Chapter 5- Health Information Systems
Basic Informatics Concepts & Technology
1. Computer- a device that follows
instructions to work on electronic data base
on the user input.
2 parts:
 Hardware: physical components of a
computer
 Ex: monitor, CPU, mouse
 Software: programs that allows a
computer to perform its task.
Embedded are sets of instructions
that tells a computer what to do.
2. File-collection of data identified by a
specific name and group into specific
purpose.
2 parts:
 Applications: executable files
 Data file: image, text, doc, sound
Folder or Directory: a collection of files
3. CPU-Main information processor and is
driven by clock pulses. Speed measured in
Gigahertz. 1 billion clock pulses per second.
4. Memory- physical chips on the
motherboard that holds programs and data
for the rapid access by the CPU
 RAM- Random Access Memory
-Volatile where the contents of the
chips are loss when the computer is turned
off.
 ROM- Read Only Memory
-Permanent memory
5. Storage- Physical media that stores data
permanently
 Internal: hardrive
 External: flashdrive, USB, cd room or
sd card
Networks & Security
1. Network- interconnected group of
computers that share information and
resources.
Bandwidth: rate of data transmission
Laboratory: ability to obtain orders from
and send results to other information
systems.
-Most computers need a card or adapter to
connect to a network. ETHERNET is the
most common type of networking
standard
Types of Ethernet:
 LAN: Local Area Network- small are;
computer shop
 WAN: Wide Area Network
IN A NETWORK SYSTEM, IT INVOLVES
NETWORKING:
 Server- Client
 Client - computer/device that
performs a task in which the end
user interacts.
Different Client types
o Thick- client performs most of
the data processing operations
o Thin- all application logic
executes on the client server
Common Network Components
Modem- modulates an analog carrier signal
to encode digital information; modulation
of signal and convert it to digital
information
Router- routes and forwards information;
agianan/route of info
Server- accepts connections to service
requests by sending back responses
Client- application or system that accesses
the server
Firewall- device and/or software that
inspects network traffic passing through it
and denies or permits passage based on a
set of rules.
_______________________
DATABASE
-BUILDING BLOCKS OF INFORMATION
SYSTEMS
-Structured collection of records comprised
of data fields
-needs to be managed by a set of programs
known as DBMS or DATABASE
MANAGEMENT SYSTEMS
2 types of database:
1. Flat file database: a single, wo-
dimensional array of data elements,
similar to an electronic spreadsheet.
2. Relational database: the data are
organized in tables
a. Patient registration- patient
id #: patient
information/registration data
b. Test order- test
orders/results
c. Test result- generic info
about the test
d. Reference range-
normalization: redundancy is
eliminated
-SQL-structured query language
HEALTH INFORMATION SYSTEMS
-Health informatics is the application of
both technology and systems in a health
care setting. While health information
technology focuses on tools, health
information systems cover the records,
coding, documentation, and administration
of patient and ancillary services.
-Concerns about the cost and quality of
health care are among the motivating
factors why health information systems are
increasingly implemented across health
industries all over the world. The
combination of elements in a health
information system enables the provision of
more efficient and effective health care
services. The components of a health
information system are correlated and
translated into harmonious operations. 
-The health information systems (HIS)
cover different systems that capture, store,
manage, and transmit health-
related information that can be sourced
from individuals or activities of a health
institution.
These include:
1. Disease Surveillance Systems
2. District Level Routine Information
Systems
3. Hospital Patient Administration
Systems (PAS)
4. Human Resource Management
Information Systems (HRMIS)
5. Laboratory Information Systems (LIS)
-use in policy making and decision-making;
should be sustainable, user-friendly and
economical
 The information collected from a well-
functioning HIS is very useful in
policymaking and decision-making of health
institutions and becomes the basis in
creating program action. This translates to
efficient resource allocation at the policy
level, and improvement of the quality and
effectiveness of health at the delivery level.
-НIS should be sustainable, user-friendly
and economical. Health care personnel
should be educated on the use of the
routine data collected from the system and
the significance of good quality data in
improving health (Pacific Health
Information Network, 2016).
Role and Function of Health Information
Systems
-Sheahan (2017) defines health information
systems (HIS) as a mechanism which keeps
track of all data related to the patient such
as patient's medical history, contact
information, medication logs, appointment
schedule, insurance information, and
financial account including billing and
payment.
~The roles that a well-implemented HIS can
perform in improving health services are as
follows:
1. Easier access to files
-The systems have revolutionized the
collection and management of patient
information. The need for a hardcopy of the
patient's medical records becomes optional
as the systems are electronic.
2. Better control
-Only authorized personnel can have access
information on the patient's health. Doctors
may be given permission to update patient
information while a receptionist may only
have the authority to update a patient's
appointments.
3. Easier update
-After creation of the record, patient
information can be accessed and reviewed
any time and copies can be printed or
released to the patient upon request.
4. Improved communications
-HIS assists communication among doctors
and hospitals. However, medical
professionals must adhere to regulations on
patient privacy and security to ensure that
information is kept confidential and safe
from unauthorized access.
-A good health information system delivers
accurate information in a timely manner,
enabling decision-makers to make informed
choices about the different aspects of the
health institution, from patient care to
annual budgets. It also upholds
transparency and accountability due to
easier access to information.
Components of Health Information
Systems
-The Health Metrics Network (HМN),in its
Framework and Standards for Country
Health Information Systems (2008), defines
health information systems as consisting of
six components:
1. Health information systems resources
-These include the framework on
legislation, regulation, planning, and the
resources required for the system to be
fully functional (eg, personnel, logistics,
support, financing, ICT, and the
component's coordinating mechanism. 
2. Indicators
-The basis of the HIS plan and strategy
includes indicators and related targets such
as the determinants of health; health
system inputs, outputs, and outcomes; and
the health status,
3. Data sources
 Data sources are divided into two main
categories:
(1) population-based approaches such as
civil registration, censuses, and population
surveys and
(2) institution-based data such as individual
records, resource records, and service
records. Occasional health surveys,
research, and community-based
organizations may not be directly classified
under the main categories, but they may
provide useful information. 
 4. Data management
-Data management refers to the handling of
data, starting from collection and storage to
data flow and quality assurance, processing,
compilation, and data analysis.
5. Information products
-Data is transformed into useful information
that serves as evidence and provides insight
crucial to shaping a health action.
6. Dissemination and use
HIS enhances the value of health
information by making it readily available to
policymakers and data users.
 These six components of health
information systems can be categorized
into inputs, processes, and outputs.
-Inputs refer to the health information
system resources. These resources include
health, institutional coordination and
leadership, health information policies,
financial and human resources, and
infrastructures.
 -The indicators, data sources, and data
management form. The process in HIS. Core
indicators are needed as bases for program
planning, monitoring, and evaluation.
Population- and institution-based sources
are also essential for decision-making as
they provide guide to health service
delivery. Importantly, these data must be
accessible and understandable by users and
policymakers.
-Outputs refer to the transformation of
data into information that can be used for
decision-making and to the dissemination
and use of such information.
-Donaldson and Lohr (1994) explain that a
comprehensive database for health
information systems include the following:
1. Demographic data refers to the (facts)
about the patient which include age and
birthdate, gender, marital status, address of
residence, race, and ethnic origin.
Information on educational background and
employment is also recorded along with
information on immediate family members
to be contacted during emergency.
 2. Administrative data includes
information on services such as diagnostic
tests or out-patient procedures, kind of
practitioner, physician’s specialty, nature of
institution, and charges and payments.
 3. Health risk information records the
lifestyle and behavior (e.g., use of tobacco
products or engagement in strenuous
activities) of a patient and facts about his or
her family's medical history and other
genetic factors. This information is used to
evaluate the patient's propensity for
different diseases.
4. Health status refers to the quality of life
that a patient leads which is crucial to his or
her health. This shows the domains of
health which include physical functioning,
mental and emotional well-being, cognitive
functioning, and social functioning. It also
shows one's perception of his or her health
in comparison with that of his or her peers.
5. Patient medical history gives information
on past medical encounters like hospital
admissions, pregnancies and live births,
surgical procedures, and the like. It also
includes previous illnesses and family
history (e.g., alcoholism or parental
divorce).
6. Current medical management reflects
the patient's health screening sessions,
diagnoses, allergies (especially on
medications), current health problems,
medications, diagnostic or therapeutic
procedures, laboratory test, and counseling
on health problems.
7. Outcomes data presents the measures of
aftereffects of healthcare and of various
health problems. These data usually show
the health care events (e.g., readmission to
hospital, unexpected complications or side
effects) and measures of satisfaction with
care. Outcomes directly reported by the
patient after treatment will be most useful.
KEY POINTS
-Health information systems (HIS) refer to
systems that capture, store, manage, and
transmit health-related information that
can be sourced from individuals or activities
of health institutions.
-HIS improves the delivery of health services
because it ensures easier file access, better
control, easier update, and i improved
communications.
-The components of health information
systems are health information system
resources (inputs); indicators, .data sources,
and data management (processes); and
transformation of data into information,
and its dissemination and use (outputs).
-The different data sources are
demographic data, administrative data,
health risk information, health status,
patient medical history, current medical
management, and outcomes data.
CH09- HOSPITAL INFORMATION SYSTEM
-SHOULD BE EFFICIENT IN PROVIDING
SERVICES
CHALLENGES
-EFFICIENCY CAN BE CHALLENGED COZ OF
HANDLING NUMEROUS PATIENTS
-EMPLOYEES MANAGE AND COMBINE
CLINICAL, ECONOMICAL, AND
OPERATIONAL RECORDS WITH THE
PRACTICE…… NEW PATIENT=NEW RECORD;
RECORDS MUST BE UPDATED
HOSPITAL INFORMATION SYSTEM
-To be able to assist and manage all the
medical and administrative records.
-a computer system structured to manage
all the records of a healthcare providers to
make available information and reports
useful to health care personnel in doing
their jobs efficiently.
 1960s: billing and inventory
 Present: includes the integration of
all scientific, financial , and
administrative programs
Modern HIS: many applications addressing
the needs of numerous departments in a
health facility. They manage the data
related to the clinic, finance, laboratory,
nursing, pharmacy radiology, and other
pathology departments.
-Offers the advantage of not only having
reliable information but making this
information accessible.
-Hospitals using the HIS experience
efficiency in accessing reliable patient
information with just a few clicks. With this
advancement and new developments will
be useless if it is not user-friendly, and
training is inadequate.
CHARACTERISTICS OF HIS
 User-friendly
 Training is required
 Scalable
 Affordable
 Centered on patient and medical
personal needs
 Adaptable to rapid technological
changes
 Enhanced integrity of facts
 Minimization of transcription errors
and duplication of records
 Shorter Turn-around Time (TAT) for
reports
-TAT in laboratory: when patient should
return to get result: time of collection to
release of result; should not be too long;
routine test 1-2 hours
-having an HIS really helps in having a faster
TAT.
HIS DIFFERENT DEPARTMENTS
-HIS can link computers that are capable of
quickly optimizing operations and delivering
quality service.
-System gathers, process, retrieve patient
information & provide real-time data that
aids for better decision-making
-Optimized information delivery
-Can be customized to consider the
particular needs of the different
departments and centralize them onto the
system.
1. Nursing Information Systems (NIS)
- Computer based information systems are
designed to assist nurses offer enhanced
patient care.
 Improving personnel schedules- staffing
levels, overtime, absences, cost-
effective staffing; Monitor schedule of
nurses
 Accurate patient charting- patient’s
critical signs, admission information,
care plan, and applicable nursing notes;
Crucial facts are safe and can be
retrieved when required
 Better clinical data integration
___care plan____
 Collect
  Retrieve
 Examine
2. Physician Information Systems (PIS)
-Enhances the practices of physicians and
encourage by the gov’t for deployment. PIS
can be added to computer servers, network
and used extensively for the use of:
 Electronic Medical Records- makes
paperless records, accessible,
retrievable information, easily
transferred to another institution
 Electronic Health Records
-PIS enables professionals to troubleshoot
issues
3. Radiology Information System (RIS)
-Capable in providing radiology billing
services, appointment scheduling, reporting
and patient database storage. Efficient data
retrieval.
-Patients can have electronic copy of MRI,
CT scans, X-rays
4. Pharmacy Information Systems
(PIS)
-Enables pharmacists to monitor how
medicine is utilized in hospitals.
-PIS facilitates users, supervise drug
allergies, and different medication-related
complications.
 Integrated to the whole HIS
 Can be monitored and check what
drugs should not be given to the
patient
 Controls drug dispense
-Enables users to identify drug interactions
and also helps administer the appropriate
drugs based on the patient’s physiologic
conditions.
SELECTING A HOSPITAL INFORMATION
SYSTEM
1. Total cost of package
 A low cost of ownership
 Less hardware and fewer servers
o Reduce upfront acquisition
fees and additionally reduces
maintenance
2. Web-based system
 WAN
 Available on the internet
 Authorized employees can access
the information whenever they need
anytime and anywhere
 Share relevant information quickly
 Data sharing between hospitals
3. Implementation and Support
 Staff training
 Gives 24/7 support through the
telephone or web services
MOST COMMON HIS PROVIDERS IN THE
PHILIPPINES
1. BizBox
- BizBox, Inc. was founded 25 years ago. It’s
very first hospital project was completed in
1994. The goal of the company is to
improve work efficiency in health care
institutions through software systems, and
to produce advanced solutions for better
patient care.
-Today, it is among the top IT companies in
the health care industry. Aside from being a
certified Microsoft Gold Partner, it has also
received the Independent Software Vendor
(ISV) of the Year Award. It has fully
integrated systems such as electronic health
r records (EHR) and document management
system (DMS) that will streamline tasks and
help provide better health services (BizBox,
2017).
-Most common; top
    2. KCCI Medsys
-Kaiser-dela Cruz Consulting, Inc. specializes
in application development for hospitals,
industrial clinics, and medical-related
educational institutions in the Philippines.
Its products, Visual MEDSYs for hospitals
and MEDSCНO for schools, provides
integrated, comprehensive, and proven
solutions for efficient health care practices.
    3. Comlogik
-Comlogik Business Systems, Inc. is a
Philippine-based software development
company that was established in 1999, with
a vision to be a global technology company.
Comlogik led the way in developing
innovative applications like online hospital
services in which patients can access their
billings and examination results, while
administrators can access reports and
doctors can access patients' records
anywhere and anytime.
HIS FUNCTIONS
~HELP DESK, SCHEDULING, PATIENT
REGISTRATION
1. Help desk
- The help desk becomes more efficient
through the HIS because the manual
retrieval of information is no longer needed.
Clients are provided with information and
guidelines associated with a company’s or
institution's products and services without
any hassle.
-a useful resource meant to offer or guide
the customer or end user with information
and guide associated with a company’s or
institutions products or services
2. Scheduling
- Managers and employees can access work
schedules from anywhere they are and
effectively discuss their scheduling
preferences through the HIS. An employee
scheduling software helps save time
and makes employee scheduling less
difficult.
3. Patient Registration
- The HIS patient registration form records
the name, age, gender, marital status, and
other relevant information regarding the
patient. These pieces of information are
used for record keeping and
account management purposes. This form is
usually filled out during the patient's visit or
consultation but if the patient is unable to
complete the form due to the need for
prompt medical attention, the form can be
filled out by a relative or guardian.
-Patient admission form
-Unknown: Jane doe/Jan doe; Juan dela
Cruz
-Collects facts about the patient’s name,
age, marital status, gender, medical history,
previous consultations and varying essential
data.
~ADMISSION, DISCHARGE, TRANSFER
PROCEDURE
1. Admission
-Admitted to a health facility
-Preliminary information, offer vital
information concerning your hospital stay
and answer your questions
-Physician additionally may schedule
recurring medical exams, such as laboratory
tests or X-rays, before your hospitalization.
-Admission counselor: gather prelim
information and vital information
concerning hospital stay and answer your
questions
2. Discharge
-Point at which the patient leaves the
health facility and either returns home or is
transferred to some other facility including
one for rehabilitation or to a nursing home.
-Entails the medical instructions that the
patient will need to fully recover.
2.1 Discharge Planning: a service that
considers the patient’s needs after the
hospital stay, and may involve numerous
exceptional services which includes visiting
nursing care, physical therapy, and home
blood drawing.
-Indicates treatment, follow-up check-ups
3. Transfer
-Movement (along with the discharge) of an  Less clinical flexibility
individual outside a hospital’s premises at  Other expectations
the instruction of any person employed by
(or affiliated or related, directly or
indirectly, with) the hospital. BILLING, CONTRACT MANAGEMENT,
PACKAGE DEAL DESIGNER
-It does not encompass movement of an
individual who: 1. Billing
 Billing statements
a. Has been declared lifeless (DOA)
o Itemize all of a purchaser’s
b. Leaves the facility without the
permission of any such authorized invoices and payments, and
person. maintain a rolling balance of
how much they owe.
PHYSCIAN PRACTICES:  When they pay, such customers will
often combine numerous invoices
a. Solo or group practices
and pay in lump sum
b. Inpatient facility or ambulatory
 Keeps you up-to-date
clinics
 HIS will display a list of those
c. Health care corporations; employed
customers that have outstanding
physicians
balance
d. Physician-run groups are structured
2. Contract Management
on an employment model
e. A group practice is structured more -Process of managing contract creation,
like a corporation that employs execution, and analysis to maximize
clinicians operational and financial performance at an
organization, all while reducing financial
ADVANTAGES OF BEING AN EMPLOYED
risk.
PHYSICIAN
-Effective and automated contract
 Lesser administrative burden
management system
-Can focus on clinical practice
When a contract management strategy is
-Baseline level of compensation is assured successfully implemented, organizations
can expect to see the following:
 More resources
 Expected business benefits and
-Reasonable coverage for clinical
financial returns are being realized
responsibilities and improved control of
 Suppliers are cooperative &
lifestyle.
responsive to the organization’s
-More robust support services and needs
opportunities for further education and  No contract disputes or surprises
training.  Satisfactory delivery of services to
both parties
DISADVANTAGES OF BEING AN EMPLOYED
3. Package Deal Designer
PHYSICIAN
-Posting Diagnostic Medical Packages in
 Diminished physician autonomy
inpatients, outpatients, and emergencies
 Scheduling and productivity
requires the same process; the difference is
expectations may beyond your
that for emergencies, this is called post-
control
diagnostic package deal.
 Policies and procedures may be
developed by others without your
input
-packages are good kay naa na tanan and
usually lower ang price because of
discounts.
4. Accounts Receivable
-Outstanding invoices a company has or the
money the company is owed from its clients
-Account a business has a right to receive
because it has delivered a product or
services
-Receivables: a line of credit extended by a
company and due within a relatively short
period of time, a few days to a year.
-Financial aspect of HIS
5. Consumption Entry
-Duty for the good which have been
imported from an international carrier and
sent for use in the commercial market
directly.
-Can be used for the personal use or
commercial use
-If the goods are first kept in any warehouse
before going to the market, the formal
warehouse entry is to be made on them.
Ex: mango exported from us to ph, stock
would go directly to the distributor without
going to any warehouse- Consumption
entry
Ex: muagi ug warehouse- Formal
Warehouse entry
 Transportation Entry: goods are
transit to a third country
 Warehouse Entry: goods are stored
in a bonded warehouse
 Foreign Trade Zone Entry: good are
stored in a place licensed by the
department of commerce of that
country
 Temporary in Bond Entry
 Drawback Entry
LABORATORY, RADIOLOGY AND
CARDIOLOGY REPORTING
1. Laboratory Reporting
-Despite differences in presentation and
form laboratory reports must possess
common elements as required by
institutional and company policies. They
may also contain supplementary items not
specifically required, but which the
laboratory chooses to report to aid in the
interpretation of results of medical testing
-For identification and filing purposes, some
laboratory reports display elements with
administrative or clerical information such
as the following:
 Patient name and identification
number or a unique patient
identifier and identification number
 Name and address of the laboratory
location where the test was
performed
 Date when report was printed
 Test report date
 Name of doctor or legally authorized
person ordering the test(s)
- Information about the specimen and
the test itself, such as those included
below, are other elements that make a
laboratory report more meaningful:
 Specimen source(if applicable)
 Date and time of specimen
collection
 Laboratory accession number
 Name of the test performed
  Test results
  Abnormal test results
 Critical results
 Units of measurement (for
quantitative results)
  Reference intervals (or reference
ranges)
 Interpretation of results
  Condition of specimen
 Deviations from test preparation
procedures
  Medications, health supplements,
etc. taken by the patient.
2. Radiology Reporting
-A clinical and source document that
provides interpretation and describes any
radiology procedure conducted by a
radiologist
-An official medical document that provides
description and interpretation for any
officially requested radiological exam
-It should have pertinent positive and
negative findings and address any specific
clinical concerns.
-All important findings need to be stated
first and any incidental findings are
reported at the end.
The report should contain:
 Patient’s demographics
 Relevant clinical information and
ICD-9 code (International
Classification of Diseases and Clinical
Modification)
 Body of the report
 Impression (conclusion or diagnosis)
3. Cardiology Reporting
-They should clearly provide about the
patient for medical records
-Doctors assigned are busy and putting
it together takes a lot of time and effort
 Vascular Sonography Reports
-Indicate valuable information about the
results of the ultrasonic ultrasound and
might include diagrams of veins and arteries
to help determine and measure items such
as:
 Blood flow
 Presence of plaque (arterial
plaque; Arteriosus sclerosis)
 Narrowing and the presence of
clots (strokes)
4. Discharge Summary
-Discharge summary is a clinical report
arranged by a health practitioner or
different health expert at the conclusion of
a hospital stay or series of treatments
-Outlines the patient’s main complaint, the
diagnostic findings, the treatment
administered and the patient’s response to
it, and guidelines on discharge.
MATERIAL MANAGEMENT, SYSTEM-
PHARMACY, MAIN STORES, AND
PURCHASE
1. Material Management
-Having MM enables a worker to easily
track, and trace inventories and devices
usage in the health care setting (devices
have barcodes or RFID tags; for monitoring
and controlling)
------TAGS ASSIST THE COMPANIES IN
FIGURING OUT WHETHER MERCHANDISE
HAD BEEN RECALLED OF DAMAGED-----
-Concerned with the planning, identifying,
purchasing, storing, receiving, and
distribution of material,
-To guarantee that the right material are in
the right location, in the right quantities
when needed.
-To ensure that the institution have the
right materials, right quantity when it is
most needed.
-Inventory purposes
-A central stock and delivering supplies
throughout the institution
-Essential to maintain supplies conveniently
available on the point of use.
-CSR: Central supply Room/Unit
- Can also determine what drugs to give or
not (expiration date)
-Enables isolation of drugs and devices that
are used regularly and forecasts capacity
shortages
-AUTOMATIC STOCK MANAGEMENT
SYSTEMS: assist health care institutions in
figuring out whether merchandise has been
recalled or damage and should not be given
to patients
2. Management Reporting
-Provides business information
-Offer financial and non-monetary
information, which could help management
take essential actions in the oversight of
their business activity.
 Data could range from:
o Monetary data
o Employee headcount
o Customer accounts
o Merchandise
o Client property in custody
o Funding overall performance
-effective management systems allows
enhanced decision-making,
responsiveness, effectiveness and
performance in the use of the resources
6 reasons that give rise for the need of a
management reporting system
1. Constant need of reports for
decision-making and analysis of
trends
2. Reports being unavailable with the
right stakeholders at the right time
3. Lack of visibility and a single holistic
view of the enterprise performance
4. Data redundancy, duplication of
data leading to data management
and quality issues leading to error
prone reports
5. High value resources
6. Changing a global report to fit local
needs
3. 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.
-Tally is easy to learn and can be
implemented with minimum resources. It is
reportedly used over by 1 million entities
across the globe.
-PANG INVENTORY SA TAX AND PAYROLL
Key points to remember
 A hospital information system (HIS)
is a fundamental computer system
that could manage all the
information to permit t health care
providers to do their jobs efficiently.
 HIS for different departments are
nursing information system (NIS),
physician information system (PIS),
radiology information system (RIS),
and pharmacy information system
(PIS).
 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 providers in the
Philippines are Bizbox, Inc., KCCI
Medsysys, and Comlogik.
 The functions of HIS address the
following concerns: help desk,
scheduling, patient registration,
admissions, discharge and transfer
procedures, billing, contract
management, and package deals.
 Materials 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.