PPHI Sindh

HEALTHCARE INFORMATION MANAGEMENT SYSTEM

(HIMS)
1. BACKGROUND
PPHI Sindh is a not-for-profit company setup under section 42 of The Companies Act 2017
(formerly The Companies Ordinance, 1984) for delivering PHC services to the poor and needy
masses of rural areas throughout Sindh. PPHI Sindh is governed by Board of Directors
comprising seven private and four Ex-officio members from Government of Sindh.

PPHI started its journey from District Kashmore in 2007 and has gradually expanded to 22
districts of Sindh. Initially it worked through Sindh Rural Support Organization (SRSO) under an
MoU with the Government of Sindh (GoS), but in 2013, the organization was registered with
SECP (Securities and Exchange Commission of Pakistan) and has since worked by signing MoUs
directly with Government of Sindh. The objective of establishing PPHI Sindh was to revitalize
health services in rural Sindh. The immediate goal was to ensure that health facilities, handed
over to PPHI Sindh, are fully functional and providing health services to communities in their
respective catchment areas. Within a short period, health facilities had regular attendance of
doctors and staff as well as continuous medical supplies. Other initiatives included renovation
and rehabilitation of physical infrastructure, provision of health care related equipment,
availability of medicines, upgrading various health facilities to round the clock maternal and
child health care services, establishing vaccination, nutrition and Kangaroo Mother Care
centers, provision of ambulances, and solarization of health facilities.

PPHI Sindh, is now managing 1176 Primary Healthcare Facilities (HFs) across Sindh and
Extended Program of Immunization (EPI) in districts Dadu and Khairpur. PPHI Sindh now proud
of having 5 Caesarian facilities, 4 major and 295 mini labs, 311 HFs upgraded to BHU Plus
(24/7 NVDs – Natural Vaginal Deliveries), 572 solarized HFs, 704 OTP (Nutrition) Sites in 19
districts, 121 TB Care facilities (TCFs), 275 EPI centers, 199 ambulances, 249 HFs equipped
with Ultrasound, and 289 Kangaroo Mother Care Centers (KMCs). Antenatal Care visits have
increased from approximately 40 thousand in year 2010-11 to 544 thousand in year 2017-18;
deliveries have increased from 12 thousand in 2010-11 to 148 thousands in 2017-18 and
family planning visits have increased from 101 thousands in 2010-11 to 433 thousands in
2017-18.

3. SCOPE OF WORK

5.1. As stated above the HCMS procurement process shall comprise of software
implementation and training components to complete the package. That is, the
successful bidder will provide the software, and assist PPHI in its phase wise
implementation along with training of the PPHI staff.

5.2. The Software shall be an All-in-One (AIO) integrated turn-key solution capable of being
accessed from PC, MAC, Phone or Tablet, on road or from home and office. The solution
 shall encompass web-based platform featuring access for PPHI Head Office, Regional
Offices (ROs), Districts Offices (DOs), District Labs (DLs), Health Facilities (HFs) and their
respective employees.

5.3. The bidders shall be provided the geographical dispersion / physical locations, workflow
and HR working in respect of all health facilities of PPHI Sindh.

5.4. Multiple interactive pre-bid sessions may be held for potential bidders to fully
comprehend the working and needs of PPHI Sindh. The bidders are encouraged to visit
PPHI health facilities at least in one district to fully comprehend PPHI’s expectations
from the software.

5.5. The successful bidder shall remain engaged with PPHI Sindh for at least one year for
training of staff at PPHI Head Office and field formations for full implementation of the
project, phase wise, starting from Rural Health Centers (RHCs) to Basic Health Units
(BHU) plus and finally to Dispensary (GD) level.
5.6. Each shortlisted participating bidder shall give a detailed presentation on the software
solution to the Procurement Committee to demonstrate the functionality of the
software. The Procurement Committee based on a predefined Evaluation Criteria shall
map the bidders with respect to utility of the software keeping in view the
organizational needs.

6. FUNCTIONAL CHARACTERISTICS OF SOFTWARE

6.1. Healthcare Management System.
It is understood that PPHI Sindh primarily manages and operates Primary Health Care
(PHC) facilities and a few secondary level health facilities. However, in view of its future
potential/needs, the Software’s Healthcare Management System may, as far as
possible, comprise of following modules / components:

6.1.1. Patient Registration

The module be capable of generating unique MR No; capturing detailed patient

profile including image, NIC etc.; preventing erroneous data entry and checking
duplicate / junk data; generating and scan patients’ information through Bar /
QR Code; and providing enquiry assistance for inpatient details.

6.1.2. Appointment Management

The module be capable of managing appointments (including multiple services

appointments, multiple slots booking and multiple appointments on per slot
basis), through PPHI Sindh Portal / Walk-in at any of the PPHI Sindh managed
Health Facility; facilitate patients to search consultants (as per desired service);
 manage max visits of each consultant; calendar set up (to cater for non-working
and working days / timings); consultant’s time slots management (on the basis
of per day and time combinations); maintaining record of medico-legal cases;
generating SMS and alerts for reminders (including erroneous appointments).

6.1.3. Patient Referral

The module be able to present complete list of healthcare facilities (including

their specialties), where the patient can be referred while providing patients
details / data (including assurance of patients billing) to refer healthcare facility
through emails and HL-7 messaging before the transfer of patient.

6.1.4. Patient Portal

The module be capable of providing secure access to patients’ health

information; managing patients’ online appointments; facilitate easy access to
patients’ relevant current reference information while enabling patients to view,
download and transmit their health information including lab reports; e-
delivering summary of care documents; fielding routine inquiries and providing
communications between the patient and healthcare provider.

6.1.5. Roster Management

The module be capable of managing employees’ attendance (through

biometric / face recognition attendance machines) and duty shifts including shift
rotation, overtime scheduling, substitutes (in case of the absent employees),
generate emails automatically to the staff members about their duties and
schedules (including real-time updates of the duties assigned to the employees);
generate reports about workload of an individuals and maintaining log of
employee attendance.

6.1.6. Electronic Medical Record (EMR)

The module may provide administration panel to control access to the clinical
data based on requirement, roles and security rights; provide an interactive
Graphical User Interface (GUI) that must enable doctors / practitioner /
Encounter Assistants (EA) to record, archive the scanned documents or past
patients’ record and retrieve the clinical information of patient (tagged to
patients’ ID and encounter as per *ICD-10 and **CPT codes for clinical findings,
diagnosis and procedures respectively) from a central repository; support
capturing of transcription data (including voice recording); have patient records
 search option (on the basis of patient ID, patient name etc.); provide built-in and
customized reports, including extensive custom form library (for patient
demographic details, encounter assistants, doctors, consultants, tests and
medications ordering, different specialties for clinical history taking, clinical
procedure records, medical images and laboratory reports).
*ICD-10 International Classification of Diseases Rev 10
**CPT Current Procedural Terminology

6.1.7. Laboratory Information Management

The module be a configurable system that facilitates variety of workflow models

and must be able to receive online request from the encounter assistants /
doctor; allow the laboratory personnel to generate the request (that includes
date of visit, referred doctor name, the amount collected from the patients,
input the sample based on the request, sample number generation, sticker
printing with bar codes for the sample identification, sample tracking etc.);
provide searching on the basis of unique patient ID, Record ID, name and others
between the two dates; integrate with EMR (wherein practitioner / doctor can
prescribe lab tests to the patients); automatically place the test results in patient
records (that would be accessible to doctor in EMR as well as on patients’
portal); enable the doctors to see the Lab results in next appointment (and can
mark their feedback and can prescribe accordingly); perform various test under
various disciplines; provide direct integration with data providers as custom file
parsers, data loaders and automatically reduce data; print reports (showing
abnormal and normal test result values) and export test results to MS Word,
PowerPoint, Excel, and Adobe PDF formats); support following cheminformatics
(but not limited to compound registration, structure visualization, drawing and
searching and calculated properties); monitor status of the lab’s instruments,
schedule work and maintenance; recording of doctor wise incentives
calculation; providing instrument control for liquid handling and synthesis work
stations and integration with third-party systems / lab analyzers; manage stock
supplies and reagents and generate re-order alerts.

6.1.8. Radiology Information Management

The module be integrable with EMR (para 4.1.6 above) so that reports / films
are accessed and previous reports are available to doctors for references;
facilitate the storage of radiology images against the patients EMR details
precisely data related to date, time and condition of patient at the time when
 diagnostic imaging was done; present reported and unreported status against
an imagery; capable of handling Digital Subtraction Angiography (DSA) and CT
scan imagery; facilitate radiographic imagery viewing with and without reports
in indoor / outdoor departments including Emergency Room (ER); facilitate
primary and final reports view for urgent cases at ER and other selected areas;
provide tracking of imagery; facilitate purging, archiving and move list etc. based
on user-defined criteria; provide latest tools for manipulation and labelling of
images; capable of communicating with all radiological modalities using PACS
(DICOM protocol) and Vendor Neutral Archive (VNA) as an option; capable of
burning of high quality diagnostic images in optical / external storage media;
capable of sending radiological images with reports through internet and
remote connection to other PPHI healthcare facilities; provide user / system
administration features but not limited to maintenance of storage system
without data or time loss, warning in case of storage space used above
threshold limit and capability of remaining online automatically.

6.1.9. Blood Bank Management

The module be capable of maintaining donor database (Area and Blood Group
wise (with unique donor identifications i.e., donor ID and patient record ID for
managing future list and updates); providing search facility to track and maintain
all donor types on voluntary, exchange and directed basis; maintaining rejected
donor database for donor control and identification blood transfusion for
disease control and prevention; providing blood cross match and result storage
facility; providing search option for expired and destroyed blood; managing
inventory of key consumables Blood Banks of PPHI Sindh and generating reports
on stocks that includes blood group wise, expiry date wise and area wise.

6.1.10. Physiotherapy and Rehabilitation

The module be able to maintain schedule for the management of physiotherapy

sessions of the patients’ (including referrals management by surgeon for the
purpose of post-operative rehabilitation); collecting detailed description of
physiotherapy sessions; generating automatic alerts / reminders to patients
according to the schedule; recording complete schedule of exercises which are
recommended at home while maintaining patterns tracking improvement for
the patients.

6.1.11. In-patient Admission-Discharge-Transfer (ADT) Management

 The module be capable of presenting form for acquisition of precise data
regarding patient; evaluation of patient condition; e-prescribing of medications
including features but not limited to tools for decision making process;
recording doctors and nursing notes for management; real time orders
processing mechanism for respective departments; integrated clinical packages
management; ward / bed allocation and transfer; billing process management
(including final settlements and payments to third parties).

6.1.12. Operation Theatre (OT) Management

The module be capable of surgery team management; operations scheduling

(with complete flexibility in bookings management and provision of tracks the
surgeries which take place in hospital); providing complete patients monitoring
checklists; anaesthesia details recording; constant monitoring abnormal
readings alerts; recording comprehensive preoperative assessment,
postoperative conditions of patient and handling consent forms (with
multilingual support); supporting sterilization schedules, audits and checks
(including keeping records of different items during an operation); stock and
inventory management; providing an interface for monitoring devices and must
be equipped with CPT codes for different procedures carried out in the OT.

6.1.13. Nursing and Ward Management

The module be able to provide Graphical User Interface (GUI) to nursing and
ward staff and must integrate doctor’s workbench for effective management of
wards clinically / administratively as well as facilitate the nurses to administer
and maintain a high class patient care. Module must provide following
functional requirements i.e. Patient Administration System Access (for user
defined data items), record admissions, discharge and transfers at wards (to
update bed census), notification of patients (pending arrival and current status),
departmental communication (housekeeping, security and maintenance etc.),
location confirmation of patient and notify ancillary departments for real time
test, procedure and medication ordering (to concerned departments), OT
schedule notification (with any required preparation), comprehensive charts to
monitor patients’ condition.

6.1.14. Bed Census

The module be capable of managing staff re-organization in turnover process of

bed, housekeeping scheduling and maintenance activities; providing statistical
 information regarding occupancy status of bed over time; presenting statistical
analysis of ward utilization, consultant and specialty and making revenue
calculation with respect to beds occupancy.

6.1.15. Pharmacy Management

The module be capable of receiving the prescriptions from consulting doctors

and reflecting them automatically into the dispensing unit to respective patient
without manual interface. Module must be capable of maintaining database of
complete list of hospital drugs formulary; accepting e-Prescriptions from various
departments and consulting doctors; manipulating of medicines (according to
the various aspects); providing online requisition for stock order from main
store; auto generating alerts after reaching at minimum stock levels;
maintaining transactions / depletion of stock depending on batch numbers,
manufacturing and expiry dates; presenting real time reports on the
consumption details and have complete provisions for LIFO and FIFO etc.

6.1.16. Dietary Management

The module be able to provide complete assistance to the hospital kitchen such
as record keeping of provision of meals to the inpatients according to the
instructions of dietician / physician to any patient; meal scheduling; meals
customization according the patient meal needs; recording of the individual
meal orders; allows the users to create food items groups and other food items
available in kitchen of the hospital; capture the calorie count along with the
nutritional information of various food items; facilitate in capturing the recipes
which are made of the food items along with their quantities (with an option to
include steps for the items preparation); manage various charts for the
maintenance of nutritive information of various food stuffs; Meal plan creation
for kitchen for breakfast, lunch and dinner for given time period of time
according to patient requirements; order generation for kitchen which provide
complete list of items needed to be prepared for every day based on
requirements of patient.

6.1.17. Ambulance Services Management

Ambulance Services Management Module is required to manage availability,

scheduling, tariffing, running, maintenance and tracking of ambulances /
vehicles, along with doctor / paramedic / driver / duty roster. Module will also
 facilitate maintaining the communication, basic life support and emergency
facilities in the ambulances/vehicles.

6.1.18. Housekeeping and Laundry Management

This module must provide quality indicators for assurance of cleanliness and
facilitate managing and monitoring housekeeping activities such as patient room
preparation, furniture dusting and cleaning of fixtures, windows, walls and other
places in health facility/hospital and must be able to deliver following functional
requirements including but not limited to maintaining schedule (cleaning
different areas of hospital, changing of linen, equipment’s cleaning), count
maintenance of incoming and outgoing laundry items, real time updates of
cleaning orders from different departments, staff appointment for specific
housekeeping activities, generating alerts and notifications for the housekeeping
and laundry departments (about the activities which needs to be carried out),
integration with Stores department for maintenance of required stock.

6.1.19. Vaccine and Cold Chain Management

This module must be capable of meeting functional characteristics i.e.

forecasting and supply planning, requisition / allocation, order processing /
fulfilment (dispatch), transport, receiving, inventory management, dispensing,
temperature monitoring (via remote temperature monitoring device), routine
reports and alerts.

6.1.20. Sterilization Management

The Module shall be capable of recording daily instruments, linen etc.

classification of instruments and linen (based on sterilization techniques);
scheduling sterilization equipment maintenance and continuous monitoring of
quality of sterilization.

6.1.21. Analysis and Statistics Dashboard

The module must provide business intelligence (BI) and advanced analytics
reporting wizard (reports exportable in to different formats that include PDF, MS
word, MS Excel and other formats) for doctors to do self-service BI that collects
the data from multiple source systems and perform Extract, Transform and Load
 (ETL) functions and consolidate the data and do decisions based on facts. It must
be capable of customizability in drag and drop fashion to build dashboards
(according to needs of management), revenue categorization in accordance with
the department, payment type and counter etc., efficient forecasting and
reporting statistical tools for data visual analysis, reports arrangement (based on
departmental requirements), active alerts and notifications on web and mobile,
R language integration.

6.2. ERP Suite

A set of modules which will be used to manage all the resources of PPHI Sindh, right
from the employee’s recruitment, on job duty movements & performance, till their
professional history within organization. These modules are supposed to provide
support to all business processes within the organization. The proposed set of modules
will help to manage business processes of various departments & functions through the
centralized application so that decisions can be made by screening the information
provided by ERP. Suite comprises of following integrated modules.
6.2.1. Recruitment and Job Portal
Required portal will facilitate HR department to perform activities like placing
job ads to find people, reviewing application forms, scheduling interviews and
recruiting & staffing operations.
6.2.2. Attendance
A complete Biometric Attendance Management System is required to ensure
effective and fool-proof implementation of company’s policies/ practices on
Attendance, Punctuality and Availability of employees. Successful bidder shall
be fully responsible for the supply, delivery, installation, integration,
configuration, interfacing, testing, and commissioning of the whole system
including hardware, Software to meet the PPHI’s requirement.
6.2.3. Employee Self Service Portal
Required Portal shall contain a dashboard which will help to access information
about attendance, leave management and also from their dashboard they can
easily download Pay slips and other useful documents.
6.2.4. Employee Performance (Pay for Performance)
Competitive and vigilant employee will be rewarded on the basis of certain well
defines benchmarked indicators. Proposed functions should be flexible enough
to calibrate measuring indicators over the period of time for different
employees.
6.2.5. Training
Training timetable of stakeholder will be managed, scheduled and reported
accordingly to improve performance of employees.
6.2.6. Payroll
It manages the processing of employee compensation and the generation of
various analyses and documents. This is where files for accountancy, banks and
external organizations are generated. The module processes both amounts to
be received or paid by employees and interim amounts needed for analyses
and reporting purposes. The module allows provisions to be made for future
expenses.
6.2.7. Financial Accounting
It include features to address the primary accounting areas of General
Ledger, Accounts Receivable, and Accounts Payable, Budget, Fiscal Years, Cash,
Currency, Bank and Tax Management, Fixed Assets, and Payroll Management
etc. Accounting transactions initiated in purchasing, sales order management,
inventory management, service management, and more are seamlessly linked
into the financial modules for the same timeliness, accuracy and detailed audit
trail.
6.2.8. Inventory and Purchase
It handles all the store activities of issues, dispatches, receipts and quality
control. Control function which should allow tracking of goods across business’s
supply chain & optimizes the entire spectrum spanning to entire order
placement journey of a product.
6.2.9. Employees Compulsory Provident Fund (ECPF)
A robust functionality will be required to detect PF from employees and
employer’s account on monthly basis. This function allows end user to select
the profit sharing feature.
6.2.10. Medical Reimbursement of Claims (MRC)
System should provide claims and reimbursements feature for employees
against medical expenses.
6.2.11. Group Life Insurance (GLI)
The management of employee’s information is required for the renewal of
annual life insurance policy.
6.2.12. Vehicle
 A complete train and monitoring of vehicles movement will be required so that
its overall maintenance cost can be compared with movement activity. It also
covers detail record management including of logs, monthly consumption, fuel
rates, revenue and expenses.
6.2.13. Summary of Additional Services (SAS)
SAS caters all numerical data entry criteria related to OPD, ORT, Referrals, PSBI,
LR, MH, Lab, US, OBS, KMS, Family planning and others.
6.3. Mobile Apps
6.3.1. Expanded Program on Immunization (EPI)
It required to manage all immunization program activities from schedule
creation, updating of immunization logs till stake holder reach upon fully
immunized stage.
6.3.2. Monitoring of Monitors (MOM)
To cater field observations, a robust application will be required so that
concern team member can visit any location and get required feedback against
required indicators. These indicators further help management to view
performance & take required actions against observed location.

6.3.3. Mother-n-Child Healthcare (MNCH)

Automation will be required to provide on job coaching & training to concern
medical staff members. Management will evaluate the performance of concern
staff on defined criteria.
6.3.4. Pay for Performance (P4P)
An online survey will be filled by the concern employees so that his /her
personal progress can be evaluated on the basis of SAS, DHIS, CK, and MOM.
6.3.5. Tuberculosis (TB)
Robust application will be required for TB & TB suspect patients so that their
complete, historical and current information can be store for further evolution
according to diagnosis.
6.3.6. Nutrition
Treatment, screening, follow-ups and drugs information of fewer than five year
children is captured in respect of SAM and MAMM cases.