Health Information System Lecture PDF

HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT MISSION, VISION, CORE VALUES, VISION STATEMENT AND OBJECTIVES OF THE...

HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT MISSION, VISION, CORE VALUES, VISION STATEMENT AND OBJECTIVES OF THE The end desire aspiration of an INSTITUTION academic institution. Usually a one-sentence statement LEARNING OUTCOMES describing the distinct and motivating Definition of Vision, Mission, and Values. long-term desired transformation Comparison of Vision and Mission. resulting from an institutional program. Purpose and Inclusion of Vision and Should be clear, memorable and concise Mission. with an average length of 14 words, with Understanding of the Value Statement. the shortest of 3 words and longest of EDUCATIONAL INSTITUTION 26 words. A place where learners of different ages gain TUA’s Vision: A Premiere Christian education. University in Asia and the Pacific, Carries out educational activities based on the age grade system provide considerable transforming a community of learners diversity of learning milieus and learning into leaders towards a humane society. spaces. MISSION STATEMENT TWO TYPES OF EDUCATIONAL Is a one-sentence relating to the INSTITUTION intention of your institution's existence. FORMAL- conventional classroom setup Answer the questions “What do you do?” whereby a governing body administers a or “Who do you do this for?” structured learning method, and a Must be clear by using simple language, school or other institutions are the usual concise, which aims for 5 to 14 words places for learning. (maximum of 20 words); and valuable, INFORMAL- anything learned that is informed, focused, and guide. independently outside of the conventional classroom. VISION STATEMENT MISSION STATEMENT FUNCTION It inspires to give the best and Defines the key measure of shapes your understanding of why the institution’s success. you are in the institution. DEVELOPING When do we want to reach What do we do today STATEMENT success? Where do we want to go forward? For whom do we do it? How do we want to do it? Why do we do it? TIME Futuristic Talks about the present. QUESTION Where do we aim to be? What makes you different? Where do you want to be? How will you get where you want to be? Ezekiel mark t. Adduru |tua - cmt|1  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT VALUE STATEMENT To facilitate the formation of the Is a list of fundamental doctrines that students into the medical technology guide and direct the educational profession, guided by the values of institution and its belief. integrity, excellence, respect, and dignity. Creates the moral direction of the Foster a culture of research among institution and its academic community students and contribute in diagnostic that guides decision-making and creates and laboratory medicine. yardstick against any action. To cultivate a nurturing and engaging Ask the following questions: environment for the holistic ○ What values are distinct to our development of students and academic educational institution? staff. ○ What value should direct our To enable students to lead a “life for institution? others” through their constant care for TUA’s Values: Integrity, Excellence, hospital patients and active Teamwork, Innovation, and Social participation in the various community Responsibility. outreach activities of the college. OBJECTIVES Educational Objectives, or goals, are THE HEALTH CARE SYSTEM short statements that learners should Roemer (1991) defined health systems achieve within or at the end of the as “the combination of resources, course or lesson. organization, financing and Must follow the SMART criteria: management that cultivate in the ○ SPECIFIC delivery of health services to the ○ MEASURABLE population.” ○ ATTAINABLE In a World Health Organization Report ○ REALISTIC (2000), the health system was defined ○ TIME-BOUND as “all the organizations, institutions and resources that are devoted to producing CMT OBJECTIVES health actions.” To develop the dexterity of the students in the technical procedures of medical 6 IMPORTANT BUILDING BLOCKS OF technology. HEALTH CARE SYSTEM (WHO) To strengthen the student’s sense of Service Delivery accountability and dedication in the use Human Resource of medical laboratory science. Medicines and Technology To enhance the leadership skills, and the Financing internationalized and intercultural Information competencies of students for a Leadership and Governance harmonious working relationship with ○ The Health Care System in the the professionals globally. Philippines is led and governed by the Department of Health (DOH). Ezekiel mark t. Adduru |tua - cmt|2  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT *Department of Health (DOH)- Oversees the 4 VITAL HEALTH SYSTEM FUNCTIONS health care, public health, and medical HEALTH SERVICE PROVISION needs and requirements of the Filipino. It is the most visible product of the healthcare system. GOALS AND FUNCTIONS OF A HEALTH Health service- any service which aims CARE SYSTEM to improve wellness of the population. 1. IMPROVING THE HEALTH OF Offer services which provide Preventive, POPULATIONS Diagnostic, Treatment, and Population must be protected from Management/Rehabilitative. existing and emerging health risks. HEALTH SERVICE INPUTS Example: Measles, Polio, Dengue, Generating the essential physical Leptospirosis, Tuberculosis, HIV and resources for delivery of health services. COVID-19 ○ Policymakers Equity in Health system (without ○ Human Resources (Medical Doctors, reservation and absolute disparity) Hospital Personnel) ○ Giving priority to those who have ○ Supply of medicines less to give. ○ Medical equipment ○ Giving importance to those who STEWARDSHIP cannot provide for themselves. It is the overall system that sets 2. IMPROVING THE RESPONSIVENESS OF direction, context and policy framework THE HEALTH SYSTEM for overall health systems. Responsiveness- Providing satisfactory Core of stewardship includes: health services and engaging people as ○ Identifying health priorities for active partners. allocation of public resources Embodies the values of: ○ Identifying an institutional ○ Respectfulness framework ○ Dignity ○ Coordinating activities with other ○ Confidentiality systems related to external health ○ Autonomy care ○ Quality ○ Analyzing health priorities and ○ Timeliness resource generation trends and their 3. PROVIDING FAIR HEALTH CARE implications FINANCING ○ Generating appropriate data for An ideal health system provides social effective decision-making and and financial risk protection on health. policymaking on health matters. WHO defines fairly financed health HEALTH FINANCING systems as “one that does not deter Involves raising and pooling resources individuals receiving needed care due to to pay for health services. payments required at the time of service.” Ezekiel mark t. Adduru |tua - cmt|3  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT funded by individuals and employers. (Germany) ○ The National Health Insurance Model- Private hospitals, bills paid by the government, and are funded by taxes (Canada). ○ The Out-of-Pocket Model- Private hospitals, bills paid and funded by A. REVENUE COLLECTION individuals. (US [uninsured Earnings coming from health care population]) services. PHILIPPINE HEALTH CARE SYSTEM Mechanisms for revenue collection: ○ PhilHealth ○ General Taxation C. STRATEGIC PURCHASING ○ Direct household out-of-pockets Risk pooling organizations use collected expenditures funds and pooled financial resources to ○ Mandatory payroll contributions finance health care service for the ○ Risk rated contributions members. ○ Donor financing SERVICE DELIVERY ○ Personal savings Refers to timely delivery of quality and Public health system relies on general cost-effective personal and taxation for financing while Social non-personal health services. Security Organizations rely on HEALTH WORKFORCE mandatory payroll contributions from Set of individuals and groups working workers and employees. towards the achievement of best health B. RISK POOLING outcomes by being responsive, fair and A form of risk management which aims efficient. to spread financial risks from an Staff to volume of work ratio. (ensures individual to all pool members. competency and productivity) Core function of health insurance INFORMATION companies. (Health Information System) which Example: Medicard, Pru Life U.K, Sun Life, analyzes, disseminates and uses Maxicare, Etc. reliable and relevant information on It helps families (marginalized) from health status, determinants and system financial losses due to health shocks. performance. (financial protection) HEALTH PRODUCTS, VACCINES AND HEALTH CARE SYSTEM MODEL TECHNOLOGIES ○ Beveridge Model- Public hospitals, Well-managed pharmaceutical service bills are paid by the government, and and education on proper use of are funded by taxes (UK) medication. ○ Bismarck Model- Private hospitals, bills are paid by insurers, and are Ezekiel mark t. Adduru |tua - cmt|4  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT FINANCING 1991: LOCAL GOVERNMENT CODE (RA Health Financing System- takes care of 7160) funding for health care services to Transferred the responsibility of guarantee that people can use health providing health service to local services when needed. government units. 1995: NATIONAL HEALTH INSURANCE ACT LEADERSHIP AND GOVERNANCE (RA 7875) Involves task of ensuring effective Instituted a national health insurance stewardship of the entire health system. mechanism for financial protection with Monitor accountability of the entire priority given to the poor. health system. 1996: HEALTH SECTOR REFORM AGENDA The Department of Health (DOH) is the Ordered the major organizational lead agency for Philippine health care. restructuring of the DOH to improve the According to its mandate (E.O No. 119, way healthcare is delivered, regulated Sec. 3), the DOH is responsible for the: and financed. 1) Formulation and development of 2005: FOURMULA ONE (F1) FOR HEALTH national policies, guidelines, Adopted an operational framework to standards and programs; undertake reforms with speed, precision, 2) Issuance of rules and regulations, and effective condition and to improve licenses, and accreditations; the Philippine health system. 3) Promulgation of national health 2008: UNIVERSALLY ACCESSIBLE standards, goals, priorities, and CHEAPER AND QUALITY MEDICINES ACT indicators; and (RA 9502) 4) Development of special health Promoted and ensured access to programs and projects, and affordable quality drugs and medicines advocacy for legislation on health for all. policies and programs. 2010: KALUSUGANG PANGKALAHATAN OR PHILIPPINE HEALTH SYSTEM UNIVERSAL HEALTH CARE (AO 2010 - 0036) 1979: ADOPTION OF PRIMARY HEALTH Provided universal health coverage and CARE SYSTEM (LOI 949) access to quality health care for all Promoted participatory management of Filipinos. the local health care system. 2019: RA 11223 - UNIVERSAL HEALTH 1982: REORGANIZATION OF DOH (EO 851) CARE (UHC) LAW Integrated the components of health That automatically enrolls all Filipino care delivery into its field operations. citizens in the National Health Insurance 1988: THE GENERICS ACT (RA 6675) Program and prescribes complementary Ushered the writing of prescriptions reforms in the health system. This gives using the generic name of the drug. citizens access to the full continuum of health services they need, while protecting them from enduring financial hardship as a result. Ezekiel mark t. Adduru |tua - cmt|5  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT THE PHILIPPINE HEALTH SYSTEM ○ No one is poor (building predominant middle class society) ○ Promoting long and healthy life ○ Becoming smarter and more innovative. ○ Building a high-trust society Sustainable Developmental Goals 2030 Also known as the 2030 agenda, this compilation of 17 global development targets to end poverty, fight inequality and injustice, and confront issues DIRECTIONS OF THE PHILIPPINE involving climate change. HEALTH SECTOR ○ No poverty The Philippine Health Agenda (DOH ○ No hunger Administrative Order 2016-0038) ○ Good health and well-being “All for Health towards Health for All” ○ Quality education With this agenda, the health system ○ Gender equality guarantees: ○ Clean water and sanitation ○ Population and individual-level ○ Affordable and clean energy interventions for all life stages that ○ Decent work and economic growth promotes health and wellness, ○ Industry, Innovation and prevent and treat diseases, delay Infrastructure complications, rehabilitations and ○ Reduced inequalities provide palliation for both well and ○ Sustainable cities and communities sick ○ Responsible consumption and ○ Access to health interventions production through functional service delivery ○ Climate action works. ○ Life below water ○ Financial freedom using Universal ○ Life on lan Health Insurance ○ Peace, justice and strong institutions The Philippine Developmental Plan ○ Partnerships for the goals 2017-2022 A four-key medium-term plans to PRIMARY HEALTH CARE DELIVERY translate the vision of matatag, SYSTEM maginhawa, at panatag na buhay for FIlipinos in the country. INTRODUCTION NEDA AmBisyon Natin 2040 Alma-Alta Declaration It envisions a better life for all Filipinos ○ The attainment of the highest and the country for the next 25 years by possible level of health is a most formulating policies and implementing important worldwide social goal programs to attain the AmBisyon. whose realization requires the action Focuses on 4 areas: of many other social economic Ezekiel mark t. Adduru |tua - cmt|6  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT sectors in addition to the health ESSENTIAL ELEMENTS OF PRIMARY sector. HEALTH CARE Disparities in people’s health status 1) Education concerning prevailing health should not be politically, socially and problems and the methods of economically tolerated. identifying, preventing and controlling DEFINITION OF PRIMARY HEALTH them CARE 2) Locally endemic disease prevention and Essential health care is made universally control accessible and acceptable to individuals 3) Expanded program of immunization through full participation at a cost the against major infectious diseases community and country can afford. 4) Maternal and child health care including An approach to health beyond the family planning traditional health care system that 5) Essential drugs arrangement focuses on health equity-producing 6) Nutritional food supplement, an social policy adequate supply of safe and basic HEALTH CARE SYSTEM - refers to an nutrition organized plan of health services 7) Treatment of communicable and (Miller-Keane, 1987) non-communicable diseases and HEALTH CARE DELIVERY - rendering of promotion of mental health health care service to people 8) Safe and water sanitation (William-Tungpalan, 1981) OTHER ELEMENTS OF PRIMARY HEALTH CARE DELIVERY SYSTEM - HEALTH CARE network of health facilities and 1) Expanded options of immunizations personnel which carries out the task of 2) Reproductive health needs rendering health care to the people. 3) Provision of essential technologies for PHILIPPINE HEALTH CARE SYSTEM- a health complex set or organizations interacting 4) Health promotion to provide an array of health services in 5) Prevention and control of the Philippines (Dizon, 1997) non-communicable diseases KEY ELEMENTS FOR BETTER PRIMARY 6) Food safety and provision of selected HEALTH CARE food supplements 1) Universal coverage to reduce exclusion PRINCIPLES OF PRIMARY HEALTH and social disparities in health; CARE 2) Service delivery organized around Health systems based on primary health people’s needs and expectations; cares should always be empathized 3) Public policy that integrates health into Primary healthcare is integrated into a all sectors; larger whole and its principle will inform 4) Leadership that enhances collaborative and guide the functioning of the overall models of policy dialogue; and system 5) Increased stakeholder participation. Ezekiel mark t. Adduru |tua - cmt|7  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT A health system based on primary health MANAGEMENT OF PRIMARY HEALTH care will: CARE 1) Build on the Alma-Ata principles of 1) Equitable distribution of health care equity, universal access, community a) Primary care and other services participation, and intersectoral must be equally provided approaches; 2) Community participation 2) Take account of broader population a) Adequate number of distributions of health issues, reflecting and reinforcing trained health care professionals public health functions; 3) Multi-sectoral approach 3) Create the conditions for effective a) Other sector are equally important provision of services to poor and 4) Use of approachable technology excluded groups; a) Must be accessible, affordable, 4) Organize integrated and seamless care, feasible, and culturally accessible linking prevention, acute care, and PRINCIPLES OF PRIMARY HEALTH chronic care across all components of CARE the health systems; and 1. PLANNING 5) Continuously evaluate and strive to Sets direction and determines what improve performance. needs to be accomplished OBJECTIVES TO SUSTAIN PRIMARY Set priorities and determine HEALTH CARE performance targets 1) Improvement in the level of health care 2. ORGANIZING of the community Designs the organizations or the 2) Favorable population growth structure specific division, unit or services. 3) Reduction in the prevalence of Determines position, teamwork preventable, communicable and other assignments and distribution of diseases authority and responsibility 4) Reduction in morbidity and mortality 3. STAFFING rates, especially among infants and Acquiring and retaining human children resources 5) Health Information System for Medical Developing and maintaining the Laboratory Science workforce through various strategies 6) Extension of essential health service 4. CONTROLLING with priority given to the underserved Monitoring staff activities and sectors performance and taking the appropriate 7) Improvement in basic sanitation actions for corrective actions to 8) Development of the capability of the increase performance community aimed at self-reliance 5. DIRECTING 9) Maximizing the contribution of the other Initiate action in the organization sectors for the social and economic through effective leadership and development of the community\ motivation of and communication with subordinates Ezekiel mark t. Adduru |tua - cmt|8  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT MANAGEMENT PRINCIPLES IN FORMALIZATION RELATION TO ORGANIZING Refers to a written documentation provided for the direct control of the AUTHORITY, RESPONSIBILITY, employees. ACCOUNTABILITY AUTHORITY STAFFING Refers assignment of individuals to Formal and legitimate right of a responsible position identified in a manager to issue orders, make management plan decisions, and allocate resources to Determines the competencies required achieve desired outcomes of the for a position through: organization. ○ Identifying key results areas (KRAs) RESPONSIBILITY per major activity in the plan. Duty of the employee to perform the Also includes assigning ort recruiting assigned tasks and activities. staff that qualifies for the ACCOUNTABILITY responsibilities Means reporting and justification of task For existing programs and services, this outcome to higher management by involves: those people with authority. ○ Reviewing and adjusting TYPES OF AUTHORITY (AND competency requirement for each RESPONSIBILITY) major activity with corresponding LINE AUTHORITY managers issue KRAs; orders to their subordinates and are ○ Matching competency requirements responsible for the results. vis-á-vis the responsible person FUNCTIONAL AUTHORITY- is for already assigned to the activity. managers that have power only over a specific set of activities. PHILIPPINE HEALTH CARE SYSTEM STAFF AUTHORITY- is given to a complex set or organizations specialists in their areas of expertise. interacting to provide an array of health The staff manager simply advises, services in the Philippines (Dizon, 1997) recommends, and counsels. Usually THE DOH SHALL BE RESPONSIBLE FOR given on a senior level. THE FOLLOWING: 1. Formulation and development of CENTRALIZATION, DECENTRALIZATION, & FORMALIZATION national health policies, guidelines, CENTRALIZATION standards, and manual of operations for Refers to the concentration of planning health services and programs and decision-making to the top of the 2. Issuance of rules and regulations, organization licenses, and accreditations; 3. Promulgation of national health DECENTRALIZATION standards, goals, priorities, and Refers to the delegation of planning and indicators; and decision-making to the lower branches 4. Development of special health programs of the organization and projects, and advocacy for Ezekiel mark t. Adduru |tua - cmt|9  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT legislation on health policies and level are for clients affiliated with programs. diseases that seriously threaten their DOH VISION AND MISSION health and which require highly technical VISION- Filipinos are among the and specialized knowledge, facilities, healthiest people in Southeast Asia by and personnel for effective treatment. 2022, Asia by 2040 FACTORS ON THE VARIOUS MISSION- To lead the country in the CATEGORIES OF HEALTH WORKERS development of a productive, resilient, AMONG COUNTRIES AND equitable, and people-centered health COMMUNITIES care system 1. Available health manpower resources LEVELS OF HEALTH CARE UNITS 2. Local health needs and problems 1. PRIMARY 3. Political and financial feasibility Rural health units and their sub-centers LEVELS OF PRIMARY OF HEALTH CARE Chest clinics WORKERS Malaria eradication units Schistosomiasis control VILLAGE OR GRASSROOT WORKERS First contacts of the community and Puericulture centers initial link of health care Tuberculosis clinics and hospitals Perform simple curative and preventive Private clinics health care measures promoting healthy Clinics operated by the Philippine environment Medical Association or large industrial Involved in activities geared towards the firms for their employees improvement of the socio-economic Community hospitals level of the community like food Health centers operated by the production program Philippine Medical Care Commission; Community health workers, volunteer and and traditional birth attendants Other health facilities operated by INTERMEDIATE HEALTH WORKERS voluntary religious and civic groups Represent the first source of 2. SECONDARY professional health care Smaller, non-departmentalized hospitals, Attend to the health problems beyond including emergency and regional the competence of the village workers hospitals in which services to patients Provide support of frontt-line health with symptomatic stages of the disease, workers in terms of supervision, which require moderately specialized trainings, supplies and services knowledge and technical resources for Medical practitioners, nurses, midwives adequate treatment are offered FIRST LINE HOSPITAL PERSONNEL 3. TERTIARY Provide backup health services for Medical centers and large hospitals that cases that require hospitalization offer highly technological and Establish close contact with sophisticated services. intermediate level health care workers or These are the specialized national village health workers hospitals. The services rendered at this Ezekiel mark t. Adduru |tua - cmt|10  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT Physicians with specialty, nurses, ETHICS IN HEALTH INFORMATICS dentist, pharmacists, and other health Application of the principles of ethics to professionals the domain of health informatics Health informatics has three main ETHICS PRIVACY AND SECURITY aspects: ETHICS ○ Healthcare Also called moral philosophy, the ○ Informatics discipline concerned with what is ○ Software morally good and bad and morally right Information systems are developed in and wrong. (Britannica, 2023) order to assist in the dispensation of HEALTH INFORMATICS healthcare of other supplementary Is the interprofessional field that studies services. and pursues the effective use of In addition, health informatics als dwells biomedical data, information, and in the efficiency of processing data knowledge for scientific inquiry Patient information has to be stored for problem-solving, decision-making, future use, to be retrieved when needed. motivated by efforts to improve human Transfer of information als needs to be health (National Library of Medicine, facilitated with proper security. 2022) ETHICAL PRINCIPLES 1. A computer program should be used in clinical practice only after appropriate evaluation of its efficacy and the documentation that if performs its intended task at an acceptable cost in time and money. 2. All uses of informatics tools, especially GENERAL ETHICS in patient care should be preceded by AUTONOMY adequate training and instruction, which Defined as either allowing individuals to should include review of applicable make their own decision in response to product evaluations. a particular societal context, or as the 3. Users of most clinical systems should idea that no one human person does not be professionals who are qualified to have authority nor should have power address the question at hand on the another person. basis of their licensure, clinical training Electronic health records (HER) must experience. Software system should be maintain respect for patient autonomy used to augment or supplement, rather A compromise must be reached than to replace or supplant, such an between levels of patient autonomy and individual's decision-making. quality of patient records. ○ If patients have full control, they can modify or delete critical information Ezekiel mark t. Adduru |tua - cmt|11  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT without prior knowledge of health data-needs of a free, responsible and professionals. democratic society and by the equal and BENEFICENCE AND NON-MALEFICENCE competing rights of others. Defined as “do good” and “do no harm”. 6. LEAST INTRUSIVE ALTERNATIVE In health informatics, beneficence Any infringement of the privacy rights of a relates most significantly with the use of person or group of persons, of their right of the stored data in the EHR system, and control over data about them, may only non-maleficence with data protection occur in the least intrusive fashion and with Must have multiple back-ups that can be minimum of interference with the rights of recovered rapidly and easily the affected. Highest possible level of security should 7. ACCOUNTABILITY always be upheld. Any violation of the privacy rights of a INFORMATICS ETHICS person or group of persons, and their right Involves the ethical behavior required of of control over data about them, must be anyone handling data and information justified to latter in good time and in an and has seven principles: appropriate fashion. 1. INFORMATION PRIVACY AND SOFTWARE ETHICS DISPOSITION Heavily relies on use of software to All persons and groups of persons have a store and process information. fundamental right to privacy and hence to As a result, activities carried out by control over the collection, storage, access, software developers might significantly communication, manipulation, linkage and affect end-users. disposition of data about themselves. Activities should be carried out in the 2. OPENNESS best interests of the following: Information must be disclosed in an ○ Be mindful of social impacts of appropriate and timely fashion to the software systems subject or subjects of that date. Institutions and employees 3. SECURITY ○ Straightforward about personal All data that have been legitimately limitations and qualifications collected must be protected by all Professional standards reasonable and appropriate measures ○ Strive to build products of high against loss degradation, unauthorized standards destruction and modification. ○ Prescribe ethical approach 4. ACCESS ○ Encourage realistic and effective Subjects of electronic health records have cost, schedules and procedures the right of access to those records and the PRIVACY, CONFIDENTIALITY AND right to correct them with respect to its SECURITY accuracy, completeness and relevance. Privacy applies to individuals and their 5. LEGITIMATE INFRINGEMENT aversion to eavesdropping, whereas Fundamental right of privacy and of control confidentiality is related to unintended over the usage of data is conditioned only disclosure of information. by the legitimate, appropriate and relevant Ezekiel mark t. Adduru |tua - cmt|12  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT Reasons to protect privacy and creating this purpose a national privacy confidentiality commission, and for other other ○ Rights of all people which merits purposes respect without need to be earned, Applies to the processing of all type of argued and defended. personal information including the ○ Advantageous for both individual person involved in the processing and society Approved on August 15, 2012 ○ Benefits public health HEALTH PRIVACY CODE Obligations fall on system designers, IMPLEMENTING THE JOINT A.O maintenance personnel, administrators, 2016-0002 physicians, nurses and other fortnite Otherwise known as Privacy Guidelines users of the information system. for the Implementation of the Philippine Protection of privacy and confidentiality Health Information System (PHIE) is non-negotiable because it is a duty It will allow different applications to that does not fluctuate based on the exchange data with each other without disease or the data-storage medium. loss of semantics and will enable health HEALTH INSURANCE PORTABILITY facilities particularly rural health units, AND ACCOUNTABILITY ACT OF 1996 health centers, hospitals, DOH and (HIPAA) PhilHealth to communicate with each A federal law that requires the creation other effectively and to collaborate with of national standards to protect the healthcare providers in the care of sensitive patient health information the patients. from being disclosed without the The consent shall conform to the patient’s consent or knowledge requirement or characteristics of a valid To comply with the HIPAA Security Rule, informed consent which consists of the all covered entities must: following: ❖ Ensure the confidentiality, integrity, A. COMPETENCE- of sound mind, at and availability of all e-PHI least 18 y/o, and not under the ❖ Detects and safeguard against influence of drugs or liquor; anticipated threats to the security of B. AMOUNT AND ACCURACY OF the information. INFORMATION- relevant factual ❖ Protect against anticipated data about a procedure and/or impermissible uses of disclosures treatments, its benefits, risks, and that are not allowed by the rule possible complications or outcomes; ❖ Certify compliance by their workforce C. PATIENT UNDERSTANDING- PHILIPPINES DATA PRIVACY ACT OF Education, language or dialect; 2012 R.A. 10173 D. VOLUNTARINESS- Make an An act protecting individual personal autonomous decision without force information in information and or intimidation, and understands that communications system in the he/she can withdraw consents government and the private sector, anytime without consequence Ezekiel mark t. Adduru |tua - cmt|13  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT LEVELS OF SECURITY IN THE HOSPITAL INFORMATION SYSTEM Solutions and tools which may be utilized to implement security policies. This can be any of the following: ○ ADMINISTRATIVE- may be implemented by the management as organization-wide policies and procedures ○ PHYSICAL- mechanisms to protect equipment, systems, and locations ○ TECHNICAL LEVEL- automated processes to protect the software and database access and control. EXAMPLES OF ADMINISTRATIVE, PHYSICAL, AND TECHNICAL SAFEGUARDS TYPE OF SECURITY EXAMPLES ADMINISTRATIVE Continual risk assessment of your health IT environment SAFEGUARDS Continual assessment of the effectiveness of safeguards for electronic health information Detailed processes for viewing and administering electronic health information Employee training on the use of health IT to appropriately protect electronic health information Appropriately reporting security (e.g., to those entities required by law or contract) and ensuring continued health IT operations PHYSICAL Office alarm systems SAFEGUARDS Locked offices containing computing equipment that store electronic health information Security guards TECHNICAL Securely configured computing equipment (e.g., virus SAFEGUARDS checking, firewalls) Certified applications and technologies that store or exchange electronic health information Access controls to health IT and electronic information (e.g., authorized computer accounts) Encryption of electronic health information Auditing of health IT operations Health IT backup capabilities (e.g., regular backups of electronic health information to another computer file server) LEVELS OF SECURITY IN THE HOSPITAL INFORMATION SYSTEM 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 (5) key functions: 1. AVAILABILITY- ensuring that accurate and up-to-date information is available when needed at appropriate places Ezekiel mark t. Adduru |tua - cmt|14  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT 2. ACCOUNTABILITY- helping to ensure that healthcare providers are responsible for their access to and use of information, based in a legitimate need and right to know 3. PERIMETER IDENTIFICATION- knowing and controlling the boundaries of trusted access to the information system, both physically and logically. 4. 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. 5. COMPREHENSIBILITY AND CONTROL - ensuring that records owners, data stewards and patients understand and have effective control over appropriate aspects of information privacy and access. KEY STEPS IN LABORATORY INFORMATION FLOW FOR A HOSPITAL PATIENT STEP DESCRIPTION REGISTER PATIENT Patient records (e.g., ID Number, name, sex, age, location) must be created in the LIS before tests can be ordered. LIS usually automatically receives this data from a hospital registration system when a patient is admitted. ORDER TESTS Physician orders tests on a patient to be drawn as part of the laboratory's morning blood collection rounds. The order is entered into the CIS and electronically sent to the LIS. COLLECT SAMPLE Before morning blood collection, the LIS prints a list of all patients whose blood samples have to be drawn and the appropriate number of sample bar-code labels for each patient's test order. Each barcode has a patient ID, sample contained, and laboratory workstation that can be used to sort the tube once it reaches the laboratory. Another increasingly popular approach is for a patient's caregiver or nurse to collect the blood sample. Immediately prior to collection, sample barcode labels can be printed (on demand) at the nursing station on an LIS printer or portable bedside printer RECEIVE SAMPLE When the samples arrive in the laboratory, their status has to be updated in the LIS from "collected" to "received." This can be done by scanning each sample container's barcode ID into the LIS. Once the sample is "received," the LIS transmits the test order to the analyst who will perform the test. RUN SAMPLE The sample is loaded onto the analyzer, and the barcode is read. Having already received the test order from the LIS, the analyzer knows which tests to perform on the patient. No work list is needed. For manually performed tests, the technologist prints a work list from the LIS. The work list contains the names of the patients and the tests ordered on each. Next to each test is a space to record the result Ezekiel mark t. Adduru |tua - cmt|15  HEALTH INFORMATION SYSTEM|lecture 1ST SEMESTER | MR. ANGELO CHRISTIAN O. DE GUZMAN, RMT REVIEW RESULTS The analyzer produces the results and sends them to the LIS. These results are only viewable to the technologists because they have not been released for general viewing. The LIS can be programmed to flag certain results-for example, critical values-so the technologist can easily identify what needs to be repeated or further evaluated. RELEASE RESULTS The technologist releases the results. Unflagged results are usually reviewed and released at the same time. The LIS can also be programmed to automatically review and release normal results or results that fall within a certain range. The latter approach reduces the number of tests that a technologist has to review. Upon release, the results are automatically transmitted to the CIS. REPORT RESULTS The physician can view the results on the CIS screen. Reports are printed when needed from the LIS. SAFEGUARDS FOR THE LABORATORY INFORMATION SYSTEM TYPE OF SAFEGUARD PROCEDURE ADMINISTRATIVE Continuous employee training on the use of LIS SAFEGUARDS Periodic view of standards in identifying which results should be flagged Strengthen laboratory authorization and supervision policies Implement strict rules and regulations regarding the testing procedures Release guidelines on proper disposal of laboratory specimen Enforce policies on the proper use of laboratory workstations Impose disciplinary measures as needed PHYSICAL Periodic maintenance of laboratory equipment SAFEGUARDS Biometrics or other security protocol for laboratory access Controlled temperature both for equipment and specimen Contingency operations plan Use of appropriate personal laboratory safety equipment TECHNICAL Automated identity confirmation procedures for users SAFEGUARDS requesting access Regular change of username and password Different access capabilities based on user position Automatic log-off after long periods of inactivity -END- Ezekiel mark t. 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