INTEGRATED HOSPITAL OPERATIONS AND MANAGEMENT

INFORMATION SYSTEM
(iHOMIS)

MANAGEMENT MANUAL

DEPARTMENT OF HEALTH
REPUBLIC OF THE PHILIPPINES

2020 Revision
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Table of Contents

OVERVIEW OF CONTENTS ............................................................................................................... 2

SECTION 1: THE iHOMIS SOFTWARE ..................................................................................................................................4

SYSTEM BACKGROUND ........................................................................................................................................... 4
SOFTWARE OVERVIEW ............................................................................................................................................ 5
SOFTWARE OBJECTIVES........................................................................................................................................... 5
SOFTWARE BENEFITS .............................................................................................................................................. 5
SOFTWARE FEATURES ............................................................................................................................................. 5
SOFTWARE FUNCTIONS ........................................................................................................................................... 6

SECTION 2: IMPLEMENTATION REQUIREMENTS ................................................................................................................7

SECTION 3: HARDWARE, OPERATING SYSTEM AND DATABASE MANAGEMENT SOFTWARE REQUIREMENTS ...................8

SECTION 4: SOFTWARE CONFIGURATION MANAGEMENT .................................................................................................9

SOFTWARE MAINTENANCE ..................................................................................................................................... 9
TECHNICAL SUPPORT .............................................................................................................................................. 9

SECTION 5: INPUT DATA AND REPORT STANDARDS ........................................................................................................ 10

INPUT DATA STANDARDS ...................................................................................................................................... 10
OUTPUT/REPORT STANDARDS .............................................................................................................................. 26
STANDARDS ON DATA ENTRY PROCESS ................................................................................................................ 28
STANDARDS ON REPORT GENERATION ................................................................................................................. 28
STANDARDS ON BACKUP PROCEDURES ................................................................................................................ 28

SECTION 6: SOFTWARE TROUBLESHOOTING GUIDELINES ................................................................................................ 29

GENERAL GUIDELINES ........................................................................................................................................... 29
PROBLEM CASES AND SOLUTIONS ........................................................................................................................ 29

SECTION 7: DUTIES AND RESPONSIBILITIES ...................................................................................................................... 32

SYSTEM ADMINISTRATOR ..................................................................................................................................... 32
DATABASE ADMINISTRATOR ................................................................................................................................. 32
HARDWARE AND NETWORK ADMINISTRATOR ..................................................................................................... 32
DATA ENTRY OPERATORS AND/OR HOSPITAL USERS ........................................................................................... 33

SECTION 8: TERMS AND CONDITIONS FOR SOFTWARE IMPLEMENTATION...................................................................... 34

SECTION 9: COMPUTER ERGONOMICS FOR USERS .......................................................................................................... 35

CHAIR..................................................................................................................................................................... 35
MONITOR AND DOCUMENT .................................................................................................................................. 36
KEYBOARD AND MOUSE ........................................................................................................................................ 38
WORK PROCESS ..................................................................................................................................................... 40
ENVIRONMENT ...................................................................................................................................................... 42

APPENDIX ..................................................................................................................................... 45
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OVERVIEW OF CONTENTS
This Management Manual serves as guide in the successful implementation of the Integrated Hospital
Operations and Management Information System (iHOMIS) software. The purpose of this manual is to
guide hospital staff through all aspect of software implementation by providing information about the
software, standards, and procedures. The manual is divided into sections. Each section provides
information about a specific aspect of these topics. The contents of the manual are as follows:

SECTION 1. THE iHOMIS SOFTWARE

This section presents a brief overview, objectives, benefits, features and functions of the software.
SECTION 2. IMPLEMENTATION REQUIREMENTS
This section presents the prerequisites and provisions to successfully use and maintain the system.
Requirements for manpower, software, hardware and maintainability are included.
SECTION 3. HARDWARE, OPERATING SYSTEM AND DATABASE MANAGEMENT SOFTWARE
REQUIREMENTS
This section defines the recommended set of specifications for the hardware, operating system
and database management software for the iHOMIS to run.
SECTION 4. SOFTWARE CONFIGURATION MANAGEMENT
Software Configuration Management is the ability to control and manage change in the software.
This section presents the change management processes to prevent unauthorized changes and
procedures to follow when making changes, required information, possibly workflow management
as well.
SECTION 5. INPUT DATA AND REPORT STANDARDS
This section presents the standards input data sets and outputs/reports that shall be used and
generated to support the implementation of the software.
SECTION 6. SOFTWARE TROUBLESHOOTING GUIDELINES
This section presents cases and solutions to solve a particular problem. Problem cases can be
related to the software and/or standard manual operating procedures.
SECTION 7. DUTIES AND RESPONSIBILITIES
This section presents the duties and responsibilities that shall be exercised by people assigned to
implement the system.
SECTION 8. TERMS AND CONDITIONS FOR SOFTWARE IMPLEMENTATION
This section presents the terms and conditions for implementing the iHOMIS software to be signed
by the Director and/or Chief of the Hospital.
SECTION 9. ERGONOMICS FOR USERS
Ergonomics is the study of the relationship between people and their work with the goal of
designing job tasks, workstations, tools and equipment to fit the varying capabilities of people. It
refers to things that one can do to make working on a computer more comfortable and better for
the body. This section presents guidelines for users to become more efficient and effective in their
work.
Aside from this Management Manual, the following documents are available for system
implementation:

A. SOFTWARE OPERATIONS MANUAL OR USER’S MANUAL

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This manual is intended for users who shall be responsible for operating the software. This
teaches the users on how the operate or use the software. The detailed technical discussions
are included in the iHOMIS USER’S MANUAL.

B. SOFTWARE INSTALLATION MANUAL

This manual is for Users and Technical Persons who shall be responsible for operating the
software and/or extending technical support. The detailed technical discussions on this are
included in the iHOMIS IMPLEMENTATION KIT MANUAL.

C. HOSPITAL INFORMATION SECURITY POLICIES AND PROCEDURES MANUAL

This manual is for the users and Technical Persons who shall be responsible for the enforcing
and/or implementing of security measures in using iHOMIS. The detailed technical discussions
on this is included in the HOSPITAL INFORMATION SECURITY POLICIES AND PROCEDURES MANUAL
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SECTION 1: THE iHOMIS SOFTWARE

SYSTEM BACKGROUND
The Integrated Hospital Operations and Management Information System (iHOMIS) Software is a computer-
based information system developed by the Department of Health – Knowledge Management and
Information Technology Service (DOH-KMITS), formerly Information Management Service (DOH-IMS). In
1998, the IMS developed the initial prototype of the software under its own initiative. Programming works
started in the Admission and Medical Records Systems. The technical service of IMS was requested by the
Health Intelligence Service (HIS), which is now the National Epidemiology Center (NEC), to support the
Hospital Retrieval Information System (HRIS) project.
One of the objectives of the HRIS project is to develop the simple software of capturing data from the
Admission and Medical Records Section to provide the statistical reports needed by the Central Office.
Series of meetings and discussions were conducted towards the development of the software. Another
office, the Hospital Operations Management Service (HOMS) that is now the National Center for Health
Facility Development (NCHFD) had project called Hospital Epidemiology Program (HEP), with the same
objective of developing the same software.
The HRIS and the HEP projects have the same objective, i.e. to develop the software that will systematically
collect, process, store, and share information in support of hospital functions; and provide the necessary
statistical data required by the Central Office. In order not to duplicate activities and maximize time and
effort, activities were synchronized into the HEP project. The name of the HEP project was later changed
to Integrated Hospital Operations and Management Program (IHOMP). The IHOMP has twenty-four (24)
government pilot hospitals for the implementation of the iHOMIS Software.
The Health Management Information System component of the Integrated Community Health Services
Project (HMIS-ICHSP) is also going to develop the hospital software with the same objective with that of the
IHOMP. The technical services of the IMS were again requested to support the software development of
the HMIS. The HMIS has six (6) pilot provinces for the implementation of the iHOMIS software. These are
Apayao, Guimaras, Kalinga, Palawan, South Cotabato and Surigao Del Norte provinces.
Because of the lack of technical manpower for IMS, the ICHSP funded the hiring of additional contractual
programmers to assist in the development of the software. Staff from the IMS, managed the entire software
development and provided technical assistance in the design and programming of the software. Members
of the DOH technical team were two (2) full-time Systems Analyst/Programmers, one (1) part-time Database
Specialist, one (1) part-time Network Specialist and one (1) full-time Trainer/Programmer. The iHOMIS
software will be the same software that will be used by the HMIS-ICHSP and IHOMP. The NCHFD will be
responsible for evaluating and monitoring the manual standard operating procedures of the hospital to
comply with existing standards to use the iHOMIS Software.
The programming of the software started in March 1999 and the contract was terminated in December
2000. In June 1999, the first module of the software was already developed and ready for testing. The
approach to pilot testing and implementing the software is modular. Additional requirements and problems
in testing particularly compliance to the standard manual operating procedures of the hospitals were
encountered. Requirements from the Philippine Health Insurance Corporation (PHIC) and different
stakeholders and the need to respond to the various needs of the Health Sector Reform Agenda (HSRA)
turned the basic software into a complicated one. Because of this, the software has to be continuously
enhanced to meet the requirements.
In May and June of 2002, the software installed in six (6) ICHSP pilot sites was evaluated by the IMS, ICHSP,
Bureau of International Health and Cooperation (BIHC), Bureau of Local Health and Development (BLHD)
and National Epidemiology Center (NEC). Important findings were:
a. The software is useful to all the hospitals.
b. All hospitals will continue to use the software.
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c. Hospital personnel cited reasons for being anxious due to lack of experience in using computers
and the fear of technical problems. Most of these components were from hospital staff with
lack of experience in using computers.
d. Interactivity and design of the software were positive.
e. The development of the software was based on the standards set by the NCHFD. In actual
implementation and evaluation there were requirements to be incorporated in the software to
make it more useful to the hospital.
f. Other problems ca be attributed to non-compliance to the manual standard operating
procedures vis-à-vis the computer-based system.
To date, iHOMIS will be replicated in seven (7) identified sites of the ICHSP starting this August, 2003.

SOFTWARE OVERVIEW
HOMIS is an integrated Windows based hospital information system designed for hospitals, and
encompasses the patient’s medical records. The system uses the latest in information technology that
facilitates the day-to-day operations of the hospital. The system integrates the clinical system with the
financial and administrative systems.

SOFTWARE OBJECTIVES
The primary objective of the software is to put in place a standard operating procedures that will be
common and useful to all hospitals. Specific objectives are as follows:
To systematically collect, process, store, present, and share information in support of hospital
functions; and
To improve hospital services in a time-efficient and cost-effective manner.

SOFTWARE BENEFITS
The expected benefits from using the software are as follows:
Reduces redundancies because operations/procedures can be simplified.
Avoids inconsistencies because standard have to be put in place.
Maintains data integrity.
Improves hospital services in time-efficient and manner resulting to increased patient/client
satisfaction.
Provides accurate, timely, complete, up-to-date and meaningful data/information.
Processes large volume of data and retrieves information quickly.
Eliminates duplication of efforts among departments.
Improves internal and external communications and management control.

SOFTWARE FEATURES
Features of the software are as follows:
User-Friendly. The software has graphical user interfaces that are easy to use.
Portable. The software runs on Windows operating systems.
Standardized. The software has incorporated international standards like ICD-10.
Maintainable. The software easily adapts to new requirements because of its object-oriented model.
Secure. The software is secured against threats to confidentiality, integrity and availability.
Comprehensive. Covers a full range of application systems beginning from a simple to full-scale
implementation.
Adapts to local settings. The software’s requirements are based on local needs.
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Improved performance. The software processes large volume of data at increased speed and less
time.

SOFTWARE FUNCTIONS
SYSTEM ADMINISTRATION. This function includes the security setup of the user accounts for security
and confidentiality, backup process, and generates the transaction log for monitoring purposes.
REFERENCE. This function enables build-up of master data and/or libraries required for the
transactions.
TRANSACTION. This function enables entry of patient’s master record, admission, discharge, billing,
medical social service, Philippine Health Insurance Claims, Medical Records, payments and others.
REPORT. This function generates reports and/or outputs on screen and hard copy forms including
graphs to present statistical results.
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SECTION 2: IMPLEMENTATION REQUIREMENTS

To put into successful operation the iHOMIS in a hospital facility, the following shall be made available:
1. There shall be an available 24-hour electricity in the facility.
2. Hospital Management shall procure the recommended Hardware, Operating System, Database
Management Software and Network Operating System software prior to the implementation of the
system.
3. Hospital Management shall be able to provide annual continuing budget for the following:
a. Computer supplies like ink/ribbon, compact discs, and other related computer supplies.
b. Hardware maintenance.
c. Local information technology training updates.
4. Hospital Management shall be able to provide full time and backup personnel who shall be responsible
for operating the software.
5. Hospital Management shall issue and implement policies related to the following:
a. Placement of processing and support activities for the software.
b. Responsibilities and extent of involvement of the users of the software.
c. Responsibilities for information system security and administration.
d. Responsibilities for monitoring and compliance with policies and standards regarding the use of
the software.
e. Incorporation of all activities and needs of the software in its information system plan.
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SECTION 3: HARDWARE, OPERATING SYSTEM AND

DATABASE MANAGEMENT SOFTWARE REQUIREMENTS

This section defines the recommended set of technical specifications for the software to run. Prior to
implementing the system, the technical Person from the Knowledge Management and Information Technology
Service (KMITS) of the DOH shall assess the existing hardware and software of the hospital.
The recommended hardware specifications are as follows:
1. Intel Core i3 processor or higher
2. 8GB memory or higher
3. 1TB disk space or higher
4. Quality printer for reports.
The following are the recommended software specifications for the Operating System, Database Management
System (DBMS) and Administration are as follows:
1. Operating System: Microsoft Windows 10 Professional
2. DBMS: Microsoft SQL Server or MySQL Administrator. The selection of the appropriate DBMS is
dependent on the type of hospital and existing budget.
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SECTION 4: SOFTWARE CONFIGURATION MANAGEMENT

Software Configuration Management (SCM) is included in this manual to provide direction on identifying change,
controlling change and assuring that change is properly implemented and maintained. This establishes
mechanisms for evaluating, controlling and making modifications to the software. There are three (3) major
activities included in SCM, namely:
a. CORRECTIVE MAINTENANCE. Diagnose and correct errors that were not identified or resulted to some
changes or modifications in the manual procedures.
b. PERFECTIVE MAINTENANCE. Add new capabilities, modify existing functions and make general
enhancements if necessary.
c. PREVENTIVE MAINTENANCE. Update the software to improve future maintainability or reliability or to
provide a better basis for future enhancements.
This section presents also the strategies for technical support in case of problems arising from the
implementation of the system. This is required for the continuing maintenance of the system to ensure effective
and efficient implementation of the system.

SOFTWARE MAINTENANCE
Software Maintenance includes activities intended to keep the iHOMIS useful at all times. Hospital
Management shall be able to maintain the software under the following conditions:
1. Provide annual continuing budget for the following:
a. Logistics Support, i.e. computer supplies like ink/ribbon, compact discs, tapes for backups and
other related supplies.
b. Hardware Maintenance. This will ensure that computers, printers and other peripheral devices
and equipment shall be in good working condition.
c. Regular Personnel Training. This will ensure that knowledge and skills of users in computers as
well as in Information Technology shall be regularly updated.
2. Provide continuous management commitment and support in terms of budget, full time involvement
and participation of users and establishment and implementation of policies and guidelines relative to
the software implementation.

TECHNICAL SUPPORT
Hospital personnel shall be able to respond to the issues, concerns and/or problems related to the
implementation of the system. To be able to attain this, the following are recommended:
a. iHOMIS Technical Persons shall be made available in the Provincial Health Office (PHO) and the
Centers for Health Development (CHD) to attend to problems that may be encountered. The
knowledge and skills required shall be continuously enhanced by series of technical training. The
Information Management Service of the Department of Health shall conduct the initial training as
well as the Technical Updates Training to maintain the system.
b. iHOMIS Technical Persons shall be trained on Installation of the Database, Installation of the
Software, Software Operations, Training of Trainers, Software Troubleshooting and Creation of
Additional Reports.
c. iHOMIS Technical Persons shall have the privilege to undergo Technical Updates Training. The
main task after the training is to re-echo and train the other users on the updates related to the
system.
d. The Knowledge Management and Information Technology Service of the Department of Health
shall extend technical support to problems that cannot be solved at the level the Hospital Users
and Technical Persons.
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SECTION 5: INPUT DATA AND REPORT STANDARDS

The manual standard operating systems and procedures shall be in place to support the implementation of the
software. The requirements for input data sets and output reports have to be defined and implemented vis-à-
vis the computerized system.

INPUT DATA STANDARDS

Refer to Annex 1: Standards on Input Forms for screen layout of iHOMIS input data forms. Input data forms
available in the software are as follows:
ADMISSION AND DISCHARGE SYSTEM:
MASTER PATIENT INPUT FORM. This is the form that is filled up by a new patient at the
time of consultation/visit. Data required are as follows:
5.1.1.1.1 Hospital Number that establishes the uniqueness of each patient
5.1.1.1.2 Last Name
5.1.1.1.3 First Name
5.1.1.1.4 Middle Name
5.1.1.1.5 Sex
5.1.1.1.6 Place of Birth
5.1.1.1.7 Date of Birth or Age if the exact date of birth is not available.
5.1.1.1.8 Address of Patient (Number of House, Street Name, Barangay,
City/Municipality, Province, Region, Country, Zip code)
5.1.1.1.9 Alias Name, Prefix, Suffix, Civil Status, Employment Status, Nationality,
Religion, Telephone No., Occupation
5.1.1.1.10 Contact Person (Last Name, First Name, Middle Name, Suffix, Address,
Telephone Number, Relation to Patient).
5.1.1.1.11 Maiden Name (Last Name, First Name, Middle Name, Suffix)
5.1.1.1.12 Spouse’s name (Last Name, First Name, Middle Name, Suffix)
5.1.1.1.13 Mother’s Name (Last Name, First Name, Middle Name, Suffix)
5.1.1.1.14 Mother’s Maiden Name (Last Name, First Name, Middle Name, Suffix)
5.1.1.1.15 Spouse Address
5.1.1.1.16 Spouse’s Employer’s Information (Name, Address, E-mail Address, Telephone
Number)
5.1.1.1.17 Father’s Address
5.1.1.1.18 Father’s Employer’s Information (Name, Address, E-mail Address, Telephone
Number)
5.1.1.1.19 Mother’s Address
5.1.1.1.20 Mother’s Employer’s Information (Name, Address, E-mail Address, Telephone
Number)
Admission Form. This is the form filled up by the hospital when a patient is to be admitted.
Data required are as follows:
5.1.1.2.1 Patient Information (Last Name, First Name, Middle Name, Suffix, Sex, Alias
Name, Date of Birth, Place of Birth, Nationality, Religion, Civil Status).
5.1.1.2.2 Patient Address (House No. and Street, City or Municipality, Province, Region,
Barangay, Zip code, Country, Telephone No., Occupation).
5.1.1.2.3 Contact Person (Last Name, First Name, Middle Name, Address, Telephone
No., Relation To Patient).
5.1.1.2.4 Father Information (Last Name, First Name, Middle Name, Address,
Telephone No.).
5.1.1.2.5 Spouse Information (Last Name, First Name, Middle Name, Address).
5.1.1.2.6 Admission (Age At Time of Admission, New or Old Patient, Type of Admission,
If PHIC, Type of Service, Admission Date, Admission Time, Reason for
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Admission, Admitting Diagnosis, Admitting Physician, Attending Physician,

Mode of Admission, Pregnancy Status, Ward, Room, Bed).
5.1.1.2.7 Person Responsible for the Account (Last Name, First Name, Middle Name,
Address, Telephone No., Relation to Patient). Informant (Last Name, First
Name, Middle Name, Address, Telephone No., Relation to Patient).
5.1.1.2.8 Source of Payment (Payment 1, Payment 2, Payment 3, House Case or Private
Case, Admitting Clerk).
ROOM RESERVATION FORM. This is the form filled up by the hospital when a patient is to
avail for a room reservation. Data required are as follows:
5.1.1.3.1 Patient Info (Last Name, First Name, Middle Name
5.1.1.3.2 Sex
5.1.1.3.3 Reservation Info (Date, Time, Accommodation, Ward, Room, Bed, Reservation
Status)
5.1.1.3.4 Remarks
ROOM FORM. This is the form filled up by the hospital when a patient is to modify an
assigned room. Data required are as follows:
5.1.1.4.1 Date Logged
5.1.1.4.2 Time Logged
5.1.1.4.3 Ward
5.1.1.4.4 Room
5.1.1.4.5 Bed Code
5.1.1.4.6 Rooming-in Baby
5.1.1.4.7 Remarks
REFERRAL FROM FORM. If the patient was referred from another facility, data required
are as follows:
5.1.1.5.1 Date of Referral
5.1.1.5.2 Time of Referral
5.1.1.5.3 Name of Referring Facility (Referral From)
5.1.1.5.4 Diagnosis. This can be Final Diagnosis or other types of diagnosis.
5.1.1.5.5 Type of Diagnosis
5.1.1.5.6 Reason for Referral
5.1.1.5.7 Category of Referring Person
5.1.1.5.8 Referred By
5.1.1.5.9 License No.
5.1.1.5.10 Last Name
5.1.1.5.11 First Name
5.1.1.5.12 Middle Name
5.1.1.5.13 Referred by Agency
5.1.1.5.14 Notes
5.1.1.5.15 Reference Control Number
REFERRAL TO FORM. This is the form filled up by the hospital when referring a patient to
another facility. Data required are as follows:
5.1.1.6.1 Actual Data Transferred
5.1.1.6.2 Actual Time Transferred
5.1.1.6.3 Referral To
5.1.1.6.4 Management
5.1.1.6.5 Reason for Referral
5.1.1.6.6 Notes for Reason
5.1.1.6.7 Category of Referring Person
5.1.1.6.8 Referred by Physician
5.1.1.6.9 Referred by Agency
5.1.1.6.10 Referred to Physician
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5.1.1.6.11 Type of Service

DISCHARGE FORM. This is the form filled up by the hospital when a patient is to be
discharged. Data required are as follows:
5.1.1.7.1 Date Discharged
5.1.1.7.2 Discharged
5.1.1.7.3 Disposition
5.1.1.7.4 Discharge Notes
5.1.1.7.5 Condition Upon Discharge
BILLING SYSTEM:
CASE TYPE FORM. This is the form filled up by the hospital to classify a patient’s condition.
Data required are as follows:
5.1.2.1.1 Case Type
PATIENT CHARGE FORM. This is the form filled up by the hospital to process charging fees
accumulated by a patient. Data required are as follows:
5.1.2.2.1 Account No.
5.1.2.2.2 Charge Slip No.
5.1.2.2.3 Charge Slip Date
5.1.2.2.4 Cost Center
5.1.2.2.5 Type of Charge
5.1.2.2.6 Item
5.1.2.2.7 Unit of Measure
5.1.2.2.8 Quantity
5.1.2.2.9 Price
5.1.2.2.10 Amount
DISCOUNT FORM. This is the form filled up by the hospital to apply discount amount for
the particular patient. Data required are as follows:
5.1.2.3.1 Date
5.1.2.3.2 Discount Reference No.
5.1.2.3.3 Discount Code
5.1.2.3.4 Discount Amount
5.1.2.3.5 Discount Type
5.1.2.3.6 Date As Of
PROFESSIONAL SERVICE FORM. This is the form filled up by the Billing Section to charge a
patient with professional/doctor’s fee or simply called Services Fee. Data required are as
follows:
5.1.2.4.1 Name of Doctor
5.1.2.4.2 Type of Doctor
5.1.2.4.3 Service Date From
5.1.2.4.4 Service Date To
5.1.2.4.5 Type of Professional Service
5.1.2.4.6 Professional Fee
5.1.2.4.7 Discount
5.1.2.4.8 Discount Type
5.1.2.4.9 Additional Fee
5.1.2.4.10 Type of Additional Fee
5.1.2.4.11 Total Amount
5.1.2.4.12 Include PF in Bill?
5.1.2.4.13 Remarks
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OUTSIDE DM/LAB FORM. This is the form filled up by the Billing Section to record the
drugs and medicine, and laboratory service procured or contracted outside of the hospital.
Data required are as follows:
5.1.2.5.1 Account No.
5.1.2.5.2 Reference No.
5.1.2.5.3 Charge Slip Date
5.1.2.5.4 Charge Code
5.1.2.5.5 Item Description
5.1.2.5.6 Unit of Measure
5.1.2.5.7 Quantity
5.1.2.5.8 Unit Price
5.1.2.5.9 Amount
ADJUSTMENT FORM. This is the form filled up by the Billing Section to record the
adjustment(s) in charges made to the patient. Data required are as follows:
5.1.2.6.1 Account No.
5.1.2.6.2 Adjustment Date
5.1.2.6.3 Adjustment/Ref. No.
5.1.2.6.4 Cost Center
5.1.2.6.5 Charge Code
GEN. ACCT. NO. FORM. This is the form filled up by the Billing Section to assign a patient
with a billing account number for a particular confinement. Data required are as follows:
5.1.2.7.1 Patient Account Number
TRANSFER FEE FORM. This is the form filled up by the Billing Section to indicate if the
patient will be charged with a transfer fee for utilizing the room transfer process. Data
required are as follows:
5.1.2.8.1 All or individual?
5.1.2.8.2 With Transfer Fee?
CASHIER SYSTEM:
PAYMENTS FORM. This is the form filled up by the cashier to record a patient’s payment.
Data required are as follows:
5.1.3.1.1 Account No.
5.1.3.1.2 OR Date
5.1.3.1.3 OR Number
5.1.3.1.4 Amount Paid
5.1.3.1.5 Currency Code
5.1.3.1.6 Type of Payment
5.1.3.1.7 Mode of Payment
5.1.3.1.8 Notes
PAYMENT IN KIND/SERVICE FORM. This is the form filled up by the cashier to record a
patient’s payment made either in kind or service. Data required are as follows:
5.1.3.2.1 Account Number
5.1.3.2.2 OR/Reference No.
5.1.3.2.3 Date
5.1.3.2.4 Amount
5.1.3.2.5 Type
5.1.3.2.6 Description
PROMISSORY NOTE FORM. This is the form filled up by the cashier to record a patient’s
promissory note. Data required are as follows:
5.1.3.3.1 Promissory Note Number
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5.1.3.3.2 Promissory Note Date

5.1.3.3.3 Name of Person Signing the Promissory Note
5.1.3.3.4 Payable Due First
5.1.3.3.5 Payable Due Second
5.1.3.3.6 Payable Due Third
5.1.3.3.7 Payable Due Amount-First
5.1.3.3.8 Payable Due Amount-Second
5.1.3.3.9 Payable Due Amount-Third
CANCEL OR FORM. This is the form filled up by the cashier to cancel an OR. Data required
are as follows:
5.1.3.4.1 OR Number
5.1.3.4.2 Date
5.1.3.4.3 Amount
5.1.3.4.4 Currency
5.1.3.4.5 Mode of Payment
5.1.3.4.6 Remarks
WALK-IN FORM. This is the form filled up by the cashier to record a walk-in patient’s
payment. Data required are as follows:
5.1.3.5.1 OR Number
5.1.3.5.2 OR Date
5.1.3.5.3 Last Name
5.1.3.5.4 First Name
5.1.3.5.5 Middle Name
5.1.3.5.6 Total Amount Paid
5.1.3.5.7 Cost Center
REFUND FORM. This is the form filled up by the cashier to record a walk-in patient’s for
refund. Data required are as follows:
5.1.3.6.1 OR Number
5.1.3.6.2 OR Date
5.1.3.6.3 Total Computed Amount
5.1.3.6.4 Amount of Refund
5.1.3.6.5 Amount Refunded?
PHILHEALTH SYSTEM:
PHIC MEMBERSHIP FORM. This is the form filled up by the hospital to record a patient as
PhilHealth member. Data required are as follows:
5.1.4.1.1 Type of Membership
5.1.4.1.2 Name of Member (Last Name, First Name, Middle Name)
5.1.4.1.3 Date of Birth
5.1.4.1.4 Civil Status
5.1.4.1.5 Sex
5.1.4.1.6 Address (No. and Street, City or Municipality, Region, Province, Zip code,
Barangay, Country)
5.1.4.1.7 Name of Spouse (Last Name, First Name, Middle Name)
5.1.4.1.8 Employer’s Registered Name & Identification No.
5.1.4.1.9 Employer’s Address (No. and Street, City or Municipality, Region, Province, Zip
code, Barangay, Country)
BENEFICIARIES FORM. This is the form filled up by the hospital to record a member
patient’s beneficiaries. Data required are as follows:
5.1.4.2.1 Last Name
5.1.4.2.2 First Name
5.1.4.2.3 Middle Name
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 15

5.1.4.2.4 Date of Birth

5.1.4.2.5 Sex
5.1.4.2.6 Patient age
5.1.4.2.7 Relation To Member
5.1.4.2.8 Continue PHIC Claim?
MSS SYSTEM:
Medical Social Service Classification Form. This is the form filled up by the Billing Section
to identify the medical social service classification. Data required are as follows:
5.1.5.1.1 Social Service Classification
REFERRAL SYSTEM:
REFERRAL FROM FORM. If the patient was referred from another facility, data required
are as follows:
5.1.6.1.1 Date of Referral
5.1.6.1.2 Time of Referral
5.1.6.1.3 Name of Referring Facility (Referral From)
5.1.6.1.4 Diagnosis. This can be Final Diagnosis or other types of diagnosis.
5.1.6.1.5 Type of Diagnosis
5.1.6.1.6 Reason for Referral
5.1.6.1.7 Category of Referring Person
5.1.6.1.8 Referred By
5.1.6.1.9 License No.
5.1.6.1.10 Last Name
5.1.6.1.11 First Name
5.1.6.1.12 Middle Name
5.1.6.1.13 Referred by Agency
5.1.6.1.14 Notes
5.1.6.1.15 Reference Control Number
MEDICAL RECORDS SYSTEM:
ADMITTING DETAILS FORM. This is the form filled up by the medical records section to
modify a patient’s admitting details. Data required are as follows:
5.1.7.1.1 Admitting Notes
5.1.7.1.2 Mode of Admission
5.1.7.1.3 Pregnancy Status
5.1.7.1.4 Informant’s Name (Last Name, First Name, Middle Name, Suffix)
5.1.7.1.5 Address
5.1.7.1.6 Telephone Number
5.1.7.1.7 Relation To Patient
5.1.7.1.8 Source of Payment (1)
5.1.7.1.9 Source of Payment (2)
5.1.7.1.10 Source of Payment (3)
ALERT FORM. This is the form filled up by the medical records section to modify a patient’s
alert details. Data required are as follows:
5.1.7.2.1 Date Alert was Recognized
5.1.7.2.2 Time Alert was Recognized
5.1.7.2.3 Type of Alert
5.1.7.2.4 Details
RESULT FORM. This is the form filled up by the medical records section to modify result
details. Data required are as follows:
5.1.7.3.1 Result
5.1.7.3.2 Condition Upon Discharge
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 16

5.1.7.3.3 Case Type

5.1.7.3.4 Special Instructions
DEATH FORM. This is the form filled up by the medical records section to modify death
certificate details. Data required are as follows:
5.1.7.4.1 Date of Death
5.1.7.4.2 Immediate Cause : a
5.1.7.4.3 Interval Between Onset and Death
5.1.7.4.4 Immediate Cause : b
5.1.7.4.5 Interval Between Onset and Death
5.1.7.4.6 Immediate Cause : c
5.1.7.4.7 Interval Between Onset and Death
5.1.7.4.8 Other significant conditions contributing to Death
5.1.7.4.9 Death by Non-Natural Causes (Manner of Death, Specify, Place of Occurrence)
5.1.7.4.10 Attendant (Private or Public Health Officer or Hospital Authority or None /
Others, If Attended, Duration From, Duration To)
5.1.7.4.11 Time death occurred
5.1.7.4.12 Name in Print of Attendee & Date of Attendance
5.1.7.4.13 Corpse Disposal
5.1.7.4.14 Name and Address of Cemetery or Crematory
5.1.7.4.15 Informant (Name in Print, Relationship to the Deceased, Address, Date)
5.1.7.4.16 Prepared By (Name in Print)
5.1.7.4.17 For Ages 0 to 7 Days (Date of Birth, Age of the Mother, Method of Delivery,
Length of Pregnancy, Type of Birth, If Multiple Birth, Child was)
NEWBORN FORM. This is the form filled up by the medical records section to modify
newborn details. Data required are as follows:
5.1.7.5.1 Assign Hospital Number
5.1.7.5.2 Patient Code
5.1.7.5.3 First Name
5.1.7.5.4 Middle Name
5.1.7.5.5 Last Name
5.1.7.5.6 Sex
5.1.7.5.7 Date/Time of Birth
5.1.7.5.8 Distinguishing Marks
5.1.7.5.9 Physical Examination Date
5.1.7.5.10 APGAR Score at Birth
5.1.7.5.11 Minute After
5.1.7.5.12 10 Minutes After
5.1.7.5.13 General Condition
5.1.7.5.14 Hour After Birth
5.1.7.5.15 Measurement
5.1.7.5.16 Head
5.1.7.5.17 Circumference
5.1.7.5.18 Chest
5.1.7.5.19 Abdomen
5.1.7.5.20 Birth Weight
5.1.7.5.21 Birth Length
5.1.7.5.22 General Muscular Tonus
5.1.7.5.23 Skin Color
5.1.7.5.24 Turgor
5.1.7.5.25 Rash
5.1.7.5.26 Desquamation
5.1.7.5.27 Spleen
5.1.7.5.28 Kidney
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 17

5.1.7.5.29 Head Molding

5.1.7.5.30 Scalp
5.1.7.5.31 Fontanelles
5.1.7.5.32 Suture
5.1.7.5.33 Liver
5.1.7.5.34 Umbilical Cord
5.1.7.5.35 Inguinal Hernia
5.1.7.5.36 Face
5.1.7.5.37 Diastasis Recti
5.1.7.5.38 Eyes Conjunctives
5.1.7.5.39 Sclera
5.1.7.5.40 Pupils
5.1.7.5.41 Discharge
5.1.7.5.42 Other Findings
5.1.7.5.43 Genitals
5.1.7.5.44 Male Testes
5.1.7.5.45 Male Tr
5.1.7.5.46 Male L
5.1.7.5.47 Abnormalities
5.1.7.5.48 Ears
5.1.7.5.49 Nose
5.1.7.5.50 Mouth Lip
5.1.7.5.51 Tongue
5.1.7.5.52 Palate
5.1.7.5.53 Vaginal bleeding
5.1.7.5.54 Abnormalities
5.1.7.5.55 Extremities
5.1.7.5.56 Neck
5.1.7.5.57 Sternocleidomastoid
5.1.7.5.58 Fistula
5.1.7.5.59 Other Neck Findings
5.1.7.5.60 Clubfoot
5.1.7.5.61 Hip Dislocation
5.1.7.5.62 Femoral Pulse
5.1.7.5.63 Spine
5.1.7.5.64 Anus
5.1.7.5.65 Chest Shape
5.1.7.5.66 Respiration
5.1.7.5.67 Clavicles
5.1.7.5.68 Breast
5.1.7.5.69 Heart
5.1.7.5.70 Lungs
5.1.7.5.71 Impression
5.1.7.5.72 Resident
5.1.7.5.73 Assistant Resident
LIVE BIRTH FORM. This is the form filled up by the medical records section to modify birth
certificate details. Data required are as follows:
5.1.7.6.1 First Name
5.1.7.6.2 Middle Name
5.1.7.6.3 Last Name
5.1.7.6.4 Sex
5.1.7.6.5 Date of Birth
5.1.7.6.6 Place of Birth
5.1.7.6.7 Type of Birth
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 18

5.1.7.6.8 If Multiple Birth, Child was

5.1.7.6.9 Birth Order
5.1.7.6.10 Weight at Birth
5.1.7.6.11 Maiden Name (First, Middle, Last, Suffix)
5.1.7.6.12 Citizenship
5.1.7.6.13 Religion
5.1.7.6.14 Total Number of Children Born Alive
5.1.7.6.15 Total Number of Children Still Living Including This Birth
5.1.7.6.16 No. of Children Born Alive But Are Now Dead
5.1.7.6.17 Occupation
5.1.7.6.18 Age at the Time of this Birth
5.1.7.6.19 Residence (House No., Street, Barangay, City or Municipality, Province)
5.1.7.6.20 Name (First, Middle, Last)
5.1.7.6.21 Citizenship
5.1.7.6.22 Religion
5.1.7.6.23 Occupation
5.1.7.6.24 Age at the Time of this Birth
5.1.7.6.25 Date and Place of Marriage of Parents
5.1.7.6.26 Attendant (Physician or Traditional Midwife or Midwife or Nurse or Others)
5.1.7.6.27 Certification of Birth (Time, Name in Print, Name of Hospital, Date)
5.1.7.6.28 Informant (Name in Print, Relationship to the Child, Address, Date)
5.1.7.6.29 Prepared By (Name in Print, Title or Position, Date)
5.1.7.6.30 Received at the Office of the Civil Registrar (Name in Print, Title or Position,
Date)
PATIENT RECORD FORM. This is the form filled up by the medical records section to modify
patient record details. Data required are as follows:
5.1.7.7.1 VITAL SIGNS FORM:
Blood Pressure:
5.1.7.7.1.1.1 Date Log
5.1.7.7.1.1.2 Time Log
5.1.7.7.1.1.3 BP
5.1.7.7.1.1.4 Entered/Updated By
Temperature:
5.1.7.7.1.2.1 Date Taken
5.1.7.7.1.2.2 Time Taken
5.1.7.7.1.2.3 Temp
5.1.7.7.1.2.4 Entered/Updated By
Pulse:
5.1.7.7.1.3.1 Date Taken
5.1.7.7.1.3.2 Time Taken
5.1.7.7.1.3.3 Pulse
5.1.7.7.1.3.4 Entered/Updated By
Respiratory:
5.1.7.7.1.4.1 Date Taken
5.1.7.7.1.4.2 Time Taken
5.1.7.7.1.4.3 Respiratory
5.1.7.7.1.4.4 Entered/Updated By
Intake:
5.1.7.7.1.5.1 Date Taken
5.1.7.7.1.5.2 Time Taken
5.1.7.7.1.5.3 Oral
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 19

5.1.7.7.1.5.4 N/C
5.1.7.7.1.5.5 I.V.
5.1.7.7.1.5.6 Blood
5.1.7.7.1.5.7 Miscellaneous
5.1.7.7.1.5.8 Entered/Updated By
Output:
5.1.7.7.1.6.1 Date Taken
5.1.7.7.1.6.2 Time Taken
5.1.7.7.1.6.3 Urine
5.1.7.7.1.6.4 N.G.
5.1.7.7.1.6.5 Stool
5.1.7.7.1.6.6 Emesis
5.1.7.7.1.6.7 Miscellaneous
5.1.7.7.1.6.8 Entered/Updated By
Vital Signs:
5.1.7.7.1.7.1 Name of Hospital
5.1.7.7.1.7.2 Address
5.1.7.7.1.7.3 Surname
5.1.7.7.1.7.4 Given Name
5.1.7.7.1.7.5 Age
5.1.7.7.1.7.6 Sex
5.1.7.7.1.7.7 Hospital No.
5.1.7.7.1.7.8 Ward /Rm.
5.1.7.7.1.7.9 Vital Signs Record (Blood Pressure, Temperature, Pulse,
Respiratory)
5.1.7.7.2 HISTORY FORM:
Gen. Data and Patient Profile:
5.1.7.7.2.1.1 Date Log
5.1.7.7.2.1.2 Time Log
5.1.7.7.2.1.3 General Data and Patient Profile
5.1.7.7.2.1.4 Entered By/Updated By
Past History (Illnesses, Operations):
5.1.7.7.2.2.1 Date Log
5.1.7.7.2.2.2 Time Log
5.1.7.7.2.2.3 Past History (Previous Illnesses and operations)
5.1.7.7.2.2.4 Entered By/Updated By
Occupation and Environment:
5.1.7.7.2.3.1 Date Log
5.1.7.7.2.3.2 Time Log
5.1.7.7.2.3.3 Occupation and Environment
5.1.7.7.2.3.4 Entered By/Updated By
Complaint:
5.1.7.7.2.4.1 Date Log
5.1.7.7.2.4.2 Time Log
5.1.7.7.2.4.3 Complaint
5.1.7.7.2.4.4 Entered By/Updated By
Family History:
5.1.7.7.2.5.1 Date Log
5.1.7.7.2.5.2 Time Log
5.1.7.7.2.5.3 Family History
5.1.7.7.2.5.4 Entered By/Updated By
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 20

Drug Therapy:
5.1.7.7.2.6.1 Date Log
5.1.7.7.2.6.2 Time Log
5.1.7.7.2.6.3 Drug Therapy
5.1.7.7.2.6.4 Entered By/Updated By
Alcohol:
5.1.7.7.2.7.1 Date Log
5.1.7.7.2.7.2 Time Log
5.1.7.7.2.7.3 Alcohol
5.1.7.7.2.7.4 Entered By/Updated By
Tobacco:
5.1.7.7.2.8.1 Date Log
5.1.7.7.2.8.2 Time Log
5.1.7.7.2.8.3 Tobacco
5.1.7.7.2.8.4 Entered By/Updated By
Drug Allergies:
5.1.7.7.2.9.1 Date Log
5.1.7.7.2.9.2 Time Log
5.1.7.7.2.9.3 Drug Allergies
5.1.7.7.2.9.4 Entered By/Updated By
Other Allergies:
5.1.7.7.2.10.1 Date Log
5.1.7.7.2.10.2 Time Log
5.1.7.7.2.10.3 Other Allergies
5.1.7.7.2.10.4 Entered By/Updated By
All:
5.1.7.7.2.11.1 Date Log
5.1.7.7.2.11.2 Time Log
5.1.7.7.2.11.3 Type
5.1.7.7.2.11.4 History
5.1.7.7.2.11.5 Entered By/Updated By
History:
Name of Hospital
5.1.7.7.2.12.1
Hospital Code
5.1.7.7.2.12.2
Surname
5.1.7.7.2.12.3
Given Name
5.1.7.7.2.12.4
Age
5.1.7.7.2.12.5
Sex
5.1.7.7.2.12.6
Hospital No.
5.1.7.7.2.12.7
Ward, Rm.
5.1.7.7.2.12.8
History Record [General Data and Patient Profile, Present
5.1.7.7.2.12.9
Complaint, Past History (Previous Illness and Operations),
Family History, Occupation and Environment, Alcohol,
Tobacco, Drug Therapy Drug Allergies, Other Allergies]
5.1.7.7.3 SYSTEM REVIEW FORM:
General:
5.1.7.7.3.1.1 Date Log
5.1.7.7.3.1.2 Time Log
5.1.7.7.3.1.3 General
5.1.7.7.3.1.4 Entered By/Updated By
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 21

Skin:
5.1.7.7.3.2.1 Date Log
5.1.7.7.3.2.2 Time Log
5.1.7.7.3.2.3 Skin
5.1.7.7.3.2.4 Entered By/Updated By
EENT:
5.1.7.7.3.3.1 Date Log
5.1.7.7.3.3.2 Time Log
5.1.7.7.3.3.3 EENT
5.1.7.7.3.3.4 Entered By/Updated By
Musculoskeletal:
5.1.7.7.3.4.1 Date Log
5.1.7.7.3.4.2 Time Log
5.1.7.7.3.4.3 Musculoskeletal
5.1.7.7.3.4.4 Entered By/Updated By
Respiratory:
5.1.7.7.3.5.1 Date Log
5.1.7.7.3.5.2 Time Log
5.1.7.7.3.5.3 Respiratory
5.1.7.7.3.5.4 Entered By /Updated By
Cardiovascular:
5.1.7.7.3.6.1 Date Log
5.1.7.7.3.6.2 Time Log
5.1.7.7.3.6.3 Cardiovascular
5.1.7.7.3.6.4 Entered By/Updated By
Gastrointestinal:
5.1.7.7.3.7.1 Date Log
5.1.7.7.3.7.2 Time Log
5.1.7.7.3.7.3 Gastrointestinal
5.1.7.7.3.7.4 Entered By/Updated By
Genitourinary:
5.1.7.7.3.8.1 Date Log
5.1.7.7.3.8.2 Time Log
5.1.7.7.3.8.3 Genitourinary
5.1.7.7.3.8.4 Entered By/Updated By
Female-Reproductive:
5.1.7.7.3.9.1 Date Log
5.1.7.7.3.9.2 Time Log
5.1.7.7.3.9.3 Female-Reproductive
5.1.7.7.3.9.4 Entered By/Updated By
Nervous:
5.1.7.7.3.10.1 Date Log
5.1.7.7.3.10.2 Time Log
5.1.7.7.3.10.3 Nervous
5.1.7.7.3.10.4 Entered By /Updated By
PTB:
5.1.7.7.3.11.1 Date Log
5.1.7.7.3.11.2 Time Log
5.1.7.7.3.11.3 Type
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 22

5.1.7.7.3.11.4 Site
5.1.7.7.3.11.5 Treatment
5.1.7.7.3.11.6 Entered By/Updated By
Asthma:
5.1.7.7.3.12.1 Date Log
5.1.7.7.3.12.2 Time Log
5.1.7.7.3.12.3 Type
5.1.7.7.3.12.4 Site
5.1.7.7.3.12.5 Treatment
5.1.7.7.3.12.6 Entered By/Updated By
Cancer:
5.1.7.7.3.13.1 Date Log
5.1.7.7.3.13.2 Time Log
5.1.7.7.3.13.3 Type
5.1.7.7.3.13.4 Site
5.1.7.7.3.13.5 Treatment
5.1.7.7.3.13.6 Entered By/Updated By
Others:
5.1.7.7.3.14.1 Date Log
5.1.7.7.3.14.2 Time Log
5.1.7.7.3.14.3 Type
5.1.7.7.3.14.4 Site
5.1.7.7.3.14.5 Treatment
5.1.7.7.3.14.6 Entered By /Updated By
System Review:
Hospital Name
5.1.7.7.3.15.1
Hospital Code
5.1.7.7.3.15.2
Surname
5.1.7.7.3.15.3
Given Name
5.1.7.7.3.15.4
Age
5.1.7.7.3.15.5
Sex
5.1.7.7.3.15.6
Hospital No.
5.1.7.7.3.15.7
Ward, Rm.
5.1.7.7.3.15.8
System Review Record (General, Skin, EENT,
5.1.7.7.3.15.9
Musculoskeletal, Respiratory, Cardiovascular,
Gastrointestinal, Genitourinary, Female-Reproductive,
Nervous. PTB, Asthma, Cancer, Others)
5.1.7.7.4 PHYSICAL EXAM FORM:
Skin:
5.1.7.7.4.1.1 Date Log
5.1.7.7.4.1.2 Time Log
5.1.7.7.4.1.3 Skin
5.1.7.7.4.1.4 Entered By/Updated By
Head-EENT:
5.1.7.7.4.2.1 Date Log
5.1.7.7.4.2.2 Time Log
5.1.7.7.4.2.3 Head-EENT
5.1.7.7.4.2.4 Entered By/Updated By
Lymph nodes:
5.1.7.7.4.3.1 Date Log
5.1.7.7.4.3.2 Time Log
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 23

5.1.7.7.4.3.3 Lymph nodes

5.1.7.7.4.3.4 Entered By/Updated By
Chest-Lungs:
5.1.7.7.4.4.1 Date Log
5.1.7.7.4.4.2 Time Log
5.1.7.7.4.4.3 Chest-Lungs
5.1.7.7.4.4.4 Entered By /Updated By
Chest-Cardiovascular:
5.1.7.7.4.5.1 Date Log
5.1.7.7.4.5.2 Time Log
5.1.7.7.4.5.3 Chest-Cardiovascular
5.1.7.7.4.5.4 Entered By/Updated By
Breast:
5.1.7.7.4.6.1 Date Log
5.1.7.7.4.6.2 Time Log
5.1.7.7.4.6.3 Breast
5.1.7.7.4.6.4 Entered By/Updated By
Abdomen:
5.1.7.7.4.7.1 Date Log
5.1.7.7.4.7.2 Time Log
5.1.7.7.4.7.3 Abdomen
5.1.7.7.4.7.4 Entered By/Updated By
Rectum:
5.1.7.7.4.8.1 Date Log
5.1.7.7.4.8.2 Time Log
5.1.7.7.4.8.3 Rectum
5.1.7.7.4.8.4 Entered By/Updated By
Genitalia:
5.1.7.7.4.9.1 Date Log
5.1.7.7.4.9.2 Time Log
5.1.7.7.4.9.3 Genitalia
5.1.7.7.4.9.4 Entered By/Updated By
Musculoskeletal:
5.1.7.7.4.10.1 Date Log
5.1.7.7.4.10.2 Time Log
5.1.7.7.4.10.3 Musculoskeletal
5.1.7.7.4.10.4 Entered By/Updated By
Extremities:
5.1.7.7.4.11.1 Date Log
5.1.7.7.4.11.2 Time Log
5.1.7.7.4.11.3 Extremities
5.1.7.7.4.11.4 Entered By /Updated By
Neurological:
5.1.7.7.4.12.1 Date Log
5.1.7.7.4.12.2 Time Log
5.1.7.7.4.12.3 Neurological
5.1.7.7.4.12.4 Entered By /Updated By
All:
5.1.7.7.4.13.1 Date Log
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 24

5.1.7.7.4.13.2 Time Log

5.1.7.7.4.13.3 Type of Physical Exam
5.1.7.7.4.13.4 Description
5.1.7.7.4.13.5 Entered By/Updated By
5.1.7.7.4.13.6 Physical Exam Record (Skin, Head-EENT, Lymph nodes,
Chest Lungs, Chest Cardiovascular, Breast, Abdomen,
Rectum, Genitalia, Musculoskeletal, Extremities,
Neurological)
5.1.7.7.5 DOCTOR FORM:
Doctor/Physician
Type
5.1.7.7.6 DIAGNOSIS FORM:
Date Log
Time Log
Type of Diagnosis
Diagnosis
Doctor
Remarks
5.1.7.7.7 DOCTOR’S ORDER FORM:
Examinations/Prescription/Supplies:
5.1.7.7.7.1.1 If Examination:
a) Date of Order
b) Time of Order
c) Ordered By
d) Order Exam
e) Date Posted
f) Time Posted
g) Entered By
h) Verified By
5.1.7.7.7.1.2 If Prescription:
a) Order Control ID
b) Date of Order
c) Time of Order
d) Ordering Doctor
e) Order Status
f) Drug Item
g) Quantity Intake
h) Frequency
i) For
j) Total Quantity
k) Preferred Time/Every
l) Preferred Days
m) Start of Medication
n) Remarks
o) Date Posted
p) Time Posted
q) Entered By
r) Verified By
5.1.7.7.7.1.3 If Supplies:
a) Order Control ID
b) Date of Order
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 25

Time of Order
c)
Ordering Doctor
d)
Order Status
e)
Item
f)
Quantity
g)
Date Posted
h)
Time Posted
i)
Entered By
j)
Verified By
k)
5.1.7.7.8 REFERRAL FROM FORM:
Date of Referral
Time of Referral
Referral From
Diagnosis
Type of Diagnosis
Reason for Referral
Category of Referring Person
Referred By
License No.
Last Name
First Name
Middle Name
Referred By Agency
Notes
Reference Control Number
5.1.7.7.9 DISPOSITION/RESULT FORM:
Disposition/Result:
5.1.7.7.9.1.1 Result
5.1.7.7.9.1.2 Condition Upon Discharge
5.1.7.7.9.1.3 Case Type
5.1.7.7.9.1.4 Special Instructions
Next Visit, Appointment:
5.1.7.7.9.2.1 Frequency
5.1.7.7.9.2.2 For
5.1.7.7.9.2.3 Day
5.1.7.7.9.2.4 Time
5.1.7.7.9.2.5 Next Visit or Schedule (Date, Time, Day)
5.1.7.7.10 CHARGES FORM:
Drugs & Medicine/Supplies & Equipment:
5.1.7.7.10.1.1 Date of Issue
5.1.7.7.10.1.2 Time of Issue
5.1.7.7.10.1.3 Qty Issued
5.1.7.7.10.1.4 Unit of Measure
5.1.7.7.10.1.5 Issued By
5.1.7.7.10.1.6 Date of Return
5.1.7.7.10.1.7 Time of Return
5.1.7.7.10.1.8 Qty Return
5.1.7.7.10.1.9 Unit of Measure
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 26

5.1.7.7.10.1.10 Returned By
5.1.7.7.10.1.11 Remarks

OUTPUT/REPORT STANDARDS
The software has customized reports that can be generated by the users. Refer to Annex 2: Standards on
Output/Report Forms for sample/layout of HOMIS output forms. Customized reports available in the
software are as follows:
ADMISSION AND DISCHARGE SYSTEM:
REPORT BY ADMITTED PATIENTS. This report shows the list of admitted patients of
consultations sorted by Date, LOS, Room, Service, Gender, Ward, Patient Name, and
Municipality for a selected period of time.
REPORT BY BED OCCUPANCY. This report shows the list of occupied bed(s) for a selected
period of time.
REPORT BY DISCHARGED PATIENTS. This report shows the list of discharged patients
sorted by Date, Diagnosis, LOS, Service, Gender, Ward, Patient Name, and Municipality for
a selected period of time.
REPORT BY HOSPITAL DAILY CENSUS. This report shows the list of daily census sorted by
service for a selected date.
CONSOLIDATED CENSUS REPORT. This report shows the list of consolidated census report
of admissions, transfers-in, discharges, transfer out, deaths, remaining admissions sorted
by service.
IN-PATIENT REGISTRY REPORT. This report shows the list of admitted patients sorted by
Hospital No., Date Admitted, Patient, Sex, and Service for a selected period of time.
PATIENT RECORD REPORT. This report shows a patient record for a selected patient.
ROOM STATUS REPORT. This report shows the status of all rooms sorted by
Ward/Room/Bed, Bed Status, Patient Name, and Admission Date.
REPORT OF VACANT ROOMS. This report shows the list of vacant rooms with bed number
sorted by Service.
CLINICAL COVER SHEET REPORT. This report shows the Clinical Cover Sheet for a selected
patient.
REPORT OF PATIENT ADMISSION. This report shows all of a patient’s admission history
for a selected patient.
BLACKLISTED REPORT. This report shows the list of blacklisted patients with unpaid
hospital bills.
REPORT ON EPI INFORMATION. This report shows the list EPI information regarding a
patient sorted by hospital number.
ADMITTED PATIENTS-SECURITY REPORT. This report shows the list of admitted patients-
security sorted by Date, Hospital No., Patient Name, Ward, Room, and Bed.
CLEARANCE CERTIFICATE (1 PAGE). This report shows a patient’s clearance record in a
one-page format for a selected patient.
CLEARANCE CERTIFICATE (1/4 PAGE). This report shows a patient’s clearance record in a
¼ page format for a selected patient.
CLEARANCE CERTIFICATE (1/2 PAGE). This report shows a patient’s clearance record in a
½ page format for a selected patient.
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 27

INTER-AGENCY-REFERRAL SLIP. This report shows the inter-agency- selected patient.

BILLING SYSTEM:
TENTATIVE BILL REPORT. This report shows the tentative bill (Statement of Account)
usually issued to the patient who is still in confinement for a selected patient.
BILLING REPORT PER TYPE OF CHARGES. This report shows the amount of bill per Type of
Charges for a selected period of time.
BILLING REPORT PER TYPE OF ACCOUNT. This report shows the amount of bill per Type of
Account for a selected period of time.
BILLING REPORT PER COST CENTER. This report shows the amount of bill per cost center.
CASHIER SYSTEM
CASH COLLECTION REPORT. This report shows the cash collection for a selected period of
time.
SUMMARY OF COLLECTIONS BY TYPE OF ACCOUNT. This report shows the list of
collections acquired for a selected period of time per type of Account.
PHILHEALTH SYSTEM
INFORMATION FOR MEDICARE MEMBERSHIP REPORT. This report shows the details of
Medicare membership of a selected patient.
MEMBER/EMPLOYER CERTIFICATION REPORT. This report shows the PhilHealth
Member/Employer Certification of a selected patient to be submitted to the hospital prior
to his/her discharge.
PHILHEALTH CLAIM FORM 1 REPORT. This report shows the details of a selected patient’s
PhilHealth Claim Form 1 containing Part I: Member’s Certification, and Part II: Employer’s
Certification.
PHILHEALTH CLAIM FORM 2 REPORT. This report shows the details of a selected patient’s
PhilHealth Claim Form 2 containing Part I: Hospital and Data Charges, and Part II:
Professional Data and Charges.
PHILHEALTH CLAIM FORM 3 REPORT. This report shows the details of a selected patient’s
PhilHealth Claim Form 3 containing Patient’s Clinical Record.
TRANSMITTAL LIST. This report shows the list of PhilHealth members for transmittal.
MANDATORY MONTHLY HOSPITAL REPORT. This report shows the details of a hospital
report for PHIC containing information as
a.) Discharge During The Current Month,
b.) Daily Census of Patients (every 5:00 p.m.),
c.) Quality Assurance Indicator,
d.) Five Most Common Causes of Confinement,
e.) Surgical Output – Top 10 Procedures,
f.) Adverse Drug Reaction (Top 5 Drugs),
g.) Monthly Mortality Census (All Cases) for a selected period of Month and Year.
MSS SYSTEM
None.
MEDICAL RECORDS SYSTEM:
REPORT BY ADMISSION AND DISCHARGE. This report shows the admission and discharge
record for a selected patient.
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 28

CERTIFICATE OF CONFINEMENT REPORT. This report shows the confinement certification

for a selected patient.
CERTIFICATE OF LIVE BIRTH REPORT. This report shows a child’s live birth certification of
a selected female patient.
CERTIFICATE OF DEATH REPORT. This report shows a patient’s death certification.
DISCHARGE SUMMARY REPORT. This report shows the latest discharge summary of a
selected patient.
MEDICAL CERTIFICATE REPORT. This report shows the medical certification of a selected
patient.
MEDICO LEGAL CERTIFICATE REPORT. This report shows the medico legal findings
certification of a selected patient.
MEDICO LEGAL CERTIFICATE FOR RAPE CASE REPORT. This report shows the medico legal
findings certification for rape case of a selected patient.
NEW BORN RECORD REPORT. This report shows the new born record of a selected patient.
HISTORY REPORT. This report shows the history record of a selected patient.
PHYSICAL EXAMINATION REPORT. This report shows the findings in the physical
examination of a selected patient.
ELECTRONIC PATIENT RECORD REPORT. This report shows a medical record of a selected
patient in different categories i.e. socio demo data, diagnosis, complaint, history, intake,
output, alert, procedure operation, physical examination, specimen, encounter, system
reviews, others(date/time taken, vital sign code, measurement, unit of measure), All EPRs,
Respiratory Rate, Blood Pressure, Heart Rate, Temperature.

STANDARDS ON DATA ENTRY PROCESS

The recommended data entry processing is on-line data entry/processing. On-line data entry implies that
a PC/terminal is actively involved in operating the terminal by accepting data, updating data base files and
responding with messages for display on the terminal.

STANDARDS ON REPORT GENERATION

The iHOMIS Software – Reports Function is flexible because reports can be generated on a daily, weekly,
monthly, quarterly or yearly basis. The date range filtering feature, i.e. Date From and Date To, or Month
and Year, allows the system to generate reports for a selected time frame.

STANDARDS ON BACKUP PROCEDURES

HOMIS users shall comply with a regular data backup procedures to ensure recovery if something bad
happens to the data. The detailed technical discussions on how to back up the data is included in the
Database Back-Up Guide (SOFTWARE INSTALLATION under IMPLEMENTATION MANUAL).
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 29

SECTION 6: SOFTWARE TROUBLESHOOTING GUIDELINES

GENERAL GUIDELINES
Hospital Users are those personnel who shall be responsible for operating the software, solving
and/or troubleshooting problems, resolving issues, concerns and providing solutions and/or
recommendations.
Hospital Management shall designate a System Administrator (SA) who shall be responsible for
ensuring that the system is in operation, being used by Hospital Users and troubleshoot problems
related to the system.
Hospitals shall have a designated Database Administrator (DBA) who shall be responsible for
ensuring that the database is in operation, backing up of the data, fine-tuning of the database and
troubleshooting other problems related to database.
Hospitals shall have a designated Hardware and Network Administrator (HNA) who shall be
responsible for ensuring that the computers, networks and other devices are in operation and
troubleshooting other problems related to hardware and networking.
In the absence of a DBA and HNA, the designated SA shall be trained to provide technical support in
terms of database, hardware and networking. The SA, DBA and HNA are the Technical Persons of
the iHOMIS Software Implementation.
The Technical Persons shall be responsible for attending to and solving problems related to their
field of expertise.
If the Technical Persons cannot solve the problems, they shall consult the Regional/Provincial
Technical Persons assigned to provide iHOMIS support.
If the Regional/Provincial Technical Persons assigned cannot solve the problems, they shall consult
the Knowledge Management and Information Technology Service (KMITS) – Department of Health
(DOH). Depending on the complexity of the problems being reported, the IMS can choose to do any
of the following:
Send a softcopy of the updated program and written instructions to the hospital to solve the problems via
e-mail or courier.
Send IMS Technical Staff to the hospital to troubleshoot or resolve the problems.

PROBLEM CASES AND SOLUTIONS

The hospital users assigned to operate the software shall consult this Management Manual for issues,
concerns, and/or problems as well as solutions or recommendations to the problems.
PROBLEM CASE RECOMMENDED SOLUTION
1. Data entered cannot be There are mandatory columns/fields where data need to be
saved. entered. Mandatory columns/fields are colored green. Check for
these entries.

2. Integrity constraint Check data on the Reference Function. Data being entered is not
violation. present in the reference or library. You need to add the data into
the reference or library.

3. Attempt to insert duplicate There is data previously entered into the system. Each data has a
key or row. unique identifier that distinguishes one from another. Check the
master record if it exists.

Example: Patient code 111 has been entered previously and

another patient code 111 is being entered. The software will display
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 30

PROBLEM CASE RECOMMENDED SOLUTION

the message “Attempt to insert duplicate key or row …”. Use
another code.

4. No data can be selected Check data on the Reference Function. If the data is not available,
from any of the drop down enter the data through the Reference Function before it can be
selection boxes. displayed on any of the drop down selection boxes.

Example: You want to select a doctor but the name of the doctor is
not available on the list. Go to the Reference Function and enter
data on the Employee and Provider.

5. The report does not include Check the Transaction Function and retrieve the patient master
data entered into the record, consultation records, referral from/to and laboratory
system. records. This will prove that required data are entered into the
system.

6. Reports do not print. Check if the printer is plugged on to the electric current, properly
connected to the computer and with paper on it.

Check for the default printer assigned to print the reports.

If the printer attached does not match the default setting,

select/change printer configuration.

If no printer of that type exists, install the printer driver.

7. Report Totals do not display Check for the default printer assigned to print the reports.
on the screen.
If the printer attached does not match the default setting,
select/change printer configuration.

If no printer of that type exists, install the printer driver.

8. The report displays wrong Check the Transaction Function if the data is correctly entered into
values as a result of the system.
computations.
If the data is correctly entered into the system, validate the formula
used in the computation.

9. Insufficient memory Troubleshoot memory by allocating more memory to the

problem. application, closing other applications and windows, turning on
virtual memory, switching off RAM cache, or reducing the amount
of memory allocated to RAM cache.

10. Unexplained system crashes; Computer has become infected with a virus after using an infected
corrupted or disappearing program.
files.
To eradicate a virus, boot the computer from a startup disk that
contains an antivirus application and launch the eradication
program.

Be sure the virus program is compatible with your system software.

Incompatible versions can cause unexpected problems that are
difficult to track down.
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 31

PROBLEM CASE RECOMMENDED SOLUTION

To prevent future virus infection, use an antivirus application
program to screen all disks for known viruses. In addition, be sure
that all master disks remain locked.

11. Monitor Problems. a. Power off the system unit and monitor.
- Incorrect colors
b. Remove all adapter cards from the riser card.
- No high intensity
- Missing, broken or c. Make sure the monitor I/O signal cable is properly connected to
incorrect characters the system unit and monitor.
- Blank monitor (dark)
- Blank monitor (bright) d. Make sure the power cords are properly connected to the
- Distorted image system unit and monitor and that the line voltage is correct.
- Unreadable monitor
e. Make sure the monitor contrast and brightness controls are
turned too low.

f. Power on the monitor and wait 20 seconds.

DOH - iHOMIS MANAGEMENT MANUAL P a g e | 32

SECTION 7: DUTIES AND RESPONSIBILITIES

SYSTEM ADMINISTRATOR
Manages the data security, safety, integrity and disaster recovery.
Plans and implements system security policy, to include users’ access, file permissions and user
accounts.
Conducts growth analysis and capacity planning, and develops capital and operating budget
proposals.
Provides on-call consulting advice and technical support to various users regarding specific
operational and/or applications issues.
Reviews outputs of hospital users, coordinates with the administrator officer regarding work
assignments and schedules to maintain adequate staffing levels and respond to fluctuating
workloads.
Observes hospital users progress and ensures that jobs are data are processed accurately and timely.
May evaluate hospital users performance and prepares performance appraisals.
Troubleshoots system and/or iHOMIS application to identify and correct malfunctions and other
operational problems.
Develops and implements various training and instruction programs for hospital users on the use
and implementation of the iHOMIS software and system.
Assesses training needs of hospital users and arranges for or provides appropriate instructions.
Maintains a broad knowledge of state-of-the art technology, equipment and/or systems.
Maintains technical support documentation related to iHOMIS installation, training, implementation
and maintenance.
May lead or guide the work of hospital users to efficiently and effectively implement the iHOMIS.
May provide 24-hour on-call support.

DATABASE ADMINISTRATOR
Monitors iHOMIS database to optimize database performance, resource use, and physical
implementation.
Monitors and maintains database security.
Monitors and manages database backups and logs.
Installs, maintains and upgrades the iHOMIS database if necessary.
Restores and/or recovers data as required.
May provide 24-hour on-call support.
Maintains a broad knowledge of state-of-the-art technology, equipment and/or systems.
Formulates and implements policies and guidelines for iHOMIS database implementation.
Maintains technical support documentation related to database management and administration.
Performs miscellaneous job-related duties as assigned.

HARDWARE AND NETWORK ADMINISTRATOR

Manages help desk function (desktop pcs, laptops, e-mail, servers, backup, web, phones and others)
in supporting hospital staff in their daily computer operations.
Installs, maintains and troubleshoots computer hardware, network, ancillary, peripheral devices and
communication equipment.
Performs routine maintenance and updates of intranet, internet and website.
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 33

Coordinates all technical activities leading to effective configuration of hardware, network, database
and iHOMIS application system.
May define, negotiate and manage all vendor it support contracts and maintenance agreements.
Reviews and recommends the use of new hardware and networking assets which are needed to
meet hospital needs and technology requirements and to improve speed and efficiency of processes.
Formulates and implements network security policies and procedures, ensuring that all hospital
hardware and networking are protected.
Maintains a broad knowledge of state-of-the art technology, equipment and/or systems.
Maintains technical support documentation related to hardware and networking.
May provide 24-hour on-call support.

DATA ENTRY OPERATORS AND/OR HOSPITAL USERS

Checks, verifies and edits data coding to ensure compatibility with data entry system and procedural
requirements.
Interacts with the different hospital departments/sections/units to resolve routine data problems.
Receives and routes associated source paperwork to and from departments.
Works with the different hospital departments/sections/units as necessary to facilitate and expedite
the efficient flow of documentation and to resolve routine administrative problems.
Inputs and retrieves alphabetical and numerical information in prescribed format.
Creates and maintains data, files and logs as required, makes individual and/or mass corrections,
modifications and/or updates to data as appropriate.
Extracts and releases information according to specified criteria and in strict compliance with
established policies, procedures and/or regulations, answers questions from client departments and
others on specific data as requested and prepares reports as specified.
Ensures strict confidentiality of client records.
Performs miscellaneous job-related duties as assigned.
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 34

SECTION 8: TERMS AND CONDITIONS FOR SOFTWARE

IMPLEMENTATION

This Terms and Conditions for Software Implementation shall be signed by the Chief of the Hospital and/or
Director to ensure that the iHOMIS software is continuously maintained and properly used. This also serves as
an agreement between the User and the DOH Developers of the iHOMIS.
(See the Terms and Conditions document in Appendix, page 45)
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 35

SECTION 9: COMPUTER ERGONOMICS FOR USERS

ERGONOMICS is the study of the relationship

between people and their work with the goal of
designing job tasks, workstations, tools and
equipment to fit the varying capabilities of
people. It refers to things that one can do to
make working on a computer more comfortable
and better for the body.
The following are the guidelines for iHOMIS users
to become more efficient and effective in their
line of work to implement the computer-based
system:

CHAIR
A properly designed and adjusted chair will provide appropriate support to the back, legs, buttocks and
arms. This support can reduce contact stress, over exertion and fatigue. It will also promote proper
circulation to the extremities. The following items are critical to an iHOMIS user who spends extended
hours at the workstation:
SEAT POSITION
POTENTIAL HAZARD
Improper size, shape, or choice of materials for the seat pan and backrest may result in uneven
weight distribution, contact stress, decreased circulation to the extremities and awkward posture.

POSSIBLE SOLUTIONS
 The seat and backrest of the chair should
support a comfortable posture that allows
frequent changing of the seating position.
 The seat pan should accommodate the specific
user (not too big or small). It should be padded
and have a rounded, "waterfall" edge. This will
reduce contact stress to the back of the legs.
 The angle of the seat pan is also important. A
Seat pan with an adjustable tilt ensures the
worker is able to maintain proper support in
different positions.

CHAIR HEIGHT
POTENTIAL HAZARD
Improper chair height.
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 36

POSSIBLE SOLUTIONS
 The chair height is correct when the entire sole
of the foot can rest on the floor or a footrest.

 The back of the knee is slightly higher than the

seat of the chair. This position allows blood to
circulate freely in the legs and feet.

ARM REST
POTENTIAL HAZARD
Armrests that are too high or too low can produce awkward postures, create contact stress to the
elbow, provide inadequate support, and may prevent the user from moving close enough to the
workstation.

POSSIBLE SOLUTIONS
 Adjustable armrests can be lowered to fit
under work surfaces. This allows the user to
work from a comfortable distance.
 The armrests should support both forearms
while the user performs tasks and should not
interfere with movement.

MONITOR AND DOCUMENT

Monitor and document placement are important in creating a comfortable workstation. The following
items must be considered in order to reduce awkward head and neck postures, fatigue and/or headaches:
DISPLAY
POTENTIAL HAZARD
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 37

 A display screen that is too high, too low, or

placed to the side of the user, may, over time,
cause awkward postures and increased stress
on the muscles of the neck, shoulders, and
upper back.

POSSIBLE SOLUTIONS
Keep monitor directly in front of the user.
The topmost line of the screen should not be
higher than the user's eyes.
Screens that swivel horizontally and tilt or elevate
vertically enable the user to select a comfortable
viewing angle.
Generally, placing the monitor on top of the
computer will raise it too high.

POTENTIAL HAZARD
Tilting the head back to read through the bottom portion of bifocal lenses can stress the neck, back
and shoulders.

POSSIBLE SOLUTIONS
Tilting of the head can be avoided by lowering the display or using single-lens glasses with a shorter
focal length while viewing the monitor.

POTENTIAL HAZARD
Viewing distances that are too long or too short can cause stress and eye strain.

POSSIBLE SOLUTIONS
 The preferred viewing distance is 18 to 24
inches. If there is not enough table depth to
accommodate this distance, install a keyboard
extender or tray underneath the desk.
 The table depth should generally be at least 30
inches from the wall to properly
accommodate monitors.
 Pull tables and desks away from the wall and
dividers to provide more space for monitors.

POTENTIAL HAZARD
Viewing the monitor for long periods of time can cause eye fatigue and dryness.

POSSIBLE SOLUTIONS
 Rest eyes periodically by focusing on an object at least 20 feet away.
 Stop, look away, blink and/or stretch at regular intervals.
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 38

 Expand the user’s duties with other non-computer tasks such as filing, phone work, or customer
interaction to provide periods of rest for the eyes.
SOURCE DOCUMENT POSITION
POTENTIAL HAZARD
Awkward posture or frequent movement of the head and neck to look from the monitor to a
document.

POSSIBLE SOLUTIONS
 The screen and document holder should be
close enough together so the user can look
from one to the other without excessive
movement of the head, neck or back.

 If writing needs to be performed, a document

holder can be positioned directly beneath the
monitor. This provides a sturdy writing
surface and prevents frequent movement of
the head, neck or back.

KEYBOARD AND MOUSE

The proper position of the keyboard and mouse is essential in creating a comfortable workstation. The
following factors can help prevent musculoskeletal disorders such as carpal tunnel syndrome and
tendonitis:
HEIGHT AND ORIENTATION
POTENTIAL HAZARD
Improper height and angle of the keyboard, mouse, or working surface can cause users to bend their
wrists or lift their arms for extended periods.

 The work surface may need to be raised or

lowered to keep the user's arms in a
comfortable position. This can be achieved by
installing an adjustable keyboard extender or
tray, by providing an adjustable table or
working surface, or by raising the chair and
providing a footrest if needed.

 Adjust the keyboard and/or chair height so the user's elbows can hang comfortably at the
side of the body, the shoulders are relaxed and the wrist is not bent up or down or to either
side during keyboard use.
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 39

 The angle of the keyboard should also be considered when determining the preferred
height. The preferred working position for most keyboard users is with the forearms parallel
to the floor and elbows at the sides; this allows the hands to move easily over the keyboard.
PLACEMENT
POTENTIAL HAZARD
 A keyboard or mouse that is not directly in
front of or close to the body forces the user to
repeatedly reach during use.

 The mouse should be positioned at the user's

side with his or her arm close to the body. A
straight line should be maintained between
the hand and the forearm. The upper arm
should not be elevated or extended while
using the mouse. The user should not have to
reach to use the mouse.

 Consider using a mouse platform that rotates

above the keyboard while maintaining about
the same plane. This design allows the mouse
to be used above the 10-key pad, which gives
the user a better wrist angle and reduces
reach.

DESIGN AND USE

POTENTIAL HAZARD

Bending wrists sideways or up and down while keying poses potential hazard.

POSSIBLE SOLUTIONS
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 40

 Do not use the feet provided on the back of

most keyboards if this causes wrists to
bend upward. If the user sits lower in
relation to the keyboard, the keyboard feet
may be used to maintain a neutral wrist.

Wrists should be extended straight, not bent up or down. A mousepad or wrist rest can be used to
help maintain straight wrists. Wrist/palm rests should not be used while keying, but to rest the
wrists between periods of keying.

Consider using alternative pointing devices

such as trackballs or touch pads.

ALTERNATED KEYBOARD

Split and Rotated Keyboard with Wrist Rest Split and Tented Keyboard

WORK PROCESS
Even when the workstation design and environmental factors are at their best, a user can suffer discomfort
and injuries from factors related to the work process.
The following factors may increase the risk of health problems such as visual fatigue, headaches, repetitive
strain injuries (e.g., carpal tunnel syndrome) and back pain:
 Prolonged and repetitive activities
 Excessive overtime
 Inadequate medical awareness
 Inadequate training
PROLONGED AND REPETITIVE ACTIVITIES
POTENTIAL HAZARD
Computer work may appear to be easy and require little overall exertion of force. While this is true
for the body in general, repetitive movements or prolonged awkward postures can lead to localized
pain and injury. For example a user using a mouse may move or activate a few small muscles and
tendons of the hand hundreds or even thousands of times per hour. This can lead to localized fatigue,
wear and tear, and injury in those small localized areas. Likewise looking at the monitor for a
prolonged period of time requires that the head be supported by only a few muscles of the neck and
shoulder. These muscles may need to be activated for hours without significant rest leading to
fatigue and overuse. While work on the computer may appear to be a low impact activity, the lack
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 41

of motion and presence of high repetitions and awkward postures can lead to pain and serious injury
if not recognized and dealt with.

POSSIBLE SOLUTIONS
 Provide a workstation where users can easily change their working postures. Changing the
way one sits allows different muscles to provide support while others rest. Providing
enough workspace so users can change the hand with which they perform mouse tasks
allows the tendons and muscles of the hand to rest.

 High repetition jobs or jobs that require long periods of static posture may require a
different strategy for break periods. Taking very short rest breaks in addition to the
standard industrial break schedule (about every two hours) can provide needed rest. Some
have found that users experience fewer MSDs when a 15 to 30 second break is taken every
10 to 20 minutes or a five-minute break is taken every hour. During these breaks users
should be encouraged to stand, stretch, and move around a bit. This provides rest and
allows the muscles enough time to recover.

 Alternate job duties whenever possible, mixing non-computer-related tasks into the
workday. This encourages body movement and the use of different muscles groups.

WORKING EXCESSIVE OVERTIME

POTENTIAL HAZARD
Working overtime, especially when the overtime is performed as an extension of the normal
workday, may overstress the body's muscles and tissues by reducing rest and recuperation times.

POSSIBLE SOLUTIONS
 If possible, provide additional staff for peak periods. If overtime cannot be eliminated,
reduce the overtime as much as possible to reduce the cumulative effects of stress.

 Limit overtime to off-days instead of tacking it onto the end of a shift. This will allow a
period of recovery between shifts when muscles and other tissues can recover.

INADEQUATE MEDICAL AWARENESS

POTENTIAL HAZARD
Facilities that do not have a medical management program generally have less awareness of
musculoskeletal disorders (MSDs). In such facilities, symptoms may go untreated until they become
disabling injuries. Injured users are less likely to get timely and appropriate care and restricted duty
programs are less likely to be established or utilized.

POSSIBLE SOLUTIONS
 Symptoms should be reported as soon as they start to develop. Early reporting can help
address a potential problem early in the injury cycle before it becomes a serious and costly
lost-time injury.

 Consult with a medical specialist who has experience with work-related musculoskeletal
disorders (MSDs). This person can be a physician, a nurse, or any other healthcare
professional that is familiar with causes of musculoskeletal injuries. Depending on the
scope of the person's practice, they may treat injuries on-site or provide a coordination role
with a local health care facility.

 A relationship should be developed with a local medical clinic if an on-site health care
professional is not an option. It is imperative that the healthcare professionals be familiar
with the type of tasks the employees perform. This will assist in diagnosis and the return-
to-work process after an injury. If a clinic is used, it is important to have a responsible
person on-site act as a liaison with the health care professional.
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 42

 A return-to-work program should be developed with placement of injured users into jobs
consistent with their work restrictions. The challenge of such a plan is to develop and
categorize jobs within a facility that are consistent with the work restrictions given by the
health care professional. Care should be taken to develop a program in cooperation with
the user’s union and the health care staff.

INADEQUATE TRAINING
POTENTIAL HAZARD
Users may not be adequately trained to recognize hazards or understand effective work practices to
reduce these hazards.

POSSIBLE SOLUTIONS
 Provide general ergonomics training and work task specific training to users. Explain risk
factors and proper work practices to minimize these hazards.

 Provide users with a mentor who can provide insight into the safest and most efficient
method to do the task.

 Explain the injury management system to users. It is important for users to understand how
to report an injury, and how the hospital prefers its users to seek medical attention. This
can expedite assistance, reduce costs, and improve lines of communication.

ENVIRONMENT
 Lighting that is not appropriate for computer
work is a major factor in visual discomforts
such as eyestrain, burning or itchy eyes,
headaches and blurred or double vision.
 Lighting should be adequate for the user to
see the text and the screen, but not so bright
as to cause glare or discomfort. For optimal
comfort and performance, the amount of
light and contrast of light with environment
must be considered.

LIGHTING
POTENTIAL HAZARD
Bright light on the display screen "washes out" images making it difficult for users to clearly see the
work.

POSSIBLE SOLUTIONS
 Use light diffusers so that desk tasks (writing, reading papers) can be performed without
direct brightness on the computer screen.

 Place rows of lights parallel to the user’s line of sight.

 Use user adjustable task/desk lighting.

 If diffusers or alternative lights are not available, removing the middle bulbs of 4-bulb
fluorescent light fixtures can also reduce the brightness of the light.
POTENTIAL HAZARD
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 43

 Bright light in the user's field of view.

POSSIBLE SOLUTIONS
 Use blinds or drapes on windows to eliminate
bright light. Blinds should be adjusted during
the day to allow light into the room, but not
directly into the user's field of view.
 Lamps should have glare shields or shades
and the line of sight from the eye to the light
should be at an angle greater than 30
degrees.
 Reorient the workstation so that bright lights
from open windows are not in the field of
view.
 Use indirect or shielded lighting where
possible and avoid intense or uneven lighting
in the field of vision.

CONTRAST OF LIGHT WITH THE ENVIRONMENT

POTENTIAL HAZARD
High contrast between light and dark areas of the computer screen, horizontal work surface, and
surrounding areas.

POSSIBLE SOLUTIONS
 For computer work, well-distributed diffuse light is best. The advantages of diffuse lighting
are two-fold: There tend to be fewer hot spots, or glare surfaces, in the visual field, and the
contrasts created by the shape of objects tend to be softer.

 Use light, matte colors and finishes on walls and ceilings in order to better reflect indirect
lighting and reduce dark shadows and contrast.

GLARE
 Glare on the viewing screen may cause
eyestrain, headaches and/or fatigue. The
user may not be conscious of the irritation;
however, over the course of a long day, it can
cause problems. Direct and reflected sources
of light may cause glare:

POTENTIAL HAZARD
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 44

Direct light sources (e.g., windows, overhead lights) that cause a reflected light to show up on the
monitor.

POSSIBLE SOLUTIONS
 Orient workstations so that light sources do
not reflect on the screen. Position task
lighting (e.g. desk lamp) such that the light
does not reflect on the screen.
 Use blinds or drapes on windows to help
reduce glare.
 Clean the monitor frequently. A layer of dust
can contribute to glare.
 Screen glare filters that attach directly to the
surface of the monitor can reduce glare.
Use barriers or light diffusers on fixtures to reduce glare from overhead lighting.

Generally, a large number of low powered lamps rather than a small number of high powered lamps
will result in less glare.

REFLECTED LIGHT
POTENTIAL HAZARD
Reflected light from polished surfaces (e.g., keyboards) that may cause annoyance, discomfort, or
loss in visual performance and visibility.

POSSIBLE SOLUTIONS
 To limit reflection from walls and work surfaces around the screen, these areas should be
painted a medium color and have a non-reflective finish. Workstations and lighting should
be arranged to avoid reflected glare on the display screen or surrounding surfaces.

 Tilt the monitor down slightly; this will prevent it from reflecting overhead light.

 Use dark characters on a light background; they are less affected by reflections than are
light characters on a dark background.
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 45

APPENDIX
I. Terms and Conditions Document
PAGE 1/2

TERMS AND CONDITIONS

IMPLEMENTING THE DEPARTMENT OF HEALTH
INTEGRATED HOSPITAL OPERATIONS AND MANAGEMENT INFORMATION SYSTEM
(DOH-iHOMIS) SOFTWARE

The (NAME OF HOSPITAL) agrees to use and/or operate the DOH-

iHOMIS, a computer-based hospital system, to avail of its worthiness, operating capabilities,
user friendliness, and overall benefits to the hospital. As an implementing hospital, we shall
also participate in the overall evaluation of the system.

We likewise agree that we must observe certain Terms and Conditions to protect the DOH
and the hospital from misusing the system and others from improperly obtaining any copy.

We therefore agree on the following TERMS AND CONDITIONS. We commit to:

1. Procure and/or upgrade the following requirements based on the DOH-KMITS

specifications for the iHOMIS to operate:

1.1. Hardware (Computers, Printers and other peripheral devices)

1.2. Networking (Network Configuration, Cables, Cards and other related devices)
1.3. Licensed copy of the Relational Database Management System Software
(Sybase, SQL Anywhere, MS SQL, or MySQL)
1.4. Licensed copy of the Operating System (Windows 2000 and higher)

2. Implement the system, document and report problems and concerns, and

3. Communicate to the system developers, namely, the KMITS (formerly IMS) and the HFDB
(formerly NCHFD), all observations we make of the system.

4. Implement security measures to protect the DOH-iHOMIS by NOT:

4.1. Reproducing and installing the iHOMIS software in any other hardware except
those that will be explicitly identify as the resident hardware by the hospital and
the developer.
4.2. Modifying the database.
4.3. Modifying, reverse engineering, decompiling or disassembling any subsystem,
module or any program except the Billing Module; assigning, lending, or otherwise
conveying to another party the whole or any part of the system without prior
written consent from the KMITS of the Department of Health.
4.4. Using any program or module of the system for timesharing, rental, or service
bureau purposes.
4.5. Copying, by any means, any program or module of the system. When the hospital
needs to copy, a formal request should be made to KMITS, DOH.
DOH - iHOMIS MANAGEMENT MANUAL P a g e | 46

PAGE 2/2

5. To satisfy our additional requirements for the hospital, we agree to DO the following by:

5.1. Creating additional database that will connect to the DOH iHOMIS database
where we can incorporate our additional requirements.
5.2. Coding programs required for our additional requirements.
5.3. Using third-party software to connect to the DOH iHOMIS database and retrieve
the data that we want to produce the necessary reports for the hospital.

6. For the continuing maintenance of the system, we agree to DO the following:

6.1. Provide annual operating budget for computer supplies (ink/ribbon, papers and
other related supplies).
6.2. Provide annual hardware and network budget maintenance to ensure that the
computers, networks, equipment and other devices are in good working
condition.
6.3. Provide annual Information Technology Training budget to enhance the
knowledge and skills of Users who shall be involved in the implementation of the
system.
6.4. Provide transportation expenses, food and accommodation for the Technical
Persons who shall be involved in extending technical support or troubleshooting
problems that cannot be solved by the Hospital Technical Personnel.

We finally agree that if we violate any of the foregoing terms and conditions, we shall not be
allowed to use the software.

For the <NAME OF HOSPITAL>

__________________________________________
Chief of Hospital

For the System Developers (DOH):

_____________________________________________________________ __________________
Knowledge Management and Information Technology Service Date Signed

_____________________________________________________________ __________________
Health Facilities and Development Bureau Date Signed

**** END OF MANAGEMENT MANUAL ****