HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER
LESSON 10: OVERVIEW OF LABORATORY
INFORMATION SYSTEM
 A laboratory information management system
(LIMS) is software designed to make labs more
efficient and effective, especially those that process
massive amounts of samples for research and
development (R&D), manufacturing, and medical
research.
 Any kind of lab can gain from a LIMS or a
laboratory management system (LMS). However,
they are more commonly found in manufacturing
and quality assurance
Examples include:
o Labs dealing with R&D for oil and fuel
companies industrial chemical creation
and testing
o Water treatment plant testing food safety
o Environmental facilities
 The form of lab you run will decide which type of
software you ought to go with. LIMS are also used
in the medical and pharmaceutical industries.
And, in conjunction with laboratory information
systems (LIS), LIMS is also a form of medical lab
software program.
The Purpose of a LIMS
 To enhance efficiency in lab operations through
reducing manual responsibilities. As an example, a
LIMS automatically records information that might in
any other case need to be typed in or written down,
thereby saving time and reducing mistakes. helps in
the management of inventories.
 What information your LIMS automatically captures,
the way it enters the system, and where and how
it’s saved relies upon on which LIMS supplier you
select.
 Some LIMS might be better at supporting certain
kinds of labs function more successfully, but not be
as suitable for others (Reisenwitz, 2017).
Functional Requirements and Features of LIMS
Reisenwitz (2017) elaborates on the functionality of an
LIMS as follows:
1. Sample Management
 As samples move from person to person and place
to place, it’s easy for them to get lost or mixed up.
Accurate, detailed records are essential to making
sure everything gets done and done right.
 When you create a sample, most LIMSs will record
and store information such as:
o Who or what the sample was taken from?
o Which researchers/providers are working
with it?
o Where it's been, and where it needs to go
next?
o How to store it?
o When it needs to move?
2. Workflow Management
 You should use a LIMS to automate workflows for
the same reason you should use it to automate
records keeping, but instead of saving work, this
 For example, it can automatically assign work to
scientists and suggest instruments based on preset
rules. And instead of looking up what you need to
do with a sample and where it
needs to go next, a good LIMS will automatically
provide this information function saves you time.
3. Reporting
 It's good to be able to quickly pull reports that can
answer questions such as which instruments get
used the most, how long your sample backlog is,
and how long it takes your lab, on average, to
process a sample. This kind of data is extremely
useful for data analysis auditing and audit trail.
 Some LIMS will be more granular in their reporting
than others. For example, one LIMS might be able
to tell you what your average sample processing
time is, but another might tell you your average time
broken out by type of sample. It's helpful to know
what kind of reporting and level of reporting you
need before you begin comparing vendors.
4. EMR/EHR
 Electronic health records (EHR) is its own type of
software, but some LIMSs have EHR functionality
built-in, including patient check-in and billing. If you
don't have a software package offering these
features, choosing a LIMS with this kind of
functionality can be a huge asset when managing
your clinical lab.
5. ERP
 ERP software helps manage inventory, and it can
be very helpful to have a LIMS that performs this
function. Being able to view what you have on hand
at a glance, getting alerts when supplies are
running low, auto-calculation of storage and freezer
capacity, and location management can be
extremely useful in a clinical lab.
Core Components of LIMS
LIMS software suites usually involve multiple
components in order to provide a variety of functions for
different levels of the laboratory. IEEE GlobalSpec (2015)
specifies that components may include:
 Electronic lab notebooks
 Sample management programs
 Process execution software
 Records management software
 Applications to interface with analytical instruments
or data systems
 Workflow tools
 Client tracking applications
 Best practice and compliance databases
 Enterprise resource planning (ERP) software
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER
Figure 10.1 below displays a view of the primary
components and interfaces of a Laboratory Information
Management System.
LABORATORY STANDARDS
The Occupational Safety and Health Administration
(OSHA) released an "Occupational Exposure to Hazardous
Chemicals in Laboratories standard (29 CFR 1910.1450)" in
2011 to facilitate laboratory safety. Some important
provisions are excerpted from the standard below:
Laboratory means a facility where the laboratory
use of hazardous chemicals occurs. It is a workplace
where relatively small quantities of hazardous chemicals are
used on a non-production basis.
Laboratory use of hazardous chemicals means
handling or use of such chemicals in which all of the
following conditions are met:
 Chemical manipulations are carried out on a
laboratory scale (i.e., work with substances in which
the containers used for reactions, transfers, and
other handling of substances is designed to be
easily handled by one person);
 Multiple chemical procedures or chemicals are
used;
 The procedures involved are not part of a
production process, nor do they in any way simulate
a production process; and
 "Protective laboratory practices and equipment" are
available and in common use to minimize the
potential for worker exposure to hazardous
chemicals.
Any hazardous chemical use which does not meet this
definition is regulated under other standards. This includes
other hazardous chemical use within a laboratory.
For instance:
 Chemicals used in building maintenance of a
laboratory are not covered under the Laboratory
standard.
 The production of a chemical for commercial sale,
even in small quantities, is not covered by the
Laboratory standard.
 Quality control testing of a product is not covered
under the Laboratory standard.
If the Laboratory standard applies, employers must
develop a Chemical Hygiene Plan (CHP). CHP is the
laboratory's program which addresses all aspects of the
Laboratory standard.
 The employer is required to develop and carry out
the provisions of a written CHP.
 A CHP must address virtually every aspect of the
procurement, storage, handling, and disposal of
chemicals in use in a facility.
Primary elements of a CHP include the following:
 Minimizing exposure to chemicals by establishing
standard operating procedures, requirements for
personal protective equipment, engineering controls
(e.g., chemical fume hoods, air handlers, etc.) and
waste disposal procedures.
 For some chemicals, the work environment must be
monitored for levels that require action or medical
attention.
 Procedures to obtain free medical care for work-
related exposures must be stated. The means to
administer the plan must be specified.
 Responsible persons must be designated for
procurement and handling of Material Safety Data
Sheets, organizing training sessions, monitoring
employee work practices, and annual revision of the
CHP.
Registration, Billing, Contract Management,
Accounts Receivables
PATIENT REGISTRATION
When you arrive at the hospital, the Admission Clerk will
take some basic information and then will guide you to a
registration window.
BILLING
The process of generating SOAs or Billing Statements of
Inpatients, Outpatients, and Emergencies are the same.
CONTRACT MANAGEMENT
Most Laboratory Information Management Systems allow the
laboratory professional to manage the billing and payment
aspects of their activities and create statistical and billing
reports at par with the laboratory and management needs.
LIMS automate billing processing, hasten collections, and
offer marketing tools which minimizes the time spent on
standard flow and allows billing and accounting personnel to
focus on improving collection of problematic accounts
(Informed, 2017).
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER

Common features of LIMS for invoicing and
contract management include:
 Customer customizable invoices including balance
and charges history analysis, history balance,
detailed services, participation when in insurance
coverage, discounts etc.
 Different electronic formats for invoices allow
interfacing to customer electronic systems
 Customizable information completion reports for
customers
 Managerial reports display laboratory billing status
for payer groups including projected return values
for each payer group
 Ability to change the Insurance Organization of a
Patient per visit.
 Ability to select which Tests of a Patient's Visit are
covered by the Insurance Organization and which
are privately-with automatic modification of the
prices accordingly.
 Supervision-financial data management of the
Senders.
 Reminder for amounts due from past visits
 Immediate access to the Billing Card of each
Patient.
 Consistency with the International Laws.
LIMS have functions that enable users to set standards
about the relevant range of patient test results, or extract test
result information for the purpose of quality assurance.
Outliers and deviations can be flagged, and appropriate
warning signals can notify users of issues which might
involve the quality of the samples or the equipment currently
in use.
BARCODE-GENERATION, PRINTING AND READING
LIMS modules are commonly linked to a barcoding label
generator, enabling a fast and easy method to identify tubes,
samples, documents, among many others. Simply print it on
labels stickers to place on whatever item needs
identification. A barcode editor also allows mulStiple labels to
be printed at a label printer. The barcode series can usually
be customized to suit your organization or classification
needs. With this kind of technology, you can effortlessly find
and retrieve information about a tube, a specimen, or
equipment within the laboratory using a barcode
IN-BUILT BI-DIRECTIONAL INTERFACES WITH
EQUIPMENT

ACCOUNTS RECEIVABLES

Because of the integration of the LIMS, the personnel in

charge of managing Accounts receivables can easily extract
information which was already available from the invoicing
and contract management procedures. Additionally, the
LIMS can:

 Generate specific or complete Accounts Receivable

reports
 Monitor balances for reconciliation and audit
purposes
 Export data to other accounting systems
 Ability to change the Insurance Organization of a
Patient per visit.
 Customize reports according to specifications
WORK LIST AND WORKFLOW
A bi-directional interface (Figure 10.6) involves true two-way
communication between the analyzer (equipment) and
information system interface. The LIMS interface downloads
specimen ID and test orders, while the analyzer uploads
specimen ID and test results. More recently, bi-directional
interface capability has been implemented into various
microbiology, immunoassay, coagulation and hematology
instruments.

LIMS assist laboratories in setting priorities of current

workloads, based on analyst and instrument availability. This
function allows user to track a sample, a batch of samples,
or a "lot" of batches through its lifecycle.

QUALITY CONTROL

Diagnostic tests executed inside the clinical laboratory may

yield two kinds of results, a patient result or a quality control
(QC) result. The result can be quantitative (in numbers) or
qualitative (positive or negative) or semi-quantitative (limited
to a few different values).

Quality control results are used to verify whether or not the

instrument is working within prescribed parameters,
confirming that patient test results are reliable (Bio-Rad LESSON 11: CARDIOLOGY AND RADIOLOGY
Laboratories, 2008).
INFORMATION SYSTEM
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER

 Cardiology and Radiology Information System  Type of scan that uses strong magnetic fields and
are in charged in the management of different radio waves to produce detailed images of the
images for diagnosing, monitoring, and inside of the body. An MRI scanner is a large tube
visualizing the heart and other body parts. that contains powerful magnets.

Cardiology Information System MRI Scan CT Scan

 Cardiology Information Systems (CIS) are mainly Detail pictures in soft Less detailed compared to
focused on the storage and retrieval of Cardiology- tissues MRI scans
centric images. CIS usually receive an order with Bony structures are less Bony structures are more
patient demographics from other information detailed as compare t CT clear and detailed
management systems, and once the images are No known side effects on Little side effects.
acquired from imaging modalities, they are profiled radiation and very few Frequent radiations with
side effects on MRI CT scans might rarely
against the order and stored for further distribution,
contrast scans cause cancer
viewing, and long-term archive (Katipula and
Due to the structure and Scan procedure is very
Ireland, 2013). sound, claustrophobia simple and does not
 The information used by cardiologists for diagnosis patients may need to take require anesthesia
and treatment of their patients varies from personal anesthesia
notes (history, physical examination), to signals Duration of MRI scan is CT scan procedure is
(electrocardiograms), images (echocardiograms, much longer than CT quick compared to MRI
angiograms, CT, MRI) and reports from Higher Cost CT scans are less
investigations and from procedures. All this expensive than MRI scans
information can currently be provided in digital You may be asked to hold Holding breath is not
format, and Cardiology Information Systems serve your breath from time to required as much
as a repository which houses these forms of time
imagery. Patients with metal or CT scan can be performed
certain medical implants with no risk to medical
EVOLUTION are not able to undergo implants or metal
MRI’s due to the magnetic
 Decades ago, the requirements for an electronic
field pulses
medical information system were restricted by the
availability of equipment. A good database schema
combined with a functional user interface was 4. PET AND SPECT
deemed adequate.
 In the 1970s, available cardiology information  Cardiac Positron Emission Tomography (PET)
system originated from a mainframe environment, Scan and Cardiac Single Photon Emission
the technical specifics of which would be Computed Tomography (SPECT)
considered ridiculous in the present day setting.  Noninvasive nuclear imaging test.
 Cardiology information systems nowadays have  It uses radioactive tracers (called radionuclides)
unique features that enable remote access and to produce pictures of your heart.
easy retrieval. Some CIS have also attempted to  Used to diagnose coronary artery disease (CAD)
integrate with a Radiology Information System to and damage due to heart attack
create a Cardiovascular Information System that is
capable of more than just storage, particularly 5. CORONARY ANGIOGRAPHY
involving more administrative processes.
 A procedure that uses a special dye (contrast
1. CARDIAC ULTRASOUND (ECHOCARDIOGRAPHY) material) and x-rays to see how blood flows through
the arteries in your heart.
 A test that uses high frequency sound waves
(ultrasound) to make pictures of your heart Benefits of Cardiology Information System
 An echo uses sound waves to create pictures of  Ease of access while maintaining data security
your heart’s chambers, valves, walls and the blood o Unlike in the past when doctors would
vessels (aorta, arteries, veins) attached to your need to request different imaging results
heart. from different departments, CIS
consolidates multiple types of patient
2. COMPUTERIZED TOMOGRAPHY (CT Scan) cardiology information.
 CT scan combines a series of x-ray images taken  Flexibility in the workflow
from different angles around your body and uses o Availability of mobile technology allows
computer processing to create cross-sectional cardiologists to assess a wide array of
images (slices) of the bones, blood vessels and soft information without having to leave the
tissues inside your body. patient bedside. Having cardiology data in
a single platform offers mobility to
3. MAGNETIC RESONANCE IMAGING (MRI) physicians and nurses alike, thereby
improving the efficiency of providing
service.
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER
 Enhanced Comparability
o Retrieval of multiple images is convenient
hence comparison and correlation enables
health professional to make more informed
decisions
o Because a CIS is essentially a repository
of cardiology imagery results, retrieval of
past data is effortless. This comparability
enables healthcare professionals to make
more informed decisions for their patients
treatment.
Functionalities of Cardiology Information System
 Editing, Viewing and Storing Multi-modal
cardiology data
o different types of data, including computed
tomography (CT), cardiac ultrasound
(echocardiography), magnetic resonance
imaging (MRI), nuclear imaging (PET and
SPECT), and angiography, may be
managed on a single platform with the
help
of the CIS.
 Remote Access
o the use of networks and integrated
information systems, coupled with the
availability of the internet and tablets and
smartphones, offer flexibility to Cardiology
Information Systems.
 Visualization and reporting capabilities
o one of the main benefits of Cardiology
Information Systems is the ease and
consistency of reporting. Virtually real-time
information retrieval is possible with just a
couple of clicks and queries, and is
possible from multiple locations.
 Electronic Health Record Integration
o since a CIS may be integrated with
existing Electronic Health Record
Systems, it can enhance the quality of
services offered by health professionals by
offering a more comprehensive view of the
patient care spectrum.
Radiology Information System
 A Radiology Information System (RIS) is a
networked software system for managing medical
imagery and associated data. An RIS is especially
useful for tracking radiology imaging orders and
billing information, and is often used in conjunction
with Picture Archiving and Communication Systems
(PACS) and Vendor Neutral Archivals (VNA) to
manage image archives, record-keeping and billing
within a Hospital Information System (HIS) (Rouse,
2017).
PITURE ARCHIVING AND COMMUNICATION SYSTEM
It is a healthcare technology for short and long term storage,
retrieval, management, distribution and presentation of
images.
VENDOR NEUTRAL ARCHIVAL (VNA)
In a health information technology context, it is as medical
imaging used by the healthcare professionals that stores
images in a standard format and interface, making medical
imaging data accessible through different picture archiving
and communication systems (PACS).
Advantages of Radiology Information System
 Improving the overall operations of the institutions
 Easier access to patient information if it’s integrated
to HER
 Improves patient’s experience
 Allows faster processing of payments
 Faster generation of reports and results hence
enhancing the workflow.
Advantages of Radiology Information System
(LECTURE)
Better communication with referring doctors
An RIS can integrate with the referring doctors
electronic health record or EHR system, so you can access
patient data easily and quickly. The result is a better
experience for referring doctors, which dramatically
increases the likelihood theyll refer more patients to you.
Faster payments
A chief benefit of a RIS is that you can use it to
verify insurance before a patient visit. The electronic
payments you are now capable of receiving means that you
get paid faster.
Improved efficiency
Its much faster to find, input, and create reports
from patient data when the records are computerized. With
the information digitized and no longer needing to be entered
into records a second or third time.
Functions of Radiology Information System
(ROUSE 2017)
Patient Management
An RIS can track a patient's entire workflow within the
radiology department; radiology providers can add images
and reports to EHRs, where they can be retrieved and
viewed by authorized radiology staff.
Scheduling
The RIS allows staff to make appointments for both
inpatients and outpatients.
Results Reporting
A RIS can generate statistical reports for a single patient,
group of patients or particular procedures.
Patient Tracking
Using a RIS system, providers can track a patient's entire
radiology history from admission to discharge and coordinate
the history with past, present and future appointments.
Image Tracking
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER

Traditionally, radiology providers use RIS to track individual

films and their associated dataociated data. But as EHRs
have become standard across the healthcare industry and
digitized images and PACS have been widely adopted,
radiology departments and their RIS-PACS systems have
been more drawn into the clinical workflow of the entire
medical enterprise.

Billing

RIS systems provide detailed financial record-keeping and

process electronic payments and automated claims, though
these functions are becoming incorporated into medical
organizations' overall EHR systems.

Radiology Information System Operation

(1) If the doctor has order request, he/ she gives it to the
patient and then the patient will be informed about the
procedure

(2) The patient will go to the reception area to register the

request. The request then comes in the radiology
department for the x-ray.

(3) The patient will go inside the radiology room and the
radiologists will check whether the patient has paid for the
test request

(4) If the patient has paid, the patient will be called and the
procedure will be done.

(5) After the procedure, double check the results.

(6) The results will be sent back to the PACS. Serves as a

storage of the images

(7) If the radiologist has already done reading the results.

They will send the results back to PACS with the final results
of the test

(8) The attending physician can now see the health status of
the patient with the test result

Radiology Information System - Picture Archiving and

Communications Systems (RIS PACS)

Picture Archiving and Communications System (PACS)

 Use for storage, distribution, review of diagnostic

images

Radiology Information System (RIS)

 Use for storage, recording, and distribution of

radiologists’ reports

LESSON 12: MATERIALS MANAGEMENT

SYSTEM (MMS)
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER
 The management function of hospital materials
making sure that services go successfully from one
source to an end user-includes several areas of the
hospital and could drastically affect medical
institution expenses.
 Executing this function in a manner that lessens
expenses and ensures adequate cash flow requires
effective management of a large amount of
information from several sources.
 To successfully manage such information, many
hospitals implement a form of materials
management information system (MMIS).
 The aforementioned systems can be used to
manage functions like purchasing, accounting,
inventory management, and patient supply charges
(Materials management information systems,
1996).
PURCHASING
 A purchase request could be used as a first step in
the process of purchasing. This is used internally to
identify a need for an item.
 A purchase request generally is a document which
is made by a user to notify the purchasing
department regarding needed items and services.
This document specifies quantities, as well as a
timeframe for the items requested.
 It could also contain the authorization information
needed to proceed with the purchase.
 After a request is made, the item could either be
ordered directly or a request for a quotation could
be asked from the vendors. The purchase quotation
document allows one to track the vendor quotations
for items.
INVENTORY CONTROL
 Johnston (2014) states that inventory is one of the
biggest expenses for most medical institutions.
Inventory control plays an important part in refining
the quality of healthcare services, since the lives of
the people are on the line, as well as because
medical costs are increasing.
 Moreover, Johnston details the strategies on how to
improve inventory control within healthcare
facilities:
MAKING SURE SHIPPERS ARE ACCURATE
Tracking medical inventory must involve checking shipments
for accuracy. Most medical suppliers use third-party
shippers, and the tracking system must ensure that the
correct supplies were loaded at the warehouse. Even if items
are ordered correctly, tracking can catch any errors in filling
those orders. It can also reveal whether medical supplies
have been properly handled in transit.
ALIGNMENT WITH SALES PROJECTIONS
In the field of medicine, sales projections can be wildly
inaccurate. It is difficult to predict disease and accident
patterns, and patients are notoriously reluctant to switch
doctors, hospitals and health insurance. Tracking inventory
in comparison to actual sales is essential. This prevents
waste, frees up cash that would have gone to excess
inventory and helps medical companies identify trends they
might not have seen before.
COMPLIANCE WITH REGULATIONS
The medical field is heavily regulated. A company that
routinely fails to serve the best interests of patients can
quickly find itself being investigated, sued or simply shunned
by health-care consumers. Tracking inventory can be
extremely important in maintaining the responsiveness of a
medical company. This applies not only to front-line health
providers but also to the suppliers of those providers.
Knowing what inventory is on hand and what items are
needed can keep a medical company responsive and
prevent closer scrutiny by regulators.
ESTABLISHING BUYING CYCLES
Inventory control helps medical companies understand
buying cycles. Instead of responding to needs for supplies
and equipment, inventory personnel can anticipate needs
based on previous cycles. Smoothing ordering out to fit
predictable cycles can eliminate shortages and overages.
Buying cycles can also be tracked to determine whether
trends are shifting and need to be adjusted. In this way,
tracking inventory can make inventory ordering into a
manageable process that is proactive instead of reactive.
ITEM MASTER MAINTEANCE - MEDICAL AND NON-
MEDICAL INVENTORY ITEMS
Because the importance of inventory control has been
recognized, the usage of a materials management system
could bring an advantage.
In Material Management Systems, the Inventory Item
Maintenance screen has many sections. The upper portion
contains master information. Additional options appear after
the selection of an existing item.
"Item Tab" is used for maintenance of the attributes of an
inventory item, such as product type, item class, item type,
etc. If the balance and order activity is zero (0), items can be
deleted using this option.
Users could set the product type to group similar items for
sales analysis and inventory reporting. Most of the inventory
reports are based on a certain product type.
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER
The Item Availability form specifies inventory levels across
all warehouses.
ITEM INDENTS AND ISSUES
In some cases, there are instances where items are
damaged either upon receiving from the supplier or during
the move from the source to another location.
Some suppliers allow returns of the said goods that have
indents or the like, with a guarantee of replacement without
any additional payments. This applies to distribution and
retail industries where the goods for sale are fast-moving.
Normally, damaged items are moved to another warehouse
for them to be monitored.
RE-ORDER LEVEL, RE-ORDER QUANTITY, MINIMUM
AND MAXIMUM LEVELS FOR EACH STORE
In a typical material management system, Re-order level is
the minimum quantity of an item that a company has in
stock, so when the stock reached the minimum quantity
stated, the item must then be re-ordered (Purchase
Order/Production Order).
A basic re-ordering method implemented in many ERPs and
other inventory management software is the Min/Max
inventory ordering method. The Min value is representative
of a stock level that prompts a re-order, and the Max value is
representative of a new targeted stock level that follows the
re-order. The main difference of these two Max and Min is
often interpreted as Economic Order Quantity (EOQ).
ENQUIRIES AND QUOTATIONS FOR DRUGS,
CONSUMABLES, ASSETS AND GENERAL ITEMS
Webrino (2018) states the following documentation needed
in the material management process:
 Enquiries
 Quotations
 Orders
 Invoices
 Documents
ENQUIRIES
Enquiries are the start point of a sale or purchase process.
Enquiries lead to getting information from a vendor/ supplier
for the requirement at hand. Enquiries lead to establishing a
connection with the right vendor / supplier in order to get a
quotation, place the order and receive the requirements.
QUOTATIONS
Quotations consist of various pieces of vital information of a
requirement towards a sale /purchase. Quotations state
important information such as price, delivery times, delivery
details, payment terms, taxation etc. On a quotation being
accepted an order is placed for the requirements.
ORDERS
In business or commerce, an Order is a stated intention,
either spoken or written, to engage in a commercial
transaction for specific products or services. From a buyer's
point of view it expresses the intention to buy and is called a
purchase order. From a seller's point of view it expresses the
intention to sell and is referred to as a sales order. When the
purchase order of the buyer and the sales order of the seller
agree, the orders become a contract between the buyer and
seller.
INVOICES
An invoice or bill is a commercial document issued by a
seller to the buyer, indicating the products, quantities, and
agreed prices for products or services the seller has
provided the buyer. An invoice indicates the sale transaction
only.
DOCUMENTS
For any sales / purchase to take place, documents need to
be created in order to enable a quotation, order, invoice, tax
forms etc. to be used. These documents are statutory
requirements to enable smooth transition of the processes
involved in successfully completing a sale/ purchase.
COMPARISON OF QUOTATIONS AND PREFFERED
VENDORS
PURCHASE QUOTATIONS
A purchase quotation is a document for requesting prices
and delivery information from a vendor before the purchase
order.
One could create a purchase quotation, then send the
document to a vendor; when a response from the vendor is
received, with a list of prices and delivery dates, one can
enter the information in the purchase quotation. This way,
one can store in the system the complete history of the
sourcing process.
From the quotation, the information tracked enables one to
choose the right vendor for the purchase. Using the
quotation helps in lessening expenses, improving the quality
and increasing on-time delivery. A purchase quotation report
allows one to compare offers in order to pick the appropriate
vendor for the purchase scenario. Afterwards, one can
create the purchase order from the selected quotation.
PREFERRED VENDORS
Companies typically maintain a list of preferred vendors,
from which inventory items are usually purchased. Several
qualities of a preferred vendor that a company looks for are:
 On-time performance
 Reasonable costs
 High quality of products and services
 Fully licensed, bonded, and insured
 Good Business practices
PURCHASE REQUESTS, ORDERS, AND APPROVAL
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER
PURCHASE REQUESTS
A Purchase Request or Purchase Requisition is a document
that notifies the purchasing department that certain items or
services need to be replenished.
The document stipulates a timeframe and required quantities
for the items requested. In certain instances, it also contains
authorization to acquire assets
PURCHASE ORDER
A document which records a business transaction between
the buyer and the seller. A buyer issues his order, and upon
seller acceptance of the order, a legally binding contract is
created between the parties (SAP, 2012).
A simple Purchase Order will identify the following basic
elements:
 Buyer: name, address, and contact info of party
giving money for goods
 Seller: name, address, and contact info of party
receiving money for goods
 Order Number: a unique ID number to track each
business transaction
 Item Description: details, quantity of goods, cost per
unit, and total price of goods
 Shipping Address: where the goods will be shipped
 Shipping Date: when the goods will be delivered to
the final location
 Billing Address: location of where the invoice should
be sent so the Buyer can pay
 Signature: signature of Buyer offering to buy and
signature of Seller accepting
 Order Date: when the business transaction
occurred
APPROVAL PROCESS
The person who creates the document, either a purchase
request or order, is the originator. Upon adding documents to
the material management system, the system checks for any
approval requirements. If the document fails to meet the
requisites for an approval, the originator is notified that the
document needs approval. The document is temporarily
saved as a draft.
An internal request is immediately sent to the first approval
stage when the approval process is launched. This request
is received in the Messages/Alerts Overview window, and
the approver can access the document. Approval can be
done through a mobile phone if the devices are integrated. A
internal notification goes back to the originator with a link to
the rejected document should the approver reject the
document. The originator can amend the document, and the
approval procedures will continue until the approval
conditions are adequately satisfied (SAP, 2012).
RECEIVING OF GRN FULL/ PARTIAL ITEMS, FREE
ITEMS, AND TRACKING THEM
The York College (2017) details the following policies for
the receipt and inspection of goods:
SIGNING FOR DELIVERIES
Whenever possible, the person receiving the product should
sign the receiving documents provided by the supplier or
shipping company. The person receiving the delivery should
inspect the items before signing the receipt and should also
initial the packing list. Then, submit the packing list to the
appropriate person (Accounts Payable, Requester, Asset
Management) for financial reconciliation.
REFUSING DELIVERY
Whenever possible, departments should refuse to accept
shipments if they are unable to confirm that the order was
placed by their department, or if the packing appears
sufficiently damaged to warrant concern.
RECORD RETENTION
During the receiving process, the Receiving Department
takes physical possession and legal ownership of the
shipment. Therefore, it is important for the supplier to provide
the department with a packing list for all shipments delivered
to the department. If the supplier fails to provide the packing
list, the department should contact the supplier to request
that copies be sent to the department for its files.
Department must keep receiving documents on file in
accordance with these guidelines. The need for saving
receiving documents is particularly important when accepting
any partial or staggered deliveries over a period of time.
PARTIAL DELIVERIES
Departments should contact the appropriate Purchasing
Agent whenever a purchase is received as a partial delivery
without acknowledgement or notification from the supplier.
This information is typically noted on the packing list.
TRACKING OF GOODS
Goods can be easily tracked /traced when they are managed
by Serial or Batch. Aging of products can also be done if the
items are slow moving/stay longer in the warehouse.
PURCHASE RETURNS ALONG WITH RETURNABLE/
NON-RETURNABLE GATE PASS
Defective or substandard quality goods, incorrect order
delivery, and deterioration among inventory purchased and
sold are usually common in business, and this gives rise to
purchase or sales returns.
When purchased goods are returned, the material
management system updates inventory levels to reflect the
decrease in quantity.
Movement of inventory isn't limited to purchases or purchase
returns. Supplies and equipment are also sometimes
required to be taken out of the department for repairs or
consignment, among many reasons. For temporary
movement, a Returnable Gate Pass is issued. On the other
hand, a Non-returnable Gate Pass is given for permanent
movement.
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER
The material management system can be configured to track
returnable and non-returnable items of inventory or
equipment. It can also monitor due dates for returnable
items, and provide detailed reports about the status of
different inventory items.
CONSIGNMENT STOCK RECEIPT CONSUMPTION
AND REGULARIZATION
In the process of consignment, the vendor or consignor
issues materials to the receiver or consignee, and these
materials are stored on the consignees premises. The
vendor maintains legal ownership until such materials are
removed from consignment stores. The invoice is due at
predetermined intervals, such as monthly. In addition,
customers can also arrange to take over ownership of the
remaining consignment material after a certain period of time
(SAP, 2011).
EXPIRED STOCK AND QUARANTINE
EXPIRED STOCK/ INVENTORY
Upon reaching their expiration dates, some goods, such as
food and medicine, can no longer be utilized. In rare
instances, it may be sold to other parties at a lower cost.
However, as soon as inventory expires and its value falls
below its original cost, this must be reflected in the financial
records so as not to misstate the financial statements. The
amount that reduces inventory in your records is recognized
as a loss that is a reduction in profit (Keythman, 2017).
QUARANTINE STOCK/ INVENTORY
When undecided about how to handle defective goods,
whether to be sold as scrap, reworked, returned, or used as
it is, a quarantine location or warehouse can be used to
temporarily house them until a final decision has been
reached.
 Inventory is put into quarantine if initially rejected
during:
 Production, upon completion of an operation, when
specified as Move Rejected End Item to
Quarantine.
Inbound inspection upon receipt of:
 Manufactured end items
 Purchased items
 Sold items on sales return orders
 Enterprise Planning distribution orders
 Outbound inspection upon issue of:
 Materials to production (Infor LN Warehousing,
2018).
DRUGS AND CONSUMABLE ISSUES AND RETURNS
TO PATIENT
Nagarajan (2017) affirms that 30 to 50% of hospital charges
are actually attributable to diagnostics, drugs, and
consumables, and doctors get only between 10 to 20%. For
both hospitals and patients, drugs and consumables take up
the bulk of expenditure. This is why material management is
critical, at least on the part of the hospital, in order to
optimize the investment in these kinds of consumable
assets.
While some hospitals have functional inventory databases,
the lack of integration does not give them holistic
information, and this affects decision-making, both on a
managerial level, and during day-to-day operations. For
instance, some drugs are misplaced or misappropriated, or
shortages and surpluses may occur, as a result of improper
inventory controls in a traditional system (Infor LN
Warehousing, 2018).
This is where Material Management Systems become
advantageous. Because it provides an overview of the entire
institution's purchasing and inventory control processes,
decision-makers can have more reliable information, and can
monitor the bigger picture.
LIFO, FIFO, FEFO ISSUES METHOD
Inventory management is a crucial function for any product-
oriented business. Common inventory handling methods
include:
FIRST IN, FIRST OUT (FIFO)
Inventory items are sold in the order they are purchased.
This is the most common technique.
LAST IN, FIRST OUT (LIFO)
Last to enter the system are so first. This is common among
non-perishable items like petroleum, minerals, and metals.
FIRST EXPIRED, FIRST OUT (FEFO)
Materials are sold based on date they should be consumed,
regardless of when it was purchased.
GENERIC TAX FORMULA CONFIGURATIONS
Material Management Systems usually allow tax rates to be
defined internally via tax codes, or imported from an external
source. Tax configurations are usually accounted for on a
per country basis. The following taxes can usually be
processed while posting documents:
 Tax on sales and purchases
 Additional taxes like VAT
 Sales and Use tax as in USA
 Withholding tax like income tax in India
PERIODIC PHYSICAL STOCK TAKING AND
ADJUSTMENTS WITH TRACKING
An inventory count is a process where a business physically
counts its entire inventory. A physical inventory may be
mandated by financial accounting rules or the tax regulations
to place an accurate value on the inventory, or the business
may need to count inventory so component parts or raw
materials can be restocked. Businesses may use several
different tactics to minimize the disruption caused by
physical inventory.
Businesses may use the ff tactics to minimize the
disruption caused by physical inventory (CTI Reviews,
2016):
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER

 Inventory services provide labor and automation to

quickly count inventory and minimize shutdown
time.
 Inventory control system software can speed the
physical inventory process.
 A perpetual inventory system tracks the receipt and
use of inventory, and calculates the quantity on
hand.
 Cycle counting, an alternative to physical inventory,
may be less disruptive (CTI Reviews, 2016).

Fortunately, these are all features and benefits offered by the

Material Management System. Barcode and RFID are
supplementary technologies that can be used in combination
with the Material Management System in order to have more
accurate and less burdensome inventory counts.

LESSON 13: CLINICAL DATA REPOSITORIES

HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER
Clinical Data - this are information you get from different
check-ups or laboratory, pharmaceutical or radiology test
that you undergone.
Repositories - a place where something is being stored.
Clinical Data Repositories - storage of clinical data
Nowadays, most institutions have existing Clinical Data
Repositories (CDR), in electronic or written format, to
represent an aggregated database of clinical information. It
usually houses a multitude of laboratory results, diagnostic
reports, and various clinical documentation. The data are
readily searchable and exportable, often because the
information is gathered from standard clinical care
procedures (Roberston and Williams, 2016)
A clinical data repository can successfully depict the same
sample across different points in time, from varying sources
both within and outside the health institution. Common kinds
of available information in the CDR are listed below:
Maintaining a CDR possess a lot of advantages, particularly
in making more informed patient care decisions fr healthcare
providers. The longitudinal view of a patient’s medical record
can assist in improving patient experience, and having
information about prior test results and procedures helps
avoid redundant treatment.
CDR INTEGRATION WITH HIS
Bergeron (2013), describes a clinical data repository as a
structured and systematically gathered storehouse of
patient-specific data, which is usually mirrored from a clinical
application, or supplemented with data from other clinical
systems.
Since it is maintained as a separate database created
particularly in aiding decision analysis, the main application
avoids computational loading, and response time to a query
is improved. Moreover, because almost all patient
information is mirrored in a CDR, customized, and even
complex, queries are possible without sacrificing the
performance of the source applications.
Clinical data repositories have different levels of integration,
usually dependent on locations, indices, catalogues,
semantic translations or equivalences, syntactic structures,
and links to external information.
The level of integration of a CDR influences its functionality
by setting constraints on how easily someone can make
queries for any of its contents. The integration structure from
the CDR to the Laboratory Information System, for example,
might be different from that from Radiology or the Pharmacy
These differences might mean that a user may only access
certain types of information, and using different types of
queries, from a given information system, depending on the
restrictions which were set during the integration process.
Wade (2014) emphasizes that the longitudinal nature of the
CDR requires a way of linking various observations of the
same identified subject. Most repositories usually contain
personally-identified data, however, due to privacy issus,
they only release de-identified data, which can lead to the
omission of some data in a dataset. The lack of identifiers
could also prevent the linking of data for some patients.
TYPES OF CLINICAL DATA REPOSTORIES
Clinical Data repositories are beneficial in consolidating
patient information, a disadvantage is that most CDRs are
only integrated with clinical lab. Lab results, diagnoses, and
demographics might be available for use in one platform, but
overall patient satisfaction, the amount of time a patient had
to wait before being treated, and other information not
related directly to his/her care might be unavailable.
MULTIPLE VIEWS FOR PATIENT MEDICAL RECORD
Information for patients is typically scattered across multiple
subsystems. A clinical data repository standardizes data
from disparate sources into a cohesive format. It comprises
numerous tables, each offering a partial view of patient
information (Gensinger, 2014)
Ball and Douglas (2013) elaborate that:
A well-deployed clinical repository has multiple advantages.
One examples is the CDR function to provide longitudinal
views of patient information. Data repositories are often
organized primarily around patients and secondly around
visits or encounters, a method that easily accommodates
views that span multiple visits. This allows clinicians to trend
and chart results independent of the visits and test panel
organization. For example, a clinician could study the trend
of a patient’s blood sodium levels over the past siz months
independent of other factors.
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER

GRAPHICAL REPRESENTATION OF LAB RESULTS

AND VITALS
Data collected through an electronic health record system
may be retrieved at the request of an authorized user,
whether a physician, medical technologist, nurse or
radiologist. The electronic health record may present patient
care information as text, tables, graphs, sounds, images, full-
motion video, or signals on an electronic screen, phone,
pager, or paper (Bronzino and Peterson, 2014)

Unfortunately, analyzing trends and patterns from large dta

sets can be a challenging process. This is where data
visualization, the art of representing data in a pictorial or
graphical format, becomes useful. Data visualization helps in
simplifying a wide array of information, and it allows
decision-makers to derive analytical results from information
presented visually. Correlations, patterns, and trends which
might be undetected from text-based clinical data can be
revealed and recognized with more ease because of data
visualization.

Visualization is increasingly becoming an important tool in

decision making. The graphical representation feature of
most clinical data repositories enable scenario analysis,
which helps users use different kinds of filters in order to
change the level of information that may b seen. Common
filters include age and gender, in order to assess how the
outcomes of a certain intervention will be based on isolating
certain factors. This kind of analysis is a good opportunity in
empowering the frontline staff by giving them straightforward
data which will facilitate the performance of their tasks more
efficiently and effectively (Rains and McCuistion, 2018)

LESSON 14: ETHICS, PRIVACY, AND SECURITY

Modernization in healthcare has led to the tendency of most
practitioners to rely on the use of mechanical aids throughout
the process of providing patient treatment.
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER

However, the fact remains that human values should

continue to govern research and practice in the healthcare
profession. Healthcare informatics encompasses issues of
proper and improper behavior, honorable actions, and of
right and wrong.

Ethical questions in medicine, nursing, human subject

research, psychology, and other related fields continue to
become more twisted and complex, but some overarching
issues are common among them. Ethical issues in health
informatics, on the other hand, are less familiar, even if some
of them have been controversial for decades. Privacy and
confidentiality might be the more popular sources of debates,
but the rest of the field is surrounded with other ethical
issues of significant concern, such as the use of appropriate
informatics tools in clinical settings, determination of users of
those tools, system evaluation, system development and
maintenance, and the use of computers in tracking clinical
AUTONOMY
outcomes. Informatics also raises questions about various In a general sense, autonomy is defined as either allowing
legal and regulatory requirements (Goodman, 2016). individuals to make their own decisions in response to a
particular societal context, or as the idea that no one human
The rest of the discussion directs us to a set of ethical person does not have the authority nor should have power
principles for appropriate use of decision-support over another human person.
systems, particularly in Informatics, as described by
Shortlife and Cimino (2013): Electronic health records (EHR) must maintain respect for
patient autonomy, and this entails certain restrictions about
 A computer program should be used in clinical the access, content, and ownership of records. A
practice only after appropriate evaluation of its compromise must be reached between levels of patient
efficacy and the documentation that it performs its autonomy and quality of patient records.
intended task at an acceptable cost in time and
When patients are given too much control over their EHRs,
money.
this could defeat the purpose of the use of such a document
 All uses of informatics tools, especially in patient
because critical information might be modified or deleted
care, should be preceded by adequate training and
without the knowledge of the health professionals. Limiting
instruction, which should include review of
patient access and control over patient records improves
applicable product evaluations.
document quality because they can become proofreaders of
 Users of most clinical systems should be health
their own patient history (Mercuri, 2010).
professionals who are qualified to address the
question at hand on the basis of their licensure,
BENEFICENCE AND NON-MALIFICENCE
clinical training, and experience. Software systems
should be used to augment or supplement, rather
than to replace or supplant, such as individual’s These two principles are respectively defined as do good
decision making. and do no harm. In health informatics, beneficence relates
most significantly with the use of the stored data in the EHR
OVERVIEW OF HEALTH INFORMATICS ETHICS system, and non-maleficence with data protection.

Deeply-integrated EHR systems will contain substantial

Health informatics ethics is the application of the principles of
ethics to the domain of health informatics. There are three
main aspects of health informatics: healthcare,
informatics, and software. Information systems are
developed in order to assist in the dispensation of healthcare
or other supplementary services. In addition, health
informatics also dwells in the efficiency of processing data.
Voluminous patient information has to be stored for future
use, to be retrieved when needed. Transfer of information
also needs to be facilitated with proper security
ETHICS IN HEALTH INFORMATICS
amounts of raw data, and great potential exists for the
conduction of groundbreaking biomedical and public health
research. These kinds of research will be beneficial to both
the individual patient, and to the entirety of society. With this
in mind, new EHR systems should be developed with the
capacity to allow patients to release information from their
EHRs which can be valuable to researchers and scientists.
Similarly, the available consolidated from clinical data
repositories will be able to allow healthcare professionals to
provide the best possible treatments for their patients, further
upholding the principle of beneficence.
INFORMATICS ETHICS
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER
Informatics ethics, on the other hand, involves the ethical
behavior required of anyone handling data and information,
as prescribed by the International Medical Informatics
Association (2016).
It covers seven principles: privacy, openness, security,
access, legitimate infringement, least intrusive alternatives,
and accountability.
PRINCIPLE OF INFORMATION - PRIVACY AND
DIPOSITION
All persons and group of persons have a fundamental right
to privacy, and hence to control over the collection, storage,
access, use, communication, manipulation, linkage and
disposition of data about themselves.
PRINCIPLE OF OPENNESS
The collection, storage, access, use, communication,
manipulation, linkage and disposition of personal data must
be disclosed in an appropriate and timely fashion to the
subject or subjects of those data.
PRINCIPLE OF SECURITY
Data that have been legitimately collected about persons or
groups of persons should be protected by all reasonable and
appropriate measures against loss degradation,
unauthorized destruction, access, use, manipulation, linkage,
modification or communication.
PRINCIPLE OF ACCESS
The subjects of electronic health records have the right of
access to those records and the right to correct them with
respect to its accurateness, completeness and relevance.
PRINCIPLE OF LEGITIMATE INFRINGEMENT
The fundamental right of privacy and of control over the
collection, storage, access, use, manipulation, linkage,
communication and disposition of personal data is
conditioned only by the legitimate, appropriate and relevant
data-needs of a free, responsible and democratic society,
and by the equal and competing rights of others.
PRINCIPLE OF LEAST INTRUSVE ALTERNATIVE
Any infringement of the privacy rights of a person or group of
persons, and of their right of control over data about them,
may only occur in the least intrusive fashion and with a
minimum of interference with the rights of the affected
parties.
PRINCIPLE OF ACCOUNTABILITY
Any infringement of the privacy rights of a person or group of
persons, and of the right to control over data about them,
must be justified to the latter in good time and in an
appropriate fashion.
Health informatics ethics heavily relies on use of software to
store and process information. As a result, activities carried
out by software developers might significantly affect end-
users. The software developer has ethical duties and
responsibilities to the following stakeholders: society,
institution and employees, and the profession.
Activities should be carried out with the best interest of the
society in mind. Developers should be mindful of social
impacts of software systems. This includes disclosing any
threats or known defects in software. In addition, activities
must be done in the best interests of the institution and its
employees, while balancing their duties to the public,
including being straightforward about personal limitations
and qualifications.
Furthermore, software products should meet expected
professional standards. Developers should strive to build
products that are of high standard, by thoroughly testing and
detailing unresolved issues. Moreover, managers and
leaders should prescribe ethical approaches in software
development. Realistic and effective costs, schedules, and
procedures should be encouraged (Samuel and Zaïane,
2014).
PRIVACY, CONFIDENTIALITY, AND SECURITY
Privacy and confidentiality protection also benefits public
health. When people are not afraid to disclose personal
information, they are more inclined to seek out professional
assistance, and it will diminish the risk of increasing
untreated illnesses and spreading infectious diseases
(Goodman, 2016).
When patients trust you and your health information
technology enough to disclose their health information, you
will have a more holistic view of patient’s overall health and
both you and your patient can formulate more-informed
decisions. In addition, when breaches of privacy and
confidentiality occur, they can have serious consequences
for your organization, such as reputational and financial
harm, or harm to your patients. Poor privacy and security
practices heighten the vulnerability of patient information and
increases the risk of successful cyber-attacks (USA
Department of Health and Human Services, 2015).
In summary, the olden idea that physicians should hold
health care information in confidence should be applicable
no matter what the circumstance. Th obligations to protect
privacy and to keep confidences fall on system designers,
maintenance personnel, administrators, and, ultimately, to
the physicians, nurses, and other frontline users of the
information. The protection of privacy and confidentiality is
non-negotiable because it is a duty that does not fluctuate
based on the diseases, or the data-storage medium
(Goodman, 2016).
LEVELS OF SECURITY IN THE HOSPITAL
INFORMATION SYSTEM
Now that the importance of privacy and confidentiality in
relation to security is established, the next focus of the
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER
discussion would be on safeguards, or the solutions and
tools which may be utilized to implement your security
policies. Safeguards can be on an Administrative (may be
implemented by the management as organization-wide
policies and procedures), Physical (mechanisms to protect
equipment, systems, and locations), or Technical Level
(automated processes to protect the software and database
access and control).
The National Research Council (1997) emphasizes that
technological security tools are essential components of
modern distributed health care information systems, and
that they serve five key functions:
 Availability-ensuring that accurate and up-to-date
information is available when needed at appropriate
places;
 Accountability-helping to ensure that health care
providers are responsible for their access to and
use of information, based on a legitimate need and
right to know;
 Perimeter identification-knowing and controlling the
boundaries of trusted access to the information
system, both physically and logically;
 Controlling access-enabling access for health care
providers only to information essential to the
performance of their jobs and limiting the real or
perceived temptation to access information beyond
a legitimate need; and
 Comprehensibility and control-ensuring that record
owners, data stewards, and patients understand
and have effective control over appropriate aspects
of information privacy and access.
PHILIPPINE DATA PRIVACY ACT OF 2012
Business Process Management, particularly involving Health
Information Technology, is an increasingly growing industry
within the Philippine economy. With total IT expenditure
reaching $4.4 Billion in 2016, the industry is forecasted to
more than double itself by the year 2020. In addition,
Filipinos utilize social media heavily, with a whopping 3.5
Million users on LinkedIn, 13 Million on Twitter, and 42.1 on
Facebook (Wall, 2017).
Given the rapid evolution of the digital economy and
heightened international data trading, the Philippines has
decided to strengthen its privacy and security protection by
passing the Data Privacy Act of 2012, with an aim to protect
the fundamental human right of privacy, of communication
while ensuring free flow of information to promote innovation
and growth. (Republic Act. No. 10173, Ch. 1, Sec. 2).
The Data Privacy Act applies to individuals and legal
entities that are in the business of processing personal
information. The law applies extraterritorially, applying both
to companies with offices in the Philippines, and even those
located outside, but which use equipment based in the
Philippines. It covers personal information of Filipino citizens
regardless of the place of residence.
The main principles that govern the approach for the
Data Privacy act include:
 Transparency;
 Legitimacy of purpose; and
 Proportionality.
Comprehensibility and control- ensuring that record
owners, data stewards, and patients understand and have
effective control over appropriate aspects of information
privacy and access.
Consent is one of the major elements highly-valued by the
Data Privacy Act. The act provides that consent must be
documented and given prior to the collection of all forms of
personal data, and the collection must be declared,
specified, and for a legitimate purpose.
Furthermore, the subject must be notified about the purpose
and extent of data processing, with details specifying the
need for automated processing, profiling, direct marketing, or
sharing. These factors ensure that consent is freely-given,
specific, and informed.
However, an exception to the requirement of consent is
allowed in cases of contractual agreements where
processing is essential to pursue the legitimate interests of
the parties, except when overridden by fundamental rights
and freedom. Such is also the case in responding to national
emergencies.
Processing of sensitive and personal information is also
forbidden, except in particular circumstances enumerated
below.
The Data Privacy Act describes sensitive personal
information as those being:
 About an individual's race, ethnic origin, marital
status, age, color, and religious, philosophical or
political affiliations;
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER

 About an individual's health, education, genetic or

sexual life of a person, or to any proceeding or any
offense committed or alleged to have committed;
 Issued by government agencies "peculiar" (unique)
to an individual, such as social security number;
 Marked as classified by executive order or act of
Congress.

The exceptions are:

 Consent of the data subject;

 Pursuant to law that does not require consent;
 Necessity to protect life and health of a person;
 Necessity for medical treatment;
 Necessity to protect the lawful rights of data
subjects in court proceedings, legal proceedings, or
regulation.

The provisions of the law necessitate covered entities to

create a privacy and security program to improve the
collection of data, limit processing to legitimate purposes,
manage access, and implement data retention procedures.

PENALTIES
 Unauthorized processing
 Processing for unauthorized purposes
 Negligent access
 Improper disposal
 Unauthorized access or intentional breach
 Concealment of breach involving sensitive personal
information
 Unauthorized disclosure; and
 Malicious disclosure.
 Any combination or series of acts enumerated
above shall make the person subject to
imprisonment ranging from three (3) years to six (6)
years, and a fine of not less than One million pesos
(Php1,000,000.00) but not more than Five million
pesos (Php5,000,000.00) (Republic Act. No. 10173,
Ch. 8, Sec. 33).

LESSON 15: HEALTH INFORMATION

PROFESSION
The Role of Health Information Management
Professionals
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER
Health Information Management (HIM) professionals,
credentialed with their academic preparation, work
experience, commitment to patient advocacy, an
professional code of ethics, have a specialized skillset that
uniquely qualifies them to assume the role both of privacy
official and/or security official. Store, protect, and transmit
information in all media and formats (May, 2014).
A Health Information Management professional:
 Collects, aggregates, analyzes, and disseminates
patient health information.
 Committed to the timely and accurate collection of
health information and its maintenance, storage,
retentions, and disclosure.
 Represents patient’s interest in matters of privacy
and security,information release, and issues and
guidelines regarding record access.
 Certified by the American Health Information
Management Association.
 Ensures confidential patient information is kept
private, secure, and in accordance with federal and
state laws.
They specialize in managing patient health information and
medical records, administering computer information
systems, and classifying using standard coding systems, the
diagnoses, and procedures for health care services provided
to patients.
Those with health information management and health
information technology careers manage all aspects of the
content of patient medical records and patient information
systems. Job responsibilities can include aspects of clinical
information documentation capture and maintenance, data
analytics and interpretation, as well as designing,
implementing, and maintaining health information technology
systems.
Health Information Management Professionals fall into
many job categories with varied titles, including:
 Health Information Management Department
Director
 Health Information Management System Manager
 Information Security Officer
 Chief Privacy Officer
 Health Data Analyst
 Health Record Technician Specialist
 Clinical Coding Specialist
 Patient Information Coordinator
 Physician Practice Manager
 Health Information Administrator
 Revenue Cycle Specialist
 Director of Quality Management
 Health Information Manager
 Health Information Technologist/Technician
The typical day-to-day activities of a Health Information
Management Professional include:
 collecting, aggregating, analyzing, and
disseminating patient health information for doctor’s
offices, hospitals, managed care organizations,
insurance companies, research and policy
agencies, and other health care facilities and
related industries
 providing accurate coding of diagnoses and
procedures from patient visits with health care
providers, ensuring accurate patient billing and
proper reimbursement to health care providers
 compiling and analyzing health care data from
patients, assisting with the identification of ways to
better utilize health care resources, uncovering
public health patterns, improving patient care, and
providing critical information for health care
research
 Developing policies to support the delivery of high
quality health care by ensuring the availability of
quality information for accurate health care decision
making (May, 2014).
The Philippine Health Information Profession
Advancements in ICT (information and communication
technology) are upsetting not only traditional businesses, but
even those not immediately thought of as probable
beneficiaries such as the healthcare sector. From electronic
patient records to the wireless transmittal of patient files for
remote diagnosis, improvements in communication and
technology will lead to better delivery of healthcare services.
Telemedicine, or the use of electronic communications to
transmit and exchange medical information and data to
provide patient treatment, is quickly gaining momentum
within the country and the rest of the ASEAN region.
Thailand, Singapore, and Malaysia have started adopting
healthcare IT solutions to bring the sector to the next level. In
2009, Singapore developed its National Electronic Health
Record initiative, which permitted healthcare practitioners in
the island state access to a patient’s records across the
healthcare continuum.
Malaysia initiated a Hospital Implementation System in 1993,
with its first telemedicine project in 1996, and Thailand
created its National Health Information Committee in 2010.
Likewise, the Philippines has developed an eHealth Strategic
Framework and Plan for 2014 to 2020, whose objective is to
utilize information and communication technologies in the
health sector. This will assist in the delivery of health
services and manage health systems for greater efficacy,
with the ultimate goal of providing universal healthcare for
the Filipinos.
In line with this, the Department of Health (DOH) in Region
4B has launched the first interactive telemedicine system in
Marinduque, and seemingly the entire country, at the Dr.
Damian J. Reyes Provincial Hospital. The system currently
HOLY NAME UNIVERSITY
HEALTH INFORMATION SYSTEM (HIS)
MT 102-LABORATORY AND LECTURE
BSMT1-C
FINAL EXAM NOTES - 1ST SEMESTER

provides medical consultations and diagnostics through
video calls (De Dios, 2016).
Telemedicine in the Philippines
For an archipelago such as the Philippines, the delivery of
healthcare services might prove to be challenging.
Fortunately, the rise of Telemedicine within the region, as
discussed above, has been a beneficial turn of events forthe
Philippine Healthcare sector.
Multiple players in the Telemedicine scene in the Philippines
currently exist, ranging from mobile apps to call center
services.
Some providers of over-the-phone telemedicine services are
Med gate and Lifeline. Common features include 24/7 call
centers, diagnosis using images sent via email, medical
certificates, and treatment plan summaries. These kinds of
telemedicine centers usually have a corresponding mobile
app to facilitate easier access. Unique to Lifeline, however, is
video consultation with doctors, patient education, free
doctor or nurse home visits, and delivery of medication and
prescriptions in exchange for a fixed monthly subscription
fee.
Mobile App-based Telemedicine centers, on the other hand,
include My Pocket Doctor and My Doc Now. These providers
are usually in partnership with other international
telemedicine centers. Medway Healthcare Inc., by far, offers
the most comprehensive set of telemedicine services, being
the first medical clinic in the Philippines to mobilize its Pre-
Employment Medical Examination (PEME) arm into the path
of delivering interactive healthcare. They offer Tele follow-up
and Teleconsultation procedures which are accessible online
and through a specially-designed computer program.
In Telefollow-up, patients are notified of the medical
evaluation results via text messages on their individual cell
phones. Within 24 hours of PEME, patients will already know
if they are fit to work, unfit to work or still with pending
workups. Follow-up visit to the clinic is then advised. Follow-
up of results using traditional landline call is also
accommodated.
patient’s blood pressure, temperature, oxygen saturation
rate, pulse rate, and even the electrocardiogram rate, and
this information may all be sent to the specialist doctor via
email or SMS, aiding in patient care. Afterwards, the RXBox
stores and files data into a community health information
system (Ronda, 2016).
KEY POINTS TO REMEMBER
Change is inevitable and pervasive. Organizations are driven
to change in order to respond to the many pressures they
encounter from their environment. These pressures include:
global competition, changes in customer demand,
technological advances and new legislation.
Change management is a series of tools, techniques and
processes aimed at successfully effecting change. Health
Information Management (HIM) professionals, credentialed
with their academic preparation, work experience,
commitment to patient advocacy, and professional code of
ethics, have a specialized skillset that uniquely qualifies
them to assume the role both of privacy official and/or
security official. store, protect, and transmit information in all
media and formats (May, 2014).A
One of the strategic goals of this framework is to establish
unified and coherent health and management information
systems, and also to take advantage of ICT to reach and
provide better health services and support the attainment of
the UN’s Sustainable Development Goals.
Telemedicine efforts from the government and other non-
profit organizations have also ensued. The National
Telehealth Center is the leading research unit in the
University of the Philippines responsible for developing cost
effective tools and innovations in the realm of information
and communications technology (ICT) for improving health
care.

The Department of Science & Technology (DOST)has

also begun distributing the breakthrough RXBox
telemedicine device developed by engineers and
researchers from University of the Philippines (UP) Diliman
and UP Manila to 1,000 far-flung municipalities in the
country, focusing on disadvantaged municipalities to benefit
from having affordable health care in their respective
communities.

The RXBox was a collaboration between a team of

engineers, doctors and researchers from UP Diliman and UP
Manila, led by electronics and communication engineer
Nathaniel Cruz, who is currently with the National Telehealth
Center.

RXBox has features that enable teleconsultations via email,

video call, orSMS. It has sensors that can measure a