Case Study:

Tulsi Multispecialty Hospital

Hospital Management System (HMS)

Case Study
Hospital Management System

TMH

Abstract
The case study highlights a need to analyze human resource management processes that exist in healthcare sector
and suggests better ways to achieve higher levels of patient satisfaction. It consists of developing a conceptual
framework for human resource management in healthcare industry. The proposed framework comprises of three
parts: inputs which include determining employee competencies, HR planning, job analysis, recruitment, selection,
compensation benefits, pay/rewards, labor and employee relations; processes (training and development) focus on
healthcare systems; and outputs which include quality, cost, technology, and responsiveness leading to patient
satisfaction .The most important skill required for healthcare workforce to deliver high-quality care to patients is the
human resource development. It is designed to facilitate training and development at both the individual and at
organizational levels, advocating a balance between “healthcare employee” and “healthcare system.”

Abstract:
Healthcare sector forms the backbone of a society. This is more so in the case of an emerging
economy like India, where, the need to reach out to every nook and corner of the country is indeed
a real challenge. In such a scenario the healthcare organizations ought to leverage technology to
the fullest, in order to optimize the usage of human capital present within the organization. The
case paper diagnoses a corporate hospital in India, so as to decipher the role of Human Resource
Information System (HRIS), in providing quality healthcare services to the customers.
Furthermore, it also dissects the major anomalies present in the HRIS and the need to overhaul the
processes, culminating in making it more dynamic and vibrant. Various aspects of the management
team have been brought to the fore that has attributed towards the implementation of HRIS. The
perfect blend of understanding the actual art and science of Human Resource Management with
the Technology based element is being presented in the case for understanding the scenario
prevailing with and without HRIS. This in turn provides interesting food for thought for HRIS
professionals to know the pros and cons of technology based human resource management.
Tursunvayeva and et. al; 2016, in their study concluded that research on HRIS in the healthcare
sector was interdisciplinary, atheoretical study conducted primarily in the hospital sector of high-
income economies, and largely focused uncritically on use and realized benefits. The case study
therefore, analyzes the ramification of the presence of HRIS in only selected few corporate and
high end public funded hospitals, culminating in not realizing the true potential, so as to use the
talent towards a better output, in an emerging economical set-up.

I. Introduction

Business and non-business organization need to keep themselves up to date with the changes
happening in the area of technology. Therefore, it is important for every function to intertwine their
processes with the emerging technologies. Human Resource function over the years have started to
play a pivotal role in the organizational set-up since the human element forms the center stage for
happenings taking place both at the operation and at the strategic level. Human Resource function has
blended technology with almost all the core and non-core elements of the processes through Human
Resource Information System (HRIS). Experts have always opined about the need for HRIS in a
professional organizational set-up especially when the expected output to be delivered needs to be
optimized every single time, in a situation where there as stiff deadlines

At present, most of the Indian hospitals are adopting HMIS as a way of automation and digitalization of their health-care
records

Background

It was a dewy evening of New Delhi in July 2018 and a biscuit fall into the hot coffee which
Medical Superintendent of Tulsi Multispecialty Hospital, New Delhi was drinking into his huge vintage
cup. Deputy Medical Superintendent and hospital management information system (HMIS)
Nodal Officer at Tulsi multispecialty Hospital bought a letter sent by one of the Heads of a Clinical
Department to his office. It was mentioned in the letter that in most domains of the HMIS,
the providers have not completed the modules and required integration which they have
requested them to make as per the departments’ clinical and documentation requirements.
The letter added that the training team was helping them only with cursory skills which
they could learn by themselves once the modules would be effectively designed and given.
Hence, the representatives of Tech Solutions India Pvt. Ltd. were suggested to be
called in a meeting along with Heads of all the Departments and other users of the system in
the presence of Medical Superintendent and Director to avoid financial losses to the hospital.
The Deputy Medical Superintendent and the HMIS Nodal Officer discussed with the
Medical Superintendent that it was only one among many letters received by HOD of many
departments of the hospital where HMIS was implemented as a pilot project by the Director
in the past few months.
Tulsi Multispecialty Hospital

Tulsi hospital is a multi-specialty hospital that includes a number of departments,

rooms, doctors, nurses, compounders, and other staff working in the hospital.
Patients having different kinds of ailments come to the hospital and get checkup
done from the concerned doctors. If required they are admitted in the hospital and
discharged after treatment.
The aim of this case study is to design and develop a database for the hospital to
maintain the records of various departments, rooms, and doctors in the hospital. It
also maintains records of the regular patients, patients admitted in the hospital, the
check up of patients done by the doctors, the patients that have been operated,
and patients discharged.

GOALS
❖ To develop state of art health care institute that can provide multi and super-
specialty quality services at ethical prices to the patients of this region.
❖ To offer charity health services to the needy population of this region.

OBJECTIVES
❖ To establish Tulsi Multispecialty Hospital as a holistic health care center that is
patient and employee centric.
❖ To offer timely and quality health care services to patients with robust preventive
and promotive health systems.
❖ To ensure efficient utilization of human and non-human resource through optimal
support of Hospital Management Information System.

Project Highlights:
 New -50— bed Multispecialty tertiary care hospital.
 Centrally located, with easy access from any part of the tri-city.
 Built as per NABH guidelines.
 Caters to the need of high-quality trauma, emergency and critical care services
in the region.
 Wide range of diagnostics, surgical services, ICU’s, single, multi-occupancy
and deluxe rooms.
 Modular operation theaters.
 Ambulance with advanced life support.
 Integrated diagnostics facilities for a quicker turn-around time to diagnose.
 Paperless computerized medical records.

What is Hospital Management System (HMS)?

Hospital management system was introduced with the cause for helping hospitals speed up their
It is a computer system that helps to manage the
processes.
information related to health care and aids in the job completion of
health care providers effectively. They manage the data related to
all
departments of healthcare such as,

 Clinical
 Financial
 Laboratory
 Inpatient
 Outpatient
 Operation theater
 Materials
 Nursing
 Pharmaceutical
 Radiology
 Pathology etc.
HMS came into the picture of hospital management as early as 1960
and have
ever since been evolving and synchronizing with the technologies
while
modernizing healthcare facilities. In today’s world, the management
of
healthcare starts from the hands of the patients through their
mobile
phones and facilitates the needs of the patient.

Why is HMS important for a hospital?

HMS was introduced to solve the complications coming from

managing all the
paper works of every patient associated with the various
departments of
hospitalization with confidentiality. HMS provides the ability to
manage
all the paperwork in one place, reducing the work of staff in
arranging
and analyzing the paperwork of the patients. HMS does many
works like:

 Maintain the medical records of the patient  

 Maintain the contact details of the patient
 Keep track of the appointment dates
 Save the insurance information for later reference
 Tracking the bill payments.

The advantages of HMS can be pinpointed to the following:

 Time-saving Technology
 Improved Efficiency by avoiding human errors
  Reduces scope for Error
 Data security and correct data retrieval made possible
 Cost effective and easily manageable
 Easy access to patient data with correct patient history
 Improved patient care made possible
 Easy monitoring of supplies in inventory
 Reduces the work of documentation
 Better Audit controls and policy compliance.

Features of Hospital Management System:

Appointment Management

For hospitals having their own site, appointment widgets will be

integrated onto the site. Patients visiting the hospital’s website can
book online appointments with ease.

Billing Management

Integrated Billing with treatments, Lab and Radiology. Alerts will be

sent on
Discount Authorisation. Automatic due capture, Option to bill
before and after consultation.

Prescription Management

Manage commonly and recently used medicines. Option to show

medicines available in the pharmacy. SMS prescriptions to Patients.

Discharge Summary

Template based Discharge Summary. ICD10 integration. Option to

prevent discharge summary till IP bill is closed.

Operation Theatre Management

Automatic notification can be sent to customers on test results. Lab

notifications like email, SMS of the test reports sent from the
Automated Lab notification module.
Pharmacy Management

Comprehensive Pharmacy Management handles stock, Prescription

Integration, Ward Request, Stock Management, Stock Moment and
intelligent reports.

Lab Management

Comprehensive Lab Management handles complete order

management, Custom Reports, Smart Notifications, Credit
Settlement, detailed MIS Reports, Analytics and App for
Phlebotomist.

Master Information Systems

Lets you access entire MIS data from your palm.

Manage Multiple Locations

Any number of branches can be added and managed using a single

account.

Benefits of Hospital Management System:

We have so far clarified on the importance of HMS, it is your

responsibility to pick out the right kind of HMS for your needs and
purposes. Here we give more information on the benefits of various
HMS
and the impact it creates on hospital systems.

Easy Patient data retrieval:

HMS
makes it possible to access all the data related to a patient via a
system by the means of a few simple clicks. Information like patient
history, current illness, doctors involved, tests reports taken, billing
information and many more can be made visible to the user. These
data
will help to connect the dots about the patient, like specific
diagnosis, related treatment, and medication.

The Electronic Medical Record (EMR)  or Electronic Health

Record (EHR):

This
electronic-based medical record system can be viewed as a
patient’s
health chart. It retrieves information based on the patient’s name or
medical record number or the physician’s record number.

Increased Data security:

The
patient data can be kept a hundred percent safe by using HMS in
your
hospital. It can be made accessible by only a limited amount of
authorized personnel. With HMS, all the data is stored on a server
or
cloud and kept safe by just securing the login information safe.

Improve Visibility and Transparency:

Hospital Management System (HMS) improves the visibility and

transparency in the complete management process and in all
records.

Streamline Accurate Reporting:

It helps in streamlining the accurate reporting with the help of

updated and accurate records.

Improved Quality Control:

Hospital Management System improves the quality control on the
products and services of the hospital.

Improved Management Visibility:

It
also improves the management visibility of hospital, all
information,
and data regarding the patient, doctor and medicine could be seen
by any
department easily.

Ease to Access System Facilities:

Hospital
Management System makes it easy to get access to the
management system
facilities for the authorized users and keep it safe from
unauthorized
users.

Cost Effective:

HMS
not only saves time in the hospital but also is cost-effective in
decreasing the number of people working on the system of manual
entry of
data and paperwork. The implementation of His will decrease the
human
intervention into the system thereby avoiding human-caused
errors.

Every hospital has different needs, analyze what is best for your
requirement and install the apt HMS system.


Multiple advantages of HMIS implementation:
India’s twelth 5-year plan highlights the need to improve HMIS throughout the nation and a possible
investment in health IT in the public health system.

 HMIS is considered to be the most promising instrument to improve the overall efficiency, safety
and efficacy of the health service (Basit et al., 2006).
 Wide and effective use of HMIS improves the quality of health care (Frere, 1987).
 It minimizes adverse events and reduces the cost of medical care (Lun, 1995).
 It increases administrative productivity (Kuruvilla et al., 2004).
 It reduces documentation as well as enhance access to affordable treatment (Basit et al., 2006;
Yasnoff et al., 2000).
 There is the availability of digital access original data through HMIS which can be used as a strong
tool in the decision support system for the Hospital management.
 The HMIS data can be used for analysis as well as for forecasting purposes.
 The electronic medical records (EMRs) as well as picture archiving and communication system
(PACS) generated can be of great use for the clinical purposes for better diagnosis and treatment.
 The HMIS data can also be used for drug calculations and better scientific inventory management
practices at the hospital.

Advantages of Hospital Management System:

HMS provides manifold benefits to hospitals whether large or medium sized.

Streamlined Operations:
 Minimized documentation and no duplication of records.
 Reduced paper work.
Improved Patient Care:
 Procedures for timely and effective patient care
 Faster information flow between various departments
 Easy access to reference records.

Better Administration Control:

 Availability of timely and accurate information
 Access to updated management information.
Smart Revenue Management:
 Optimized bed occupancy checks
 Effective billing of various services
 Exact stock information.

Tulsi Multispeciality Hospital has developed a core package — Hospital Management System that
addresses all major functional areas of Hospital. The development environment ensures that Tulsi
Multispeciality Hospital HMS has the portability and connectivity to run on virtually all standard
hardware platforms, with stringent data security and easy recovery in case of a system failure.
Tulsi Multispeciality Hospital HMS provides the benefits of streamlined operations, enhanced
administration and control, improved response to patient care, cost control, and increased
profitability.
Some of the Subsystem Modules in Tulsi Multispeciality Hospital HMS:

Reception: The reception module handles various enquiries about the patient’s admission and
discharge details, bed census, and the patient’s movements within the hospital. The system can
also handle fixed-cost package deals for patients as well as Doctor Consultation and Scheduling,
Doctor Consultancy Fees and Time Allocation.

OPD, IPD Registration and Admission: This module helps in registering information about
patients and handling both IPD and OPD patient’s query. A unique ID is generated for each patient
after registration. This helps in implementing customer relationship management and also
maintains medical history of the patient.

Administration: This module handles all the master entry details for the hospital requirement such
as consultation detail such as doctor specialization, consultancy fee, and service charges.

Security: This module handles multi level security of Tulsi Multispeciality Hospital HMS so that
every admission and transaction can be traced with the help of user ID.

Pharmacy Store: This module deals with all medical items. This module helps in maintaining
Item Master Maintenance, Receipt of Drugs/consumables, issue handling of material return,
generating retail bills, stock maintenance. It also helps in fulfilling the requirements of both IPD
and OPD Pharmacy.

Purchase: This module helps in raising purchase orders, maintaining purchase details and other
purchase related details.

Phlebotomy: This specific module caters in maintaining test requisitions, sample collection status
and various procedures for collection of sample for the tests prescribed.

Laboratory: This module enables the maintenance of investigation requests by the patient and
generation of test results for the various available services, such as clinical pathology, X-ray and
ultrasound tests. Requests can be made from various points, including wards, billing, sample
collection and the laboratory receiving point. The laboratory module is integrated with the in-
patient/ outpatient registration, wards and billing modules.

Emergency: The development of this module keeps in mind the criticality of this department.
Every care has been taken to ensure that minimum of time is taken to register the patient, so as to
reduce the tension of the already stressed out relatives. Neither any detailed contact information of
the patient is required nor any information about the payment type is solicited.

OT Management: This module deals with operation theatre activities such as equipment used
detail, resource ordering, drug order, gynecology detail recording, laboratory order and reports
transfer requisition, patient monitoring, blood request, new born baby detail and details of
delivery.

Minor Surgery: This module is same in features as in OT management though the function is
different. This module deals with the surgeries minor in nature, which does not require complete
anesthesia.

Blood Bank: The blood bank module provides information on the collection and storage of blood,
results of blood tests, cross-matching identifications, and transfusion reactions. It also enables the
maintenance of donor mailing lists and donation ledgers. It would also provide online stock of
blood available in three blood banks (GTB, LNJP and DDU

Ward Management: The ward management module takes care of medical equipment, doctor
visit, vitals recording, patient case sheet, diet ordering, blood requisition, transfer intimation and
discharge intimation etc. It also deals with the maintenance of the wards, inter- and intra-ward
transfers.

OPD and IPD Billing: The billing module facilitates cashier and billing operations for different
categories of patients and automatic posting of charges for different services such as lab tests,
medicines supplied, consulting fees, food and beverage charges, etc. It enables credit party billing
through integration with the financial accounting module.

Intensive Care Unit (ICU): This module caters to scheduling, maintaining ICU Record, drug
orders, consultant details, specific blood requests etc.

Food and Beverages: This module facilitates collection of information regarding various diet
routines of patients and identifies the resources required to satisfy diet orders. Depending on the
diet orders and other requests from canteen, the kitchen order plan can be prepared to decide the
menu for the day. Analysis of the consumption patterns helps in better and efficient management
of the kitchen.

Discharge Summary: The module helps in generating patient’s discharge summary, which
includes patient’s health at the time of discharge, medical history, various diagnosis and drug
prescriptions, history of present illness and course in hospital.

Financial Accounting: This module deals with cash/bank, receipts/payments, journal vouchers,
etc. Various books of accounts, such as cashbook, bankbook and ledgers, can be generated and
maintained using this module. It can also generate trial balance, balance sheet, and profit and loss
statements.

Marketing Module: This module ensures that the hospital gets maximum exposure to the general
public and vice versa. This module keeps track of the enquiries made at the reception and follows
the lead.

Doctor’s Module: This module helps the doctors to keep a track of the entire medical history of a
particular patient. Details such as the medicines prescribed, general medical records, previous
consultations are all available to the doctor.

HR Management: Various MIS Reports are generated on the above modules for the smooth
functioning of the hospital management so that checks can be made on any irregularity done in the
hospital.
Challenges while implementing HMS: