HEALTH INFORMATION SYSTEM FOR ML NAJIMA HUSSIN, MLS

NAJIMA HUSSIN, MLS HMIS

LESSON TITLE 8: HEALTH MANAGEMENT - is one of the six building blocks essential for
INFORMATION SYSTEM health system strengthening. It is a data collection
system specifically designed to support planning,
Health Care Administrations management, and decision-making in health
- Traditionally, it has been managed manually, facilities and organizations.
starting from patient registration to consultation - a set of integrated components and procedures
- The creation of documents proved to be time- organized with the objective of generating
consuming and pound the risk of having duplicate information that will improve health care
records. management decisions at all levels of the health
- Improper storage of these documents was also a system.
concern because of difficulty in retrieval and the - It is a routine monitoring system that evaluates
high cost of maintaining proper storage. the process with the intention of providing
- Getting an overview of the number of patients warning signals through the use of indicators. At
visiting the hospital, or consolidating the nature the health unit level,
of problems that need - HMIS is used by the health unit in charge and the
- immediate action and providing pertinent reports Health Unit Management Committee to plan and
were very difficult to achieve Tools such as coordinate health care services in their catchment
snapshots and dashboard which are necessary in area
the analysis of the performance of hospitals were - HMIS was developed within the framework of
unavailable. the following concepts (Republic of Uganda
- Hospitals using the traditional manual process do Ministry of Health Resource Centre, 2010):
not have real-time data and delays in the receipe • The information collected is relevant to the
of data pone a challenge to evidence-based policies and goals of the health care
program management Accurate and real-time institution, and to the
records of equipment and drugs could not be • responsibilities of the health professionals at
obtained in a timely manner resulting in problems the level of collection
in accountability monitoring of expiry dates
• The information collected is functional as it is
stocks, and auto indenting
to be used immediately for not wait for
- Inventory of medicine and equipment was tedious
feedback from higher levels
task due to lack of standards in filing names and
• management and should
codes in the institution.
• Information collection is integrated for there
- The need to enhance the management of health
is one set of forms and no duplication of
care services and to have real-time data to
reporting
monitor the hospital performance thus calls for a
• The information is collected on a routine
health information management system that will
address these concerns. • basis from every health unit.

MANAGEMENT INFORMATION
❖ As defined by the World Health Organization HEALTH SYSTEM
(2004), health management information system Clinical Management The ability to
(HMIS) is specially designed to assist in the studies assist principles analyze systems
management and planning of health programmes, in the enhanced by and design and
as opposed to delivery of care." understanding finance, law, and implement
The health component of HMIS of medical planning help advanced
- refers to clinical studies to understand medical terminology, administer the computer
terminologies, clinical procedures, and database clinical health care applications make
processes management refers to the principles procedures enterprise. the transfer oof
and data patient information
that help administer the health care enterprise,
processes efficient and
and information system refers to the ability to
effective.
analyze and implement applications for efficient
and effective transfer of patient information.
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NAJIMA HUSSIN,
Health information management MLSprofessionals plan Data classification- is also called Data
information systems organization which sets the efficiency of the
- develop health policy, and identify current and system.
future information needs. In addition, they may 2. Data computation - Mathematical models,
apply the science of informatics to the collection, Statistical approaches, Probabilistic approaches
storage, analysis, use, and transmission of and other data analytic processes
information to meet legal, professional, ethical 3. Data update - Facilitates new and changing
and administrative records-keeping requirements information and requires constant monitoring.
of health care delivery. • Data Output
Roles of the HMIS 1. Data retrieval
1. It should be Complete with all information but - pertains to the processes of data transfer and
avoiding duplication. data distribution. It considers the duration of
2. Consistent in assigning definitions to similar transmittal of required data from the source to
information from various sources the appropriate end-user
3. Clear as to what is measured by the elements 2. Data presentation
4. It should be Simple to use - Reporting of the interpretation of the
5. System must be Cost Effective information produced by the system.
6. Eligible user must have accessibility
7. Confidential in handling patient information

Basic Functions of the HMIS

Data input
• 1. Data acquisition
- refers to the generation and collection of data
through the input of standard coded
formats/Bar codes to assist in faster reading
of data Determinants of HMIS Performance Area
2. Data verification involves validation and ❖ The determinants affecting the performance
authentication of Data source of an HMIS may be behavioral,
• Data management (Processing phase) organizational, and technical
1. Data storage includes preservation ad archiving Behavioral determinants
data. - The data collector and users of the HMI need
to have confidence, motivation and
competence toperform HMS take in order to
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improve HUSSIN, MLS
the routine health information • Behavioral determinants
system (R S) process. - knowledge, skills, attitudes, values, and
- The chance of the task being performed motivation of the people who collect and use data.
affected by the individual perceptions on the • Organizational/environmental
outcome and the complexity of the task (Agil, - determinants information culture, structure,
Lippeveld, & Hozumi, 2009), Lack of resources, roles, and responsibilities of the health
motivation and enough knowledge on the use system and key contributors at each level, and
of data has been found to be a major • Technical determinants
drawback in the data quality and information - data collection processes, systems, forms, and
use. Changing people’s attitude towards data methods. This framework identifies the strengths
collection and analysis is necessary in order and weaknesses in certain areas, as well as the
to maximize the performance of the THIS correlations among these areas.
process (Routine Health Information ❖ This assessment aids in designing and prioritizing
Network, 2003). interventions to improve RHIS performance,
Organizational determinants which in turn improves the performance of the
- The important factors that affect the development health system
of the RHIS process are the structure of the health The PRISM framework
institution, resources, procedures, support - founded on performance improvement principles,
services, and the culture within the organization defines the various components of the routine
(Aqil Lippeveld, & Hozumi, 2009). health information system and their linkages to
- However, other factors which include lack of produce better quality data and continuous use of
funds, human resources, and management information, leading to better health system
support contribute to the determinant of the RHIS performance and, consequently, better health
process outcomes (Aqil, Lippeveld, & Hozumi, 2009).
- Having a system in place which supports data
collection and analysis and transforms it into LESSON TITLE 9: HMIS Monitoring and
useful information will help in promoting
Evaluation
evidence-based decision-making. Thus, all
components within the system are ideal in making
the RHIS perform better. HMIS MONITORING AND EVALUATION
- An improved RHIS performance means an Monitoring
effective organizational culture that promotes - refers to the collection, analysis and use of
information use by collecting, analyzing, and information from programs for the purpose of
using information to accomplish the learning from the acquired experiences,
organization's goals and mission (Sanga, 2015). accounting the resources used both internal and
Technical determinants external, and obtaining results and making
- Technical factors involve the overall design used decisions.
in the collection of information. It comprises the Evaluation
complexity of the reporting forms, the procedure - is the systematic assessment of completed
set forward in the collection of data, and the programs or policies.
overall design of the computer software used in M&E PURPOSE
the collection of information (Sanga, 2015). - The robust monitoring and evaluation (M&E)
PRISM Framework system is required to assess the effect of an
The Performance of Routine Information Systems integrated service delivery.
Management (PRISM) M&E FRAMEWORK
- is a conceptual framework that broadens the - Monitoring and evaluation (M&E) is a core
analysis of HMIS or RHIS by including the three component of current efforts to scale up for better
determinants of HMIS performance. namely: health. Global partners and countries have
developed a general framework for M&E of
health system strengthening (HSS).
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NAJIMA HUSSIN, MLS

M&E PLAN The HMIS indicators
- An M&E plan addresses the components of the - should be carefully selected to meet the essential
framework and establishes the foundation for information necessary for monitoring the
regular reviews during the implementation of the performance of various health programs and
plan for the national level. services and to present an overview of available
health resources.
✓ Maternal Survival Intervention
- The fifth millennium development goal targets to
reduce the maternal mortality ratio by 75percent
and to achieve universal access to reproductive
health.
The HMIS indicators are related to the following:
- Pregnancy care interventions
- Intrapartum care
- Postpartum care
- Interpartum period
✓ Child Mortality and Child Survival Interventions
❖ The leading cause of under- 5 child mortality in
the Philippines in 2012, as reported by the
Department of Health in its top 10 leading causes
of child mortality report, was pneumonia with
2,051 reported cases. The figure below shows the
other leading causes of child mortality in the
Philippines.
❖ The Philippine government through DOH
launched various strategies to help ensure good
health of Filipino children by 2025.
- Child 21- Child 21 or the Philippines National
Strategic Framework for plan development for
Children 2000 to 2025 serves as a framework for
policymaking and program planning and as a
roadmap for interventions aimed at safeguarding
the welfare of the Filipino children.
- Children’s health 2025 - This is a subdocument
of Child 21 which focuses on the development of
Filipino children and the protection of their rights
by utilizing the life cycle approach.
- Integrated Management of Childhood illness -
IMCI is a strategy that aims to lower child
mortality caused by common illness.
- Enhanced child growth- This is an intervention
aimed to improve the health and nutrition of
Filipino children by operating community-based
health and nutrition posts all throughout the
country.
✓ STOP TB Program
- Envisioning a tuberculosis free world, the goal of
the stop TB program is to dramatically reduce the
global burden of TB by 2015.
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- NAJIMA
This HUSSIN,
is in line MLS
with the WHO’s millennium • consistency
development goals and the STOP TB partnership • reliability
which aims to push TB up the world political • appropriate presentation
agenda. • accessibility
- TB Case detection and successful completion of Data Quality
the treatment of TB remain at the core of the Stop - signifies the data’s appropriateness to serve its
TB strategy. Thus, by 2050, one of the targets of purpose in a given context. Having quality data
the strategy is to reduce the prevalence of and means that the data is useful and consistent. Data
deaths o TB by 50 % compared with 1990 cleansing can be done to raise the quality of
baseline. available data.
The HMIS indicators to monitor Stop TB Program THE LOT QUALITY ASSESSMENT (LQAS)
are: - This is a tool that allows the use of small random
• TB Patients on DOTS samples to distinguish between different groups
• TB case detection of data elements (or Lots) with high and low data
• HIV-TB co-infection quality.
• HIV + new TB patients enrolled in DOTS
• TB Treatment outcome

The Routine Data Quality Assessment Tool (RDQA)

- is a simplified version of the Data Quality Audit
(DQA) which allows programs and projects to
verify and assess the quality of their reported
data.
- It aims to strengthen their data management and
reporting systems. The objectives are as follows:
1. Rapidly verify the quality of reported data for
LESSON TITLE 10: HMIS DATA QUALITY key indicators at selected sites.
2. Implement corrective measures with action
plans for strengthening data management and
reporting system and improving data quality.
DATA QUALITY
3. Monitor capacity improvements and
Data quality
performance of data management and
- is the overall utility of a dataset(s) as a function
reporting system to produce quality data.
of its ability to be processed easily and analyzed
for a database, data warehouse, or data analytics
system.
Aspects of Data Quality
• accuracy
• completeness
• update status
• relevance
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NAJIMA HUSSIN, MLS 5.Monitoring

- refers to the deployment of controls to ensure
conformity of data to business rules set by the
organization.
6.Enrichment
- is the enhancement of the value of data by using
related attributes from external sources such as
consumer demographic attributes or geographic
descriptors.
- Recently, these tools started to focus on Data
Quality Management (DQM), which generally
integrate profiling, parsing, standardization,
cleansing and matching processes.

LESSON TITLE 11: ROOT CAUSE

DEVELOPMENT IMPLEMENTATION PLAN ANALYSIS
An Implementation Plan
- is a project management tool that illustrates how
ROOT CAUSE ANALYSIS
a project is expected to progress at a high level. It
A root cause analysis
is developed through the following key steps
- is a problem-solving method that identifies the
(Smartsheet, 2017):
root causes of the problems or events instead of
simply addressing the obvious symptoms.
- The aim is to improve the quality of the products
by using systematic ways in order to be effective
DATA QUALITY TOOLS (Bowen, 2011). Techniques in Root cause
❖ A data quality tool analyzes information and analysis Root cause analysis is among the core
identifies incomplete or incorrect data. Data building blocks in the continuous improvement
cleansing follows after the complete profiling of efforts of an organization in terms of its operation
data concerns, which could range anywhere from dynamics, especially in the way it handles
removing abnormalities to merging repeated information.
information. - However, root cause analysis alone will not
1.Parsing and standardization produce any valuable results. The organization
- refers to the decomposition of fields into should seek to improve at every level and in every
components parts and formatting the values into department for this to work. The analysis will
consistent layouts based on industry standards help develop protocols and strategies to address
and patterns and user-defined business rules. underlying issues and reduce future errors.
2.Generalized “Cleansing” - It is suggested that “to address the root cause of
- is the modification of data values to meet domain the problem, one must identify the problem and
restrictions; constraints on integrity, or other data ask why “five” times to determine the proper
rules that define data quality as sufficient for the strategies to address its root cause.
organization. 1. Failure Mode and effects analysis
3.Matching - The failure mode and effects analysis (FMEA)
- is the identification and merging of related entries aims to find various modes of failure within a
within or across data sets. system and addresses the following questions for
4.Profiling execution:
- refers to the analysis of data to capture statistics - What is the mode in which an observed failure
or metadata to determine the quality of the data occurs?
and identify data quality issues. - How many times does a cause of failure occur?
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NAJIMA
What actionsHUSSIN, MLS to prevent this
are implemented 4. Current reality tree
cause from occurring again? - The current reality tree (CRT) is used when the
- Are these actions effective and efficient? root causes of multiple problems need to be
- FMEA is used when there is a new product or analyzed all at once.
process or when there are changes or updates in a - The problems are listed down followed by the
product and when a problem is reported through potential cause for a problem. By doing so, a
customer feedback cause common to all problems will appear
5. Fishbone Diagram
- The fishbone diagram is also called the
Ishikawa or cause-and-affect diagram.
- The diagram looks like a fishbone as it shows
the categorized causes and sub-causes of a
problem.
- This diagramming technique is useful in
grouping causes into categories. Categories
could be the 4 Ms (Manufacturing), the 4 Ss
(service), or the 8 Ps depending on the industry.
6. Kepner-Tregoe Technique
- The Kepner-tregoe technique breaks a problem
down to its root cause by assessing a situation
2. Pareto analysis using priorities and orders of concern for
- The pareto analysis uses the Pareto principle specific issues.
which states that 20 percent of the work - The various decisions that should be made to
creates 80 % of the results. It is used when address the problems are then outlined. Then, a
there are multiple potential causes to a potential problem analysis is made to ensure
problem. that the actions recommended are sustainable.
7. Rapid Problem Resolution (RPR Problem
Diagnosis)
- which diagnoses the causes of recurrent
problems by following the three phases below:
• Discover- Data gathering and analysis of
findings –
• Investigate- Creation of a diagnostic plan
and identification of the root cause through
careful analysis of the diagnostic data –
• Fix- Fixing the problem and monitoring to
confirmand validate that the correct root
cause was identified Sustaining a Culture
of Information Use Choo, Bergeron,
Detlor, and Heaton (2008) state that
3. Fault Tree Analysis information culture affects outcomes of
- The Fault tree analysis (FTA) is used in Information use.
risks and safety analysis. The information cultures
- It uses Boolean logic to determine the root - is determined by the following variables
causes of an undesirable event. mission, history leadership, employee traits,
- The understandable result is listed at the top industry, and national culture.
of the tree and then all the potential causes are - It can also be shaped by cognitive and epistemic
listed down to form shape of an upside down expectations which are influenced by the way
tree. tasks are performed and decisions are made the
result suggests that in order to have a sense of
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NAJIMA HUSSIN,
information MLSvalues, managers
attitudes and - Technological advances have made the practice
should consider taking the pulse of information of Radiology more complicated such that more
of their own organizations. and more hospitals turn to RIS to address the
- The sets of identified behaviors and values could commercial concerns of their radiology
account for significant proportions of the departments.
variance in information use. Thus, management Pharmacy information systems
plays an important role in sustaining a culture of - help monitor the utilization of medicines in
information and should continuously work health institutions.
maintaining and improving the quality of data - The system also handles information on
and information used in daily operations. medication related complications and drug
allergies of the patients. Selecting a Hospital
LESSON TITLE 12: HOSPITAL information system
INFORMATION SYSTEM The following are the aspects needed to be considered
in selecting an HIS
HOSPITAL INFORMATION SYSTEM 1. Total cost of package
A hospital information system (HIS) - HIS is available for all sizes and budgets.
- is computer system structured to manage all For hospitals with smaller budgets,
records of health care providers to make available providers may reduce upfront and
information and reports available to healthcare maintenance fees by using design that
personnel in doing their job more efficiently. requires fewer servers and Hard wares.
- HIS was introduced in the 1960s and has evolved 2. Web-based systems
since then to cope with the changes and demands - The system is available on the internet
of the modern times. which means that authorized personnel can
- Back then, the features of HIS were used mainly access the information anywhere and
for billing and inventory. However, all of these anytime. It also allows data sharing between
have changed through time. Today’s system is hospitals.
also integrated with other financial, scientific and 3. Implementation and support
administrative programs - During the deployment or upgrade of the
HIS FOR DIFFERENT DEPARTMENTS HIS, it is imperative that the vendor
Nursing Information systems provides ample training and assistance to
- are developed to enhance patient care by the users of the system. Consider vendors
providing nurses with accurate information to that offer 24/7 support through telephone or
assist them in performing their duties more Web services.
efficiently. An NIS carries out numerous HIS providers in the Philippines
functions including the handling of personal 1. BizBox
schedules, accurate pati BizBox, Inc.
- ent charting, and better clinical data integration. - was founded 25 years ago.
Physician Information - Its very first hospital project was completed
- are designed to improve the practice of in 1994.
Physicians. Electronic medical records (EMRs) - The goal of the company is to improve work
and Electronic records are some programs where efficiency in health care institutions through
PIS is deployed and extensively used. software systems, and to produce advanced
- Most systems offer support 24/7 to facilitate solutions for better patient care.
easier usage of the system by health care - Today, it is among the top IT companies in
professionals. the health care industry.
Radiology information systems - Aside from being acertified Microsoft Gold
- are capable of providing billing services and Partner, it has also received the Independent
appointment scheduling aside from reporting and Software Vendor of the year award.
database storage.
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2. KCCI MeDSYS HUSSIN, MLS Admission
Kaiser-dela cruz Cruz consulting, Inc. - is when an admission counselor gathers
- specializes in application development preliminary information, offer vital information
for hospitals, industrial clinics, and concerning the hospital stay, and answers
medical related educational institutions questions if there is any.
in the Philippines. - The physician may also medical exams.
- Its products, Visual MEDSYS for Discharge
hospitals and MEDSCHO for schools, - provides instructions that include discharge
provide integrated, Comprehensive, and planning which details services needed to be
proven solutions for efficient health care administered after the hospital stay to ensure full
practices. recovery of the patient.
3. Comlogik Transfer
Comlogik Business systems, Inc. - means (along with discharge) of an individual
- is a Philippine-based software development outside of the hospital premises at the instruction
company that was established in 1999, with a of any authorized hospital personnel.
vision to be a global technology company.
- Comlogik led the way in developing innovative BILLING, CONTRACT MANAGEMENT, AND PACKAGE
applications like online hospital services in which DEAL DESIGNER
patients can access their billings and examination Billing
results, while administrators can access reports - statements shows all records pertaining to the
and doctors can access patients’ record anywhere invoices, payments, and the current balance of a
and anytime. patient’s account. HIS lists the outstanding
HIS Functions Help Desk, Scheduling, balances of the patient.
Patient Contract Management
Help desk - is defined as the process of managing contract
- becomes more efficient through the HIS because creation, execution, and analysis to maximize the
the manual retrieval of information is no longer operational and financial performance of an
needed. organization while reducing financial risk.
- Clients are provided with information and Package Dealer
guidelines associated with a company's or - which is also called post-diagnostic package
institution's products and services without any deals.
hassle. - HIS helps in accessing information regarding
Scheduling Managers and employees package deals without going through the hassle of
- can access work schedules from anywhere they paperwork.
are and effectively discuss the scheduling
preferences through the HIS. LESSON TITLE 13: LABORATORY,
- An employee scheduling software helps save RADIOLOGY, AND CARDIOLOGY
time and kes employee scheduling less difficult REPORTING
LABORATORY, RADIOLOGY, AND CARDIOLOGY
Patient Registration REPORTING
- HIS patient registration form records the name, Laboratory Report
age, gender, marital status, and other relevant - displays elements with administrative or clerical
information regarding the patient. information in addition to the information about the
- These pieces of information are used for record specimen and the test itself.
keeping and account management purposes. - For identification purposes, some laboratory reports
- This form is usually filled out during the patient's display elements with administrative or clerical
visit or consultation but if the patient is unable to information such as the following:
1. Patient name and identification number or a
complete the form due to the need for prompt unique patient identifier and identification number
medical attention, the form can be filled out by a 2. Name and address of the laboratory location where
relative or guardian. the test was performed
3. Date when the report was printed
4. Test report date
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5. NAJIMA HUSSIN,
Name of the doctor or MLS
legally authorized person - This means that results are generated more efficiently
ordering the tests which translates to improved patient experience.
❖ Information about the specimen and the test itself, MATERIALS MANAGEMENT SYSTEM
such as those included below, are other elements that PHARMACY, MAIN STORES, AND PURCHASE
make a laboratory report more meaningful: Materials management
1. Specimen source - is primarily concerned with planning, identifying,
2. Date and time of specimen collection purchasing, storing, receiving, and distributing
3. Laboratory accession number materials.
4. Name if the test performed - Its purpose is to guarantee that the right and sufficient
5. Test results materials in the right location when needed. As such,
6. Abnormal test results the automation of an inventory or a materials
7. Critical results management systems
8. Units of measurement Materials Management Systems
9. Reference intervals - is necessary for a hectic health center to streamline the
10. Interpretation of results hospital supply chain.
11. Condition of the specimen
- Computerized stock management systems include
12. Deviations from test preparation
technologies for tracking inventories and devices used
procedures
each day in a health care setting
13. Medications, health supplements, etc. taken
- Generally, they utilize barcodes and RFID tags with
by the patient
precise information number assigned for each inventory
Radiology Report
object to enable accurate tracking and control.
- is an official medical document that provides the
- Automatic stock management systems also assist health
details of the requested radiology examination and the
care institutions in figuring out whether merchandise
procedure conducted by the radiologists.
has been recalled or damaged and should be not be
- A qualified physician authorized by the health care
given to patients.
institution interprets the report.
- They enable isolation of drugs and devices that are used
- The main objective of the report is to address the
regularly and forecasts capacity shortages. Virtually,
queries in the request.
every health care institution has a materials
- The findings in the report should take into account
management department that is accountable for
both positive and negative findings.
receiving materials, retaining central stock, and
- Important findings should be stated followed by delivering supplies within the institution.
incidental findings.
- Typically, this is where the responsibility of the
- The basic sections of a radiology report enumerated in
materials management department ends. An inspection
the ACR’s practice guideline on communication must
of a nursing unit, suite or exam floor will reveal a
include administrative information, patient
smaller, selfmanaged inventory in supply closets,
identification, clinical history, imaging technique,
nurses’ stations, and individual rooms.
comparison, observations, summary or impression,
- These inventories are essential in maintaining supplies
and signature of the radiologist. The length of the
conveniently available for use.
report is dependent on the complexity and cost of the
Management reporting
examination.
- is a platform for reporting and controlling information
Cardiology Report
valuable to the institution.
- contain important medical information based on the test
- Recent technological advancements help management
results of the patient which are set against past medical
reports to provide non-monetary information which
records.
enables the management to have an oversight of its
- Doctors are bale to write vascular reports much faster
operations.
since access and retrieval of information are made more
- In the same way, these advancements pave the way for
convenient through computer systems.
the emergence of management reporting systems.
- Using the cardiology information systems, vascular
These systems capture the necessary data required by
sonography reports are accurately created with only a
management to operate more efficiently.
few clicks.
- With this, data redundancy and data quality issues are
- Information on these reports could include ultrasonic
minimized. Employee headcount, customer account
ultrasound and diagrams, nowadays physicians opt to
information, funding, and overall performance are
provide automated reports through the use of
some of the data that can be retrieved through the
information systems.
system.
- The medical staff can process laboratory reports for the
approval of the physician.
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Thus, HUSSIN, reporting
a good management MLS system enhances 1. Sample management Accurate and detailed
the capability of the institution to be more responsive, records
efficient, and effective in decision-making which - are necessary to make sure that samples are not
affects the performance of the institution as a whole. lost or mixed up.
- These systems offer a single holistic view which - A record should show whether the sample meets
highlights high value sources and eradicates the lack of the acceptable values.
visibility in reviewing the performance of the LIMS records and stores the following information about
institution. the sample:
IN-BUILT TALLY INTERFACE Tally.ERP9 1. Who the sample was taken from?
- is software that provides simplified solutions to 2. What is the sample taken?
operations in health institutions such as registration, 3. Who is working with it?
accounting, inventory management, tax management, 4. Who handled the sample?
among others. 5. Where does it go next?
- Tally is easy to learn and can be implemented with 6. How do you store these samples?
minimum resources. 7. When does it need to move?
- LIMS automates most of these by using radio-
LESSON TITLE 14: LABORATORY frequency identification or barcodes in
INFORMATION MANAGEMENT SYSTEM recording and updating logs and track the chain
of custody of the sample.
2. Workflow management LIMS
LABORATORY INFORMATION MANAGEMENT - can be used to automate records and workflows
SYSTEM which saves time.
Laboratory Information Management System (LIMS) - Existing coding methods and procedures enable
- is software designed to make labs more efficient and the system to take part in the decision process.
effective, especially those that process massive Using preset rules, it can suggest instruments
amounts of samples for research and development needed for the procedure and assign the medical
(R&D), manufacturing, and medical research. laboratory scientist/technician to complete the
- For Example, a LIMS records information test.
automatically which saves time and reduces 3. Reporting Using LIMS
typographical error. - reports can be run and exported to make them
- This is commonly used in conjunction with laboratory standard or customized.
information systems in the medical and - Reports on the most frequently used instrument,
pharmaceutical industries. the average handling time of sample, and list of
- According to Gartner’s 2016 Hype cycle for life backlogs are useful in data analysis and
sciences, most of the top pharmaceutical companies formulation of recommendation for future
use LIMS. policymaking.
- This system is also useful for biobanks and genomic 4. EHR Some LIMS
testing centers and laboratories that study drugs and - have a built-in electronic health records functionality
develop formulations. which is capable of handling patient records and billing
- However, the health care institution must consider the information. A health institution should consider this
data capture process, storage, and retrieval in selecting during acquisition because this feature will greatly help
the solutions provider because some are more suitable in managing clinical laboratory procedures.
than others. 5. Mobile Gartner’s (2016)
- The ultimate motive of a LIMS is to enhance - reports that mobile LIMS offerings are limited. But
efficiency in lab operations through reducing manual with the accepted use of smartphones in the laboratory,
responsibilities. it is better for LIMS to be mobile friendly.
FUNCTIONAL REQUIREMENTS AND 6. ERP A LIMS
FEATURES OF LIMS - that can handle inventory functions is recommended.
The functionality of LIMS The enterprise resource planning solution is especially
- includes sample management, workflow useful in viewing current supplies, calculating storage
management, reporting, electronic health records, capacity, and managing location.
Mobile and Enterprise resource planning (ERP).
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NAJIMA HUSSIN,
CORE COMPONENTS OF LIMS MLS 4. Designation of personnel who will handle CHP-related
The core components of LIMS are: activities such as handling data sheets, organizing
1. laboratory notebooks trainings, monitoring adaption, and revising CHP if
2. electronic sample management programs deemed necessary.
3. process execution software,
4. records management software,
5. applications interface, LIMS Application
6. work flow tools, 1. Patient registration
7. client tracking, - When a patient arrives at the hospital, the admission
8. best practices clerk will take some basic information and will guide
9. compliance databases him/her to a registration window.
10. ERP software 2. BILLING
LABORATORY STANDARDS - The process of generating SOAs (Statement of
The Occupational Safety and Health Administration Accounts) or billing statements of in-patients, out
(OSHA) patients, and emergencies are the same. In the following
- released an “Occupational Exposure to Hazardous example, an in-patient’s billing statement is used
Chemicals in Laboratories standard (29 CFR 3. Contract management
1910.1450)” in 2011 to facilitate laboratory safety. - Most LIMS allow the laboratory professionals to
Some important provisions from the standard are cited manage the billing and payment aspects of their
below: activities and to create statistical and billing reports on
Laboratory a par with the laboratory and management needs.
- is a workplace where hazardous chemicals are used. It is - They provide parameters for a flexible price schedule
also a facility that stores small quantities of hazardous and enable heightened attention on customer needs.
chemicals which are not intended for production use. - They automate billing processing, hasten collections,
- On the other hand, the laboratory use of hazardous and offer marketing tools which reduce the time spent
chemicals should meet the conditions listed below: on standard flow and allow billing and accounting
1. The manipulations of chemicals should be on personnel to focus on improving collection of
“laboratory scale” only and can be handled by one problematic accounts.
person. - In addition, the common features of LIMS for
2. There is the use of multiple chemicals and procedures. invoicing and contract management include:
3. 3. The Procedures should not simulate any production a) Customer customizable invoices including balance
process. and charges history analysis, history balance,
4. Protective laboratory tools are available and proper detailed services, participation when in insurance
practices are followed to minimized potential exposure coverage, discounts etc.
to harmful chemicals. b) Different electronic formats for invoices allow
5. Any hazardous use of chemicals which does not meet interfacing to customer electronic systems
this criterion is regulated under other standards. c) Customizable information completion reports for
• Examples are: Chemicals used in the maintenance of the customers
Lab building, Production for commercial sale and d) Managerial reports display laboratory billing
status for payer groups including projected return
Testing of a product for quality control.
values for each payer group
• A chemical hygiene plan (CHP) which discusses all
e) Ability to change the Insurance Organization of a
aspects of the laboratory standards should be formulated
Patient per visit.
if the standards apply. f) Ability to select which Tests of a Patient’s Visit are
• The employer must implement the provisions which covered by the Insurance Organization and which
address the proper purchase, storage, handling, and are privately – with automatic modification of the
disposal of the chemicals used in the facility. prices accordingly.
The primary elements of a CHP include the following: g) Supervision – financial data management of the
1. Establishment of standard operating procedures (SOP) to Senders.
minimize exposure to chemicals and dissemination of h) Reminder for amounts due from past visits. i)
information on the requirements for personal protective Immediate access to the Billing Card of each
equipment. Patient.
2. Monitoring of the work environment to provide the action i) Consistency with the International Laws.
and medical attention required for some chemicals;
3. Statement of plan on how to obtain free medical care for
work related exposures
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4. NAJIMA
Accounts receivablesHUSSIN, MLS - The barcode series can usually be customized to suit the
- Through the integration of the LIMS, the personnel in organization’s or classification needs. With this kind of
charge of managing accounts receivables can easily technology, information about a tube, a specimen, or
extract information which was already available from equipment within the laboratory can be found and
the invoicing and contract management procedures. retrieved effortlessly using a barcode scanner.
Additionally, the LIMS can:
- Generate specific or complete accounts receivable
reports Monitor balances for reconciliation and audit
purposes,
- Export data to other accounting systems, and
- Customize reports according to specifications.
WORKLIST AND WORKFLOW
- LIMS assists laboratories in setting priorities of current
workloads based on analyst and instrument availability.
- This function allows the user to track a sample, a batch of
samples, or numerous batches through their life cycles.
- Queuing can also be done by sample or workflow which
is a block of repetitive procedure in a certain process.
- The queuing and work list feature provide insights about
when an event occurred, how long it was, and who was
involved. IN-BUILT BI-DIRECTIONAL INTERFACES WITH
- In addition, other features also enable personnel and EQUIPMENT.
workload management, thereby, allowing users to plan - A two-way communication between the information
workload schedules and assignments, and employees system and the clinical instrument is required,
information and training. Ultimately, the worklist and - LIMS downloads the test orders and specimen ID for
workflow functions operate to facilitate more efficient each test. On the other hand, the clinical instrument
laboratory purposes. uploads the same information for analysis.
QUALITY CONTROL - The same method is also used by instruments for
- Diagnostic tests executed inside the clinical laboratory Microbiology, Hematology and other areas. When a
may yield two kinds of results, a patient result or a quality health institution uses this type of application,
control (QC) result. productivity is enhanced because it minimizes the time
- The result can be quantitative or qualitative or semi- spent in programming the order into the analyzer, and
quantitative (limited to a few different values). ensures the accuracy due to the elimination of errors
- QC results are used to verify whether or not the usually committed in the manual process.
instrument is working within prescribed parameters. - Nowadays, these machines also have the random access
- Based on the said results, reliability of a patient’s test testing feature and barcode label scanning for specimen.
results will be determined.
LIMS’ functions
LESSON TITLE 15: OTHER HOSPITAL
- enable users to set standards about the relevant range of
INFORMATION SYSTEMS
patient test results or to extract test result information for
the purpose of quality assurance.
- Outliers and deviations can be flagged, and appropriate
warning signals can notify users about issues which
Cardiology Information System
might involve the quality of the samples or the equipment Cardiology Information System (CIS)
currently in use. - is mainly focused on the storage and retrieval of
BARCODE-GENERATION, PRINTING AND cardiology-centric images.
fREADING - This system usually receives an order with patient
LIMS modules demographics from other information
- are commonly linked to a barcoding label generator management systems.
which enables a fast and easy method to identify tubes, - Once the images are acquired from imaging
samples, documents, and many others. modalities, they are profiled based on the order
- The code can simply be printed on a label sticker to be
and stored for further distribution, viewing, and
placed on any item which needs identification.
long-term archiving.
- A Barcode editor also allows multiple labels to be printed
at a label printer.
 HEALTH INFORMATION SYSTEM FOR ML NAJIMA HUSSIN, MLS

- NAJIMA
The HUSSIN,
information used byMLS
cardiologists for the 3. Enhanced Comparability
diagnosis and treatment of diseases varies from - CIS is an essential repository of cardiology imagery
personal notes (History, Physical environment), results; thereby, retrieval of past data is convenient. This
to signals (electrocardiograms), images (Echo comparability enables health care professionals to make
more informed decisions on their patient’s treatment.
diagrams, Angiograms, CT, MRI), and reports
FUNCTIONALITIES OF CIS
from investigations and procedures. 1. Editing, Viewing, and Storing Multi-Modal Cardiology
- Cardiologists never seem to treat a patient from a Data
single diagnostic test. Before a patient is treated - With the help of CIS. Different types of data, including
for angioplasty, they may undergo several those computed tomography (CT), cardiac ultrasound
noninvasive diagnostic procedures such as a chest (Electrocardiography), Magnetic resonance imaging
X-ray, computed tomography angiogram (CTA), (MRI), Nuclear imaging (PET and SPECT), angiography
ECG, echocardiogram and several others. may be managed on a single platform.
- All these types of information can currently be 2. Remote access
provided in digital format, and the system serves as - The use of networks and integrated information systems
repository of these forms of images. Unfortunately, coupled with the availability of the internet and tablets
most systems are limited by their storage capabilities and smart phones, offers flexibility to CIS.
and do not include post-processing functions. 3. Visualization and reporting capabilities
EVOLUTION OF CIS - two of the main benefits of CIS are the ease and the
• Decades ago, the requirements for an electronic medical consistency of reporting. As a result, virtual real-time
information system were restricted by the availability of information retrieval is possible anytime and anywhere
• equipment. with just a couple of clicks.
• A good database schema combined with a functional user 4. HER Integration
interface was deemed adequate. - CIS may be integrated with existing electronic health
• In the 1970s CIS uses mainframe environments. In the record systems; this results in the enhancements of the
1980s, modular systems that emphasized the use of real- quality of services of the health professionals by offering
time a more comprehensive view of the patient care spectrum.
• applications and mini computers became the trend. RADIOLOGY INFORMATION SYSTEM
• Over the years, the trend for smaller computers remained, A Radiology Information System (RIS)
but the introduction of the internet became a turning point - refers to a network system used for managing imagery
that shifted the focus of most systems towards creating and associated data in the radiology department. It tracks
networks and facilitating integration. the orders and billing information of the requesting
• Cardiology information systems nowadays have unique department.
features that enable remote access and easy retrieval. - It uses picture archiving and communication systems
• Some systems have also attempted to integrate Radiology (PACS) for the storage and management of medical
information systems to involve more administrative images and vendor neutral archival (VNA) to manage
process and go beyond storage purposes. image archives and for record-keeping and billing within
• Implementation of a well-evaluated enterprise CIS allows a hospital information system (Rouse, 2017).
cardiologists and clinical staff to be significantly more - The use of RIS in health care institutions has many
• efficient in the preparation and post-procedural phases of advantages in the context of improving overall operations
patient care. of the institution.
BENEFITS of CIS - The system enables easier access to patient information
1. Ease of access while maintaining data security because it can be integrated in referring to the doctor’s
- CIS consolidates multiple types of patient cardiology electronic health record system, resulting in better patient
information, thus eliminating the need for doctors to experience.
request different imaging results from different - It also allows faster processing of payments because the
departments. insurance plans of patients may be verified prior to their
2. Flexibility in the workflow visit and electronic payment is unavailable option. It also
- Availability of mobile technology allows cardiologists to permits reports to be easily generated and sent to the
assess a wide array of information without having to requesting department which dramatically improves the
leave the patient’s bedside. Having cardiological data in efficiency of the workflow of the institution.
a single platform offers mobility to physicians and - RIS aims to store the data derived from imaging
nurses, thereby improving the efficiency of providing technologies like:
service. • X-ray radiography,
• magnetic resonance imaging,
 HEALTH INFORMATION SYSTEM FOR ML NAJIMA HUSSIN, MLS

NAJIMA
• medical HUSSIN,
ultrasonography or MLS
ultrasound,
• endoscopy,
• elastography,
• tactile imaging,
• thermography,
• medical photography,
• nuclear medicine functional imaging techniques
FUNCTIONS OF RIS
Rouse (2017) describes the following functions of an RIS:
1. Patient management
The system tracks the patient’s 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.
2. Scheduling
The system allows staff to schedule appointments for
in-patients and out-patients.
3. Patient Tracking
It means tracing the patient’s radiology history
starting from admission to discharge and coordinating
it with his or her past, present, and future
appointments.
5. Results reporting
- Results reporting is possible through the statistical
reports generated by RIS. The reports may be done for
a single patient or a group of patients, as well as for
specific procedures, depending on the needs.
6. Image tracking
- RIS was traditionally used to track individual films
and associated data. Nowadays, RIS-PACS systems
managed by radiology departments cover the entire
clinical workflow of the medical enterprise.
7. Billing
- Billing is made convenient through the system’s
financial record keeping and processing of electronic
payments and automated claims.