How automated information system grew in Philippines.

      

    Knowledge generation and knowledge utilization in any community: local, national or global are initiated, promoted and sustained by the information resources of the community.  Information Centers provide bibliographic, indexing, clearing and referral services in addition to research, instructional and document support services.  Information in specific formats/media provides news gathering, interpretation and editorial services in print, broadcast, film or special media.  Information from specific providers bring to the attention of information seekers the  knowledge, thoughts or ideas of key informants, subject authorities and specialists on specific topics from indigenous belief and value systems, traditions and practices to current lifestyles and trends; and information super highway projects reflect efforts to be linked with the global information system and which could promote active participation in the development programs of the global village.

   In the Philippines, all line agencies (departments, bureaus, agencies), academic institutions (universities, colleges, institutes), business establishments, (engaged in the mass media or in the production of consumer goods or provision of services) function as information centers for these service institutions maintain information storage and retrieval units such as libraries, information offices, public affairs offices, and public relations officers.

    Automated healthcare information system (HIS) grew almost parallel with the advancements in computer technology in the country.

• In early 1970s, the first personal and network-ready computer started to appear in the healthcare community exclusively used in business and accounting. The earliest computers are mainly used to automate billing in few healthcare institutions. The computers are connected via network setup allowing multi-user environment. They used as storage drive the computers run with 8 KB internal memory (RAM) with cassette tapes. It comes with the built in software like spreadsheet and work processor and BASIC programming language.
• In the mid 1970s hospital networks expanded to include the information processes in admission, discharge and transfer or ADT section. Computers are run with 16 KB RAM and 320 KB floppy disk drive storage and in this period line printers are popularly used.
• In late 1970s network further expanded to include pharmacy section. In this period, an integrated system, which is a network of several computers using single program, was formed connecting the three big departments: accounting, ADT and pharmacy. Some programs are written with COBOL, ORACLE and BASIC language and these departments are seamlessly share their data to each other. The system required a server which is more powerful computer that provides copies of programs and data to clients, integrate functions of the terminals and backup files. During this period, XT computers with processing speeds of 10-20 MHz were commonly used.
• In early 1980s, the laboratory and imaging departments, with their special computers, attempted to connect to the main integrated system but no avail due to incompatibility reasons. Since communication is not possible, request made in the ward and other and other clinical areas were put on paper such forms or slips and brought to the laboratory or imaging departments for processing. When the result is ready, it is brought back manually. Because of detached status the two department remained stand-alone systems.
• In the middle of 1980s, integrated system expanded to the clinical area. It is believed that nursing informatics started during this period. Network ready PCs running with 80286 processor, 16 to 64 MB RAM with 20 to 40 MB hard disks are becoming common. Nursing clinical information systems were implemented and automated the process of order entry. Nurses entered orders on medication and lab exams that are promptly transmitted to the pharmacy and lab departments respectively. They also entered request for linens and supplies, request of the patient or relative were able to retrieve and print billing summary which is saving time and effort. The were also able to view the what and whereabouts of the patient.
• In the middle of 80s to late 90s hospitals bought conversion software and hardware from the same vendors who delivered the laboratory and imaging machines to link their stand-alone systems to the main system creating interfaced systems. Though connectivity to the main information system was possible, they operated somewhat with limited functionality due to persistent compatibility problems.
• In early to mid 2000s laboratory information system (LIS) and radiology information system (RIS) started to encroach into the main hospital information system that are developed with more flexible programming languages such as Oracle, SQL (structured query language) or FOSS (free open source software). LIS integrates all information systems coming from biochemistry, hematology and etc. Radiology information system or RIS integrates all information system coming from X-ray, MRI, CY, Ultrasound and other ancillary departments that produce image outputs. Interoperability between various systems was made possible with the use of the standard protocol for formatting, transmitting and receiving data known as HL7 (Health Level Seven). With the new systems expansion in the HIS, order entry and results reporting became virtually complete at the convenience of the nurses and other health care worker as end users. During this period, computers run with capacities ranging from Pentium to dual core processors, 128 MB to 2 GB RAM, and 10 to 500 GB hard disk drive with printers ranging from dot matrix to inkjet to laser printer. Inter-department communication systems (SMS, chat, conferencing, and emailing) were made possible with use of efficient wired and wireless network systems.
• In late 2000s, the Philippine Heart Center will soon implement the Internet-based hospital information system (HIS). This will allow their healthcare team to access automated HIS anywhere anytime through internet. New hospitals plan to use new fully integrated information systems while some hospitals chose to retain their old integrated systems.

          There are institutions, however, that are entirely engaged in information/knowledge generation, analysis, IEC materials production and knowledge validation like the Philippine Information Agency (PIA). The PIA through its various subprograms namely: research, institutional development, production and dissemination provide development-oriented communication services.

           Treatment with bad outcome needs to be investigated further or avoided. This most probably prompted Florence Nightingale to push through the reliable and efficient documentation of every clinical case.