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I.

EXECUTIVE SUMMARY

Health care is among the largest economic activities and among the most visible
social enterprises worldwide. Developments in the industry are of broad international
concern since nearly all countries are presently engaged in major health care reform
processes that have enormous social and economic implications. Its fundamental
importance in the maintenance of societies is evident, being a basic need. However, its
direct contribution to the economy is very minimal.
Cost-cutting reforms are advocated everywhere, especially in the most advanced
nations with the most universal and comprehensive systems. All nations increasingly
compete in the same market where expenditures continue to escalate everywhere. The
pressures on the industry to become more efficient without sacrificing quality of care
and at the same time increasing access is growing stronger.
In the light of these developments, this paper aims to present information meant to: (1)
define current business situation of the health services industry specifically the desired
business which is Ospital ng Makati, (2) identify its business/IS link, (3), (4) identify its
current IS situation, (5) determine IS Industry of the said business, (6) assess its
information system, (7) identify the industrys strengths, weaknesses, opportunities, and
threats, (8) know its IS direction and (9) know how organization affects the business
operation.
The Philippine Health Service Industry with its strengths, weaknesses,
opportunities and threats. The health care sector of the Philippines is experiencing a
time of growth and adjustment. As the government proceeds with its goal of providing
universal health care to the population, both the public and the private health sectors as
well as pharmaceutical companies are modifying their systems and forward planning
accordingly in order to align with governmental, regulatory and societal shifts.
The Philippines performed well in the UNs 2000-15 Millennium Development
Goals (MDGs), achieving five of eight MDGs. It was judged neutral in one, but did not
meet two goals: improving maternal health and achieving universal basic education.

Following on the MDGs, work on achieving 17 sustainable development goals (SDGs)


has been agreed by nations around the world. But given the Philippines limited
resources and its lack of success on two of the MDGs, the government has indicated it
will focus on just three of the 17 SDGs: improved universal health care, meeting poverty
reduction and sustainable education the last two SDGs being the MDGs it did not
achieve. For our case, because of limited resources and different levels of importance
and intensities of problem, we just have to select the ones that are so crucial to our
development efforts, Socioeconomic Planning Secretary Arsenio Balisacan said in an
October 2015 press briefing. The goal we have is to develop specific targets and
indicators associated with [the challenges we are facing]; many of these are also our
concerns in the MDGs.
In 1995 the movement towards a single-payer, premium-based financing
insurance system was signaled by the establishment of the National Health Insurance
Program, managed by Philippine Health Insurance Corporation (PhilHealth). A 2010
reform effort aimed at achieving universal coverage aimed to increase the enrolment of
poor families in PhilHealth, offer a more comprehensive benefits package, and reduce
or eliminate co-payments. In November 2014, President Benigno Aquino signed
Republic Act 10645, which granted automatic coverage of the full range of PhilHealth
benefits to Filipino citizens aged 60 and over, with the national government paying their
premiums. As of February 2015, PhilHealth membership was estimated at 81.63m
beneficiaries, or about 82% of the countrys population of nearly 100m.
The Philippine healthcare industry is particularly poised for exciting growth.
Increased government spending and contributions from sin taxes are being channeled
to improve on the delivery of and access to public healthcare. In the private sector,
business expansion and opportunities currently unfolding have caused major local and
regional business groups to look more closely and expand their investment plans in the
sector.

II.

CURRENT BUSINESS SITUATION

Philippine Health Service Industry


Healthcare in the Philippines at a glance
The healthcare system in the Philippines can be considered to be of a good
standard, despite the fact that the facilities may not be as impressive as those found in
high-end US or European hospitals.
Medical practitioners in the Philippines are graduates from the top universities in
the country and most of them have studied in US medical schools. Additionally, there
are doctors that have practiced medicine in the US before sharing their expertise in the
Philippines. Filipino nurses are also trained by nursing schools that have excellent
standards. In fact, a large percentage of Filipino nurses go on to work in the US.
The healthcare system in Philippines is a mixed public-private system.
Public health care is organized in 2 tiers: Primary care is delivered through public health
and primary health care centers linked to peripheral barangay health centers (BHCs) or
health outposts. Private healthcare services are well-established and growing in
Philippines through specialist clinics and private hospitals. The private sector is much
larger than the public sector in terms of human, financial and technological resources
and caters to 30% of the population. It is structured according to the North American
model organized around independent free-standing hospitals, individual medical offices
and private clinics, dependent on fee-for-service payments.
Hospitals
Finding the right hospital in the Philippines is not considered too difficult as there
are a number of options to choose from. The Philippines has both private and public
healthcare institutions as explained above. Most of the government hospitals provide
quality healthcare in the same way private hospitals do. Although some people may
have misconceptions, most of them are unfounded. The main difference between public

and private hospitals are the facilities and technologies offered. Most of the public
hospitals would not be equipped to the same standard as the private ones. However,
some of the best doctors are serving in the government hospitals. Also, most Filipinos
would seek advice from these government hospitals because fees are not charged.
Private hospitals are located in key cities throughout the nation and there are also
tertiary hospitals that have the latest in medical technologies. However, as you would
expect, private hospitals are more expensive.
Emergency Care in the Philippines
Specialist medical and surgical care is available in some facilities in Manila to
international standard, but not in all areas. The public emergency system directs most
serious emergencies into designated public facilities which may cause logistical and
payment issues. ICU care is usually equivalent to international standard in some tertiary
public facilities and in a number of private hospitals. Blood and blood products are
generally regarded as safe however there are high levels of Hepatitis and HIV in the
population. As is generally advised, transfusion should be avoided unless immediately
life-saving. Complex trauma and major medical emergencies may require medical
evacuation, in cases where local capabilities are exceeded.
Pharmacies
There are numerous pharmacies in the Philippines that provide medicines which
have been approved by the Bureau of Food and Drugs. Most of the standard
pharmacies are manned by professional pharmacists that have studied and trained in
top medical schools in the country. There are strict guidelines in relation to prescription
drugs; while some countries allow their patients to obtain certain drugs without a
prescription, the Filipino pharmacists have stringent directives in relation to the sale of
such drugs.
Cost of Healthcare in the Philippines
Generally speaking, hospitals are not that expensive in the Philippines.
Medicines are also affordable; both locals and expatriates will attest to this fact.

Additionally, in the Philippines, almost ninety percent of the population can speak and
understand English. Communication is never a problem when you are in the Philippines.
The people are very hospitable and accommodating, the doctors and medical
practitioners are friendly and the place is very inviting. Overall, the healthcare system in
the Philippines is affordable, the doctors are well-trained and the nurses are of a high
standard.

Direction
In its current decentralized setting, the Philippine health system has the
Department of Health (DOH) serving as the governing agency, and both local
government units (LGUs) and the private sector providing services to communities and
individuals. The DOH is mandated to provide national policy direction and develop
national plans, technical standards and guidelines on health. Under the Local
Government Code of 1991, LGUs were granted autonomy and responsibility for their
own health services, but were to receive guidance from the DOH through the Centres
for Health Development (CHDs). Provincial governments are mandated to provide
secondary hospital care, while city and municipal administrations are charged with
providing primary care, including maternal and child care, nutrition services, and direct
service functions. Rural health units (RHUs) were created for every municipality in the
country in the 1950s to improve access to health care. The private sector, which is
much larger than the public sector in terms of human, financial and technological
resources, is composed of for-profit and non-profit providers that cater to 30% of the
population. Although the private health sector is regulated by the DOH and the
Philippine Health Insurance Corporation, health information generated by private
providers is generally absent in the information system of the DOH. Regulation of health
science schools and universities is under the Commission on Higher Education, while
the regulation of health professionals is carried out by the Professional Regulation
Commission. PhilHealth introduced health technology assessment (HTA) in the early
2000s to examine current health interventions and find evidence to guide policy,
utilization and reimbursement. As a third party payer, PhilHealth regulates through the

accreditation of health providers that are in 16 compliance with its quality guidelines,
standards and procedures. The Food and Drug Administration (FDA) regulates
pharmaceuticals along with food, vaccines, cosmetics and health devices and
equipment. At present, patients rights and safety are expressed under the purview of
the Penal Code and Medical Act of 1959 and health professional practice acts. The lack
of a gatekeeping mechanism in the health system allows patients to choose their
physicians. Patient empowerment, on the other hand, has remained more a concept
than a practice. The relationship of the health system with individuals, families and
communities is still largely one of giver to recipient.
Organization and Governance at Local Level
Local Government Level
The LGUs make up the political subdivisions of the Philippines. LGUs are
guaranteed local autonomy under the 1987 Constitution and the LGC of 1991. The
Philippines is divided into 78 provinces headed by governors, 138 cities and 1496
municipalities headed by mayors, and 42 025 barangays or villages headed by
barangay chairpersons (NSCB, 2010). Legislative power at local levels is vested in their
respective sanggunian or local legislative councils. Administratively, these LGUs are
grouped into 17 regions.
Within this decentralized setting, the LGUs continue to receive guidance on
health matters from the DOH through its network of DOH representatives under the
supervision of the regional centers for health and development (CHDs). Provincial
governments are primarily mandated to provide hospital care through provincial and
district hospitals and to coordinate health service delivery provided by cities and
municipalities of the provinces. City and municipal governments are charged with
providing primary care including maternal and child care, nutrition services and direct
service functions through public health and primary health care centers linked to
peripheral barangay health centers (BHCs) or health outposts.
Private Sector

A major share of the national expenditures on health (about 60%) goes to a large
private sector that also employs over 70% of all health professionals in the country. The
private sector consists of for-profit and non-profit providers which are largely marketoriented. Health care is paid through user fees at the point of service, or subsidized by
official aid agencies or philanthropy. This sector provides services to an estimated 30%
of the population who can mostly afford to pay these user fees.
The PhilHealth benefits scheme pays for a defined set of services at
predetermined rates. However, claims payments are uncertain because both the whole
claim and the items in each claim may be disregarded or reduced. Private hospitals
derive a significant proportion of their incomes from PhilHealth payments as the largest
number of PhilHealth members are employed in the private sectors and usually go to
private hospitals for health care. HMOs and other private prepayment schemes that
supplement PhilHealth coverage of private sector employees further facilitate their
accessing of private hospital care services.
The private health sector is regulated by the DOH through a system of standards
implemented by licensure procedures of the department and accreditation procedures
of the PhilHealth. Professional organizations, particularly medical specialty groups, also
participate in certification systems and programmes.
Decentralization and Centralization
Under the decentralized or devolved structure, the state is represented by
national offices and the LGUs, with provincial, city, municipal, and barangay or village
offices. Figure 2-1 shows the structure of the Department of Health (DOH) alongside the
levels of health facilities found in the LGU and the private sectors. The DOH, LGUs and
the private sector participate, and to some extent, cooperate and collaborate in the care
of the population.
Before devolution, the national health system consisted of a three-tiered system
under the direct control of the DOH: tertiary hospitals at the national and regional levels;
provincial and district hospitals and city and municipal health centres; and barangay
(village) health centres. Since enactment of the 1991 LGC, the government health

system now consists of basic health servicesincluding health promotion and preventive
unitsprovided by cities and municipalities, province-run provinicial and district hospitals
of varying capacities, and mostly tertiary medical centres, specialty hospitals, and a
number of re-nationalized provincial hospitals managed by the DOH.
The DOH was made the servicer of servicers by:
1) Developing health policies and programs;
2) Enhancing partners capacity through technical assistance;
3) Leveraging performance for priority health programs among these partners;
4) Developing and enforcing regulatory policies and standards;
5) Providing specific programs that affect large segments of the population; &
6) Providing specialized and tertiary level care.
The LGUs serve as stewards of the local health system and therefore they are
required to formulate and enforce local policies and ordinances related to health,
nutrition, sanitation and other health-related matters in accordance with national policies
and standards. They are also in charge of creating an environment conducive for
establishing partnerships with all sectors at the local level. Among the LGUs, the
Autonomous Region of Muslim Mindanao (ARMM) has a unique organizational and
governance structure. It has retained the centralized character of its health system
under the ARMM DOH, which directly runs the provincial hospitals and the municipal
health centers under its jurisdiction instead of the component provinces and towns of
ARMM.

The Stated Objectives of the Health System


The Philippine health system has elaborated specific goals and objectives for the
medium term period of 2005-2010 in its National Objectives for Health 2010
monograph. It specifies three goals of (1) better health outcomes, (2) more equitable
financing, and (3) increased responsiveness and client satisfaction. For the 20112016

plan, the government has identified achieving universal health care (Kalusugan
Pangkalahatan) as the main goal.
Improvements in the delivery of key public health services have, in turn,
improved overall health outcomes but progress towards the health MDGs appears to
have slowed, especially in economically-depressed communities. Regulation of goods
and services has been strengthened by laws, but commercial interests continue to
dominate regulatory processes. Despite strong efforts in the implementation of
Philippine Health Insurance Law, out-of-pocket costs have continued to increase,
eroding progress towards more equitable health financing. Reforms in the governance
of the health system continue to be stymied by a flawed Local Government Code (LGC)
that has increased fragmentation in the management of health services.

SWOT Analysis
Strengths and Weaknesses
The strengths that the industry has are:
Performance of the Philippines Health Sector shows that for its income and
health spending levels, at the aggregate level the Philippines performs relatively
well in terms of key health outcome indicators such as infant mortality and life
expectancy.
The Philippines took a bold step in 1995 to create the legal framework for
expansion of a single-payer health insurance system to achieve universal health
insurance coverage.
Through its program for indigent families (Sponsored Program), the country has
greatly advanced the topic of universal health insurance coverage and access to
health services within the political agenda at the national and LGU levels.
With the establishment of PhilHealth, the previously fragmented functions of
accreditation and claims management (which the Philippines Medical Care
Commission used to manage), enrollment, collection of contributions and claims
processing (which was managed by the Government Service Security System

and the Social Security System) were integrated into one organization
(PhilHealth), thereby contributing to less administrative fragmentation.
PhilHealth is vested full powers, as per the NHI Law to administer the NHI
Program and formulate and implement policies for sound administration of the
program, as well as set the necessary standards, rules and regulations for quality
of care, appropriate utilization of services, fund viability, member satisfaction and
overall achievement of Program objectives.
The weaknesses that the industry has are:
The Philippines health sector continues to face significant challenges with regard
to sustainable health financing.
In 2005 at the beginning of F1, the Philippines spent only some 3.5 percent of its
GDP on the health sector while other Southeast Asian countries spent, on
average, about 4-5 percent.
Fiscal Space and Health Spending. The low levels of public spending on health

are partly related to fiscal space issues in the Philippines.


Overall trends in DOH, LGU and PhilHealth Financing
Inequity in LGU Financing and Absorption Capacities
Fragmentation in Financing
Recent efforts under F1
Until recently, there was little planning capacity for health in LGUs. This problem
is being addressed with the roll-out of the Province-wide Investment Plans for
Health (PIPH).

Opportunities and Threats


The opportunities that the industry faces are:
Social
The growing demands of an ageing and increasingly health conscious
population.
The growing perception of the benefits of primary care services.
Increased willingness to use alternative therapies.
Shortages in the number of general practitioners.
Technological

Advances in medical treatments.


Emergence of new information and telecommunications technologies.
Political
Deregulation of foreign markets.
The threats that the industry faces are:
Social
Evolution of the informed patient.
Lack of evidence of the effectiveness of alternative medicine.
Technological
Intensive research by industrialized countries.
Economic
Aggressive marketing by industrialized countries.
High financial requirements.
High operating costs.
Political
Healthcare markets are complex and highly regulated.

III.
IS Implication

BUSINESS/IS LINK

A hospital information system (HIS) is an element of health informatics that


focuses mainly on the administrational needs of hospitals. In many implementations, a
HIS is a comprehensive, integrated information system designed to manage all the
aspects of a hospital's operation, such as medical, administrative, financial, and legal
issues and the corresponding processing of services.
As healthcare information systems become increasingly crucial to clinical care
and hospital operations, CIOs are under significant pressure to prioritize their resources.
As decades passed, the most commonly implemented systems were those designed to
automate transactions, either in a clinical or administrative context. The proliferation of
transaction systems led to the dramatic increase in readily available digitized data.
Suddenly, we found ourselves with enormous amounts of data siloed in multiple,
discrete applications.
Another focus of hospital information system implementation over the years has
been dashboard reporting. This reporting has provided snapshots of information about
the hospital to management or other data groups. As valuable as these reporting
systems have been, they have not been able to meet the analytics requirements of
todays industry. Todays focus, out of absolute necessity, must be on quality
performance improvement in healthcare, especially on the clinical side. Essential to this
focus is the need for an analytics offering that can bridge and merge multiple
applications. Analytics requires more than mere reporting; health systems must support
the ability to drill down into this comprehensive, merged data to achieve real insight into
operational performance.
Finally, complex analytics queries against millions of rows of data cannot be
performed on transaction system databases without adversely affecting performance.
Clearly a spate data warehouse is required. IT in healthcare has broadly implemented
EMRs and operational data systems. These EMRs will ultimately have pervasive clinical
decision support and drive performance improvement throughout the system.
Organizational leadership cant ignore the performance improvement resulting from
effective analytics applications.

In summary, for CIOs to retain their strategic value as chief information officers, they
must be actively engaged in a strategy that results in the capture and analysis of
comprehensive data. This enables the health system to constantly improve quality in
healthcare.
Hospital Information Systems provide a common source of information about a
patients health history. The system has to keep data in secure place and controls who
can reach the data in certain circumstances. These systems enhance the ability of
health care professionals to coordinate care by providing a patients health information
and visit history at the place and time that it is needed. Patients laboratory test
information also visual results such as X-ray may reachable from professionals. HIS
provide internal and external communication among health care providers.
The HIS may control organizations, which is Hospital in these case, official
documentations, financial situation reports, personal data, utilities and stock amounts,
also keeps in secure place patients information, patients medical history, prescriptions,
operations and laboratory test results.
The HIS may protect organizations, handwriting error, overstock problems,
conflict of scheduling personnel, official documentation errors like tax preparations
errors.
Systems administrator/database administrator
IT Administrators
The systems administrator-database administrator is responsible for systems
administration to ensure the high uptime of the system and for handling all database
back-up and restoration activities.

Application specialist and trainer

The hospitals application specialist together with the software vendor is involved in all
the activities required for implementing the application software. Trainers train and
retrain new employees in the hospital.
Hardware/network engineers
Hardware/Network engineers are responsible for maintaining the hardware and network
systems in the hospital. They undertake all troubleshooting activities that may be
required to keep the system online and patient data available to doctors and nurses.

Standardization
There is no standardization but for data formats and for data interchange, as with
the HL7 initiative supported by ISO.

Efficient and accurate administration of finance, diet of patient, engineering, and

distribution of medical aid. It helps to view a broad picture of hospital growth


Improved monitoring of drug usage, and study of effectiveness. This leads to the
reduction of adverse drug interactions while promoting more appropriate

pharmaceutical utilization.
Enhances information integrity, reduces transcription errors, and reduces

duplication of information entries.


Hospital software is easy to use and eliminates error caused by handwriting. New
technology computer systems give perfect performance to pull up information
from server or cloud servers.

Key Business Measures


The Geneva-based International Organization for Standardization (ISO) grants
certificates of compliance to quality management systems of government and private

enterprises that comply with international standards of excellence. SGS audited and
certified the following processes at OsMak: Admitting of patients to ER up to discharge
of in-patients; Medical diagnostic (Radiology and Laboratory) services for both inpatients and out-patients; Health records and documentation management and
Admitting; Finance including Philhealth and MHP administration; Support offices such
as HRMO, Building and Medical equipment maintenance (BEMSS), Information
Technology and Central Supplies Warehouse.
The standards met by the hospital that earned the ISO nod included, among
others, disposition of patients at the Emergency Room made within six hours; admission
process completed within 20 minutes; period of transaction from billing to discharge
within one day; laboratory results for in-patients and ER patients obtained within two to
three hours; and radiology results within two days. Binay expressed hope that, with the
new OsMak annex now fully operational and the Emergency Department undergoing
expansion, its other processes to be included in next years audit will also gain ISO
certification.
These are In-patient clinical and medical management, Out-patient Department
(OPD) medical services, and facilities improvement to increase efficiency and the
enhancement of customer delight. OsMak provides free outpatient consultations and
subsidized hospitalization benefits to Makati residents, particularly beneficiaries of the
Yellow Card (Makati Health Plus) program and senior citizens.
It offers a wide range of quality medical services, which include Obstetrics and
Gynecology,

Pediatrics,

Surgery,

Ophthalmology,

Internal

Medicine,

Otorhinolaryngology, Dermatology, Radiology and Laboratory. Earlier this year, three


frontline offices of the city government received ISO certification anew: Business
Permits Office, City Building Official, and UDD Zoning Administration. SGS Philippines
also validated the compliance with ISO 9001:2008 of frontline and support offices that
were certified in December 2009, namely, Assessment Department, Finance
Department, City Civil Registration Office, Makati Health Department (Environmental,
Sanitation & Health Section), Human Resources Development Office, General Services
Department, Public Facilities Maintenance Section and the MIS & PRPW of UDD.

Makatis remarkable public health status continues to improve as the city


government pursues more innovations. In a move to decongest the Ospital ng Makati
and bring tertiary health services closer to the people of the first district, the city
government gave priority to the construction of a second hospital at the site of the
Ospital ng Makati Acute Care Center in Bel-Air.
The new hospital will have six major operating rooms and two minor operating
rooms; an ER with a Trauma Center; 32 critical care beds in the ICU and NICU; an MRI
suite and an Ultrasound suite, and top-of-the- line laboratory facilities.

Key Business Requirements


To meet goals of improved quality and reduced costs in today's changing
healthcare environment, hospitals are being forced to be creative and flexible in their
strategies. As part of the transformation to value-based care, many hospitals are
beginning to focus strategies on population health management, one of the core goals
of healthcare reform. Managing population health will require close relationships with
physicians, partnerships with organizations in the community and expansion into
preventative and outpatient care. Here are six key strategies forward-thinking hospitals
and health systems are using to achieve population health management and other
quality and cost goals.

1. Forming relationships with physicians.


Hospital-physician relationships have changed dramatically in recent years,
with physicians moving from private practice to hospital employment or
partnership in droves. Hospitals are beginning to leverage this relationship for a
variety of initiatives.
Market share

On a basic level, partnering with physicians gives hospitals the opportunity to


expand their market share, as physicians are typically the source of patient
referrals.

Hospital quality

Beyond increasing market share, physicians can also help hospitals increase
quality. Engaging physicians is crucial to any quality improvement project
because they are the ones delivering care directly to the patient. Involving
physicians in leadership of the hospital can ensure everyone's goals are aligned
and that the focus stays on quality.

Population health management

Beyond the hospital walls, hospitals' relationships with physicians are also a
valuable strategy in improving quality. Collaborating with physicians on data
collection and analysis can help hospitals manage population health.
Furthermore, a crucial part of managing population health is improving access to
preventative care, which is largely provided by physicians through yearly
checkups and other screenings.
2. Pursuing payer relationships and new revenue models.
Many hospitals seeking to reduce costs and improve quality are seeking new
relationships with payers to create payment models that reward value. Hospitals
use these new models, such as accountable care organizations and bundled
payments, as strategies to align incentives for low cost, high quality care.
Formalizing coordination of care
ACOs and other collaborative care delivery models are also a useful strategy
because they formalize the coordination of care their definition requires a level
of partnership between hospitals, physicians and payers. An ACO can therefore
provide an avenue for hospitals to build a relationship with physicians and
community organizations to coordinate care and improve population health.
3. Partnering with the community.

In addition to partnering with physicians and payers, hospitals are partnering


with other organizations in the community to better coordinate services for
patients along the continuum of care.
Managing transitions of care
Collaborating with organizations in the community such as nursing homes and
long-term care facilities can help hospitals manage transitions of care and
improve population health.
Sharing data in the community
Some hospitals aim to better manage population health by partnering to share
data on patients throughout the community to identify current problems and
strategize ways to eliminate them. Health information technology systems such
as electronic health records and health information exchange can help hospitals
gather more complete data on the population.
4. Focusing on the outpatient arena.
Another strategy many hospitals are using to reduce costs is investing in
outpatient care, as the goals of healthcare reform increased quality,
decreased cost and improved population health will shift much of patient care
to less expensive outpatient settings.
Remaining relevant
Hospitals are building facilities such as ambulatory surgery centers, outpatient
health centers and urgent care centers to remain relevant in an industry that is
beginning to focus on keeping patients out of the hospital
Increasing access to care
In addition to investing in outpatient facilities, hospitals are focusing on outpatient
care as a core competency, emphasizing the need to make care more accessible
to patients. Increased access to care can lead to increased market share and an
opportunity to better manage population health.
5. Investing in technology.
Investing in technology is also a key strategy for hospitals, not only to
meet meaningful use requirements, but also to more easily connect with
physicians, payers and the community strategies discussed above and to
gather data necessary for improving quality. Health IT systems enable hospitals

to capture metrics relating to the practice and outcomes of the delivery of care to
identify areas that need improvement and track progress. Furthermore,
resources such as decision support tools and computerized provider order entry
help physicians improve quality and avoid medical errors.
6. Merging with other hospitals and healthcare systems.
Mergers and acquisitions in the healthcare industry have spiked in the last few
years as hospitals use consolidation as a strategy to gain capital necessary for
health IT investments, outpatient facility construction, physician partnerships and
other projects.
Strategy for survival vs. strategy for continued growth
Some hospitals are merging with larger healthcare systems out of a need
for survival, having suffered steep budget cuts and shrinking patient volume.
These hospitals may need to close if they don't find a partner, so they pursue a
merger as a strategy for gaining capital and continuing to offer care in the
community.
For larger hospitals and health systems, mergers and acquisitions are a
strategy to increase market share, improve quality, gain efficiencies and reduce
costs by eliminating unnecessary duplicated services. For these institutions, a
merger or acquisition expands their reach in the community, giving them access
to more data on the local population, which can be used to manage population
health.

Combining strategies

While each of these strategies implemented alone may achieve some goals,
hospitals need to use multiple strategies in tandem to see lasting, meaningful
change.

Business Process Improvements

In a world of continuously changing business environments, organizations have


no option; however, to deal with such a big level of transformation in order to adjust the
consequential demands. Therefore, many companies need to continually improve and
review their processes to maintain their competitive advantages in an uncertain
environment. Meeting these challenges requires implementing the most efficient
possible business processes, geared to the needs of the industry and market segments
that the organization serves globally. Before, the processes of Ospital ng Makati are
only paper based, but now because of technologies they are now able to improve their
business process. Their E.R is now fully computerized to make their transactions faster
unlike before.
The recent push for health-care reform has caused healthcare organizations to focus
on ways to streamline their processes in order to deliver high-quality care while at the
same time reducing costs. Health-care processes are very complex, involving both
clinical and administrative tasks, large volumes of data, and a large number of patients
and personnel. Health-care processes are also very dynamic. Health-care processes
require the cooperation of different organizational units and medical disciplines. In such
an environment, optimal process support becomes crucial. The main progress has been
achieved through emerging concepts of business processes, business process
orientation, and business process developments.

IV.

CURRENT IS SITUATION

Business Application
Hardware

Computer

Almost every business uses computers to complete daily tasks. From making
contact with clients to inputting data for reports, computers allow businesses a more

efficient way to manage affairs when compared to traditional paper and manila folders.
Communication is key when gaining and maintaining clients and other important
contacts. Computers give businesses access to email, instant messaging and custom
customer contact systems. Computers allow businesses to create websites, stunning
ads and complete marketing campaigns. Accounting without computers presents a high
risk for human error. Accounting software allows businesses to simply input their
financial data and instantly see gains and losses. Instead of filing cabinets, businesses
are able to store millions of files using computers and servers. Most businesses have
some sort of productivity software which typically includes a word processor and
Spreadsheet application. Businesses use computers to help educate employees on
software, company policy, standard procedures and safety. From learning more about
the competition to discovering what customers really want, research isn't as difficult as it
once was, thanks to computers.
Dell INSPIRON 3847
CPU: Intel Core i3 (4th Gen)
4130 / 3.4 GHz
Dual-Core
RAM: DDR3 SDRAM
Memory: 16 GB

Printer

A printer is

a peripheral which

makes

persistent

human-readable

representation of graphics or text on paper or similar physical media. The two most
common printer mechanisms are black and white laser printers used for common
documents, and color inkjet printers which can produce high quality photograph output.
Inkjet Printer

When your identity and capabilities materials contain photographic content, inkjet
printers provide superior output based on variable-sized dots of ink sprayed from tiny
nozzles. Although some types of inkjet devices can produce nearly water-resistant
output, the nature of ink makes it more vulnerable to environmental stresses than the
heat-set output of a laser device would be. Inkjets also can produce fuzzy type that
presents a less than stellar impression in a set of business marketing materials. The
costs of ink cartridges can make inkjet hardware less viable as an output medium for
large numbers of copies.
EPSON L-300+

LaserJet Printer

There is a new High-Speed


Draft mode that delivers an
astonishing 337 characters
per second! An even bigger
surprise is that the LX300+II is still one the
quietest printers in its class.
It
out-performs
its
predecessor with a new
bottom-feed paper path
that's ideal for handling

Laser-based devices provide a first choice for materials that require superior
water resistance and the ability to withstand friction. Identity materials and capabilities
brochures need the kind of durability that can hold up through handling, postal
processing and other physical stresses. Because laser printing uses high heat to fuse
toner onto the surface of its output media, its results offer greater permanence than
other choices can. Laser printing's downside can be reflected in its rendition of
photographs. These devices use tiny dots to make up continuous-tone content, but their
reliance on only one dot size to render image detail can limit the faithfulness of their
reproduction. In contrast, laser printers' output of typographic content excels because of
its potentially high resolution.

HP LaserJet 1320
The text looked excellent at
normal, readable sizes. At the
default setting of 600x600dpi,
our grayscale-graphics test
document
produced
impressively smooth, evenly
stepped shading from dark to
light.

Dot Matrix Printer


Dot matrix printing or impact matrix printing is a type of computer printing which
uses a print head that moves back-and-forth, or in an up-and-down motion, on the page
and prints by impact, striking an ink-soaked cloth ribbon against the paper, much like
the print mechanism on a typewriter. However, unlike a typewriter or daisy wheel printer,
letters are drawn out of a dot matrix, and thus, varied fonts and arbitrary graphics can
be produced.
Epson L110
The L110 is equipped with
Epson's
proprietary
Micro
Piezo print head driving a
high resolution of 5760 dpi x
1440
dpi
that
delivers
exceptional high prints for both
text and images.

Switch

Switch is used to connect multiple computers together in a LAN segment.


Switches are available with 4,8,12,24,48,64 ports. Each switch port has a separate
collision domain. Switch works at layer two in OSI Layer model. At layer two data
signals are formatted in frames.

ProCurve Switch 2610-48-PWR

Router

Number of Ports: 48
Fast Ethernet Port: Yes
Interfaces/Ports:
- 48 x RJ-45 10/100Base-TX LAN
- 2 x RJ-45 10/100/1000Base-T LAN
- 1 x RJ-45 Console Management
Connectivity Media: Twisted Pair
10/100/1000Base-T
Performance:
- Up to 13Mpps Throughput
- 17.6Gbps Routing/Switching Capacity
Number of Expansion Slots: 2

A router is a networking device that forwards data packets between computer


networks. Routers perform the traffic directing functions on the Internet. A data packet is
typically forwarded from one router to another through the networks that constitute
the internetwork until it reaches its destination node.
ZyXEL Armor Z1
4 Ethernet ports
1G WAN
2 USB3 ports
2.4 GHz and 5GHz bands

Software

Windows 10

Windows 10 is a personal computer operating system developed and released


by Microsoft as part of the Windows NT family of operating systems. It was officially
unveiled in September 2014 following a brief demo at Build 2014. Windows delivers
more built-in security features and safer authentication.

Hospital Information Management System

It provides secure, robust environment for transactions across all departments of


the hospital and remote access of patient medical records for physicians. It also
provides quick response time to the hospital administrators helping them to significantly
improve their operational control. It specifically designed to cater to the needs of
hospitals and teaching hospitals.

Incident Report Ticketing System

Osmak uses incident reporting system to monitor adverse events and other
patient safety issues. Incident reporting systems, which vary in design and functionality,
capture and maintain reports of patient-safety-related events documented by
physicians, nursing staff, or other hospital staff. Reported patient safety events could
include adverse events, near-misses, or situations with the potential to harm patients.
Completed reports typically include first-person accounts and other descriptive
information about the events. Incident reports may also include information about the

impact of the event on the patient and the causes of the events, if known. Hospital staff
can submit reports in writing or electronically, depending on the reporting system.

Request Management System

Request Management System (RMS) effectively manages the external grant


request submission and approval process for multiple activity types in an ever-shifting
regulatory environment. RMS allows organizations to easily track and report on a variety
of request activities, providing requestors, approvers, and administrators full visibility
into the grant processing lifecycle. RMS tracks the entire workflow of a grant request
including registration, request submission, review and approval, contracting (electronic
LOA) and payment, outcomes and financial reconciliation, and custom reporting.

Personnel
In order for the transition to go smoothly, he says hospitals must start with a
basic assessment and establishment of an ICD-10 committee. This committee, which
most likely will fall under the hospital CFO's supervision, ought to be comprised of
several factions of hospital personnel with distinct responsibilities. Converting to ICD-10
is not something the health information management department or the finance
department can do on its own. This project will require participation and effort from
numerous levels of the hospital staff in a coordinated manner.

Financial personnel

A hospital's CFO most likely will be the supervisor of the entire ICD-10 transitional
project. From there, the entire financial staff must understand that even though all
healthcare organizations must use ICD-10 by Oct. 1, 2013, not everyone will be using
them efficiently or correctly. Payers might be reimbursing hospitals on the ICD-9 and
ICD-10 systems simultaneously for a while, and this could lead to botched
reimbursements. Catching trends in accounts receivable now can hopefully alleviate
problems after the switch, but in the end, financial personnel must be steadfast in
monitoring payments initially because there will be a lag in backend production, he
adds.

Technology personnel

The chief information officer must have a handle on several different aspects. For
example, there must be a robust inventory procedure of all IT systems throughout the
organization. Hospitals must record which IT systems are used on a regular basis.

Clinical personnel

The chief medical officer, chief nursing officer and several other top clinical leaders must
help lead the charge in the conversion because clinical documentation the
cornerstone of proper coding will be changing drastically.

Health information management personnel

HIM professionals obviously must be active and willing participants in the switch
because coding will become significantly more specific. Hospitals must be ready to
retrain coders in anatomy, physiology and other medical terminology through training
modules to guarantee nothing will be lost between future documentation and coding, Mr.
Stark says. Coders that have not had retraining in several years might have a tough
time, but hospitals must take this step.

Compliance personnel

Compliance employees must make sure that all parties involved stay within the bounds
of HIPAA transactions and monitor the overall progress of the project to stay in line with
the compliance dates.

Technical Infrastructure
Based on information communication technology, as well as wireless and mobile
communication protocols, an intelligent healthcare technical infrastructure builds
efficiency across an organization. Acting as the central nervous system of a hospital, the
infrastructure integrates and enables communication between traditionally disparate
systems, such as power, building management, security and IT. When a hospitals
systems can talk with each other, the infrastructure as a whole is stronger and makes
effective use of all resources.
The OsMak offers competitive prices in health-related services. Their technical
infrastructures are their network, 300 computer, 100 printers, 150 telephones and
scanners.

Organization

Ospital ng Makati

Figure 1.0 Organization Structure of Ospital ng Makati

This is the hierarchical arrangement of lines of authority, communications, rights and


duties of Ospital ng Makati. It determines how the roles, power, and responsibilities are
assigned, controlled and coordinated, and how information flows between the different
levels of management. The top layer of management which is the medical director has
most of the decision making power and has tight control over departments and
divisions.
I.T. Department

Mr. RICHARD T. DELA


RAMA
Director for Central
Information Management

(Vacant)
Deputy Officer

JOHANNA
PLACER &
JESSICA
MONICON
SIAPCO
Administrator

FLORENDO DEL
ROSARIO JR.
Programmer

JOHN PHILIP ANIDO,


MARK KENNETH
GAYATGAY,
KRISHA AMELOU
ANTIDO
Technicians

Figure 2.0 Organization Structure of Ospital ng Makatis I.T. Department


This is the organizational structure of the IT Department of Ospital ng Makati. The
Director for Central Information Management as the top of it which has the most

decision making power in the IT Department. The Deputy Officer is responsible for the
operation of all correctional institutions operated by the IT Department. The
Administrators are involved in planning, organizing, directing, controlling and evaluating
activities of the top unit. The Programmer is the person who writes computer software
and the one who make the system for the business. And the Technicians are skilled
workers who provides technical support.

Processes
Budget
V.

IS INDUSTRY

IS Industry Trends

The trends impact either positively or negatively on the healthcare system of a


developing city that has a relatively abundant supply of human resources such as the
Makati. The barcoding system is one of there IS trend which can help them to lessen
the manpower.

Manufacturing Industry
The cost of medical care is increasing at an alarming rate where it is going
beyond a common mans affordability. A significant percentage of these cost increases
can be attributed to an increase due to capital intensive infrastructure, high cost
technology, complexity of healthcare delivery, and operating inefficiencies. Even if there
is advancement in medical technology, the cost of healthcare service is increasing due
to poor operating efficiency (one of the reason). Though there is technological
advancement but less people are able to take benefit of that.
The Ospital ng Makati have the conflict or dilemma of improving quality of
treatment and service at one hand and reduce the cost of delivery at the other hand.
The challenges for hospitals are: how to increase the operational effectiveness to be

able to afford a high quality healthcare, provide more with less, patient centric services
and others.

VI.

IS ASSESSMENT

Strengths
They are now paper less, they minimize their time, accurate and less effort in
retrieving the data of their patient.

Weaknesses
Because of the system they are not able to interact well with the system.

Opportunities
Telehealth
Trade in health services is aided by telecommunications (so-called telehealth).
Trade is aided by the use of computer-assisted telecommunications to support the
functions for clinical (e.g, telemedicine) and nonclinical purposes (e.g., medical
transcription, business process outsourcing, management, surveillance, literature and
access to knowledge). Two market niches to be considered are telemedicine and
medical transcription.
Telemedicine
There is a relatively wide spectrum of telemedicine services such as
teleconsultations, telepathology, teleradiology, telepsychiatry, teledermatology, and
telecardiology. The European Commissions Healthcare Telematics Program in 1996

defines telemedicine (medicine at a distance) as the rapid access to shared and


remote

medical

expertise

by means of

telecommunications and

information

technologies (e.g., telephones, fax machines, personal computers, and other forms of
multimedia) no matter where the patient or relevant information is located. Information
exchange takes the form of data, audio and/or visual communication between physician
and patient or between physicians and healthcare professionals in geographically
separate locations to facilitate the exchange of information on medical, healthcare,
research, and/or educational purposes.

Threats
We all know that threats are inevitable in some businesses. As in Ospital ng
Makati they are experiencing cyber-attack in their information system that cause in
leakage of data.

Scorecard
They compare their previous business processes wherein they are only using
paper based in recording data than now that they are now fully computerized.

Recommendations
They wanted to make their whole business process computerized.

VII.

IS HIGH LEVEL DIRECTION

Vision
To make Ospital Ng Makati into a state-of-the-art hospital providing ultimate
health care services.

Mission

To ascertain the evolution of Ospital Ng Makati into a world-class hospital that will
restore the health of the Makati Citizenry into an optimum state of well-being and
productive through delivery of the highest level of medical care in a competent
responsible and humane manner with breakthrough technologies and sustainable
financing.

Goals
To effectively deliver quality health care through caring and highly competent
personnel utilizing world-class technology.

Scorecard, Metrics
They compare their previous business processes wherein they are only using
paper based in recording data than now that they are now fully computerized.

E-Business Direction
They have plans in making their business online to make their business process
easier and faster.

Prioritization Process
They make their prioritization based on what can satisfy their customer. They
make sure that they provide good quality service for them.

VIII.

IS DIRECTION

Business Application
Ospital ng Makati uses Ospital Information Management System that offers a fullfeatured document management suit that can scale to all areas of their organization.
The management system includes the consultation and admission of patient up to
discharging.

Technical Infrastructure
The OsMak offers competitive prices in health-related services. Their technical
infrastructures are their network, computer, printers, and scanners.

IX.

IMPLEMENTATION PLAN

Projects
They are planning to implement barcoding for Out Patient Department (OPD) for
making their transactions easier and faster.

Roadmaps
Their planning stage starts in consulting within the involved department. They
tackled the risk, pros and cons that can affect the business process when implementing
the desired project.

Communication Plan
The project communication starts with the management, wherein they discuss
important matters with regards to the proposed project. After discussing they will consult
it to the IT department if theyll be able to implement the said project. Then the
management will execute the project to the involved department.