L9. HIS. JB line with the particular needs of a medical institution.

A
9.1. HOSPITAL INFORMATION SYSTEMS hospital can tell the solution provider its wishes, and the
9.1.1. Introduction to Hospital Information Systems (HIS applications can then be molded to deliver precisely what
was demanded. For example, you can demand a solution that
A hospital information system (HIS) is fundamentally a is primarily based on Relational Database Management
computer system that could manage all the information to System (RDBMS) for easy retrieval of information. You can
permit health care providers to do their jobs efficiently. additionally ask the vendor for a HIS that has user- friendly
These structures have been around since they were first functions and a multilingual interface that can be used by a
introduced in the 1960s and have developed with time and diverse team of workers (EMR Education Center, 2013).
the modernization of healthcare facilities. The computers
were not as fast in those days and that they were not able to 9.1.2. HIS for Different Departments
offer data in real time as they do these days. The staff used
them generally for dealing with billing and hospital inventory. 1. Nursing Information Systems (NIS) - these
All this has changed now, and today, hospital information computer-based information systems are designed to
systems include the integration of all scientific, financial, and assist nurses offer enhanced patient care. A good NIS
administrative programs. can carry out a number of functions and supply benefits
together with improving personnel schedules, accurate
Modern HIS consists of many applications addressing patient charting, and better clinical data integration.
the needs of numerous departments in a health facility. They
manage the data related to the clinic, finance department, The nursing department can have a better-managed
laboratory, nursing, pharmacy, and additionally, the radiology workforce thru agenda packages, enabling managers to
and pathology departments. The hospitals that have handle absences and overtime. The solution can also be used
switched to HIS have access to fast and reliable information to reveal staffing levels and obtain more cost-effective
including patients' records, illustrating information about staffing.
their demographics, gender, age, and so on via a simple click
on of the mouse, they receive crucial data concerning Patient charting applications also permit users to go into
hospital finance structures, diet of patients, or even the details regarding patients' critical signs. Nurses also use it for
distribution of medicinal drugs. With this information they admission information, care plan, and all applicable nursing
are able to reveal drug usage within the facility and enhance notes. All crucial facts are securely saved and can be
its effectiveness. Many hospitals have as many as 200 retrieved when required.
disparate systems integrated into their HIS.
Medical information integration is also very useful, allowing
Hospital information systems have grown to be very nurses to collect, retrieve, and examine the medical records,
advanced and new developments are continuously being after which integrate it to design a patients' care plan.
introduced. However, HIS is useless if it confuses the hospital
employees. The system should be user-friendly and should 2. Physician Information Systems (PIS) - as the name
include training by the vendors. An excellent HIS gives several suggests, PIS aim to enhance the practice of physicians
advantages to a hospital such as, but not limited to, the especially those who are encouraged by the
delivery of high- quality patient care and better financial government for deployment. PIS are added thru
management. The HIS must also be patient centric, medical computers, servers, networks, and popular programs
personnel centric, affordable, and scalable. The technology such as: Electronic Medical Records (EMRs), Electronic
changes quickly and if e system is not adaptive, it will not be Health Records (EHRs), and others. Most patient
able to accommodate hospital growth. information is stored in the EMR. Some of the
information stored in the EMR comes from applications
An effective HIS additionally provides benefits, that are part of the HELP/HELP 2 System, while some
including: comes from other applications that are interfaced to the
⚫ enhanced facts integrity; HELP/HELP 2 System. Most of these offerings have 24/7
⚫ reduced transcription errors; support that enables health professionals to
• reduced duplication of facts entries; and troubleshoot issues happening at some point in their
• optimized report turnaround times. use.

Current hospital information systems normally use fast 3. Radiology Information System (RIS) - these systems are
computers linked to each other via an optimized community. also popular for their capability to provide radiology
These computers are programmed to gather, process, and billing services, appointment scheduling, as well as
retrieve patient care and administrative information ensuring reporting and patient database storage. The radiology
better return of investment (ROI) and delivery of service. If practice has become more complicated with advances
the hospital authorities have more relevant data, they can in technology, and more hospitals now turn to RIS to
make better decisions. control the commercial enterprise side of their
practices.
A hospital information system can leverage a relatively 4. Pharmacy Information Systems - these are designed to
optimized core library that guarantees the delivery of cope with the demands of a pharmacy department.
operational and administrative facts required by users. A These systems enable pharmacists monitor how
centralized information system can be custom designed in medicines are utilized in hospitals and facilitates the
 users to supervise drug allergies and different All the healthcare solutions developed by BizBox use the
medication-related complications. The system enables latest technology from Microsoft. Leveraging on Windows
users to identify drug interactions and helps administer Server, SQL Server, and Net, BizBox builds mission-critical
the appropriate drugs based on the patient's physiologic applications for the healthcare environment. Bizbox is proud
conditions (EMR Education Center, 2013). to be a Microsoft Gold Certified Partner and the recipient of
the ISV of the Year Award.
9.1.3. Selecting a Hospital Information System
In selecting a hospital information system, the following With the demands and requirements of healthcare
factors should be taken into consideration: facilities for better patient care, Bizbox aims and committed
to produce more advanced solutions. Taking advantage of
1. Total cost of package - Normally, HIS vendors are thrilled the latest technologies in the industry, BizBox have already
to visit and discuss the necessities of the hospital with the produced the next generation of healthcare solutions. The
owner or management. Solutions are available for hospitals Electronic Health Records (EHR) and Document Management
of all sizes and budgets. It is essential to have a hospital System (DMS) are fully integrated systems that are poised to
information system that has a low cost of ownership. A few bring the healthcare facilities and services to the next level.
providers reduce prices through having a design that calls for
much less hardware and fewer servers. This kind of layout is
known to reduce upfront acquisition fees and additionally
reduces maintenance ultimately.

2. Web-based system - In addition to the user-friendly

features, an excellent HIS system ought to be available on the
internet. Availability on the internet means authorized 9.2.2. KCCI MEDSYS
employees can access the information whenever and/or Kaiser-dela Cruz Consulting, Inc. (est.1990) specializes in
wherever the need arises. This does not bind all caregivers to application development for hospitals, industrial clinics, and
their office desks and additionally offers them with statistics medical-related educational institutions in the Philippines.
when they need it most. A web-based system will become Their products, Visual MEDSYS for hospitals and MEDSCHO
even more vital if it is used to share data between or more for schools, provide integrated, comprehensive, and proven
hospitals. Healthcare centers in distinctive geographic solutions. The President of KCCI, Robert F. Kaiser, Jr. is a
locations can share relevant information quickly in the event graduate of Ateneo with Masters in Hospital Administration
that they use an internet-based HIS. For example, a hospital Program and is currently the EVP of Lorma Medical Center
may decide to shift a patient to another facility for improved
care or specialty treatment. If the present hospital has
updated all the patient history in their HIS, the next health
facility can immediately access the information necessary for
treatment. The medical records of the patient will continually
be saved within those facilities and can be effortlessly
retrieved if the patient is not able to offer it himself or
herself.

3. Implementation and support - Change is continually

resisted by people and deploying or upgrading a hospital
information system can also invite employee criticism. It is
always good to invite the vendor for assistance in an
implementation and request for staff training. Select a
vendor that gives 24/7 support thru the telephone or web, so
your hospital staff can at once access support. A few
hospitals also seek advice from their personnel while making
a purchasing decision, because the personnel may be capable
to tell you something new or let you know about things
others may have left out (EMR Education Center, 2013).

9.2. HIS PROVIDERS IN THE PHILIPPINES

Discussed in this section are some of the prominent HIS Comlogik is considered one of the leaders in
Providers in the Philippines. development and innovation of applications such as online
hospital services. Through this innovative applications,
9.2.1. BIZBOX patients can access their billing as well as the examination
Bizbox, Inc. was founded twenty-five (25) years ago results; and hospital administrators can access their reports
with the goal of helping people improve their work efficiency and the doctors' records of their patients anywhere and
through software. From the first hospital project in 1994, anytime they need to (http://www.
BizBox evolved into one of the top information technology (IT) comlogik.com/About_Us.aspx#who_we_are).
companies focused on the healthcare industry.
 hospitalization. Other routine tests can be carried out at the
9.2.4. IQVIA day of the admission.
IQVIA is the result of the 2016 merger of Quintiles, a
leading global contract research organization, and IMS Health, 9.4.2. Discharge
a leading healthcare data and analytics provider. The name of Discharge from the hospital is the point at which the
the modern company honors the legacy organizations-IQVIA: patient leaves the health facility and either returns home or
I (Intercontinental Marketing Statistics - IMS Health), Q is transferred to some other facility including one for
(Quintiles), and VIA ('by way of'). rehabilitation or to a nursing home. Discharge entails the
medical instructions that the patient will need to fully
IQVIA is a leading global provider of advanced analytics, recover. Discharge planning is a service that considers the
technology solutions and clinical research services to the life patient's needs after the hospital stay and may involve
sciences industry, dedicated to creating intelligent numerous exceptional services, which include visiting nursing
connections that deliver unique innovations and actionable care, physical therapy, and home blood collection.
insights.
9.4.3. Transfer
IQVIA Hospital Information Systems Arcus Air™™ unifies The term "transfer" means the movement (along with
the entire hospital network as a powerful communication the discharge) of an individual outside a hospital's premises
and collaboration platform that can be utilized by all at the instruction of any person employed by (or affiliated or
stakeholders involved in patient care. The use of smart health related, directly or indirectly) with the hospital. This, however,
information technology enables hospitals to deliver quality does not encompass movement of an individual who (a) has
patient care through effective coordination. Arcus Air™™ is a been declared lifeless, or (b) leaves the facility without the
single unified information system that has comprehensive permission of any such authorized person (Louisiana State
modules for Hospital Information System (HIS) and Electronic University, 1993).
Medical Record (EMR) to support patient administration, If a patient is transferred-sent from the emergency
departmental functions, and specialty configurations. room while not having been stabilized in the emergency
room-employees must fulfill the statutory requirements for a
proper switch.

9.5. PHYSICIAN PRACTICE

Masters (2015) describes the current environment of
the physician practice in the following manner:
9.3.1. Help Desk
A help desk is a useful resource meant to offer the Increasingly, physicians are being employed within one
customer or end user with information and guide associated of several practice models. Some hospitals may purchase and
with a company's or institution's products and services. manage existing solo or group practices or may directly hire
physicians to work in their inpatient facility or ambulatory
9.3.2. Scheduling clinics. Health care corporations may own and run clinics with
Managers and employees can access work schedules employed physicians. And some physician-run groups are
from everywhere and effectively discuss their scheduling structured on an employment model, where a group practice
preferences. An employee scheduling software could save is structured more like a corporation that employs clinicians
time and make employee scheduling less difficult. instead of pursuing a more traditional partnership model.

9.3.3. Patient Registration An advantage of being an employed physician is that

A patient registration form needs to be filled up much of the administrative burden of running a practice is
whenever a patient visits a hospital or clinic to avail of shifted to the employing entity, allowing clinicians to focus
medical treatment. It is also frequently referred to as the more on practicing medicine. Additionally, a baseline level of
patient admission form, which collects facts about the compensation is usually assured, although productivity
patient's name, age, marital status, gender, medical history, demands, and incentives may be significant. Because the
previous consultation, and varying essential data. The data is organizations employing physicians tend to be larger, they
used for record keeping and administrative use. If the patient usually have more resources than solo or independent group
calls for any prompt medical attention for the duration of an practices. Clinically, this usually means reasonable coverage
emergency, the form can be filled up by any relative, friend, for clinical responsibilities and improved control of lifestyle.
or guardian. This larger size and increased resources may also translate
into more robust support services and opportunities for
9.4. ADMISSION, DISCHARGE, AND TRANSFER PROCEDURE further education and training.
9.4.1. Admission
Before a patient is admitted to the health facility, an The downside of being an employed physician is that
admission counselor will call the patient or the direct relative physician autonomy may be substantially diminished relative
of the patient to gather preliminary information, offer vital to other practice models. Scheduling and productivity
information concerning hospital stay, and answer some expectations may be beyond your control, and policies and
questions. The physician additionally may schedule recurring procedures may be developed by others without your input.
medical exams, such as laboratory tests or X-rays, before the There may be less clinical flexibility due to limitations of
referrals and facilities based on the employing organization.
Additionally, there may be other expectations as an imported goods are of this category in the U.S. In markets,
employed physician, such as serving on committees or such goods can be used for personal use or commercial use.
participating in other organizational activities. If the goods are first kept in any warehouse before
transported to the market, then formal warehouse entry is to
9.6.1. Billing be made on them.
Billing statements itemize all of a purchaser's invoices
and payments and maintain a rolling balance of how much Example: An exporter from Brazil exports tea to the U.S.
they owe. Statements are valuable for customers that order and the stock goes directly to the distributor without going to
from you on a frequent basis. When they pay, such any warehouse. Then, a consumption entry is made for the
customers will often combine numerous invoices and pay in tea stock.
lump sum. Through generating statements on a regular basis,
more likely on a monthly basis, the institution will be able to Apart from consumption entry, the following entries are also
keep track of those who owes and how much. used:
 Transportation entry – when goods are in transit
Statements are not only useful for active customers, but to a third country.
they also keep the physicians up to date on customers who  Warehouse entry - when goods are stored in a
only seldom order from them. Whenever the physicians bonded warehouse before making their way to the
generate billing statements, the HIS will display a list of those market.
customers who have outstanding balances, and the doctors  Foreign Trade Zone Entry - when goods are stored
can page through each statement and quickly isolate in a place licensed by the department of commerce
someone if their payment is overdue. of that country.
 Temporary in Bond Entry
9.6.2. Contract Management  Drawback Entry
Goodrich (2013) defines contract management as the
"process of managing contract creation, execution, and 9.8.1. Laboratory Reporting
analysis to maximize operational and financial performance Despite the differences in presentation and form, all
at an organization, all while reducing financial risk. laboratory reports must possess common elements as
Organizations encounter an ever-increasing amount of required by federal legislation or by company policies. It may
pressure to reduce costs and improve company performance. also contain supplementary items not specifically required,
Contract management proves to be a very time-consuming but which the laboratory chooses to report to aid in the
element of business, which facilitates the need for effective interpretation of results (American Association for Clinical
and automated contract management system." He stresses Chemistry, 2017).
that when a contract management strategy is successfully For identification and filing purposes, some laboratory
implemented, organizations can expect to see: reports display elements with administrative or clerical
•The expected business benefits and financial returns information:
are being realized.
•The supplier is cooperative and responsive to the  Patient name and identification number or a
organization's needs. unique patient identifier and identification
• The organization encounters no contract disputes or number,
surprises.  Name and address of the laboratory location
•The delivery of services is satisfactory to both parties. where the test was performed;
 Date report printed;
9.6.3. Package Deal  Test report date; and
Designer Posting Diagnostic Medical Packages for Inpatients,  Name of doctor or legally authorized person
Outpatients and Emergencies requires the same process; the ordering the test(s)
difference is that for Emergencies this is called
'Post-Diagnostic Package Deal'. Information about the specimen and the test itself, such as
those included below, are other elements that make a lab
9.6.4. Accounts Receivables report more meaningful:
Investopedia (2017) defines accounts receivables as  Specimen source, when appropriate
"the outstanding invoices a company has or the money the  Date and time of specimen collection
company is owed from its clients. The phrase refers to  Laboratory accession number
accounts a business has a right to receive because it has  Name of the test performed
delivered a product or service. Receivables essentially  Test results
represent a line of credit extended by a company and due  Abnormal test results
within a relatively short time period, ranging from a few days  Critical results Units of measurement (for
to a year." quantitative results)
 Reference intervals (or reference ranges)
9.7. CONSUMPTION ENTRY  Interpretation of results
A consumption entry is duty entry for the goods, which  Condition of specimen
have been imported from an international carrier and sent  Deviations from test preparation procedures
for use in the commercial market directly. There is no time or  Medications, health supplements, etc., taken by
use restriction imposed on these goods. Almost 95% of the the patient
 9.8.2. Radiology Reporting clinics and surgeries or other medical procedures or
The University of Virginia (2013) briefly discusses on medications could help the patient geaients sooner to
radiology reports as follows: recovery sooner.

A radiology report is a clinical and source document that 9.9. DISCHARGE SUMMARY
provides interpretation and describes any radiology A discharge summary is a clinical report arranged by a
procedure conducted by a radiologist. The only person who is health practitioner or a different health expert at the
privileged to prepare and document a radiology report is a conclusion of a hospital stay or series of treatments. It
qualified physician who has been granted specific clinical outlines the patient's main complaint, the diagnostic findings,
privileges in that hospital or clinical settings. It is an official the treatment administered and the patient's response to it,
medical document that provides description and and guidelines on discharge.
interpretation for any officially requested radiological exam.
9.10. MATERIAL MANAGEMENT SYSTEM - PHARMACY,
As outlined by the American College of Radiology, there MAIN STORES, AND PURCHASE
are over 15 components of a radiology report. The length of Material management is basically concerned with the
the report should have some relationship to the complexity planning, identifying, purchasing, storing, receiving, and
and cost of the exam. It should have pertinent positive and distribution of materials. The purpose of material
negative findings and address any specific clinical concerns. management is to guarantee that the right materials are in
All important findings need to be stated first, and any the right location, in the right quantities when needed.
incidental findings are reported at the end. The radiology
report's main premise is to answer the clinical question from Virtually, every healthcare institution has a materials
the radiology request. The main components are: 1. Patient's management department that is accountable for receiving
demographics - name, social security number, etc.; 2. materials, retaining a central stock, and delivering supplies
Relevant clinical information and ICD-9 code; 3. Body of the throughout the institution. Regrettably, that is typically
report; and 4. Impression (conclusion or diagnosis). where the responsibility of the materials management
department ends. A better inspection of a nursing unit, OR
suite, or examination floor reveals a smaller, self-managed
9.8.3. Cardiology Reporting inventory in supply closets, nurses' stations, and individual
rooms. Despite the fact that that is essential to maintain
Sonosoft (2017) elaborates on the importance of supplies conveniently available on the point of use, the
cardiology reports: weight of keeping the supply falls on the nurse and detracts
from his or her primary task feature: offering patient care
The purpose of cardiology reports is that they should (Eisenman, 2017).
clearly provide information about a patient for medical
records. The fact is that doctors who need these reports are As such, the automation of an inventory or material
busy and putting them together takes a lot of time and effort. management system is a definite need for a hectic health
This is why so many medical offices are now using software center to streamline the hospital supply chain. These
to help them write vascular reports. computerized stock management systems include
technologies for tracking and tracing inventories and devices
Vascular sonography reports can be created with a used each day in a healthcare setting. Generally, they utilize
touch of a few buttons if software designed for cardiology is barcodes and RFID tags with precise identification numbers
used. Vascular software programs understand the needs of for each inventory object to enable accurate tracking and
the medical staff that prepare and read these reports and are control.
quite intuitive.
Automatic stock management systems also assist
Vascular sonography reports will indicate valuable healthcare companies in figuring out whether merchandise
information about the results of the ultrasonic ultrasound had been recalled or damaged and being proactive by
and might include diagrams of the veins and arteries to help avoiding giving such merchandise or medications to patients.
determine and measure items such as blood flow, presence Moreover, automatic inventory management enables
of plaque, narrowing and the presence of clots. isolation of drugs and devices that are used regularly; and
forecasts capacity shortages (Pontius, 2018).
Many physicians are now opting for automation of
vascular reports and cardiology reports through the use of 9.11. MANAGEMENT REPORTING SYSTEM
software. Instead of spending time handwriting reports on A management reporting system (MRS) provides
findings, medical staff can use forms that will allow to quickly business information. Historically, MRS structures simply
process a report in a system that understands the tests and used retrieved data. However, the system has undergone
the terminology. tremendous transformation over time, making it a strong
Today, varying softwares are designed to prepare platform for reporting and control. Because of the
reports in a standard format that works for communicating advancement in technology, it can now offer financial and
between offices and clinics and 1 to be used for medical non-monetary information, which could help management
reporting as medical billing. Therefore, the right software take essential actions in the oversight of their business
means efficiency in offices anting as well hospitals, as well as activity.
being able to get re medications could helpunicate with pad
 Management reporting systems help in capturing data
that is needed through managers to run an effective
enterprise. Data could range from monetary data, employee
headcount, customer, accounts, merchandise, client property
in custody, funding overall Performance, and so forth. The
scope of a management reporting system is extensive. An
ffective management reporting system allows enhanced
decision-making, responsiveness, edlectiveness, and
performance in the use of resources (Kumar, 2017).

Kumar (2017) also enumerates six reasons giving rise to

the need for a Management Reporting System:

 Constant need of reports for decision-making and

analysis of trends
 Reports being unavailable to the right stakeholders
at the right time
 Lack of visibility and a single holistic view of the
enterprise performance
 Data redundancy, duplication of data leading to
data management, and quality issues leading to
error prone reports
 High value resources
 Changing a global report to fit local needs

9.12. IN-BUILT TALLY INTERFACE

Tally ERP is a simplified solution that encompasses

accounting, inventory management, tax management, payroll,
and compliance, among many others. Tally is easy to learn
and can be implemented with minimum resources. It is
reportedly used by over 1,000,000 entities across the globe.