○ Billing: Involves generating and

submitting claims for healthcare

HEALTH MANAGEMENT services provided to patients.
INFORMATION SYSTEMS ○ Accounts Receivable (A/R)
Management: Manages the
(HMIS) tracking and collection of unpaid
services, including reasons for
claim denials.
Definition of HMIS
○ Reporting: Generates basic and
custom reports to monitor financial
An information system specifically designed to assist
and operational performance.
in the management and planning of health programs
○ Medical Records: Includes patient
rather than direct patient care. (World Health
assessments, treatment plans, and
Organization - WHO)
progress notes for documentation
and care management.
Aims of HMIS
○ Compliance: Maintaining medical
records and treatment plans.
● Provide real-time data for hospital
○ Financial Management: Tracking
performance monitoring
billing, receivables, payroll, and
● Enable evidence-based decision-making
accounts.
● Improve data retrieval efficiency
● Eliminate data duplication and transcription
errors Eight Elements of HMIS
● Address inventory management issues
● Standardize name codes and improve data 1. Data Acquisition: Collecting timely
analysis and relevant data.
● Enhance operational efficiency and overall 2. Data Verification: Authenticating
healthcare management and validating the data.
3. Data Storage: Preserving data
securely.
Characteristics of HMIS Information:
4. Data Classification: Organizing
the data.
1. Relevant
5. Data Computation: Analyzing data
2. Functional
for manipulation.
3. Integrated
6. Data Update: Keeping the
4. Collected on a routine basis
information current.
7. Data Retrieval: Distributing the
Three processing phases
data.
8. Data Presentation: How the data is
1. Data Input: Data acquisition and
interpreted by users.
verification.
2. Data Management: Classification,
Determinants of HMIS Performance
computation, and update of data.
3. Data Output: Data retrieval and
presentation. 1. Behavioral Determinants:
Knowledge, skills, values, and
motivation.
HMIS Functions
2. Organizational Determinants: The
culture, structure, roles,
○ Client Data: Managing clinical and
responsibilities, and resources
billing data.
within an organization.
○ Scheduling: Linking schedules to
3. Technical Determinants: Data
billing.
quality, system design, and IT
○ Authorization Tracking: Tracking
infrastructure.
authorized services.
Yung Prism Framework
 M&E Framework
MONITORING AND
EVALUATION (M&E) IN 1. Indicator Selection: Choosing relevant
metrics.
HMIS puro pic tas ang lalabo pa 2. Data Collection & Analysis: Ensuring
accurate methods and comprehensive
sinukuan ko na analysis.
3. Performance Review: Regular evaluations
Definitions against targets.
4. Communication & Use: Sharing findings to
● Monitoring: The continuous collection and inform policy and operational decisions.
analysis of data to ensure that health
programs are effective and resources are
efficiently used.
● Evaluation: A systematic assessment of
Key Performance Areas and Indicators
ongoing or completed programs to determine
their relevance, effectiveness, and impact.
1. Reproductive Health
2. Immunization
3. Disease Prevention
4. Resource Utilization
Purpose of M&E 5. Data Quality

1. Learning
Maternal Survival Strategy and HMIS Indicators
2. Accountability
3. Steering
○ Antenatal Care: Monitoring initial
and final antenatal visits.
Components of M&E ○ Delivery by Skilled Attendants:
Tracking institutional deliveries with
1. M&E Purpose: trained health workers.
○ It guides decisions by measuring ○ Maternal Morbidity and Mortality:
service delivery impacts and Monitoring complications related to
ensuring effective use of resources. labor and postpartum care.
2. M&E Plan: ○ Postnatal Care: Tracking care
○ National Plan: Should cover all provided after delivery.
health system aspects and include
regular reviews.
Child Mortality and Child Survival Interventions
○ Global Coordination: Tools like the
Joint Assessment of National
● Interventions:
Health Strategies (JANS) align
○ Universal Immunization
global monitoring efforts.
○ Nutrition Programs
○ Country-Focused: M&E strategies
○ Childhood Disease Management:
must be tailored to specific national
needs, identifying key indicators
STOP TB Program
and data sources for analysis.

Ensuring universal access to high-quality TB care.

● Goal: Halving TB prevalence and deaths by

2050, focusing on diagnosis, treatment, and
care access.
 Root Cause Analysis Techniques
DATA QUALITY IN HMIS
1. The Five Whys: Asking "why" five times to
Aspects of Data Quality get to the root cause of an issue.
2. Failure Mode and Effects Analysis
1. Accuracy (FMEA): Identifying potential failures and
2. Completeness their impacts.
3. Update Status 3. Pareto Analysis: Identifying the most
4. Relevance significant causes of a problem.
5. Consistency 4. Fishbone (Ishikawa) Diagram: A
6. Reliability brainstorming technique used to find causes
7. Presentation of a problem.
8. Accessibility 5. Fault Tree Analysis: Mapping out the
causes of specific failures.
Lot Quality Assessment Sampling (LQAS) 6. Current Reality Tree (CRT) analyzes a
system to identify root causes of multiple
A sampling method used to assess data quality problems at once, helping to address them
across various groups by analyzing small random efficiently.
samples. Originally used in industries, it is now 7. RPR Problem Diagnosis
applied to health data. ● Discover: Workers gather and
analyze data.
Routine Data Quality Assessment (RDQA) ● Investigate: Team creates a
diagnostic plan and identifies the
A tool that helps verify the quality of reported data and root cause.
strengthens data management systems. ● Fix: The issue is resolved and
continuously monitored.
● Objectives:
1. Verify the accuracy of key indicators
2. Strengthen data reporting and
management systems

Components of Implementation Plan

● Define Goals/ Objectives

● Schedule Milestones
● Allocate Resources
● Designate Team Member Responsibilities
● Define Metrics for Success

Implementation Plan is a project management tool

that shows how a project will evolve at a high level.

Data Quality Tools

● Parsing and Standardization: Ensuring

consistency in data layout.
● Cleansing: Adjusting data to meet quality
standards.
● Matching: Identifying and merging related
data entries.
● Monitoring: Ensuring that data follows
business rules.
● Enrichment: Adding additional information
to improve the dataset.
 Financial and Administrative Functions
Hospital Information
Systems (HIS) ● Cost Efficiency: The system offers remote
access, improves patient care coordination,
Overview and provides seamless data sharing
between hospitals.
● Vendor Assistance: Vendors offer 24/7
Purpose and Benefits
support and guidance, making HIS adoption
smooth and efficient.
● Efficient Healthcare Management: HIS
manages clinical, financial, and operational
Healthcare IT Providers
records to streamline processes and
eliminate manual tasks.
1. Kaiser-dela Cruz Consulting, Inc. (1990):
● Centralized Data Management: HIS
○ Focus on hospitals, clinics, and
integrates data from various departments,
medical schools in the Philippines.
ensuring real-time access to patient and
○ Products: Visual MEDSYS
financial information, enhancing
(hospital management) and
decision-making, and operational efficiency.
MEDSCHO (school management).
○ Leadership by Robert F. Kaiser, Jr.,
User-Friendly Solutions
EVP of Lorma Medical Center.
2. Comlogik Business Systems, Inc. (1999):
● Interface and Training: HIS comes with a
○ Focus on developing innovative
user-friendly interface and vendor training to
hospital applications.
ensure smooth adoption.
○ Provides online hospital services
● Scalability: The system can accommodate
where patients access billing and
hospital growth and adapt to changing
exam results, and administrators
needs.
access reports remotely.
● Affordability: HIS provides cost-effective
3. IQVIA (2016):
solutions with minimal hardware
○ Formed from the merger of
requirements.
Quintiles and IMS Health.
○ A leading provider of analytics,
Key Features of HIS technology solutions, and clinical
research for life sciences.
Clinical and Operational Management ○ Product: Hospital Information
System Arcus Air™, unifies hospital
● Personnel Scheduling: Efficient networks for all patient care
management of workforce schedules, patient stakeholders.
charting, and clinical data integration. 4. BIXBOX
● Physician Practice Enhancements: HIS ● Founded 25 years ago to improve
integrates Electronic Medical Records work efficiency.
(EMRs), Electronic Health Records (EHRs), ● Leading healthcare IT company
and other software to support physician since 1994.
practice. ● Uses Microsoft tech (Windows
● Radiology Management: Provides Server, SQL Server, .NET).
radiology billing, appointment scheduling, ● Microsoft Gold Partner, ISV of the
reporting, and patient database Year.
management, streamlining radiology ● Develops EHR and DMS for better
practice. patient care.
● Pharmacy Management: HIS monitors
medicine utilization, manages drug
interactions, and supervises drug allergies
and complications.
Administrative Processes in Hospitals Radiology Reports:

1. Patient Registration: Collects patient ● Needed:

details during hospital visits. 1. Patient demographics
2. Admission and Discharge: Pre-admission 2. Relevant clinical info and ICD-9
counseling and discharge instructions for codes
post-hospital care. 3. Exam body
3. Physician Employment: Shift from 4. Impression (conclusion or
traditional practices to hospital-owned clinics diagnosis)
with less autonomy but better administrative
support. Inventory and Supply Chain Management
○
Supply Chain Challenges:
Financial and Contract Management
● Nurse Workload
Billing Statements: ● Decentralized Inventory

● Track invoices and payments, Automated Inventory Management Systems:

providing a rolling balance for
customers who pay in lump sums. ● Tracking: Barcodes and RFID tags provide
accurate tracking.
Contract Management: ● Demand Forecasting: Systems predict
future needs and prevent shortages or
● The process of creating, executing, and overstock.
analyzing contracts to optimize financial ● Improved Patient Safety: Timely delivery of
performance and reduce risks. supplies contributes to enhanced patient
outcomes.
Accounts Receivable and Medical Device
Imports Hospital Business Intelligence (HBI)

● Represents outstanding invoices owed by Captures financial and non-monetary data to

clients for goods or services provided, support decision-making, responsiveness,
typically settled within days or up to a year. effectiveness, and resource utilization.
● Medical Device Industry in the
Philippines: ● Features:
○ Heavily dependent on imports ○ Informed decision-making
(99.2%), with the United States ○ Improved operational efficiency
contributing 12% to the market ○ Enhanced resource management
share. ○ Proactive problem-solving

Laboratory and Radiology Reports Technology Solutions for Healthcare

Laboratory Reports: Tally.ERP:

● Needed: ● A versatile solution that manages

1. Patient name and ID number accounting, inventory, tax management,
2. Lab location and address payroll, and compliance.
3. Test date and report date ● Used by over 1,000,000 entities globally due
4. Ordering physician’s name to its simplicity and minimal resource
5. Specimen source, test results, and requirements.
interpretations.
LABORATORY ● Time Tracking: Tracks employee hours and
manages project-specific time tracking.
INFORMATION
LIMS in Different Industries
MANAGEMENT SYSTEM
● Healthcare: Improves data management
(LIMS) and compliance in clinical labs.
● Pharmaceuticals: Streamlines drug
Core of LIMS manufacturing and ensures the quality of
pharmaceutical products.
1. Sample Management: Tracks samples from ● Forensics: Enhances evidence
reception to disposal. management and compliance with judicial
2. Instrument Integration: Integrates with lab standards.
instruments, controlling their functions. ● Industrial Manufacturing: Monitors
3. Data Management: Controls and configures production processes and ensures
lab procedures step-by-step. adherence to environmental standards.

Features of LIMS Software Difference of Systems:

● Audit Management: Tracks user actions, ● LIMS:

automates audits, and detects irregularities. ○ Focus on sample management.
● Barcode Handling: Ensures accurate data ○ Used in industrial settings (e.g.,
input and minimizes human errors. pharmaceutical labs).
● Chain of Custody (COC): Critical in forensic ○ Enhances workflow, safety, and
compliance.
labs, tracking sample access and movement.
● LIS (Laboratory Information System):
● Compliance: Ensures laboratories adhere to
○ Focus on patient information.
industry regulations, minimizing risk.
○ Used in clinical settings for
● Customer Relationship Management: managing patient data and test
Stores client demographic info and results.
streamlines communication. ● PDES (Process Development Execution
● Document Management: Upload, index, System):
and manage different types of files and ○ Broad application, not limited to
attachments. labs.
● Instrument Calibration and Maintenance: ○ Supports high-tech manufacturing
Schedules maintenance actions and tracks technologies.
equipment condition.
● Inventory and Equipment Management: Industries Supported by LIMS:
Monitors and controls lab inventories and
equipment. 1. Food Production
2. Health Care
● Manual and Electronic Data Entry:
3. Pharmaceutical and Biotechnology
Facilitates data input by both lab technicians
4. Forensic Laboratories
and electronic components.
5. Environmental Monitoring
● Personnel and Workload Management: 6. Industrial Manufacturing.
Assigns tasks and tracks technician
schedules.
● Training Management: Schedules training
and maintains employee data.
● Quality Assurance and Control: Ensures
the highest quality in laboratory processes.
● Reports: Customizes and distributes lab
reports in specific formats.
Steps in Implementing LIMS

1. Engage End Users: Involve the scientists

and technicians who will be using the system
daily.
2. Define Workflows: Map out the lab’s
processes to better understand its needs.
3. Select Vendors: Choose a vendor that
understands your lab’s requirements and can
tailor LIMS to meet those needs.
4. Design the LIMS: Collaborate with the
vendor to design a system that fits the lab’s
workflow and operational goals.