Standards & InteroperabilityHI 201MS Health Informatics

James Carlo N. Garcia, RN

SCENARIO“Several city and municipal health units in Zamboanga have a basic EMR called BasicHealth. DOH wants to get all cases of Hypertension, Diabetes Mellitus and Cancer for their national registry. The DOH registry is an online system using software called RegistryTech.”

I chose this scenario because it is very familiar to me since I am working for the Regional Office of the Department of Health.

Question: What organizations/entities are involved in the scenario?

Barangay Health Stations - the primary health care facility at the barangay level wherein health services are delivered.

Rural Health Units - the primary government health care facility at the municipal level wherein health services are delivered.

Question: What organizations/entities are involved in the scenario?

City/Municipal Health Office – the office that governs the BHS and RHUs within the city or municipality. Some MHOs are housed at the RHUs.

Provincial Health Office- the office that governs the BHS to the City/Municipal Health Office

Question: What organizations/entities are involved in the scenario?

Department of Health Regional Office IX – the regional office of the Department of Health in Region IX

Department of Health Central Office – the principal health agency responsible for ensuring access to basic public health services to all Filipinos

Question: What organizations/entities are involved in the scenario?

Though not directly stated, these organizations or units are usually the ones involved in the exchange of data and information. We cannot skip those at the middle because they need to have the same information with those at the grassroots before the information reaches the central office.

DOH Central Office

DOH RO IXPHOCHO/

MHORHUBHS

BHS (EMR) RHU (EMR) CHO/MHO (EMR) PHO (EMR)

DOH RO IX (System for

consolidation)

DOH Central Office

(RegistryTech)

Question: What applications within the different organizations need to talk to each other?

I am not very sure how to answer this question, but here is what I think; the applications that needs to talk to each other are the EMR (BasicHealth) used by the BHS, RHUs, MHOs, PHO and the Regional Office’s system for consolidation of reports (this is an assumption) and the Registry (RegistryTech) of the DOH Central Office.

RegistryTech

List 3–5 specific project goals for making the organizations/applications talk to each other.

• a. Minimize entry of wrong cases

• b. Provide ON time data for analysis

• c. Provide correct and accurate data for planning

• d. Identify which disease is most prominent in the province

• e. Identify which areas has the most number of each cases to provide and direct the appropriate community intervention (e.g. health education and promotion, advocacies, relevant trainings)

List 5–10 data elements that should be transferred.

Some data elements are the same for each disease, some are not.

• Facility ID• Age• Gender• Address (Barangay)• Highest recorded blood

pressure reading• Date highest recorded blood

pressure reading was taken• Medications• Family history

List 5–10 data elements that should be transferred.

Some data elements are the same for each disease, some are not.

• Facility ID• Age• Gender• Address (Barangay)• Highest recorded blood glucose

level reading• Date highest recorded blood

glucose level reading was taken• Medications• Family history• Type of diabetes

List 5–10 data elements that should be transferred.

Some data elements are the same for each disease, some are not.

• Facility ID• Age• Gender• Address (Barangay)• Type of Cancer• Severity/Stage of Cancer• Medications• Family history

List 5–10 data elements that should be transferred.

Standards must be used in some of the data elements:

• Diagnosis (ICD 10)• Medications (Philippine National Drug Formulary)• Health Facility codes

Question: At what point (activity or event) in the process should the transfer of information happen, e.g patient discharge, after clinic visit? This is called the trigger event.

The transfer of information should happen during the date set by the higher organization for the submission of data, whether daily, weekly, monthly or quarterly.

Question: At what point in the application/software process should the transfer of information happen, e.g. once patient bill is paid, once lab result is finalized?

The transfer of information should happen once data/information has been consolidated

Thank You!