Health Information System For Laboratory Science (Lab)

1st Year -Med-221 - 1st Term

HEALTH INFORMATION SYSTEM HEALTH MANAGEMENT

Health Informatics
- is the application of both technology and systems in
a health care setting.
Health Information System
- cover different systems that capture,store,manage
and transmit health- related information that can be
sourced from individuals or activities of a health
institution.
Role and Function of Health Information Systems
1. Easier acces to file
2. Better control
3. Easier Update
4. Improved Communications
Health Information System
- improves the delivery of health services because it
ensures file access, better control,easier updated, and
improved communications
* The components of a health information
systems are health system resources (input,
indicators, data sources, and data management
(processes); transformation of data into
information, and its dissemination and use
(outputs).
INFORMATION SYSTEM
❖is specially designed to assist in the
management and planning of health programmes,
as opposed to delivery of care.
❖ An HMIS needs to be complete, clear, simple,
cost-effective, accessible, and confidential
(Janneh, 2002)
The Health Management Information System (HMIS)
- is crucial for evidence-based policy-making, informed
decision-making during planning, implementation and
evaluation of health programs; and for appropriate use of
resources at all levels of the health system. This study
explored the gaps and factors influencing HMIS in the
context of a changing health sector in Tanzania.
PRISM FRAMEWORK
- Performance of Routine Information System Management
(PRISM) is a conceptual framework that broadens the
analysis of HMIS or RHIS by including the three
determinants of HMIS performance namely:
1. Behavior Determinants
2. Organizational/environmental determinants
3. Technical determinants
✓ The PRISM (Performance of Routine Information
Systems Management) framework defines the various
components of the routine health information system
(RHIS) and their linkages to produce better quality data
and continuous use of information, leading to better health
system performance and, consequently, better health
outcomes.
HOSPITAL INFORMATION SYSTEM (HIS)
- is computer system structured to manage all
records of health care providers to make available
information and reports available to healthcare personnel in
doing their job more efficiently.
• Introduced in 1960
• Effective HIS provides :
* enhanced integrity of facts,
* minimization of transcription error and duplication
of records
* Shorter turn around time

Different Data Sources for Health

Information System
1. Demographic Data
2. Administrative Data
3. Health Risk Information Nursing Information Systems
4. Health Status * Developed to enhance the patient care
5. Patient Medical History * Functions :
6. Current Medical Management *Handling of personnel schedule
* Accurate Patient Charting
7. Outcomes Data Physician Information Systems
* Designed to improve the practice physicians.
✓ The different data sources are demographic data,
administrative data, health risk information, health
status, patient medical history, current medical
management, and outcomes data.
 * EMR
* HER
➢ Radiology Information Systems
* Capable of providing the billing services and appointment
scheduling aside from reporting and databbase storage
Pharmacy Information Systems
* Helps monitor the utilization of medicines
* Infos about Medications Related Compilations and drug
allergies of the patients
* Provides information identify drug interactions which
helps in administeringthe appropriate drugs
HIS PROVIDERS IN THE PHILIPPINES
LABORATORY INFORMATION MANAGEMENT SYSTEM
HIS FUNCTIONS
(LIMS)
* HELP DESK
❖ A Laboratory Information Management System (LIMS) is
- provides clients with manual information and guidelines
designed to help process information in medical research to
asssociated with the company’s or institution’s products
improve the efficiency of the department’s services and
and services without hassle.
laboratory operations by reducing manual tasks and procedures.
Scheduling
HEALTH INFORMATION MANAGEMENT SYSTEM (LIM)
- helps save time and make employee scheduling
lesss difficult
Patient
- registration records the name, age,gender,marital status,
and othe relevant information regarding the patient.
* Admissions is when an admission counselor Gather
Preliminary Information offer vital information concerning
the hospital stay and answer questions if there is any. The
physician may also medical exams.
* Discharge provides instructions that includes discharge
Planning which details services needed to be administered
after the hospital stay to ensure full recovery of the patient.
* Transfer means ( Along with discharge) of an individual
outside of the hospital premises at the instructions of any
authorized hospital personnel
BILLING, CONTRACT MANAGEMENT, AND
PACKAGE DEAL DESIGNER
• Billing - shows all records pertaining to the
invoices, payments, and the current balance of a
patient’s account. HIS lists the outstanding balances
of the patient.
• Contract Management- is defined as the process of
managing contract creation, execution, and analysis
to maximize the operational and financial
performance of an organization while reducing
financial risk.
• Package Dealer - which is also called post-
diagnostic package deals. HIS helps in accessing
information regarding package deals without going
through the hassle of paperwork.
LABORATORY, RADIOLOGY, AND
CARDIOLOGY REPORTING
•Laboratory Report-displays elements with
administrative or clerical information in
addition to the information about the specimen
and the test itself.
* RADIOLOGY REPORT - is an official medical
document that provides the details of the
requested radiology examination and the
procedure conducted by the radiologists.
• Cardiology Report - contain important
medical information based on the test results of
the patient which are set against past medical
records.
MATERIALS MANAGEMENT SYSTEM –
PHARMACY, MAIN STORES, AND PURCHASE
• Materials Management- is primarily
concerned with planning, identifying,
purchasing, storing, receiving, and distributing
materials. Its purpose is to guarantee that the
right and sufficient materials in the right
location when needed.
• Management Report- is a platform for
reporting and controlling information valuable
to the institution.
IN-BUILT TALLY INTERFACE
• Tally.ERP9 is a software that provides
simplify solution to operations in health
institutions such as registration, accounting,
inventory management, tax management,
among others.

LABORATORY STANDARDS
❖ Occupational Safety and Health Administration
(OSHA) released an “Occupational Exposure to
Hazardous Chemicals in Laboratories standard(29
CFR 1910.1450)” in 2011 to facilitate laboratory
safety.
❖ Laboratory is a workplace where hazardous
chemicals are used. It is a facility that stores small
quantities of hazardous chemicals which are
intended for production use.
❖ Chemical Hygiene Plan discusses all aspects of
the laboratory standards should be formulated if
the standards apply.
Contract Management
The Common Features of LIMS for invoicing and contract
management include:
a) Customer customizable invoices including balance and charges
history analysis, history
balance, detailed services, participation when in insurance
coverage, discounts among
others;
b) Different electronic formats for invoices allow interfacing to
customer electronic systems;
c) Customizable information completion reports for customers;
d) Managerial reports display laboratory billing status for payer
groups including projected
return values for each payer group;
e) Ability to change the Insurance organization of a patient
per visit;
HEALTH INFORMATION SYSTEM
Records management software
Applications to interface with analytical instruments or
data systems
Workflow tools
Client tracking applications
Best practice and compliance databases
ERP software
HEALTH INFORMATION SYSTEM
f) Ability to select which tests are covered by insurance and which
have automatic modification of the prices accordingly;
g) Supervision of financial data management of the senders;
h) Reminder for amounts due from past visits;
i) Immediate access to the billing card of each patient; and
j) Consistency with the international laws.
ACCOUNTS RECEIVABLE
Through the integration of LIMS, the personnel of accounts
receivable can easily extract information and do the following:
a) Generate specific or complete accounts receivable reports;
b) Monitor balances for reconciliation and audit purposes;
c) Export data to other accounting systems, and
d) Customize reports according to specifications.
WORKLIST AND WORKFLOW
❖ LIMS assists laboratories in setting priorities of current
workloads based on analyst and instrument availability.
❖ The queuing and worklist feature provides insights about when
an event occurred, how long it was, and who was involved. Worklist
and workflow functions operate to facilitate more efficient
laboratory processes.
QUALITY CONTROL
❖ Diagnostic tests executed in the clinical laboratory
may yield two kinds of results, a patient result or a
quality control (QC) result.
❖ QC results are used to verify whether or not the
instrument is working within prescribed
parameters. Based on the said results, the reliability
of a patient’s test results will be determined (Bio-Rad
Laboratories, 2008).
BARCODE-GENERATION, PRINTING
AND READING
❖LIMS modules are commonly linked to barcoding
label generator which enables a fast and easy
method to identify tubes, samples, documents, and
many others. The information can easily be found
and retrieved effortlessly using a barcode scanner.
IN-BUILT BI-DIRECTIONAL INTERFACES
WITH EQUIPMENT
❖ A two-way communication between the
information system and the clinical instrument is
required. The LIMS downloads the test orders and
specimen ID for each test. The clinical instrument
uploads the same information for analysis.
A bi-directional
- interface application saves time in
programming test orders into the analyzer and
eliminates errors in manual entry. This can
result in a considerable enhancement in analyzer
productive
MATERIALS MANAGEMENT SYSTEM
❖ The Materials Management System can be used to
manage functions like purchasing, accounting,
inventory management, and patient supply charges
(Materials Management Systems, 1996)
INVENTORY CONTROL
Strategies in improving inventory control in the
health care facility:
1. Ensuring shipment accuracy
2. Aligning with sales projections
3. Complying with regulations
4. Establishing buying cycles
ITEM MASTER MAINTENANCE
❖ has many sectens and The upper portion contain
master information. The “item” tab is used for
maintenance of the attributes of the item.
Item Indents and Issues
* Goods that are damaged or have indents while
being transported from the source to the
warehouse may be returned when the supplier
allows it.
* Damaged items are moved to another warehouse
for them to be monitored.
Reorder Level and Minimum and Maximum
Inventory Ordering
Reorder Level - 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.
Min/Max inventory ordering method is the basic
reordering method implemented in many ERPs
and other inventory management software.
* Min value represents the stock level that
prompts the reorder
* Max Value sets the new targeted level that
follows the reorder
* Economic Order Quantity (ECQ) is often
interpreted as the main difference between the
Min and Max Value.
ENQUIRIES AND QUOTATIONS FOR DRUGS,
CONSUMABLES, ASSETS, AND GENERAL ITEMS
Documents required in materials
management process
1. Enquiries
2. Quotations
3. Orders
4. Invoices
5 . Documents
COMPARISONS OF QUOTATION AND
PREFERRED VENDORS
* Purchase Quotation - is a document requesting prices and
delivery information from a vendor before the purchase order.
* Preferred Vendor -is part of the list that a company keeps
from whom they purchase their supplies. They look for vendors
who has on-time performance, offers reasonable costs, provides
high quality products and services, fully licensed, bonded, and
insured product and services, and has good business practices.
PURCHASE REQUESTS, ORDERS, AND APPROVAL
* Purchase request or purchase requisition - is a document
that notifies the purchasing department that certain items ore
services need to be replenished.
Purchase Order - is legally binding contract which shows that
the seller has already accepted the order issued by the buyer
(SAP, 2012).
Approval Process - The request for approval is sent to the first
approver when the document fails to meet the approval
requisites. Once the document has been approved an internal
notice is sent to the originator. He can then process the
document.
RECEIVING AND TRACKING ITEMS
Proper receipt and inspection of goods
RETURNABLE/NON-RETURNABLE GATE PASS
❖ When purchased goods are returned, the materials
management system updates inventory levels to reflect the
decrease in quantity
HEALTH INFORMATION SYSTEM
❖ For temporary movement, a returnable gate pass is issued,
whereas for permanent movement, a non-returnable gate
pass is given.
CONSIGNMENT STOCK RECEIPT, CONSUMPTION, AND
REGULARIZATION
❖ In the process of consignment, the vendor or consignor
issues materials to the receiver or consignee, and these
materials are stored in the consignee’s premises. The vendor
maintains legal ownership until such materials are removed
from consignment stores.
EXPIRED STOCK AND QUARANTINE
❖ Expired Stock/Inventory
-Expirationdatesanddecreaseinvaluesofitemsmustbereflectedi
nthe financial records so discrepancies in financial statements
will be prevented.
❖ Quarantine Stock/Inventory
When undecided about how to handle defective
goods ,whether to be sold as scrap, reworked, returned, or
used as it is, a quarantine location or warehouse can be used
to temporarily house them until a final decision is reached.
DRUGS AND CONSUMABLE ISSUE AND RETUNS
TO PATIENTS
❖ Materials Management System provides an overview of the
entire institution’s purchasing and inventory control
processes so they have more reliable information regarding
the drugs and consumables which is critical to decision
making.
GENERIC TAX FORMULA CONFIGURATIONS
❖ Materials Management System usually allow tax rates to be
defined internally via tax codes, or imported from an external
source. The automatic calculation of tax dues during the
purchasing process makes the process less susceptible to clerical
errors.
PERIODIC PHYSICAL STOCK TAKING AND ADJUSTMENTS
WITH TRACKING
❖ An inventory count is a process where a business physically
counts its entire inventory. Barcode and RFID can be used to
ensure accurate and less burdensome counts. The following tactics
can be used to minimize disruption during the physical inventory:
• Inventory services
• Inventory control system software
• Perpetual inventory system
• Cycle counting
HEALTH INFORMATION SYSTEM
✓ Periodic physical stock taking or inventory count may be
mandated by financial accounting. MMS have Barcode and RFID
that can be used as tool to ensure accurate and less burdensome
counts.
CHANGE MANAGEMENT
✓ In the health care industry, the following
are factors that contribute to the changes in
management:
o Regulatory adjusments
o Shifts inconsumer behavior patterns
* Accelerdated pace of IT Development
APPLICATION OF
CHANGE MANAGEMENT
- Change management is defined as a series of
tools, techniques, and processes aimed
at successfully effecting change.
- The progress of the change initiative can be
measured against the objectives set by the
organization (Downey, 2008) which is
measured by the key performance indicators
(KPIs) such as reducing rework by x%,
improving stakeholder satisfaction, etc.
Working with Physicians
When changes involve physicians, a clear-cut
method should be adopted. Some ideas
for the success of transformation are:
1. Communicate patiently the benefits of the changes
in terms of patient care and safety.
2. Nominate physician leaders at the start of
the program.
3. Use web, CBT, and other multi-channel learning and
training opportunities.
4. Be ready and available to answer questions and
clarifications.
5. Make sure that there is a process in place in
handling enhancement requests and
developments.
Training and Education in Health Informatics
1. Provide instructor-led training classes to cover
different shifts.
2. Present contemporary models of training.
3. Make computer laboratories available for practice
(24/7).
4. Roll out accompanied by on-the-job/real-
time training.
5. Summarize the steps and make cheat sheets handy.
6. Print easy to carry colorful booklets in a pocket.
7. Provide a short manual with key facts and how-
to-tips.
8. Have well equipped training rooms.
9. Schedule train-the-trainer program to give enough
time to practice.
10. Assign a super-user to keep people involved.
11. Provide the business process maps and
process workflows.
12. Prepare a day-in-the-life scenario for the
simulation.
13. Walk them through the flow several times until
they are able to adapt.
14. Entertain and answer questions clearly and
provide details.
15. Prepare the users by discussing some of the
challenges and frustrations they might
encounter in the early stages of the rollout.
HEALTH INFORMATION PROFESSION
The Role of Health Information Management
Professionals
Health Information Management (HIM) professionals
have a special skill set that qualifies them to assume
the role of privacy and security officers who take care
of the storage, protection, and maintenance of the
information in the health care institution.
They should be committed to the timely and accurate
collection and management of data capture,
documentation, and maintenance of the clinical
information but also includes data analytics and
interpretation, and management of health information
technology systems.
PHILIPPINE HEALTH INFORMATION PROFESSION
e-Health Strategic Framework and Plan for 2014
to 2020
- is an initiative whose main
objective is to utilize information and communication
technologies in the health sector of the country.
One of the strategic goal of the framework is to establish
unified and coherent health and management
information systems, to take advantage of ICT to reach
and provide health services, and support the attainment
of the UN’s Sustainable Development Goals.
TELEMEDICINE IN THE PHILIPPINES
Medgate and Lifeline – provider of over-the-phone
telemedicine services MyPocketDoctor and
MyDocNow – mobile app-based telemedicine center
Medway Healthcare Inc. – offers telefollow-up and
teleconsultation
Government pioneered nationwide
telemedicine efforts
The National Telehealth Center of the University of the
Philippines (UP-NTHC) with the
funding from the Commission on Information and
Communications Technology (CICT) implemented
Buddyworks and Telehealth project from 2004 to 2007
which uses a web-based and SMS-based telehealth
platform.
RxBox and CHITS
RxBox diagnostic telemedicine device was incorporated
in the government telehealth
program thru DOST’s support. The clinical data gathered
by the RxBox is exchanged with the community health
information tracking system (CHITS) electronic medical
records and transmitted to specialist for
teleconsultation.