SUBJECT: Health Information System
● Completeness
TOPIC OUTLINE o Complete data measures or
TOPIC 1 HMIS DATA QUALITY describes all the relevant
TOPIC 2 HOSPITAL INFORMATION SYSYTEM aspects of the problem you’re
TOPIC 3 LABORATORY INFORMATION MANAGEMENT trying to solve.
SYSTEM o It encompasses the total
TOPIC 4 OTHER HOSPITAL INFORMATION SYSTEM population, time period and/or
geographic area that you’re
HMIS DATA QUALITY studying.
o There are no items missing from
INTRODUCTION series.
● Relevance
● Data quality has become a major concern o Your data should describe or
for large companies especially in the pertain to the time period,
areas of customer relationship location and / or population that
management (CRM), data integration and comprise and affect what you
regulation requirements. are analyzing.
● Poor data quality generates costs, and o It should also be directly related
may also affect: to the goals of your analysis.
o customer satisfaction, ensure that data collected are
o company’s reputation useful for the purposes for
o strategic decisions of the which they are collected on
management ● Consistency
o Ensure that patients’ data is
DATA QUALITY
reliable and the same across the
counter, no contradictions
● Data quality is the overall utility of a
● Reliability
dataset (collection of data) as a
o Data are reasonably complete
function of its ability to be processed
and accurate, meet the intended
easily and analyzed for a database, data
purposes, and are not subject to
warehouse, or data analytics system.
inappropriate alteration.
o It is a perception of the data's
appropriateness to serve its ● Presentability
purpose in a given context. o The extent to which the
● Having quality data means that the data aesthetic (visual and artistic)
is useful and consistent. qualities of data present the
● Data cleansing can be done to raise the desired information.
quality of available data o Every table of figures or graphs
in a report or presentation
ASPECTS OF DATA QUALITY should have a label telling about
the source of information.
● Accuracy ● Accessibility
o Your data needs to accurately o Focuses on the availability of
reflect or correspond to what data when needed
you’re measuring, to the
required level of measurement. LOT QUALITY ASSURANCE SAMPLING (LQAS)
o It should also be free of typos,
transpositions, and other ● A tool that allows the use of small
inaccuracies of data entry and random samples to distinguish between
classification. different groups of data elements
o Emphasizes on the data being (or lots) with high and low data quality.
free from errors
SUBJECT: Health Information System
● Using small samples makes conducting
surveys or supervision more efficient.
● This technique has a wide application in
the industry for decades and had
primarily been used for quality
assurance of products.
● The concept and application of LQAS
technique has been adopted in the
context of DHIS (District Health
Information System) data quality
assurance.
● The adaptation was comprised of DEVELOPMENT IMPLEMENTATION PLAN
designating health facilities, DHIS
monthly reports, sections of monthly ● An Implementation Plan is a project
reports and group of data elements as management tool that shows how a
‘Lots’ to provide representative samples project will evolve at a high level
for data quality assurance of DHIS. o helps ensure that a development
team is working to deliver and
STEPS IN APPLYING LQAS complete tasks on time
● The development of an Implementation
Plan is important to ensure that the
communication between those who are
involved in the project will not encounter
any issues and work will also be
delivered on time.
● The plan validates the estimation and
schedule of the project plan.
IMPLEMENATION PLAN – KEY COMPONENTS:
● Define Goals/Objectives:
o Answers the question “What do
ROUTINE DATA QUALITY ASSESSMENT (RDQA)
you want to accomplish?”
● Schedule Milestones:
● A simplified version of the Data Quality
o Outline the high-level schedule in
Audit (DQA) which allows programs and
the implementation phase.
projects to verify and assess the quality
of their reported data. ● Allocate Resources:
o Determine whether you have
● It aims to strengthen data management
sufficient resources, and decide
and reporting systems.
how you will procure what’s
missing.
● Designate Team Member
Responsibilities:
o Create a general team plan with
overall roles that each team
member will play.
● Define Metrics for Success:
o How will you determine if you
have achieved your goal?
DATA QUALITY TOOLS
SUBJECT: Health Information System
● Tools that analyze information and ● Recently, these tools started to focus
identifies incomplete or incorrect data. on Data Quality Management (DQM), which
● Data cleansing follows after the generally integrate profiling, parsing,
complete profiling of data concerns, standardization, cleansing and matching
which could range anywhere from processes.
removing abnormalities to merging
repeated information. ROOT CAUSE ANALYSIS
● By maintaining data integrity, the
process enhances the reliability of the ● A class of problem-solving methods
information being used by a business. aimed at identifying the root causes of
the problems or events instead of
WAYS ON HOW DATA QUALITY TOOLS ARE USED TO simply addressing the obvious
ADDRESS DATA QUALITY PROBLEMS symptoms.
● The aim is to improve the quality of the
● Praising and standardization – products by using systematic ways in
refers to the decomposition of order to be effective.
fields into component parts and
formatting the values into TECHNIQUES IN ROOT CAUSE ANALYSIS
consistent layouts based on
industry standards and patterns ● Root cause analysis is among the core
and user-defined business rules building blocks in the continuous
● Generalized “cleansing” – means the improvement efforts of the
modification of data values to meet organization.
domain restrictions, constraints on ● Root cause analysis alone will not
integrity or other rules that define produce any results.
data quality as sufficient for the ● The organization should embrace a
organization relentless pursuit of improvement at
● Matching – this is the identification every level and in every department for
and merging related entries within this to work.
or across data sets ● The analysis will help develop protocols
● Profiling – refers to the analysis of and strategies to address underlying
data to capture statistics or issues and reduce future errors.
metadata to determine the quality
of the data and identify quality 1. Failure Mode and Effects Analysis (FMEA)
issues 2. Pareto Analysis
● Monitoring – the deployment of 3. Fault Tree Analysis
controls to ensure conformity of 4. Current Reality Tree (CRT)
data to business rules set by the 5. Fishbone or Ishikawa or
organization Cause-and-Effect Diagrams
● Enrichment – enhancing the value of 6. Kepner-Tregoe Technique
the data by using related attributes 7. RPR Problem Diagnosis
from external sources such as
consumer demographic attributes FAILURE MODE AND EFFECT ANALYSIS
or geographic descriptors
● A technique which is aimed to find
APPLICATION/SCOPE OF DATA QUALITY TOOLS various modes for failure within a
system
● Dedicated data cleansing tools designed ● FMEA requires several steps for
to address normalization and execution:
de-duplication (first generation of data 1. All failure modes (the way in which
quality tools). an observed failure occurs) must be
determined.
SUBJECT: Health Information System
2. How many times does a cause of FAULT TREE ANALYSIS
failure occur?
3. What actions are implemented to
prevent this cause from occurring ● Uses boolean logic to determine the root
again? causes of an undesirable event.
4. Are the actions effective and ● This technique is usually used in risk
efficient? analysis and safety analysis.
o At the top of the fault tree, the
● FMEA is often performed and updated undesirable result is listed.
any time a new product or process is o From this event, all potential
generated, when changes are made to causes tree down from it.
current conditions, or to the design, o Each potential cause is listed on
when new regulations occur, or when the diagram in the shape of an
there is a problem determined through upside-down tree.
customer feedback
CURRENT REALITY TREE (CRT)
PARETO ANALYSIS
● The current reality tree analyzes a
● The Pareto analysis operates using system at once.
Pareto principle (20% of the work
● It would be used when many problems
creates 80% of the results.
exist and you want to get to the root
● It is used when there are multiple causes of all the problems
potential causes to a problem. o The first step in creating a
● A Pareto chart lays down list of current reality tree is listing all
potential causes in a bar graph (from the of the undesirables or,
most important cause on the left to the problems.
least important cause on the right) and o Then begin a chart starting with
track the cumulative percentage in a line each of those problems using
graph to the top of the table. causal language (if...and... then).
● The causes reflected on the table should o The tree will depict each
account for at least eighty percent of potential cause for a problem.
those involved in the problem. o Eventually, the tree will show
one because that is linked to all
four problems
SUBJECT: Health Information System
FISHBOME OR ISHIKAWA OR CAUSE AND EFFECT
DIAGRAMS
● Depending on the industry you are in, you
may use different categories such as:
o 4 M's (manufacturing),
o 4 S's (service)
o 8 P's (also service)
KEPNER-TREGOE TECHNIQUE
● Also known as rational process, it is
intended to break a problem down to its
root cause.
o This process begins with an
appraisal of the situation - what
are the priorities and orders for
concerns for specific issues?
o Next, the problem analysis is
undertaken to get to the cause
of undesired events.
RPR PROBLEM DIAGNOSIS
o Then, a decision analysis is
tackled, outlining various
● RPR stands for "Rapid Problem
decisions that must be made.
Resolution" and it deals with diagnosing
o Finally, a potential problem
the causes of recurrent problems.
analysis is made to ensure that
● This process has three phases:
the actions decided upon in step
o Discover - team members gather
three are sustainable
data and analyze their findings
o Investigate - a diagnostic plan is
created and the root cause is
SUBJECT: Health Information System
identified through careful
analysis of the diagnostic data
o Fix - the problem is fixed and
monitored to ensure that the
proper root cause was
identified.
SUSTAINING A CULTURE OF INFORMATION USE
● Information culture affects the
information use outcomes.
● The information culture is determined
by the following variables:
o mission,
o history,
o leadership,
o employee traits,
o industry,
o national culture.
● Information culture can also be shaped
by cognitive and epistemic expectations
which is influenced by the way that
tasks are performed and decisions are
made.
● The result suggests that in order to
have a sense of the information
attitudes and values, the managers
should consider taking the information
pulse of their own organizations.
o The sets of identified behaviors
and values were able to account
for significant proportions of
the variance in information use
● Management plays an important part in
sustaining the culture of information
and should continuously work on
maintaining and improving the quality of
data and information used in their daily
operations
● As organizations collect more data,
managing the quality of that data
becomes more important every day.
● After all, data is the lifeblood of your
organization.
● Data quality management helps by
combining organizational culture,
technology and data to deliver results
that are accurate and useful
SUBJECT: Health Information System
o Access to fast and reliable
HOSPITAL INFORMATION SYSTEM information including patient’s
records illustrating information
INTRODUCTION about their demographics,
gender, age
● Healthcare is a very crucial part of our o Receive crucial data concerning
society and people expect healthcare hospital finance structures,
providers to do their jobs in an efficient diet of patients, or even
and powerful manner distribution of medicinal drugs
● Each day numerous patients enter o Reveal drug usage within the
healthcare centers challenging the facility and enhance its
management to run the institution effectiveness
easily ● Delivers high quality patient care and
● The employees have to manage and better management of financial records
combine clinical, economic and ● Should be scalable, affordable, and
operational records that grow with the centered on the needs of patients and
practice medical personnel
● Formerly, this data was prepared ● Should be adaptable to rapid
manually, which was time consuming and technological changes
didn’t deliver the desired level of ● Provide enhanced integrity of facts,
performance minimization of transcription error and
● Most professionally run hospitals and duplication of records and shorter
clinics now on hospital information turnaround times of report
system (HIS) that assist them in ● Links computers that are capable of
controlling all their medial and quickly optimizing operations and
administrative records. delivering quality service
● The system gathers, process, retrieve
HOSPITAL INFORMATION SYSTEM patient information and provide hospital
stakeholders with relevant information
● A hospital information system (HIS) is through reports for better decision
fundamentally a computer system that making
could manage all the information to
permit health care providers to do their HIS FOR DIFFERENT DEPARTMENTS
job efficiently 1. NURSING INFORMATION SYSTEMS (NIS) are
o First introduced in the 1960s developed to enhance patient care by
▪ Billing and hospital nurses with accurate information to
inventory assist them in performing their duties
▪ Computers were not more efficiently
fast, not able to offer o A good NIS can carry out a
data in real time number of functions and supply
● Today hospital information systems benefits together with
include the integration of all scientific, improving personnel schedules,
financial and administrative programs accurate patient charting and
● Modern HIS consist of many applications better clinical data integration
addressing the needs of numerous o The nursing department can
departments in a health facility have a better-management work
o Manage the data related to the force thru agenda packages,
clinic, finance department, enabling managers to handle
laboratory, nursing, pharmacy, absences and overtime. The
and additionally the radiology solution can be used to reveal
and pathology departments staffing levels and obtain more
cost-effective staffing
SUBJECT: Health Information System
o Patient charting applications o It is essential to have an HIS
also permit users to go into that has a low cost of
details regarding patient’s ownership
critical signs. Nurses also use it o A few providers reduce prices
for admission information, care through having a design that
plan and all applicable nursing calls for much less hardware
notes. All crucial facts are and fewer servers
securely saved and can be o This kind of layout is known to
retrieved when needed reduce upfront acquisition fees
o Medical information integration and additionally reduces
is also very useful, allowing maintenance ultimately
nurses to collect, retrieve and 2. Web based system
examine the medical records o The system is available on the
after integrate it to design a internet which means
patient’s care plan authorized employees can
2. Physician information systems (PIS) access the information anytime
aims to enhance the practice of and anywhere
physicians. o It allows data sharing between
o Electronic medical records hospitals
(EMRs), electronic hazard o A hospital with updated patient
records (EHRs) history in their HIS facilitates
o Most systems offer 24/7 access to information from
support to facilitate easier other facilities upon request
usage by healthcare 3. Implementation and support
professionals o Vendor provide sample and
3. Radiology information system (RIS) are training and assistance to the
capable of providing billing services, users during deployment or
appointment scheduling, aside from upgrade
reporting and database storage. With o Select a vendor that gives 24/7
advances in technology, more hospitals support thru the telephone or
now turn to RIS to control the web services
commercial concerns of their radiology
departments
4. Pharmacy information system (PIS) help HIS PROVIDERS IN THE PHILIPPINES
monitor the utilization of medicines in
health institutions BIZBOX
o Also handles information on ● Founded 25 years ago with the goal of
different medication-related helping people improve their work
complications and drug allergies efficiency through software
of patients ● First hospital project implemented in
o The system enables users to 1994
identify drug interactions and ● One of top IT companies in the
also helps administer the healthcare industry
appropriate drugs based on the ● Bizbox is proud to be a Microsoft gold
patient’s physiologic condition certificate partner and the recipient of
the ISV of the year award
SELECTING A HOSPITAL INFORMATION SYSTEM ● Bizbox aims and committed to produce
more advanced solutions, taking
1. Total cost of package advantage of the latest technologies in
o HIS is available for all sizes and the industry, to produce the next
budgets generation of healthcare solutions
SUBJECT: Health Information System
KCCI MEDSYS ● Admission – admission counselor gathers
● Kaiser-dela Cruz consulting, Inc. preliminary information, offer vital
specializes in application development information concerning the hospital
for hospitals, industrial clinics and stay, and answers questions if there is
medical related educational institutions any. The physician may also schedule
in the Philippines. medical exams.
● Its products visual MEDSYS for hospital ● Discharge – provides instructions that
and MEDSCHO for schools provide include discharge planning which details
integrated, comprehensive, and proven service needed to be administered after
solutions for efficient health care the hospital stay to ensure full recovery
practices of the patient
● Transfer means “movement” (along with
COMLOGIK discharge) of an individual outside of the
● Comlogik Business Systems, Inc. is a hospital premises at the instruction of
Philippine based software development any authorized hospital of personnel
company that was established with a
vision to be a Global technology company
● Developed innovative applications like
online hospital services wherein
patients can access their building as
well as the examination results
● Administrators can access reports and
doctors can access patient’s records
anytime, anywhere
HIS FUNCTIONS
HELP DESK, SCHEDULING, PATIENT REGISTRATION
● Help desk provides clients with manual
information and guidelines associated
with the company’s or institutional
products and services without hassle
● Scheduling helps saves time and make
employee scheduling less difficult
● Patient registration records the name,
age, gender, marital status, and other
relevant information regarding the
patient
BILLING, CONTRACT MANAGEMENT, AND PACKAGE
DEAL DESIGNER
ADMISSION, DISCHARGE, TRANSFER (ADT) ● Billing statements shows all the records
PROCEDURES pertaining to the invoices, payments,
SUBJECT: Health Information System
and the current balance of a patient’s information about the specimen and the
account. HIS lists the outstanding test itself
balances of the patient ● Radiology report is an official medical
● Contact management is defined as the document that provides the details of
process of managing contract creation, the requested radiology examination and
execution and analysis to maximize the the procedure conducted by the
operational and financial performance radiologists
of an organization while reducing ● Cardiology report contain important
financial risk medical information based on the test
● Package dealer which also called result of the patient which are set
post-diagnostic package deals. HIS helps against past medical records
in accessing information regarding
package deals without going through the MATERIALS MANAGEMENT SYSTEM – PHARMACY,
hassle of paperwork 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 reporting is a platform for
reporting and controlling information
valuable to the institution
IN-BUILT TALLY INTERFACE
● Tally.ERP9 is a software that provides
simplified solutions to operations in
health institutions such as registration,
accounting, inventory management, tax
management, among others
KEY POINTS TO REMEMBER
● A hospital information system is a
LABORATORY, RADIOLOGY AND CARDIOLOFY fundamentally a computer system that
REPORTING could manage all the information to
● Laboratory report displays elements permit health care providers to do their
with administrative or clerical jobs efficiently
information in addition to the
SUBJECT: Health Information System
● HIS for different departments: nursing
information system, physician
information system, radiology
information system and pharmacy
information system
● The following should be considered
during the selection of the HIS: total
cost of the package, web based system
and implementation and support
● The top 3 HIS in the Philippines are
bizbox, Inc. KCCI Medsys and COMLOGIK
● The functions of HIS addressed the
following concerns: help desk,
scheduling, patient registration,
admission, discharge and transfer
procedures, billing, contract
management and package deals
● Material management is primarily
concerned with the planning, identifying,
purchasing, storing, receiving, and
distribution of materials. Its purpose is
to guarantee that the right and
sufficient materials are in the right
location when needed
● Management reporting systems help in
capturing the data sets that are needed
for managers to run an effective
enterprise
SUBJECT: Health Information System
o May use preset rules in
LABORATORY INFORMATION MANAGEMENT SYSTEM suggesting instruments needed
for procedures.
● A Laboratory Information Management 3. Reporting - for future policy making
System (LIMS) is designed to help o Most frequently used
process information in medical research instrument, average handling
to improve the efficiency of the time of sample, list of backlogs
department’s services and laboratory (for data analysis, formulation
operations by reducing manual tasks and of recommendation)
procedures. 4. EHR – for handling patient records &
o Saves time and reduce billing information
typographical error 5. Mobile - limited but offers better
o Used in conjunction with functionalities
Laboratory Information System 6. ERP (Enterprise Resource Planning) – can
(LIS) in medical and handle inventory functions
pharmaceutical industries. o especially helpful in viewing
o Useful for genomic testing current supplies, calculating
centers and laboratories that storage capacity, managing
studies drugs and develop location
formulations.
● A laboratory information management CORE COMPONENTS OF LMIS
system (LIMS) is software designed to
make laboratories more efficient and
effective.
● The ultimate aim of a LIMS is to enhance
efficiency in laboratory operations by
reducing manual procedures.
FUNCTIONAL REQUIREMENTS AND FEATURES OF LMIS
LABORATORY STANDARDS
● Occupational Safety and Health
Administration (OSHA) released an
1. Sample Management – LIMS records “Occupational Exposure to Hazardous
stores information about the sample Chemicals in Laboratories Standard” in
o Answers the following: Who, 2011 to help promote laboratory safety.
what, provider, handled, o Laboratory is a workplace
where, how, when where hazardous chemicals are
o Can be automated by using used.
Radio-Frequency ▪ It is a facility that
Identification (RFID) or stores small quantities
Barcodes of hazardous chemicals
2. Workflow Management – LIMS can be which are not intended
used to automate records and for production use.
workflows which saves time ● Chemical Hygiene Plan which discusses
all aspects of the laboratory standards
SUBJECT: Health Information System
should be formulated if the standards return values for each payer
apply. group;
o proper purchase, storage, e. Ability to change the Insurance
handling, disposal of chemicals organization of a patient per
in the facility visit;
f. Ability to select which tests are
LMIS APPLICATIONS 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.
ACCOUNT RECEIVABLES
● Generate complete AR reports & monitor
balances
● Export data to other account system &
customize report
WORKLIST AND WORKFLOW
● LIMS assists laboratories in setting
priorities of current workloads based on
analyst and instrument availability.
CONTRACT MANAGEMENT ● The queuing and worklist feature
provides insights about when an event
● The common features of LIMS for occurred, how long it was, and who was
invoicing and contract management involved.
include: ● Worklist and workflow functions
a. Customer customizable invoices operate to facilitate more efficient
including balance and charges laboratory processes, allowing user to
history analysis, history track samples, plan workload schedules
balance, detailed services, and assignments and employee
participation when in insurance information and training.
coverage, discounts among
others; QUALITY CONTROL
b. Different electronic formats
for invoices allow interfacing to ● Diagnostic tests executed in the clinical
customer electronic systems; laboratory may yield two kinds of
c. Customizable information results: a patient result or a quality
completion reports for control (QC) result
customers; o result can be quantitative (in
d. Managerial reports display numbers), or qualitative
laboratory billing status for (positive or negative), or
payer groups including projected semi-quantitative (limited to a
few different values)
SUBJECT: Health Information System
● 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.
● This function enables users to set
standards about the relevant range of
patient test results, or to extract test
result information for the purpose of
quality assurance.
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 label can simply be printed on
sticker and be placed on any item which
needs identification.
● The information can easily be found and OTHER HOSPITAL INFORMATION SYSTEM
retrieved effortlessly using a barcode
scanner. CARDIOLOGY INFORMATION SYSTEM
● Cardiology Information System (CIS) is
mainly focused on the storage and
IN-BUILT BI-DIRECTIONAL INTERFACES WITH retrieval of cardiology-centric images
EQUIPMENT o Usually receives an order with
patient demographic from other
● A two-way communication between the systems.
information system and the clinical o Images are profiled based on
instrument exists. the order & stored for further
o The LIMS downloads the test distribution, viewing, &
orders and specimen ID for each long-term archiving
test. o The system serves as a
o The clinical instrument uploads repository of various images
the same information for (CT, MRI)
analysis.
● A bi-directional interface application EVOLUTION OF CIS
saves time in programming test orders
into the analyzer and eliminates errors ● 1980 - modular systems emphasized the
in manual entry. use of real-time applications & mini
computers became the trend.
● The introduction of the internet became
a turning point that shifted the focus of
most systems towards creating
networks & facilitating integration
● CIS nowadays enable remote access &
easy retrieval
BENEFITS OF CIS
SUBJECT: Health Information System
1. Editing, Viewing and Storing Multi-Modal
Cardiology Data
o Different types of data may be
managed on a single platform
▪ computed tomography
(CT), cardiac ultrasound
(echocardiography),
magnetic resonance
imaging (MRI), nuclear
imaging (PET & SPECT),
angiography FUNCTION OF RIS
2. Remote Access 1. Patient Management
o offers flexibility o tracks entire workflow; add
▪ use of networks & images, generate reports to
integrated info EHRs for easy retrieval
systems, coupled with 2. Scheduling
the availability of the o appointments of in & out
internet & tablets, patients
smart phones 3. Patient Tracking
3. Visualization & Reporting Capabilities o patient’s radiology history from
o Ease and consistency of admission to discharge
reporting which result to 4. Results Reporting
real-time information retrieval o statistical reports
4. EHR Integration 5. Image Tracking
o CIS may be integrated to o RIS track films & assoc. data &
existing EHRs, enhancing quality cover the entire clinical
of service by offering a workflow of medical enterprise
comprehensive view of the 6. Billing
patient spectrum. o record keeping & electronic
payments
RADIOLOGY INFORMATION SYSTEM
● A Radiology Information System (RIS)
refers to a network system used for
managing imagery and associated data in
the radiology department. It tracks the
orders and billing information of the
requesting department.
● RIS is often used in conjunction with
picture archiving and communication
systems (PACS) and vendor neutral
archrivals (VNA) to manage image
archives and for record-keeping and
billing within a hospital information
system (HIS).
FUNCTIONS OF RADIOLOGY INFORMATION SYSTEM