Lesson 6c.

FRAMEWORKS

Frameworks
o key elements of M&E plans that depict the components of a project and the
sequence of steps needed to achieve the desired outcomes
o help increase understanding of the program’s goals and objectives
o define the relationships between factors key to implementation
o delineate the internal and external elements that could affect its success
o crucial for understanding and analyzing how a program is supposed to work

4 Common Types of M&E Frameworks

1. Conceptual framework
o “Research framework”
o useful in identifying and illustrating the factors and relationships that influence
the outcome of a program or intervention
o Mosley-Chen Framework
▪ Commonly used in the study of child survival
▪ Socio-economic determinants act through the following five “proximate” or
biological determinants to impact child health
2. Results framework
o “Strategic frameworks”
o diagram the direct causal relationships between incremental results of the key
activities to the overall objective and goal of the intervention
o clarifies the points in an intervention at which results can be monitored and
evaluated
3. Logic Model
o “M&E framework”
o provides linear interpretation of a project’s planned use of resources and its
desired ends
o It has five essential components:
i. Inputs - the resources invested in a program (e.g., technical
assistance, computers, condoms, or training
ii. Processes - the activities carried out to achieve the program’s
objectives
iii. Outputs - the immediate results achieved at the program level
through the execution of activities
iv. Outcomes - the set of short-term or intermediate results at the
population level achieved by the program through the execution of
activities
v. Impacts - the long-term effects, or results, of the program (e.g.,
changes in health status)
4. Logical framework
 HEALTH INFORMATION SYSTEM

TOPIC: CONCEPT AND TECHNOLOGY

Health Information System

• the intersection between healthcare’s business process and information systems.
• Become increasingly important as economic, social, political, and technological factors
have advanced.
• “Health information systems process data and provide information and knowledge in a
healthcare environment.” (Haux, 2006)
• Interaction between: PEOPLE, PROCESS, and TECHNOLOGY

GOAL: to improve the quality of healthcare services

PURPOSE: to deliver better healthcare services.
RELEVANCE: Utilize the Internet especially to provide better healthcare.

HISTORY
Industrial Age Medicine to Information Age Healthcare (Smith, 1997)

Industry phase at the United States of America (Bourke,M.K.,1994)

“Paradigm Shift” (Haux [Link], 2002)

o Paper-based to computer-based processing and storage
o Institution-centered department and HOSPITAL information system to REGIONAL
and GLOBAL HIS
o Inclusion of patients and health consumers
o HIS data for healthcare planning, clinical and epidemiological research
o From technical HIS problems to change management and strategic information
management
o Alphanumeric data to images and data on the molecular level
o A steady increase of new technologies – ubiquitous computing environment and
sensor-based technologies for monitoring
Transforming the Healthcare-patient relationship (Ball, 2001)
Advancement in Internet Technology (1990) - facilitated the processing, storing, retrieving,
and disseminating of data and information remotely anytime and anywhere.
• access information on the products and services they are considering from other users, not
only from producers
• customer demands changed
• The Web has become a popular channel to deliver information products or services,
including those in the healthcare industry. (Kuhn and Giuse, 2001)
•

COMPONENTS
1. Health Informatics
o the field that concerns itself with the cognitive, information processing, and
communication tasks of medical practice, education, and research. (Conrick, 2006)
o include the information science and technology that support those tasks.
 o TOOLS: Computers, clinical guidelines, formal medical technologies, and
information and communication system
2. Health Information Technology
o The application of information processing involves both computer hardware and
software. (Goldschmidt, 2005)
o It deals with the storage, retrieval, sharing, and use of healthcare information, data,
and knowledge for communication and decision-making.
3. Electronic Medical Record (EMR)
o Resides at the center of any health information system. (Protti et al., 2009)
o EMR is a medical record in a digital format.
4. Electronic Health Record (EHR)
o Refers to an individual patient’s health record in a digital format. (Protti et al., 2009)
o EHR systems coordinate the storage and retrieval of individual records with the aid of
computers (usually accessed on a computer, often through a computer network)
5. Electronic Patient Record (EPR)
o An electronically stored health information about one individual is uniquely identified
by an identifier. (Protti et al., 2009)
o EPR technology entails capturing, storing, retrieving, transmitting, and manipulating
patient-specific, healthcare-related data singly and comprehensively.
o Includes clinical, administrative, and biographical data.

ISSUES IN THE APPLICATION OF HIS

o To manage the relationship between healthcare providers and patients:
▪ Delivery of speedy and quality healthcare services to patients entails that much
patient data should be made available to the different members of a healthcare
system
▪ The availability of these patient data may trample on the patient’s right to
confidentiality

CHARACTERISTICS OF EFFECTIVE HIS

o Only a necessary portion of the patient information should be made available to someone
from the system who performs a certain function
o Fostering good relationships with customers (patients) will retain them attract them to
become loyal customers, and create greater mutual understanding, trust, and satisfaction.
(Richard and Ronald, 2008)
• A good relationship will encourage the patient’s involvement in decision-making.
• Good relations will foster effective communication which is often associated with
improved physical health, more effective chronic disease management, and better
health-related quality of life. (Arora, 2003)
•

FUTURE TRENDS OF HIS

o paperless hospital - will make it more reliable, effective, and efficient.
EFFECTS OF THE TRENDS OF HIS
o Builds on health telematics, networks, and services
o Links: offers virtual healthcare center
o Hospitals
o Laboratories
o Pharmacies
o primary care
o social centers

CURRENT STATUS OF HIS (varies among countries)

o 193 members of WHO (2009)
o 114 participated in the global survey on e-health (2011)
o Most developed countries have fully utilized HIS
o They have the resources, expertise, and capital to implement
o First countries that implemented HIS:
 i. Canada
o E-health (Ontario, March 2009)
o 3 targeted strategies:
▪ Improve diabetes management
▪ Improve medication management
Example: e-Prescribing
o It authorizes and transmits prescriptions from physicians and other
prescribers to pharmacists and other dispensers.
o It prevents medication errors due to illegible prescribing and
reduces fraudulent prescriptions.
▪ Improve wait times
ii. Australia
iii. Singapore

HEALTHGRID:
o allows the gathering and sharing of many medical, health, and clinical
records/databanks of hospitals, health organizations, and drug companies
o data of medical interest can be stored and made easily available to physicians,
allied professionals, healthcare centers, administrators, patients, and citizens in
general

CURRENT AIMS OF HIS

• Extend the application from hospitals to smaller healthcare providers, and ultimately to the
homes and families of the patients, and to the individual
• Connect not just hospitals, but the people as well to make medical information and access
to medical care readily available
• Bring provision of health from the hospital level to an individual level
 HEALTH INFORMATICS

• Also called healthcare informatics, healthcare informatics, medical informatics, nursing

informatics, or biomedical informatics
• is a discipline at the intersection of information science, computer science, and health
care.
• provides information to make decisions: Better information leads to better decisions
• Health care, management, planning and policy all need good information
• eHealth is a broad term for healthcare practice which is supported by electronic processes
and communication.

• mHealth (Mobile Health) - Mobile technologies such as mobile phones to collect and
access health information.

• Informatics is the collection, manipulation, and use of information.

• Information technology is hardware & software.

KEY ELEMENTS OF INFORMATICS

o Acquisition: Capture data
o Storage: save data
o Communication: data needs to be moved from the point of collection to storage
o Manipulation: data may be combined with other data, aggregated, or compared
o Display: analysis/interpretation of data for public use

CDC's National Center for Public Health Informatics (NCPHI)

o provides leadership in the application of information and computer science and technology
to public health practice, research, and learning.
– Electronic health record support of public health functions
– Use of health care, population and other public health data in supporting public
health systems and analyses
– Basic capabilities that support public health practice such as statistical and health
surveillance
– Public Health decision support
HIS CONTEXT

HEALTH INFORMATICS PRINCIPLE

o Use drives data
o Encourage open systems
o Buy Software - May not be an exact fit to your needs
o Build Software - Long expensive process not guaranteed to succeed.
o Modify - Start with open source software that you can modify
▪ Modified software to meet your exact requirements
▪ Everyone benefits from your investment in the software
o Interoperability using open standards
1. Incremental development and strengthening of systems
o The goal should not be to implement a single system but to encourage the
development of interoperable systems.
o Much easier to make continuous small improvements than to re-design and re-
implement the entire system
o If it works, enhance it!
2. Enterprise Architecture approach

3. Collaborative Communities
o Scalable sharing of resources
o Successful collaboration requires leadership.
 A HEALTH SYSTEM
HIS LAB MIDTERMS is well functioning if ...
REVIEWER - it ensures the production, analysis,
dissemination and use of reliable and timely
BY: VINZZZ information on health determinants, health
systems performance and health status
Lesson 6. HEALTH MANAGEMENT
INFORMATION SYSTEM Lesson 7. MONITORING &
EVALUATION
HEALTH MANAGEMENT INFORMATION SYSTEM
- Key component of Strategic Information System
- One of the six building blocks essential for MONITORING
health system strengthening. - Is an ongoing, continuous process of collection
- Data collection system specifically designed to of routine data that measures program progress
support planning, management, and decision towards achieving program objectives
making in health facilities and organizations. - Is used to track changes in program
PURPOSE performance over time
- To routinely generate quality health information - Is used to determine if activities need
that provides specific information support for adjustments during the intervention to improve
the decision making to monitor and improve desired outcomes
performance of the health sector. - Permits decisions regarding effectiveness of the
program and efficient use of resource
SIX COMPONENTS OF HEALTH INFORMATION SYSTEM
✓ Health Information System Resources And why do we need to do it?
✓ Indicators ▪ Regular and systematic assessment of progress
✓ Data Source ▪ Continued review of partners' capacity
✓ Data Management development needs
✓ Information Products ▪ Improve results-based reporting on
✓ Dissemination and Us achievements
- This would allow a well-functioning health ▪ Strengthen teamwork and ownership of the
system UNDAF among implementing partners
▪ Feeds into evaluation and real-time learning
FUNCTIONS AND GOALS OF HEALTH SYSTEM (2000)
o Service Delivery EVALUATION
o Human Resources - Measures how well the program activities have
o Information Commodities met expected objectives and/or
o Commodities Infrastructure - It measures the extent to which changes in
o Financing outcomes can be attributed to the program or
o Stewardship intervention
- Systematic, impartial assessment
- External, separated from program management
- Determines whether results made a worthwhile
contribution to national development priorities
Criteria:
✓ Relevance
✓ Efficiency
✓ Effectiveness
✓ Impact
✓ Sustainability
 3 KEY FUNCTIONS: - The activities carried out to achieve the
➢ Program improvement program's objectives
➢ Accountability Outputs
➢ Organizational learning - immediate results achieved at the program level
And why do we need to do it? through the execution of activities
▪ Whether we are Doing the Right Things ✓ A program is said to be successful if the
- Relevance/rationale/justification outputs match the objectives
- Client satisfaction Examples of outputs include:
▪ Whether we are Doing it Right ▪ number of people trained, product availability,
- Effectiveness/coherence improved skills
- Efficiency: optimizing resources
- Sustainability Objectives
- Impact - aims of a program
▪ Whether there are Better Ways of Doing it ✓ When the outputs meet or match the
- Alternatives objectives, then the program is considered
- Good practices successful
- Lessons learned Outcomes
- Improved positioning to influence next - short-term results obtained at the population
development planning framework level following activities (e.g., access,
contraceptive prevalence, percent of pregnant
MONITORING VS. EVALUATION women receiving antenatal care, etc.
MONITORING EVALUATION Impact
Monitoring simply means Evaluation goes beyond - long-term effects, or end results, of the program
counting or determining counting the frequency:
the frequency of a certain it determines if such
parameter (indicator) count has any
significance at all

MONITORING & EVALUATION TERMINOLOGIES

M&E Plan
- a variable that measures a particular aspect of a
program (input, process, output, outcome,
impact), usually related to achievement of
objectives
Indicator
- The routine collection and analysis of
measurements or indicators to determine
undergoing progress toward objectives
Transformation
- conversion of data into information
Analysis
- relates objectives and activities to problems,
and shows how indicators and tools measure
achievement of objectives
Input
- set of resources (e.g. funds, policies, personnel,
facilities, supplies, etc.) that are needed to
implement a program/activity
Processes
 Cost Consistent, Episodic, often
recurrent focused at
costs spread the midpoint and
across end of
implementation implementation
period period

Lesson 8. FRAMEWORKS

FRAMEWORKS
▪ key elements of M&E plans that depict the
components of a project and the sequence of
steps needed to achieve the desired outcomes.
▪ help increase understanding of the program's
goals and objectives
MONITORING VS. EVALUATION ▪ delineate the internal and external elements
Dimension Monitoring Evaluation that could affect its success
▪ crucial for understanding and analyzing how a
Frequency Periodic, occurs Episodic program is supposed to work
regularly ▪ define the relationships between factors key to
Function Tracking / Assessment implementation
oversight
Purpose Improve Improve 4 COMMON TYPES OF MONITORING &
efficiency, effectiveness,
EVALUATION FRAMEWORKS
provide impact, value for
information for money, 1. Conceptual Framework
reprogramming to future ▪ "Research framework"
improve outcomes programming, ▪ useful in identifying and illustrating the
strategy and factors and relationships that influence
policymaking the outcome of a program or
Focus Inputs, outputs, Effectiveness, intervention
processes, work relevance, ▪ typically shown as diagrams illustrating
plans impact, cost- causal linkages between key
(Operational effectiveness components of a program.
implementation) (population
effects)
Methods Routine review of Scientific,
reports, registers, rigorous
administrative research design,
databases, complex
field observations and intensive

Information Routine or Same sources

source surveillance used in
system, field monitoring, plus
observation population-based
reports, progress surveys,
reports, vital registrations,
rapid assessment, special ▪ Mosley-Chen Framework
program review studies
▪ Commonly used in the study of child
meetings
survival
 ▪ Socio-economic determinants act ▪ the set of short-term or intermediate
through the following five "proximate" results at the population level achieved
or biological determinants to impact by the program through the execution
child health of activities
2. Results Framework
▪ "strategic frameworks"
▪ diagram that shows the direct causal
relationships between incremental
results of the key activities all the way
to the overall objective and goal of the
intervention
▪ clarifies the points in an intervention at
which results can be monitored and
evaluated

o Impacts
▪ the long-term effects, or end results, of
the program (eg. changes in health
status

3. Logic Model
"M&E framework"
provides linear interpretation of a project's
planned use of resources and its desired
ends
FIVE ESSENTIAL COMPONENTS
o Inputs
▪ the resources invested in a program
(e.g., technical assistance, computers,
condoms or training)
o Processes
▪ the activities carried out to achieve the
program’s objectives
o Outputs EXAMPLE 2. Small portion from a logic model for an HIV
▪ the immediate results achieved at the voluntary counseling and testing (VCT)
program level through the execution of
activities
o Outcomes
 program o Data in the database reflect no
4. Logical Framework
✓ A diagram or matrix that illustrates the
linear relationships between key program
inputs, activities, immediate
results/outputs, and desired outcomes.

Type of Program Basis for Monitoring

Framework Management and Evaluation?
and Brief
Description

Conceptual- Determines No. Can help to

Interaction of which explain
various factors the results inconsistency between what is in the
factors program registers and what is in the databases
will influence
/reporting forms at facility level.
Results- Shows the Yes - at the objective
Completeness
Logically causal level
o Refers to all the relevant data elements in a
linked relationship
program between patient/client register are filled
objectives the program COMMON SOURCES OF DATA ERROR IN HMIS
objectives REPORTS
✓ Missing data
Logic Model- Shows the Yes - at all stages of ▪ Data items for whole months missing
Logically causal the program from (ex - HIV positive women delivered in
linked inputs, relationship inputs to process to facility)
processes, between outputs to ✓ Duplicate data
outputs, and inputs and outcomes/objectives
▪ Multiple counting of data variables (ex-
outcomes the
multiple counting of a fully immunized
objectives
child
✓ Thumb suck
Lesson 9. DATA QUALITY ▪ When data collection tools are not used
DATA QUALITY routinely, staff just fills digits in a likely-
- An assessment of data's fitness to serve its looking number (often using
purpose in a given context preferential end digits)
- Determined by factors such as relevance, ▪ “Nanghuhula”
accuracy, timeliness, and completeness ✓ Unlikely values for a variable
ELEMENTS OF DATA QUALITY ▪ Example: A man being pregnant; low
Relevance birth weight babies exceeding number
o Data collected and reported by HMIS is of deliveries
relevant to the information needs of the ✓ Contradictions between variables
health system for routine monitoring of ✓ Calculation errors
program performance ▪ Mistakes in addition or using other
Timeliness operations
o Data is collected, transmitted and processed ✓ Typing error
according to the prescribed time and ▪ Data is wrongly entered into the
available for making timely decisions. computer
Accuracy
 ▪“One of the worst possible typing error
is having a negative result becoming a
positive one”
✓ Capture in wrong box
▪ Example: TB cured in the place of
Treatment Completed

WHAT HAPPENS WHEN DATA IS NOT RELEVANT,

TIMELY, ACCURATE, OR COMPLETE?

Data is not relevant

- It won't have any added value in monitoring the
program performance. It only adds burden on
data collectors.
Data is not timely
- It will not help us to make timely decisions to fix
problems
Data is not accurate
- It can prevent us from seeing the actual
performance of the program
Data is not complete
- We will not be able to see the computer picture
of the performance at different levels.
OVERALL: THE DECISION MAKING BASED ON EVIDENCE
WILL BE HAMPERED.

TECHNIQUES TO CHECK HMIS DATA ACCURACY

✓ Lot Quality Assurance Sampling (LQAS)

Methodology
▪ Technique useful for assessing whether
the desired level of data accuracy has
been achieved by comparing data in
relevant record forms (i.e. registers or
tallies) and the HMIS reports.
▪ Used by Department of Health and
hospitals
✓ Routine Data Quality Assessment (RDQA)
Methodology
▪ Use at health facility level
▪ Helps to perform data accuracy at
administrative level by enabling
quantitative comparison of recounted
data to reported data
▪ Helps to assess reporting such as under
or over reporting on the data
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LESSON 9: HOSPITAL INFORMATION SYSTEM • EMRs and EHRs are some programs where PIS is
deployed and extensively used
Hospital Information System (intro in the 1960s) Offer support 24/7 to facilitate easier usage of the
Definition: Is a computer system structured to manage system by health care professionals
all the records of health care providers to make
available information and reports useful to health care Radiology Information Systems (RIS) Can provide
personnel in doing their job more efficiently billing services and appointment scheduling aside
from reporting and database storage
In the past: it was mainly for billing and inventory

Today: system is integrated with other financial,

scientific, and administrative programs

Should be: affordable, scalable, and centered on the Pharmacy Information System (PIS)
needs of patients and medical personnel, and Function: Help monitor the utilization of medicines in
health institutions and provide information to identify
adaptable to rapid technological changes.
drug interactions which helps in administering the
Customizable to the needs of the departments
appropriate drugs
Function: Gather, process, retrieve patient info,
Selecting a Hospital Information System
and provide hospital stakeholders with relevant
Total cost of package
information through reports for better decision-
HIS is available for all sizes and budgets for hardware
making. (NOT HIS FUNCTIONS but general functions)
and software
• Has applications built to address the needs of the
Web-based system
various departments of health facilities.
Available in the internet, authorized personnel can
• Provides enhanced integrity of facts, minimization
access the info, data sharing between hospital is
of transcription error and duplication of records,
possible, and can facilitate access to info from other
and shorter TAT for reports
health facilities upon request
• Advancement and new developments will be
rendered useless if the system is not user-friendly Implementation and support
and training is inadequate Provides ample training and assistance to the users of
• A person can access different HIS as long as the the system. Consider HIS provides that offer 24/7
person is affiliated to the HIS or has the support
permission to do so.
HIS Providers in the Philippines
HIS for Different Departments BizBox (1994)
Nursing Information System (NIS) Company’s goal is to improve work efficiency in health
Function: Handling of personnel schedules, accurate care institutions through software systems, and to
patient charting, and better clinical data integration produce advanced solutions for netter patient care.

• To obtain cost-effective staffing and show staffing KCCI Medsys (Kaiser-dela Cruz Consulting, Inc.)
levels • Specializes in application development for
• Patient charting applications allow better analysis hospitals, industrial clinics, and medical-related
of critical signs educational institutions
• Useful in designing the patients’ care plan since • MEDSYS for hospitals and MEDSCO for schools
the medical info integration function allows nurses Comlogik (1999)
to collect and examine retrieved medical records • PH-based software development company with a
Physician Information System (PIS) vision to be a global technology company
Function: to improve the practice of physicians • Led the way in developing innovative applications
HIS Functions
Help Desk
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Clients are provided with info and guidelines • As the process of managing contract creation,
associated with a company’s or institution’s products execution, and analysis to maximize the
and service without any hassle operational and financial performance of an
organization while reducing financial risk
Scheduling
• A very time-consuming element of business, which
Managers and employees can effectively discuss their
facilitates the need for an effective and automated
scheduling preferences anywhere through scheduling
contract management system
software.
Contract management Strategy
Patient Registration
Realization of expected business benefits and
• Patient registration form records the name, age
financial returns
gender, marital status, and other relevant
• Cooperation and responsiveness of the supplier to
information regarding the patient. (Demographic
the organization’s needs
Data)
• No contract disputes or surprises
• Information are used for record keeping and
• Satisfactory delivery of services to both parties
account management purpose
Package Deal Designer
Admission
Post-diagnostic package deal
• Admissions counselor will call him or her to
Posting diagnostic medical packages for in-patients,
gather preliminary information, offer vital info
out-patients, and emergencies requires the same
concerning the hospital stay, and answer
process; difference is that for emergencies.
questions if there are any
REPORTING
• Other routine test can also be carried out on the
day of admission Laboratory Reporting
 The point at which a person enters hospital as a Administrative Data or clerical Information
patient (inpatient to be specific) Date when report was Test report date
printed
Discharge Name and address of Patient name and
• Releasing of patient from the health facility by the the laboratory location identification number or a
person authorized to release the patient where the test was unique patient identifier
• Details services needed to be administered after performed and identification number
the hospital stay to ensure the fully recovery of the Name of doctor or
patient legally authorized
person ordering the
Transfer test(s)
• The movement of an individual outside of the Info about specimen and the test itself which
hospital premises at the instruction of any makes the lab report more meaningful
authorized hospital personnel.
Test results Critical results
• DOES NOT encompass movement of the Condition of specimen Abnormal test results
deceased, or leaves the facility without
Name of the test Interpretation of results
authorized performed
permission
Billing Laboratory accession Specimen source (if
• Shows all records pertaining to the invoices, number applicable)
payments, and the current balance of a patient’s Reference intervals (or Deviations from test
account. reference ranges) preparation procedures
• It is a good practice to generate the billing Medications, health Units of measurement
statement on a regular basis so that the institution supplements, etc. taken (for quantitative results)
could keep track of its collectables. by the patient
Date and time of
Contract Management specimen collection
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• Utilize barcodes and RFID tags with precise
identification numbers assigned for each inventory
Radiology Reporting
object to enable accurate tracking and control
An official medical document that provides the details
• Automatic stock management also assist health
of the requested radiology examination and the
care institutions in figuring out whether
procedure conducted by the radiologist
merchandise has been recalled or damaged and
The main objective of the report is to address the should not be given to patients
queries in the request • Accountable for receiving materials, retaining
central stock, and delivering supplies within the
The findings should take into account both positive and
institution
negative findings
Management Reporting
Basic Sections of Radiology Report
• A platform for reporting and controlling info
• Administrative • Patient • Clinical history info
valuable to the institution
identification
• Imaging • Comparisons • Summary or • Provide non-monetary info which enables the
technique impression management to have an oversight of its operations
• signature of radiologist • Data redundancy and data quality issues are
minimized
A good management reporting system enhances
Cardiology Reporting
the capability of an institution to be more
Contain important medical information based on the
responsive, efficient, and effective in
test results of the patient which are set against past
decisionmaking which affects the performance of
medical records
the institution as a whole
Transthoracic echocardiography (TTE) report • Offer a single holistic view which highlights high
components value sources and eradicates the lack of visibility
in reviewing the performance of the institution
In-Built Tally Interface
[Link]
Tally.ERP9 – a software that provides simplified
4/
solutions to operations in health institutions such as
Cardiology information system (CIS) or registration, accounting, inventory management, tax
Cardiovascular information system (CVIS) management, among
other
 a system that provide dynamic reporting (images,
informatics, measurements, etc) that are
structured in a template-type format for efficiency
and consistent delivery of patient report
• vascular sonography reports are accurately
created with only a few clicks
• reports could include ultrasonic ultrasound and
diagrams
Materials Management System
Materials management
• Primarily concerned with planning, identifying,
purchasing, storing, receiving, and distributing
materials.
• To guarantee that the right and sufficient materials
are in the right location when needed

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LESSON 10: LABORATORY INFORMATION EHR
MANAGEMENT SYSTEM It is capable of handling patient records and billing
info
Laboratory Information Management System (LIMS)
• Helps in managing clinical laboratory procedures
• Is designed to help process information in medical
research by reducing manual tasks and Mobile
procedures Accepted use of smartphones in the laboratory
 To improve the efficiency of the department’s
Enterprise Resource Planning (ERP)
services and laboratory operations
• Solution is useful in current supplies, calculating
• Mode of lab error Clerical error which could storage capacity, and managing locations
lead to misidentification or possible error results  Is a process used to manage and integrate the
• Useful for pharmaceutical laboratories, biobanks important parts of the businesses (can also be
and genomic testing centers and laboratory used for laboratories)
 Help implement resource planning by integrating
Functional Requirements and Features of LIMS
all the processes needed to run their companies
Sample Management
(or lab) with a single system
• Accurate and detailed records are necessary to
make sure that samples are not lost or mixed up. Core Components of LIMS
• Electronic laboratory • ERP Software
LIMS recorded and stored information: notebook
o Who the sample was taken from? • Sample management • Workflow tools
(Demographic Data) o programs
What is the sample taken? o • Record management • Process execution
Who is working with it? o software
Who handles the sample? o • Best practice and• Applications to interface
Where does it go next? compliance database with analytical
o How do you store these samples? (Samples • Client tracking instruments or data
applications systems
may vary in storing procedure and
requirements)
Laboratory Standards
o When does it need to move?
Occupational Exposure to Hazardous Chemicals in
• A record should show whether the sample meets laboratories Standards (by Occupational Safety and
the acceptable values Health Administration (OSHA))
• Regular samples are stored for 3 days only, • It specifies the mandatory requirements of a CHP
samples with special request or significant value
could be kept for a longer period Laboratory – a workplace where hazardous
• Regular samples are kept more than 3 days if chemicals are used and stores small quantities of
there are certain delays hazardous chemicals
• RFID or barcodes in recording and updating logs Lab conditions that should be met when using
and track the chain of custody of the sample hazardous chemicals:
Workflow Management • The manipulations of chemicals should be on
Used to automate records and workflows which saves "laboratory scale" only and can be handled by one
time person.
• There is the use of multiple chemicals and
Reporting procedures.
The most frequently used instrument, the average • The procedures should not simulate any
handling time of sample, and list of backlogs are production process.
useful in data analysis and formulation of
recommendation for future policymaking
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•
• Protective laboratory tools are available and  Money owned by the company (for providing goods
proper practices are followed to minimize or service) that the customers haven’t paid
• potential exposure to harmful chemicals. • generate specific or complete accounts receivable
• Any hazardous use of chemicals which does not reports,
meet this definition is regulated under other monitor balances for reconciliation and audit
standards. Examples are purposes,
• chemicals used in the maintenance of the • export data to other accounting systems, and •
laboratory building, customize reports according to specifications.
• production for commercial sale, and" • testing of
a product for quality control.
Worklist and Workflow
Chemical Hygiene Plan (CHP) • Assists laboratories in setting priorities of current
• Discuss all aspects of the laboratory standards workloads based on analyst and instruments
should be formulated if the standards apply availability
• Address the proper purchase, storage, handling, • Allows the user to track a sample, a batch of
and disposal of the chemicals used in the facility samples, or numerous batches through their
lifecycle
CHP Elements (Summarized)
• Queuing – done by sample or by workflow which is
Establishment of Monitoring of the work
a block of repetitive procedures in a certain
standard operating environment
process
procedures (SOP)
• Allowing users to plan workload schedules and
Statement of plan Designation of personnel assignments, and employee information and
LIMS Application training.
Patient Registration • Ultimately, the worklist and workflow functions
• When a patient arrives at the hospital, the operate to facilitate more efficient laboratory
admission clerk will take some basic info and will processes
guide him or her to a registration window
• Done before taking sample/s from the patient Quality Control
To verify whether the instrument is working within
Billing prescribed parameters
• Process of generating statement of accounts or Types of Result: Patient Result and Quality Control
billing statements of in-patients. out-patients, and result
emergencies Results can be: Qualitative or Quantitative or Semi-
Contract Management Quantitative
• To manage the bill and payment aspects of their • Enables users to set standards about the relevant
activities and to create statistical and billing range of patient test results or to extract test
reports on a par with the laboratory and result information for the purpose of quality
management needs assurance.
• Provide parameters for a flexible price schedule • Outliers and deviations can be flagged, and
and enable heightened attention on customer appropriate warning signals can notify users about
needs issues which might involve the quality of the
• Automate billing processing, hasten collections, samples or the equipment currently in use
and offer marketing tools Levey Jennings chart – designed to detect, reduce, and
Accounts Receivables correct deficiencies in a laboratory’s internal
• Can easily extract information which was already analytical process prior to the release of the patient
available from the invoicing and contract results
management procedures Barcode -generation,
Printing, and Reading
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•
• Enable a fast and easy method to identify tubes,
samples, documents, and many others
• Can be customized to suit the organization’s or
classification needs

In-built Bi-directional Interfaces with Equipment

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• A two-way communication between the information system and the clinical instrument is
required
• Minimizes the time spent in programing the order into the analyzer to enhance
productivity, and the elimination of errors usually committed in the manual process
ensures accuracy
• Machines also have the random access testing feature and barcode label scanning for
specimen

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LESSON 11: OTHER HOSPITAL INFORMATION 4. EHR Integration

SYSTEMS • Enhancement of the quality of services by offering
Cardiology Information system a more comprehensive view of the patient care
• Mainly focused on the storage and retrieval of spectrum
cardiology-centric images Radiology Information System
 Receives an order with patient demographics from • A network system used in managing imagery
other information management systems and associated data in the radiology department
 Images are profiled based on the order and stored  The system tracks the orders and billing
for further distribution, viewing, and long-term information of the requesting department
archiving  Uses PACS for the storage and management of
 The information used by cardiologist for the medical images and VNA to manage image
diagnosis and treatment of illnesses varies from archives and for record-keeping and billing within
personal notes, to signals, images, and reports a HIS
from investigations and procedures Benefits of CIS  Integrated in referring to the doctor’s HER system
(EFE)  Allows faster processing of payments
1. Ease of Access while Maintaining Data Security  Permits reports to be easily generated and sent to
• Consolidates multiple types of patient’s cardiology the requesting department Functions of RIS
info (PPRIBS)
• Eliminates the need for doctors to request • Patient Management
different imaging results from different Tracks the patient’s entire workflow and can add
department images and generate reports to EHRs
2. Flexibility in the Workflow • Patient Tracking
• Asses ad wide array of info without having to leave Tracing the patient’s radiology history starting
the patient’s bedside and offer mobility to from admission to discharge and coordinating it
physicians and nurses with his or her past, present and future
3. Enhanced Comparability appointments
• Comparability enables health care professionals to • Results Reporting
make more informed decisions on their patient’s it is possible through the statistical reports
treatment generated by RIS
• Retrieval of past data is convenient Benefits of CIS • Image Tracking
(ERVE) RIS-PACS systems managed by radiology
1. Editing, viewing, storing Multi-modal departments cover the entire clinical workflow of
Cardiology Data the medical enterprise
• Different types of data (CT, MRI, PET, SPECT, AND • Billing
angiography) may be managed on a single platform Made convenient through the system’s financial
2. Remote Access record keeping and processing of E-payments and
• The use of networks and integrated information automated claims
systems and modern technology offers flexibility to • Scheduling
CIS Allows staff to schedule appointments for
3. Visualization and Reporting Capability inpatients and out-patients
• Visual real-time info retrieval is possible anytime
and anywhere making reporting an ease and
consistent

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