LESSON 9

HOSPITAL INFORMATION
SYSTEM
 Introduction to Hospital Information System

• Healthcare is a very crucial a part of our society and it's far imperative for healthcare providers
to do their jobs in an efficient and powerful manner. Each day masses of thousands of sufferers
enter healthcare centers challenging the management to run the show easily. The employees
have to manage and combine clinical, economic and operational records that grow with the
practice. Formerly, this data was prepared manually, which was time consuming and didn't
deliver the desired level of performance. Most professionally run hospitals and clinics now
depend on hospital information systems (HIS) that assist them in controlling all their medical
and administrative records.
• A hospital information system (HIS) is fundamentally a computer system that could manage all
the information to permit health care providers to do their jobs efficiently. These structures
have been around since they were first introduced in the 1960s and have developed with time
and the modernization of healthcare facilities. The computers were no longer as fast in those
days and that they were now not able to offer data in real time as they do these days. The staff
used them generally for dealing with billing and hospital inventory. All this has changed now,
and today hospital information systems include the integration of all scientific, financial and
administrative programs.
Introduction to Hospital
Information System
• Modern HIS consists of many applications addressing the needs of numerous departments in
a health facility. They manage the data related to the clinic, finance department, laboratory,
nursing, pharmacy and additionally the radiology and pathology departments. The hospitals
that have switched to HIS have access to fast and reliable information including patients’
records illustrating information about their demographics, gender, age and so on. via a
simple click on of the mouse they receive crucial data concerning hospital finance structures,
diet of patients, or even the distribution of medicinal drugs. With this information they are
able to reveal drug usage within the facility and enhance its effectiveness. Many hospitals
have as many as 200 disparate systems integrated into their HIS.
• Hospital information systems have grown to be very advanced and new developments are
continuously being introduced. However, a HIS is useless if it confuses the hospital
employees. The system should be user friendly and should include training by the vendors.
Introduction to Hospital
Information System
• An excellent HIS gives several advantages to a hospital such as but not
limited to the delivery of high-quality patient care and better financial
management. The HIS must also be patient centric, medical personnel
centric, affordable and scalable. The technology changes quickly and if the
system isn't adaptive it will not be able to accommodate hospital growth. An
effective HIS additionally provides benefits including:
• enhanced facts integrity
• reduced transcription errors
• reduced duplication of facts entries
• optimized report turnaround times
 Introduction to Hospital
Information System
• Current hospital information systems normally use fast computers
linked to each other via an optimized community. These computers
are programmed to gather, process, and retrieve patient care and
administrative information ensuring better ROI and delivery of
service. If the hospital authorities have more relevant data they can
make better decisions.
 Introduction to Hospital
Information System
• HIS leverages a relatively optimized core library that guarantees the
delivery of operational and administrative facts required by users. A
centralized information system can be custom designed in line with
the particular necessities of a medical institution. A hospital can tell
the solution provider its wishes and the applications can then be
molded to deliver precisely what was demanded. For example, you
can demand a solution that is primarily based on RDBMS for easy
retrieval of information. You can additionally ask the vendor for a HIS
that has user friendly functions and a multilingual interface that can
be used by a diverse team of workers (EMR Education Center, 2013).
9.1.2 HIS for Different
Departments
• Nursing Information Systems (NIS) these computer based information
systems are designed to assist nurses offer enhanced patient care. A
good NIS can carry out a number of functions and supply benefits
together with improving personnel schedules, accurate patient
charting and better clinical data integration.
• The nursing department can have a better-managed work force thru
agenda packages, enabling managers to handle absences and
overtime. The solution can also be used to reveal staffing levels and
obtain more cost-effective staffing.
9.1.2 HIS for Different
Departments
• Patient charting applications also permit users to go into details
regarding patients critical signs. Nurses also use it for admission
information, care plan and all applicable nursing notes. All crucial
facts are securely saved and can be retrieved when required.
• Medical information integration is also very useful, allowing nurses to
collect, retrieve and examine the medical records after which
integrate it to design a patients care plan.
9.1.2 HIS for Different
Departments
• Physician Information Systems (PIS) as the name suggests, PIS systems
aim to enhance the practice of physicians and also are encouraged by
the government for deployment. PIS are added thru computers,
servers, networks, and use extensively deployed and popular
programs such as, Electronic Medical Records (EMRs), Electronic
Health Records (EHRs), and others. Most of these offerings have 24/7
support that enables health professionals to troubleshoot issues
happening at some point in their use.
9.1.2 HIS for Different
Departments
• Radiology Information System (RIS) these systems are also popular for
their capability to provide radiology billing services, appointment
scheduling as well as reporting and patient database storage. The
radiology practice has become more complicated with advances in
technology and more hospitals now turn to RIS to control the
commercial enterprise side of their practices.
9.1.2 HIS for Different
Departments
• Pharmacy Information Systems (PIS)Designed to cope with the
demands of a pharmacy department, PIS enables pharmacists
monitor how medicine is utilized in hospitals. A PIS facilitates users
supervise drug allergies and different medication-related
complications. The system enables users to identify drug interactions
and also helps administer the appropriate drugs based on the patients
physiologic conditions (EMR education center, 2013).
9.1.3 Selecting a Hospital
Information System
• Total cost of package-Normally, HIS vendors are thrilled to visit and
discuss the necessities of your hospital with you. Solutions are
available for hospitals of all sizes and budgets. It is essential to have a
hospital information system that has a low cost of ownership. A few
providers reduce prices through having a design that calls for much
less hardware and fewer servers. This kind of layout is known to
reduce upfront acquisition fees and additionally reduces maintenance
ultimately.
9.1.3 Selecting a Hospital
Information System
• Web based system-in addition to the user friendly features, an excellent HIS system ought
to be available on the internet. Availability on the internet means authorized employees
can access the information whenever they need from anywhere. this does not bind all
caregivers to their office desks and additionally offers them with statistics when they need
it most. a web based system will become even more vital if it is used to share data
between or more hospitals. Healthcare centers in distinctive geographic locations can
share relevant information quickly in the event that they use an internet based HIS. for
example, a hospital may decide to shift a patient to another facility for improved care or
specialty treatment. If the present hospital has updated all the patient history in their HIS,
the next health facility can immediately access the information necessary for treatment.
The medical records of the patient will continually be saved within those facilities and can
be effortlessly retrieved if the patient is not able to offer it himself.
9.1.3 Selecting a Hospital
Information System
• Implementation and support-Change is continually resisted by people and
deploying or upgrading a hospital information system can also invite employee
criticism. It is always good to invite the vendor for assistance in an
implementation and request for staff training. Select a vendor that gives 24/7
support thru the telephone or web, so your hospital staff can at once access
support. A few hospitals also seek advice from their personnel while making a
purchasing decision, because the personnel may be capable to tell you
something new or let you know about things others may have left out (EMR
Education Center, 2013).
 9.2 HIS Providers in the
9.2.1 BIZBOX Philippines
-The founders of Bizbox, Inc., started twenty-five (25) years ago with the
goal of helping people improve their work efficiency through software.
With the first hospital project in 1994, BizBox evolved into one of the top
IT companies focused on the healthcare industry.
-All the healthcare solutions developed by BizBox uses the latest
technology from Microsoft. Leveraging on Windows Server, SQL Server
and .Net, BizBox builds mission-critical applications for the healthcare
environment. Bizbox is proud to be a Microsoft Gold Certified Partner and
the recipient of the ISV of the Year Award.
-With the demands and requirements of healthcare facilities for better
patient care, Bizbox aims and committed to produce more advanced
solutions. Taking advantage of the latest technologies in the industry, we
have already produced the next generation of healthcare solutions. The
Electronic Health Records (EHR) and Document Management System
(DMS) are fully integrated systems that are poised to bring your healthcare
facilities and services to the next level
 9.2 HIS Providers in the
Philippines
• 9.2.2 KCCI MEDSYS
• Kaiser-dela Cruz Consulting, Inc. (est.1990)
specializes in application development for hospitals,
industrial clinics and medical related educational
institutions in the Philippines. Our products Visual
MEDSYS for Hospitals and MEDSCHO for Schools
provide integrated, comprehensive, and proven
solutions. The President of KCCI, Robert F. Kaiser, Jr.
is a graduate of Ateneo Masters in Hospital
Administration Program and is currently the EVP of
Lorma Medical Center (http://gomedsys.com).
 9.2 HIS Providers in the
Philippines
• 9.2.3 COMLOGIK
• Comlogik Business Systems, Inc.is a Philippine
based software development company that
established its operation in the year 1999 with a
vision to be a Global Technology Company.Comlogik
led the way in developing innovative applications
like online hospital services wherein patients can
access their billing as well as the examination
results, while your Administrators can access their
reports and yourDoctors their patient's records
anywhere and anytime they need to
(http://www.comlogik.com/About_Us.aspx#who_w
e_are).
9.3 Help Desk, Scheduling,
Patient Registration
• 9.3.1 Help desk
• A help desk is a useful
resource meant to offer
the customer or end
user with information
and guide associated
with a company's or
institution's products
and services.
9.3 Help Desk, Scheduling,
Patient Registration
• 9.3.2. Scheduling
• Managers and employees can
access work schedules from
everywhere and effectively
discuss their scheduling
preferences. An employee
scheduling software could
save you time and make
employee scheduling less
difficult.
 9.3 Help Desk, Scheduling,
Patient Registration
• 9.3.3Patient Registration
• A patient registration form needs to be
filled up whenever a patient visits a
hospital or clinic to avail of medical
treatment. It's also frequently referred to
as the patient admission form, which
collects facts about the patient's name,
age, marital status, gender, medical history,
previous consultation and varying essential
data. The data is used for record keeping
and administrative use. If the patient calls
for any prompt medical attention for the
duration of an emergency, the form can be
filled up by any relative, friend, or guardian.
 Admission, Discharge and Transfer
Procedure
• 9.4.1 Admission
• Before you are admitted to the health
facility, an admissions counselor will
call you to gather preliminary
information, offer vital information
concerning your hospital stay and
answer your questions. Your physician
additionally may schedule recurring
medical exams, such as laboratory tests
or X-rays, before your hospitalization.
Other routine tests can be carried out
at the day of your admission.
 Admission, Discharge and Transfer
Procedure
• 9.4.2 Discharge
• Discharge from the hospital is the point at
which the patient leaves the health facility
and either returns home or is transferred
to some other facility including one for
rehabilitation or to a nursing home.
Discharge entails the medical instructions
that the patient will need to fully recover.
Discharge planning is a service that
considers the patient's needs after the
hospital stay, and may involve numerous
exceptional services which includes visiting
nursing care, physical therapy, and home
blood drawing.
 Admission, Discharge and Transfer
Procedure
9.4.3 Transfer
• The term "transfer" means the movement
(along with the discharge) of an individual
outside a hospital's premises at the instruction
of any person employed by (or affiliated or
related, directly or indirectly, with) the hospital.
This, however, does not encompass movement
of an individual who (A) has been declared
lifeless, or (B) leaves the facility without the
permission of any such authorized person
(Louisiana State University, 1993).

• If a patient is transferred, sent from the

emergency room while not having been
stabilized in the emergency room, employees
must fulfill the statutory requirements for a
proper switch
 9.5 Physician Practice
• Masters (2015) describes the current environment of the physician practice in the following manner:

• Increasingly, physicians are being employed within one of several practice models. Some hospitals may purchase and
manage existing solo or group practices, or may directly hire physicians to work in their inpatient facility or
ambulatory clinics. Health care corporations may own and run clinics with employed physicians. And some physician-
run groups are structured on an employment model, where a group practice is structured more like a corporation
that employs clinicians instead of pursuing a more traditional partnership model.

• An advantage of being an employed physician is that much of the administrative burden of running a practice is
shifted to the employing entity, allowing clinicians to focus more on practicing medicine. Additionally, a baseline level
of compensation is usually assured, although productivity demands and incentives may be significant. Because the
organizations employing physicians tend to be larger, they usually have more resources than solo or independent
group practices. Clinically, this usually means reasonable coverage for clinical responsibilities and improved control of
lifestyle. This larger size and increased resources may also translate into more robust support services and
opportunities for further education and training.

• The downside of being an employed physician is that physician autonomy may be substantially diminished relative to
other practice models. Scheduling and productivity expectations may be beyond your control, and policies and
procedures may be developed by others without your input. There may be less clinical flexibility due to limitations of
referrals and facilities based on the employing organization. Additionally, there may be other expectations as an
employed physician, such as serving on committees or participating in other organizational activities.
Billing, Contract Management, Package
Deal Designer and Accounts Receivables
• 9.6.1 Billing
• Billing statements itemize all of a purchaser's invoices and payments, and maintain a
rolling balance of how much they owe. Statements are valuable for customers that
order from you on a frequent basis. When they pay, such customers will often combine
numerous invoices and pay in lump sum. Through generating statements on a regular
basis (at least monthly), you'll be able to keep track of who owes you and how much.

• Statements are not only useful for active customers, but they also keep you up-to-date
on customers who only seldom order from you. Whenever you generate billing
statements, the HIS will display a list of those customers that have outstanding
balances, and you can page through each statement and quickly isolate someone if their
payment is overdue.
Figure 9.10: Sample Billing,
Statement of Account (SOA)
Billing, Contract Management,
Package Deal Designer and
Accounts Receivables
• 9.6.1 Billing
• Billing statements itemize all of a purchaser's invoices and payments, and maintain a
rolling balance of how much they owe. Statements are valuable for customers that
order from you on a frequent basis. When they pay, such customers will often combine
numerous invoices and pay in lump sum. Through generating statements on a regular
basis (at least monthly), you'll be able to keep track of who owes you and how much.

• Statements are not only useful for active customers, but they also keep you up-to-date
on customers who only seldom order from you. Whenever you generate billing
statements, the HIS will display a list of those customers that have outstanding
balances, and you can page through each statement and quickly isolate someone if their
payment is overdue.
Billing, Contract Management,
Package Deal Designer and
Accounts Receivables
Billing, Contract Management, Package Deal Designer and
Accounts Receivables

• 9.6.2 Contract Management

• Goodrich (2013) defines contract management as the “process of managing contract
creation, execution and analysis to maximize operational and financial performance at an
organization, all while reducing financial risk. Organizations encounter an ever-increasing
amount of pressure to reduce costs and improve company performance. Contract
management proves to be a very time-consuming element of business, which facilitates
the need for effective and automated contract management system.”

• He stresses that when a contract management strategy is successfully implemented,

organizations can expect to see: The expected business benefits and financial returns are
being realized The supplier is cooperative and responsive to the organization’s needs
The organization encounters no contract disputes or surprises The delivery of services is
satisfactory to both parties
Billing, Contract Management, Package Deal Designer and
Accounts Receivables

• 9.6.3 Package Deal

Designer
• Posting Diagnostic
Medical Packages for
Inpatients, Outpatients
and Emergencies
requires the same
process; the difference
is that for Emergencies
this is called Post-
Diagnostic Package Deal.
 Billing, Contract Management, Package Deal Designer and
Accounts Receivables
• 9.6.4 Accounts Receivables
• Investopedia (2017) defines accounts
receivable as the outstanding invoices a
company has or the money the
company is owed from its clients. The
phrase refers to accounts a business has
a right to receive because it has
delivered a product or service.
Receivables essentially represent a line
of credit extended by a company and
due within a relatively short time
period, ranging from a few days to a
year.
 Billing, Contract Management, Package
Deal Designer and Accounts Receivables
• 9.7 Consumption Entry
• A consumption entry is duty entry for the goods which have been imported from an international carrier and sent for use in
the commercial market directly. There are no time or use restriction imposed on these goods. Almost 95% of the imported
goods are of this category in the U.S.A. In the markets, such goods can be used for the personal use or commercial use. If the
goods are first kept in any warehouse before going to the market, then formal warehouse entry is to be made on them

• Example: An exporter from Brazil exports tea to the USA and the stock goes direct to the distributor without going to any
warehouse. Then a consumption entry is made for the tea stock.

• Apart from Consumption entry, following entries are also used:

• Transportation entry: When goods are in transit to a third country

• Warehouse entry: When goods are stored in a bonded warehouse before going to the market
• Foreign Trade Zone Entry: When goods are stored in a place licensed by the department of commerce of that country
• Temporary in Bond Entry
• Drawback Entry
SAMPLE
LABORATORY
RESULT
 Laboratory, Radiology and
Cardiology Reporting
• The University of Virginia (2013) briefly discusses on radiology reports as follows:

• A radiology report is a clinical and source document that provides interpretation and describes any radiology procedure
conducted by a radiologist. The only person who is privileged to prepare and document a radiology report is a qualified
physician who has been granted specific clinical privileges in that hospital or clinical settings. It is an official medical document
that provides description and interpretation for any officially requested radiological exam.

• As outlined by the American College of Radiology, there are over 15 components of a radiology report. The length of the report
should have some relationship to the complexity and cost of the exam. It should have pertinent positive and negative findings
and address any specific clinical concerns. All important findings need to be stated first and any incidental findings are reported
at the end. The radiology report's main premise is to answer the clinical question from the radiology request. The main
components are:

• Patient's demographics. Name, social security number, etc.

• Relevant clinical information and ICD-9 code.
• Body of the report.
• Impression (conclusion or diagnosis)
 Laboratory, Radiology and
Cardiology Reporting
SAMPLE
RADIOLOGY
RESULT
 Laboratory, Radiology and
Cardiology Reporting
• 9.8.3 Cardiology Reporting
• Sonosoft (2017) elaborates on the importance of cardiology reports:

• The purpose of cardiology reports is that they should clearly provide information about a patient for medical records. The fact is that doctors who need
these reports are busy and putting them together takes a lot of time and effort. This is why so many medical offices are now using software to help them
write vascular reports.

• Vascular sonography reports can be created with a touch of a few buttons if software designed for cardiology is used. Vascular software programs
understand the needs of the medical staff that prepare and read these reports and are quite intuitive.

• Vascular sonography reports will indicate valuable information about the results of the ultrasonic ultrasound and might include diagrams of the veins and
arteries to help determine and measure items such as blood flow, presence of plaque, narrowing and the presence of clots.

• Many physicians are now opting for automation of vascular reports and cardiology reports through the use of software. Instead of spending time hand
writing reports on findings, forms can be used that allow medical staff to quickly process a report in a system that understands the tests and the
terminology.

• Today because of software that's designed to prepare reports in a standard format that works for communicating between offices and clinics and to be used
for medical reporting as well as medical billing, the right software means efficiency in offices and clinics and hospitals as well as being able to get results
quickly and communicate with patients sooner so that surgery or other medical procedures or medications could help that patient get onto the road to
recovery sooner.
 Laboratory, Radiology and
Cardiology Reporting
SAMPLE
CARDIOLOGY
RESULT
Discharge Summary
• A discharge summary is a
clinical report arranged by a
health practitioner or different
health expert at the conclusion
of a hospital stay or series of
treatments. It outlines the
patient's main complaint, the
diagnostic findings, the
treatment administered and
the patient's response to it,
and guidelines on discharge.
Discharge Summary
• 9.10 Material Management System – Pharmacy, Main Stores and Purchase
• Material management is basically concerned with the planning, identifying, purchasing,
storing, receiving and distribution of materials. The purpose of material management is to
guarantee that the right materials are in the right location, in the right quantities when
needed.
• Virtually every healthcare institution has a materials management department that is
accountable for receiving materials, retaining a central stock and delivering supplies
throughout the institution. Regrettably, that is typically where the responsibility of the
materials management department ends. A better inspection of a nursing unit, OR suite, or
exam floor reveals a smaller, self-managed inventory in supply closets, nurses’ stations
and individual rooms. Despite the fact that that is essential to maintain supplies conveniently
available on the point of use, the weight of keeping the supply falls on the nurse and
detracts from his or her primary task feature: offering patient care (Eisenman, 2017).
Discharge Summary
• 9.10 Material Management System – Pharmacy, Main Stores and Purchase
• As such, the automation of an inventory or material management system is a definite
need for a hectic health center to streamline the hospital supply chain. These
computerized stock management systems include technologies for tracking and tracing
inventories and devices used each day in a healthcare setting. Generally, they utilize
barcodes and RFID tags with precise identification numbers for each inventory object to
enable accurate tracking and control.

• Automatic stock management systems also assist healthcare companies in figuring out
whether merchandise had been recalled or damaged and being proactive by avoiding
giving such merchandise or medications to patients. Moreover, automatic inventory
management enables isolation of drugs and devices that are used regularly, and forecasts
capacity shortages (Pontius, 2018).
Discharge Summary
• 9.11 Management Reporting
• A management reporting system provides business information. Historically, MR structures
were simply used retrieve up data. However, the system has undergone tremendous
transformation over time, making it a strong platform for reporting and control. Because of the
advancement in technology, it is able to now offer financial and non-monetary information,
which could help management take essential actions in the oversight of their business activity.

• Management reporting systems help in capturing data that is needed through managers to run
an effective enterprise. Data could range from monetary data, employee headcount, customer,
accounts, merchandise, client property in custody, funding overall performance, and so forth.
The scope of a management reporting system is extensive. An effective management reporting
system allows enhanced decision making, responsiveness, effectiveness and performance in the
use of resources (Kumar, 2017).
Discharge Summary
• 9.11 Management Reporting
• Kumar (2017) also enumerates six reasons giving rise to the need for a Management
Reporting System:

• Constant need of reports for decision making and analysis of trends

• Reports being unavailable with the right stakeholders at the right time
• Lack of visibility and a single holistic view of the enterprise performance
• Data redundancy, duplication of data leading to data management and quality issues
leading to error prone reports
• High value resources
• Changing a global report to fit local needs
Discharge Summary
• 9.12 In-Built Tally Interface
• Tally.ERP is a simplified solution
that encompasses accounting,
inventory management, tax
management, payroll, and
compliance among many others.
Tally is easy to learn and can be
implemented with minimum
resources. It is reportedly used by
over 1,000,000 entities across the
globe.