
shipment if the packaging appears to be damaged or if - Goods can be easily tracked/traced when they are
there is any item that does not have a corresponding managed by serial number or batch.
purchase order. - Through that, aging of products can also be monitored
based on how long they have been in the warehouse.
3. Record Retention
Purchase Returns along with Returnable/Non-Returnable
- The packing list should be provided to the receiving
Gate Pass 
department during delivery to ensure that there is
 When purchased goods are returned, the materials
proper documentation since it is our taking possession
management system updates inventory levels to reflect the
and legal ownership of the delivered items.
decrease in quantity.
  For temporary movement, a returnable gate pass is o Sold items on sales return orders 
issued, whereas for permanent movement, a non- o Enterprise planning distribution orders 
returnable gate pass is given. o Outbound inspection upon issue of materials to
 The system can be configured to track returnable and non- production 
returnable items or equipment.
 It can also be set to monitor due dates for returnable items Drugs and Consumable Issues and Returns to Patients 
and to provide detailed reports about the status of different  Since drugs and consumables take up the bulk of
inventory items.  expenditures, it requires a wide range of monitoring.
 In this, MMS becomes advantageous by providing an
Consignment Stock Receipt, Consumption, and overview of the entire institution’s purchasing and inventory
Regularization  control processes.
 In the process of consignment, the vendor or consignor
issues materials to the receiver or consignee, and these Issue Methods 
materials are stored in the consignee's premises.  Inventory management is a crucial function for any
 The vendor maintains legal ownership until such materials product-oriented business. Common inventory handling
are removed from consignment stores. The invoice is due methods include:
at predetermined intervals.  a. First In, First Out (FIFO)
- Inventory items are sold based on the order they
Expired Stock and Quarantine  are purchased.
Expired Stock/Inventory  - Most common technique.
 In rare instances, they may be sold to other parties at b. Last In, First Out (LIFO)
lower costs. - Last items to enter the system or sold first.
 Expiration dates and decrease in values of items must be - This is common among non-perishable items like
reflected in the financial records so discrepancies in petroleum, minerals, and metals. 
financial statements will be prevented. c. First Expired, First Out (FEFO)
 The amount that reduces inventory in the records is - Materials are sold based on the dates they should
recognized as a loss which equates to a reduction in profit. be consumed, regardless of when they were
purchased.

Quarantine Stock/Inventory  Generic Tax Formula Configuration 

 When undecided about how to handle defective goods,  Materials management systems usually allow tax rates to
whether to be sold as scrap, reworked, returned, or use as be defined internally via tax codes, or imported from an
it is, a quarantine location or warehouse can be used to external source. Tax configurations are usually accounted
temporarily house them until a final decision is reached.  on a per country basis. The following taxes that can usually
 Inventory is put into quarantine if it is initially rejected be processed while posting documents are
during: o Tax on sales and purchases, 
 Production upon completion of an operation, when o Additional taxes like VAT,
specified as “Move Rejected End Item to Quarantine.”  o Sales and use tax in USA, and
 Inbound inspection upon receipt of  o Withholding tax like income tax in India. 
o Manufactured end items 
o Purchased items 
Periodic Physical Stock Taking and Adjustments with
Tracking 
 An inventory count is a process where a business
physically counts its entire inventory.
 A physical inventory may be mandated by financial
accounting or tax regulations to place an accurate value on
the inventory, or the business may need to count inventory
so component parts or raw materials can be restocked.
 Businesses may use the following tactics to minimize the
disruption caused by physical inventory: 
o Inventory services provide labor and automation to
quickly count inventory and minimize shutdown time
o Inventory control system software can speed up the
physical inventory process
o A perpetual inventory system tracks the receipt and
use of inventory, and calculates the quantity on hand
o Cycle counting, an alternative to physical inventory,
may be less disruptive
 The materials management systems offer all of these in
addition to the barcode and RFID capability which are
supplementary technologies placed to give the institution
more accurate and less burdensome inventory count