Hospital information systems in the Philippines, a buyer's guide.

A hospital charges as it treats. Every medicine dispensed, test run, room day and procedure has to land on the right patient's account the moment it happens, or the bill at discharge is wrong and the claim is short.

• Emergency room visits, admissions and a bed board that shows which beds are free.
• Doctors' orders, the medication administration record, nursing notes and vital signs.
• Laboratory and imaging worklists, and results with normal ranges.
• Pharmacy dispensing by lot and expiry, returns, and the dangerous drugs register.
• Operating room schedules and cases.
• Charges as they happen, the statement of account, discharge clearance and the gate pass.

PhilHealth pays an accredited hospital a fixed amount per case, by the diagnosis or procedure, rather than item by item, under the Universal Health Care Act (RA 11223) and its circulars. The benefit is deducted from the patient's bill at discharge, and the hospital then claims it through eClaims, generally within 60 days of discharge.

For eligible patients in basic or ward accommodation, the no balance billing policy means the patient pays nothing beyond the package. A system should apply the right case rate, show the deduction on the bill, track each claim to payment or return, and warn before a filing deadline passes.

Several laws shape how a hospital bills and discharges, and the system has to make them easy to follow rather than easy to forget.

• RA 10932 forbids requiring a deposit before giving emergency care.
• RA 9439 forbids detaining a patient for unpaid bills when a promissory note is signed; the law does not cover patients in private rooms.
• RA 9994 and RA 10754 give senior citizens and persons with disabilities a 20% discount and VAT exemption.
• RA 9165 requires dangerous drugs to be accounted for, including wastage.
• Doctors' professional fees are billed apart from hospital charges and paid out to the doctors.

A hospital operates under a licence from the Department of Health under the Hospital Licensure Act (RA 4226), and its laboratory, pharmacy and other services have their own licences. A system should keep each licence and its expiry, and the reports the DOH asks for should come from the records, not from a separate count.

Charts, results and diagnoses are sensitive personal information under RA 10173. Only the care team should open a chart, every opening should be logged, and a breach must be reported to the National Privacy Commission. Paper charts and spreadsheets cannot show who saw what.

A hospital also has more people writing to one record than any other business. A system that keeps orders, charges and claims on the same patient account is what keeps the bill and the claim right.