The computing history of the Philippine Heart Center has proven its capacity to maintain its vision to be the premiere institution to take care of cardiovascular problems and related diseases. Ever since, it has constantly expanded and utilized technology in providing better services to its clientele.

The First Step on Computing

As early as 1977, the Philippine Heart Center for Asia (PHCA) had been using a computer for its business operation, particularly for its Patient Billing. With the purchase of its first general-purpose computer on May 4, 1977, programs were developed to automate the process of Discharging of Check-up Package/Medical Patients, Notice of Additional Deposits, Balance Summary Report, Income Center Report, and Patient Directory. For the amount of P172,355.92, the computer equipment had a 2200T CPU, 16KB memory of RAM, 1/10 ports, Wang 2226 integrated CRT display, a keyboard, Wang 2270-2 diskette driver, and Wang 2231 W-line printer, comparatively inferior to today's standards.

A Journey to a Thousand Miles

Faced with an increased demand for avowed quality cardiovascular care of cardiac patients. PHCA tried to maximize the usage of its facilities and manpower. However, the corresponding functions, features and accuracy of the earlier equipment, which was of the late 60's and early 70's, was lagging behind its contemporaries of that period. It was then on 1978 with the help of the National Computer Center (NCC), then under the Department of National Defense, which conducted a feasibility study on what used to be known as the "PHCA Computerization Plans", primarily to concentrate on improved patient services and ability to support its continuing operation based on a non-profit pioneering Heart Center for Asia.

The proposal covered two specific and distinctive areas of endeavors in the use of computers and computer-based equipment (i.e. Bedside Monitors, Cath Lab. System, Digital Radiography, Holter Monitor) inside the PHCA within five-year period from 1978 to 1983:

1. Microprocessor based medical monitoring and related diagnostic equipment; and
2. Computer-based management information and control system to include business and medical applications.

which sought to address the following concerns:

1. Reduction of manpower requirements and its related benefits and advantages.
2. Reliability and accuracy of data processing
3. Speed of access and storage of data and its processing
4. Increased functional features in operations not possible with non-computer based equipment
5. Improve services to the patients.

For the computerization plan to materialize, a Management Information Services (MIS) group was formeed to provide the necessary skill, knowledge and support for the design, implementation and control of all the computer related functions and applications in the Center. The group was headed by Benito L. Tanhehco, a Ph.D. in Biomedical Engineering (from Iowa State University) who had more than 10 years of exposure and experience with computers and electronics with a support staff of a programmer and encoder is Cyrel Torres and Edna Moreno, respectively.

With demand for automated task increasing by folds, the Center purchased consecutively "Radio Shack TRS-80" on August 29, 1979, and a desktop computer HP9845A on October 3, 1979 consecutively with the following specifications and prices:

With these computers on the Center's hands, maximization of these equipment are now started to emerge. Thus, by 1980 programs were developed for PHCA payroll; Payroll journal; Payslip (PNB); Remittances; Deduction reports; Department and Division summaries yearly ledger; and computation of Withholding tax.

Meanwhile, as prices of computers in the market started to drop, different companies and businesses were starting to invest on computers for their operations. To keep abreast with the changing times, the PHCA saw the saneness investing on upgraded technology. Thus, it again purchased a new model of its TRS-80, the TRS-80 Model II on April 3, 1981 for P60,800.70. The Model II was a "business" computer composed of a Z-80 based machine which served as the disk I/O processor with single-sided floppies and full height drive having its own keyboard, disk system and a Line Printer III. In 1981, Newer programs were created such as: generation of Rice stubs, Leave credits, Service Records, and Personal data, for the Personnel Department.

In April 5, 1982, the PHCA sought the approval of the President to have the authority to purchase equipment in support of the computerization plan amounting to 32 Million. In June 17, 1982 Manuel S. Alba (then Minister of Budget) informed the PHCA that the earlier request was approved. However, the required amount was not included in the CY 1982 approved program for expenditures. It was only in 1983 that the implementation of the computerization plans took place.

Realization of Computerization

The events followed saw the increase in data to be processed coming from different units. The need to share these valuable data are foreseen. Thereby, on October 29,1982 the first multi-user environment was experienced with the purchase of the "Micromation Computer". It had 1 Main and 3 User (1M + U3) M/system with 64K RAM per user, capable of sharing data on a single Fujitsu Winchester hard disk drive with 21 MB capacity MP/M Operating System. From then on, successive acquisition of personal computers and minicomputers were made by the Center.

During Dr. Tanhehco's incumbency, the computerization of the Billing System, Payroll System, and Supplies Inventory System was put in place with the in-house development of the appropriate software utilizing the BASIC language installed on Radio Shack TRS-80 microcomputers and Micromation minicomputer.

It was during these period that the demand for automated processing of designated tasks slowly started to gain grounds after many had realized its benefits. Unmindful of the capabilities of a computer, different departments and down to the smallest unit of the Center were requesting the MIS to create a program for their respective needs. Realizing that MIS could not grant all these requests, MIS opted to conduct a "Talk/Open Forum on Computers and Its Application" on January 26, 1983, the first Information Technology training with Dr. Tanhehco as the speaker. It gathered representatives from the different departments and units and discussed the capabilities and limitations of computers. From this standpoint, the MIS group started to train programmers and users in using BASIC language.

The Management Information and Control Service

Tracing its beginning, the Management Information Services (MIS) was renamed as Management Information and Control Service (MICS) by 1983. MICS was then considered as the formal formation of an EDP department by January of 1984 with Dr. Tanhehco, then Assistant Administrator for Engineering Services as concurrent head, but directly under the Office of the Director.

Originally, MICS' functions included:

1. To provide computerization service needs to various departments in the Center in order to upgrade and improve the performance of these departments; and
2. To design and institute an integrated information system to assist the management control function based on a computerized system of operations.

By 1987, the old Billing System software was replaced and became linked with the Admission System and Pharmacy Inventory System through the installation of the "Hospital Manager" (HOMER) System, a software package d eveloped in MS-COBOL 2.3 running in a networked system developed by Compumetrics Management Service, Inc., a local software consultancy firm. The network environment utilized a bus topology using a D-Link 2.5 Mbps network card, and an Intel 80286 processor based computer as its server with a 40MB hard disk drive. By late 1988, the link to the Pharmacy System was removed due to lack of manpower to support the system and the increasing workload it possessed affecting the efficiency of the network. The MICS was then under the supervision of Mr. Moises Generoso, Jr. the Assistant Director for Administrative Services.

With the recruitment of a new personnel to carry on the functions of the MICS in 1988, which included a Management Information Analyst (Renato Doctor), Computer Programmer (Norman Baluyot) and a Data Encoder (Cynthia de Leon), dynamism became the guiding force of the unit. It was during the period, from 1989 onwards, the time when the personal computer was fast improving on its speed and memory capacity, that saw the proliferation of in-house developed stand-alone computerized information systems in various department/units. Among these were the new Payroll System, and Supplies Inventory Systems, prompted by the intermittent breakdown of the outmoded TRS systems, Medical records statistics, Tenant's Rental, Pharmacy Issuance Report, Property (Fixed Assets) Management, Purchase Order (Pharmaceuticals and Food Stuff), Accounting Systems (Receivables and Payables), etc.

Interspersed with the development of these systems was the introduction of Computer Literacy Seminars in coordination with the Personnel Division and the MICS staff as resource persons in 1991. These seminars covered Introduction to Computer Concepts, Disk Operating System (DOS), WordStar, Pro Write, and Lotus.

The Management Service Office

In July 15, 1994, by virtue of Memorandum Order No. 149:94, the Management Services Office (MSO) was activated and absorbed the functions and personnel of the MICS. However, these functions were revised and broadened to include:

1. Provide database services to various departments of the Center for systems planning.
2. Data gathering, and analysis of information towards the formulation of an integrated information system and procedure for management control and decision making; and
3. Coordinate with computer users as well as schedule computer operation to ensure reasonable computer response and optimal usage of computers.

Driven by this new mandate, the MSO continued to pursue its functions by developing software that computerized the maintenance of databases and generation of reports of several divisions/ units of the Center among which were:

1. Accounting Division
   • Journal of Check Issued
   • Journals of Bill Rendered
   • Rentals System
   • Depository Liabilities
   • Outstanding Checks
   • Certificate of Taxes Withheld on Suppliers and Professionals (Doctors)
     • VAT/NON VAT
     • Expanded VAT
2. Credit and Collection
   • Report of Checks Issued
   • Collection Report
   • Pharmacy Collection
   • Doctor's PF
3. Personnel
   • Service Record
   • Leave Credit
   • Over Time Pay

The Information Systems Plan

In 1994, with Ms. Ma. Linda G. Buhat at the helm, the MSO intimated with a Hospital Management System that aimed to integrate business operations of the Center utilizing a Computerized Local Area Network involving the Admitting, Billing and Cashier Offices. The information system modules included were: In-Patient Information System, Room Management System, In-Patient Billing System, and the OutPatient Sales and Service System. These plans of the MSO were even included in the article "Philippine Heart Center: The Specialist" in the October-December 1994 issue of IT 2000, the quarterly magazine of the National Computer Center (NCC), to showcase the direction of the Center's IT plans. But the grandiose plan failed to take off due to financial constraints. On the background though, the MSO diligently and continuously pursued these dream by preparing the PHC's Information Systems Plan (ISP) for 1996-2000.

The ISP constituted the different information systems of the various units of the Center and their status, development strategies, linkages and integration. Likewise, it discussed the information technology Strategies to be adopted in implementing the ISP consisting a comprehensive plan for the full computerization of the Philippine Heart Center. NCC's approval and endorsement of the ISP in May, 1997. As if these events were part of a greater scheme, the Memorandum Order No. 181:97 was issued on August 6, 1997 which further divided the functions of the MSO and created the two units. Hospital Information System (HIS) and Quality Assurance (QA).

With the dynamism of Dr. Gerardo S. Manzo who was named to head the HIS and assured with the basic requirement of an ISP, he pursued with the Management Committee's (MANCOM) backing of the bidding for the PHC computerized networking plan in the 4th quarter of 1997. However, the process was put to a halt due to the prevailing economic crunch. In the meantime, the acquisitions and upgrading of additional network compatible computers for important units are being pushed through while awaiting for the Computerization project's "go" signal.

As the year goes near to the 21st Century, computer based and microprocessor based medical equipment are at the threat. Assessment of these equipment were performed as early as 1997 and Y2K readiness have undergone. With the help of Engineering and Maintenance Division (EMD), Y2K contingency plans were formulated, thereby making the PHC a Y2K ready hospital.

PHC World Wide Web Presence

The need to communicate--to send messages, to share data, to access computing resources--has prompted PHC in making its appearance on World Wide Web. With Sky Internet, a local Internet Service Provider, made MSO to possibly hook up on the Internet. Thus, on the PHC's 23rd anniversary (February 14, 1998), it officially published its Web sites. It aims to improve awareness on the on-going activities of the PHC and to enhance the reputation of PHC as world-class cardiovascular care.

PHC acquired modems and Internet access for the Library and all clinical research units, including the offices the 4 Assistant Directors to be also linked to the Internet. Later, the Department of Science and Technology became the Center's Virtual Host and provided the Philippine Heart Center with domain name of "phc.gov.ph" and soon to another Service Provider-- the Pacific Internet, inheriting the same domain name.

With the additional unit for its Web Server running on a Linux Platform, it has upgraded its connection to the Internet with a 64kbps leased Line. PHC then went independently hosting its own site and was publish September 1, 2000, capable of handling its own e-mail for its domain and a Center wide Internet access.

PHC Full IT Maturation -- The Networking Project

After several years of planning and failed starts due to financial constraints, the PHC Computerization is finally being implemented. In September 1999, an agreement was signed between the PHC and Micro Distributing International (Micro-D) in providing a Local Area Network for its operation. The whole Hospital Building and Medical Arts Building are connected with a 100 Mbps Fiber Back Bone link to the switches and 10/100 Mbps link to the projected 150 desktops. Again, the implementations was covered in the IT2000 Magazine [July - December 1999 Issue] of the National Computer Center.

Initially, the PHC network had 3 servers: Two (2) Pentium II 400 MHz, dual processors, Raid 5 compliant computers as Application and Database Servers, and one (1) Pentium II 400 MHz single processor as its Web Server. The Application and Database servers will be running on Microsoft Windows NT 4.0 and the Web Server and E-mail Service will have Linux as its operating system.

The PHC Computerization remains primarily focused on the first of the four strategic thrust of the Center, which is Patient Care. It will however ensure support to all the 3 other strategic thrust of the Center namely, Education & Training, Research, and Public Information & Community Service.

The PHC aims to implement a Hospital Information System that should dramatically improve our outdated Billing System, and therefore promote patient satisfaction with faster admissions and discharges. But the heart of the PHC-HIS will be the Electronic Medical Record (EMR) which fully integrates Patient Administration by doctors and nurses at ward stations with the ancillary departments like Pharmacy, all the Clinical Laboratories, and Radiology. It also try to incorporate modules such as central inventory system which will maximize stock management and provide management the necessary information for make strategic decisions, capable to implement electronic on-line transaction.