Hospital, Laboratory, and Materials Management Information Systems

Online Hospital Platform

Many tertiary hospitals allow patients to bypass primary healthcare providers by making online appointments directly
quickly. The figure below shows the medical consultation process for an internet hospital in China. Some form of
gatekeeping within the digital health system is needed to maximize its efficiency, where a platform on an online
appointment is one of them. This encourages hospitals to provide primary care and a referral system for patients with common
conditions and chronic diseases through online platforms. This approach also acts as a triage system for hospital services. The
platform could be used to empower primary healthcare providers in the interaction between patients and the healthcare
system. The platform should also facilitate online communications between primary healthcare providers and hospital
physicians, allowing for more efficient triage than when patients self-refer. However, it is not yet clear whether this model
can improve the coordination of services, reduce pressure on secondary and tertiary hospitals, and maximize efficiency (Wu et
al., 2019).

Based on the a
 Hospital Information System
A Hospital Information System is an integrated information system that improves patient care by increasing
users’ knowledge and reducing uncertainty, allowing rational decisions to be made from the information provided.
Thus, there are two keys to this definition:
 It is integrated among other applications and technologies; and
 It delivers the information necessary to the professional in a usable format to allow him/her to make life-saving decisions
accurately and promptly.

The architecture of the Hospital Information System

The figure below describes the HIS architecture, where hospitals are required to implement HIS core modules that consist
of at least registration, order communication system (OCS), medical record, billing, as well as emergency, inpatient, and
outpatient unit module.
Order communication system (OCS) modules assist medical staff in performing medical procedures that need to be
performed according to the disease suffered by the patient.

1.
2.

3. Hospital Information System for Different Hospital Departments

a) Nursing Information Systems - Nursing information systems (NIS) are developed to enhance patient care by
providing nurses with accurate information to assist them in their duties more efficiently. An NIS carries out
numerous functions, including the handling of personnel schedules, accurate patient charting, and better clinical data
integration.
b) Physician Information Systems- Physician information systems (PIS) are designed to improve the practice of
physicians. Electronic medical records (EMRs) and electronic health records (EHRs) are some programs where PIS
is deployed and extensively use. Most systems offer support 24/7 to facilitate easier usage of the system by health
care professionals.
c) Radiology Information Systems- Radiology information systems (RIS) are capable of providing billing services and
appointment scheduling aside from reporting and database storage. Technological advances have made the
practice of radiology more complicated such that more and more hospitals turn to RIS to address the commercial
concerns of their radiology departments.
d) Pharmacy Information Systems- Pharmacy information systems (PIS) help monitor the utilization of medicines in
health institutions; the system also handles information on medication-related complications and drug allergies of
patients. It provides information to identify drug interactions, which helps in administering the appropriate drugs by
considering the physiological conditions of the patient.
e) Laboratory Information Systems – to be discussed in Unit 2
4. Selecting a Hospital Information System
The following are the aspects needed to be considered in selecting an HIS:
a. The total cost of the package – HIS is available on the Internet, which means that authorized personnel
providers may reduce upfront and maintenance fees by using a design that requires fewer servers and
hardware.
b. Web-based system – The system is available on the Internet, which means that authorized personnel can
access the information anywhere and anytime. It also allows data sharing between hospitals. A hospital with
updated patient history in its system can facilitate access to information from other health facilities upon
request.
c. Implementation and support – During the deployment or upgrade of the HIS, it is imperative that the
vendor provides ample training and assistance to the users of the system. Consider vendors that offer 24/7 support
through telephone or web services

5. Functions of the Hospital Information System

A. Help Desk, Scheduling, Patient Registration
1) Help Desk – The help desk becomes more efficient through the HIS because the manual retrieval of
information is no longer needed. Clients are provided with information and guidelines associated with a
company’s or institution’s products and services without any hassle.
2) Scheduling – Managers and employees can access work schedules from anywhere they are and
effectively discuss their scheduling preferences through the HIS. Employee scheduling software helps
save time and makes employee scheduling less difficult.
3) Patient Registration – The HIS patient registration form records the name, age, gender, marital status, and
other relevant information regarding the patient.
B. Admission, Discharge, and Transfer Procedures
1) Admission – Before a patient is admitted to a health facility, an admissions counselor will call him or
her to gather preliminary information, offer vital information concerning the hospital stay, and answer
questions if there are any. Additionally, the physician may also schedule recurring medical exams, such
as laboratory tests or X-rays, before hospitalization. Other routine tests can also be carried out on the day
of admission. All these can be done more efficiently through the HIS.
2) Discharge – Through the HIS, instructions that accompany a patient’s discharge or transfer are more
efficiently provided. These instructions may include discharge planning, which details services needed to
be administered after the hospital stay to ensure the full recovery of the patient.
3) Transfer – The term ‘transfer’ means movement (along with the discharge) of an individual outside of
the hospital premises at the instruction of any authorized hospital personnel. This, however, does not
encompass the movement of an individual who (a) has been declared lifeless, or (b) leaves the facility
without the permission of any such authorized person. If a patient is transferred from the emergency
room, employees must fulfill the statutory requirements for a proper switch. With the HIS, patient
transfer details are easily accessed and processed.
C. Billing, Contract management, and Package Deal Designer
1) Billing – Billing statements show all records on the invoices, payment, and the current balance of a
patient’s account.
2) Contract Management – Contract management is the process of managing contract creation execution
and analysis to maximize the operational and financial performance of an organization while reducing
financial risk. Organizations regularly encounter pressure to reduce costs and improve company
performance. Contract management proves to be a very time- consuming element of business, which
facilitates the need for an effective and automated contract management system. When a contract
management strategy is successfully implemented, organizations can expect to see the following:
 realization of expected business benefits and financial returns
 cooperation and responsiveness of the supplier to the organization’s needs
 no contract disputes or surprises
 satisfactory delivery of services to both parties
3) Package Deal Designer – Posting diagnostic medical packages for inpatients, outpatients, and
emergencies requires the same process; the difference is that for emergencies, this is called a post-
diagnostic package deal. HIS help in accessing information regarding package deals without going
 through the hassle of paperwork.

D. Laboratory, Radiology, and Cardiology Reporting

1) Laboratory Reporting – Despite differences in presentation and form, all laboratory reports must possess
common elements as required by institutional and company policies. They may also contain supplementary
items not specifically require, but which the laboratory chooses to report to aid the interpretation of
results of medical testing. For identification and filing purposes, some laboratory reports display
elements with administrative or clerical information such as the following:
 Patient name and identification number or a unique identifier
and identification number
 Name and address of the laboratory location where the test was performed
 Date when the report was printed
 Test report date
 Name of doctor or legally authorized person ordering the test(s)

Information about the specimen and the test itself, such as those included below, are other elements that
make a laboratory report more meaningful:
 Specimen source (if applicable)
 Date and time of specimen collection
 Laboratory accession number
 Name of the test performed
 Test results
 Abdominal test results
 Critical results
 Units of measurement (for quantitative results)
 Reference intervals (or reference ranges)
 Interpretation of results
 Condition of specimen
 Deviations from test preparation procedures
 Medications, health supplement, etc. taken by the patient

Material Management System – Pharmacy, Main Stores, and Purchase

1) Materials management is primarily concerned with planning, identifying, purchasing, storing,
receiving, and distributing materials. Its purpose is to guarantee that the right and sufficient materials in
the right location when needed.
As such, the automation of an inventory or a materials management system is necessary for a hectic health
center to streamline the hospital supply chain.
2) Management Reporting – Today, management reporting is not limited to data retrieval. It has become
a platform for reporting and controlling information valuable to the institution. Recent technological
advancements help management reports to provide non-monetary information, which enables the
management to have an oversight of its operations. In the same way, these advancements pave the way
for the emergence of management reporting systems. These systems capture the necessary data required
by the management to operate more efficiently. With this, data redundancy and data quality issues are
minimized.

LABORATORY INFORMATION SYSTEM

A laboratory information system (LIS) is a computer network of hardware and software for receiving, processing,
and storing laboratory data and information.
An LIS is also a computer-based information management system created specifically for laboratories. An LIS is used
to support workflows in the laboratory — as well as the repository to store laboratory data — while supporting the
laboratory mission. The goal is to deliver correct and complete information to laboratory staff, managers, and
customers as efficiently as possible by following four main processes.
1) Track laboratory information during the testing process (from sample login to reporting);
2) Collect, store, archive and analyze laboratory data;
3) Report test results for patient care; and Report data to administration and other agencies
 Health Information System Providers in the Philippines

I. BizBox
Bizbox, Inc. was founded 25 years ago. Its very first hospital project was completed in 1994. The goal of the
company is to improve work efficiency in health care institutions through software and to produce advanced
solutions for better patient care.
Today, it is among the top IT companies in the health care industry. Aside from being a certified
Microsoft Gold Partner, it has also received the Independent Software Vendor (ISV) of the Year Award. It
has fully integrated systems such as electronic health records (EHR) and document management system
(DMS) that will streamline tasks and help provide better health services.

II. KCCI MedSys

Kaiser-dela Cruz Consulting, Inc. specializes in application development for hospitals, industrial
clinics, and medical-related educational institutions in the Philippines. Its products, Visual MEDSYS for
hospitals and EDSCHO for schools, provide integrated, comprehensive, and proven solutions for efficient
health care practices.

III. Comlogik
Comlogik Business Systems, Inc. is a Philippine-based software development company thaw was
established in 1999, with a vision to be a global technology company. Comlogik led the way in developing
innovative applications like online hospital services in which patients can access their billings and examination
results. In contrast, administrators can access reports, and doctors can access patients’ records anywhere and
anytime.
 MATERIALS MANAGEMENT INFORMATION SYSTEM

Introduction to Materials Management Information System

The management function of hospital materials – that is, to ensure that services are rendered successfully
from one source to an end-user – covers several areas of the hospital and could drastically affect the expenses of the
medical institution.
Laboratory Inventory Management
1. The objective of an efficient laboratory is to experience a few shortages in testing reagents, supplies,
and materials.
2. Requisitions for contract and purchase orders to obtain necessary quantities of materials, etc., in
suitable time frames
3. Managers are responsible for purchasing laboratory instruments and service contracts to maintain
installments.
4. Instrument selection includes technical evaluation and cost comparison of instruments from
various instrument manufacturers.
5. Many hospital laboratories contract with outside agencies to provide blood products for patients.
6. Hospitals contract with outside companies to manage biohazardous waste and hazardous waste
disposal.
i. Purchasing
A purchase request marks the beginning of the procurement process. Using this form, the user
notifies the purchasing department regarding the needed items and services. It contains the quantity, as well
as a timeframe for the items requested. It has the necessary authorization information to proceed with the
purchase. The requested items are then confirmed using the purchase order, and a supplier is nominated.
Once completed, the order is sent to the supplier for processing.
Finally, the items are checked during the receipt of the delivery. The receiver, which is usually the
Central Supplies department, uses the purchase order as a basis for accepting the delivered items that should
be checked for indents and damages. Afterward, the said items are then released to the requesting
department.

ii. Inventory Control

Inventory is one of the most significant expenses for most medical institutions. Inventory controls
play an important part in refining the quality of health care since the lives of people are on the line, and
medical costs are increasing.

Strategies in improving inventory control in the health care facility:

a. Ensuring Shipment Accuracy – Checking shipment for accuracy means ensuring that the received items
are the ones ordered and the supplies are free from possible damages during transit.
b. Aligning with Sales Projections – Coming up with an inventory tracking report in comparison with
actual sales proves to be a challenge in the field of medicine. However, it is necessary to prevent
wastage, identity trend and ensure that there is no excess inventory.
c. Complying with Regulations – The health institution should be responsive to the current trends and needs of the
highly-regulated health care industry. The regulators monitor health institutions and determine the success or
failure of companies to serve the best interest of the patients.
d. Establishing Buying Cycles – The buying cycle (also known as a purchase cycle) is the process a
customer goes through when purchasing a product or service. Customers move through a series of
purchasing stages in the cycle as they educate themselves and move closer to making a final purchasing
decision. Buying cycles should be determined and understood by inventory personnel based on the
previous cycles so that inventory ordering becomes manageable through the elimination of shortage and
overages. The said cycles determine the trends and adjustments that can be made accordingly.
Items Intended and Issues
There are some instances when items are damaged either upon receipt from the supplier or
during the move from the source to another location. Some suppliers allow returns of 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 products for sale are fast-moving. Typically, damaged items
are moved to another warehouse for them to be monitored.

iii. Reorder Level and Minimum and Maximum Inventory Ordering

In a typical materials management system, reorder level is the minimum quantity of an item that a
company has in stock, so when the stock reaches the stated minimum quantity, the item must then be
reordered (purchase order/production order).
A basic reordering 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 reorder, and the “Max” value is representative of a new targeted stock level that follows the reorder.
The main difference between these two – Max and Min – is often interpreted as the economic order quantity
(EOQ). Although the Min/Max method is an unpolished method for inventory ordering, its settings could be
adjusted to provide better inventory performance.

iv. Enquiries and Quotations for Drugs, Consumables, Assets, and General Items
The following documents are required in the materials management process:
a. Enquiries – the enquiries mark the beginning of the purchasing process. These establish the relationship
between the entity and the right supplier. The supplier provides information on the availability and
price of the required items.
b. Quotations – quotations contain vital information regarding the requirements, which include price,
delivery details, payment terms, etc. Companies usually review two to three quotations before selecting
the supplier.
c. Orders – The buyer shows the intention to purchase the required item by issuing a purchase order. A
purchase order is placed to signify intention to engage in commercial operations for a specific product
or service. Upon agreement, the order becomes a contract between the health care institution and the
supplier.
d. Invoices – An invoice is also called a bill. It is a commercial document that indicates the product, the
ordered quantity, and the agreed price. The supplier issues this to the buyer to show the products and
services that were sold or provided to the buyer.
e. Documents – Documents are statutory requirements used during purchase and sales transactions. These
ensure smooth transition and completion of the process.

v. Comparison of Quotations and Preferred Vendors

Purchase Quotations
- A purpose quotation is a document for requesting prices and delivery information from a vendor
before the purchase order. It can be created then sent to a vendor. When a response from a vendor is received,
with a list of prices and delivery dates, the information can be entered into the purchase quotation.

Preferred Vendors - Companies typically maintain a list of preferred vendors, from whom inventory items are
usually purchased. They look for a vendor who has on-time performance, offers reasonable costs, provides high-
quality products and services, offers fully licensed, bonded, and insured products and services, and has business
practices.

vi. Purchase Request, Orders, and Approval

Purchase Request – 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 requested items.
Purchase Orders – A purchase order is a legally binding contract, which shows that the seller has already
accepted the order issued by the buyer. It should contain information about the buyer and seller (name,
address, contact details, etc.); order number and order date; item description (quantity, unit, and total price);
shipping information (shipping date and address); billing address; and the authorized signature.
Approval Process – The person who creates the document, either a purchase request or order, is the
originator. When the said originator adds document/s to the materials management system, the system
checks for any approval requirements. If the documents fail to meet the approval requisites, the originator
 is notified that the document needs approval. The document is temporarily saved as a draft.
When the approval process is launched, an internal request is immediately sent to the first approval
stage. 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. An internal
notification goes back to the originator with a link to the rejected document when the approver rejects the
document. The originator can amend the document, and the approval procedure will continue until the
conditions are adequately satisfied.

vii. Receiving and Tracking Items

The following policies should be followed for the proper receipt and inspection of goods:
a. Signing for Deliveries – the person who receives the delivery should inspect the delivered items before
signing the receiving document and the packing list. Then the document should be submitted to the
appropriate department for reconciliation.
b. Refusing delivery – the receiving department should refuse to accept any shipment if the packaging appears
to be damaged or if there is any item that does not have a corresponding purchase order.
c. Record Retention – the packing list should be provided to the receiving department during delivery to
ensure that there is proper documentation since it is are taking possession and legal ownership of the
delivered items. If no list was provided, the department should request a copy from the supplier. All files
should be kept according to the entity. This helps track partial and staggered deliveries.
d. Inspecting a Shipment – the person receiving the items should inspect the goods to ensure that the
following minimum conditions are met:
1) The received items match the requirements stated in the purchase order (type, description, color, etc.).
2) The quantity is correct.
3) The item has no damage, discoloration, and issues.
4) The quantity per unit of measurement is accurate (e.g., one dozen = 12 pieces).
5) Packing lists, certifications, and other delivery documentation are completely provided.
6) Perishable items should be in good condition and have not reached the expiration dates.
7) The items are functioning properly.
e. Partial Deliveries – when items are delivered partially without proper notification from the supplier, the
receiving personnel should advise the Purchasing department for approval and further instructions. This should
also be typically noted in the packing list or the receiving document.
f. Tracking of Goods – Goods can be easily tracked/traced when they are managed by serial number or batch.
Through that, the aging of products can also be monitored based on how long they have been in the
warehouse.

viii. Purchase Returns along with Returnable/Non-Returnable Gate Pass

Defective or substandard quality goods, incorrect order delivery, and deteriorated purchased and sold
items are usually common in business. These lead to purchase or sales returns. When purchased products are
returned, the materials management system updates inventory levels to reflect the decrease in quantity.

ix. 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 in the consignee’s premises. The vendor maintains legal ownership until such
materials are removed from consignment stores. The invoice is due at predetermined material after a certain
period.

x. Stock and Quarantine

Expired Stock/Inventory
- Upon reaching their expiration dates, some goods, such as food and medicine, can no longer be utilized. In
a rare instance, they may be sold to other parties at lower costs. Expiration dates and decrease in values of
items must be reflected in the financial records, so discrepancies in financial statements will be prevented.

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 house them until a final decision is reached
temporarily.

xi. Drugs and Consumable Issues and Returns to Patients

30 to 50 % of hospital charges are attributable to diagnostics, drugs, and consumables, and doctors get
only between 10 to 20 percent. For both hospitals and patients, medicines and consumables take up the
bulk of expenditure. This is why materials management is critical for hospitals to optimize investment in
these kinds of consumable assets.

xii. Issue Methods

Inventory management is a crucial function for any product-oriented business.
Common inventory handling methods include:
a. First In, First Out (FIFO) – inventory items are sold based on the order they are purchased. This is
the most common technique.
b. Last In, First Out (LIFO) – last items to enter the system are sold first. This is common among non-
perishable items like petroleum, minerals, and metals
c. First Expired, First Out (FEFO) – materials are sold based on the dates they should be consumed,
regardless of when they were purchased.

xiii. 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 tax regulations to place an accurate value on
the inventory, or the business may need to count inventory so parts or raw materials can be restocked.