Hospital Information System

( HIS)
 Objective:

• The course orients the trainees on the ways of

managing hospital information for the
effective functioning of the hospital. It gives
emphasis on the computerization of hospital
services.
 Contents

1. Introduction to Hospital Information Management: Concept of

information management, use of information in hospital administration;
application of information system in hospitals.
2. Confidentiality, Security and privacy of hospital information system
3. Introduction to Hospital Software
4. Introduction to the Hospital patient care process analysis
5. Introduction to IT in medical equipments
6. Introduction to IT Projects
 Evaluation method
• Modular exam Structured Essay and MCQ
• Assignment – Project report
 Contents
1. Introduction to Hospital Information Management: Concept
of information management, use of information in hospital
administration; application of information system in hospitals.
2. Confidentiality, Security and privacy of hospital information
system
3. Introduction to Hospital Software & Projects
4. Management of computerization project in the hospital:
Areas of computerization in the hospital: patient care,
medical records, and business administration
5. Modular evaluation : Conceptualize a project on
computerization of a hospital service unit
 Topic 01

Introduction management Information systems (MIS)

Concept of information management and the definitions
and the process involved.
Introduction to the hospital information system (HIS )
Basic concepts and categories in information management
in hospitals, information flow and the process chart in
healthcare services setting
Description and the role of Medical record department and
the responsibilities of the Medical Administrator in HIS.
Concept of Electronic Medical Records, current challenges
and advantages.
 Data , Information , Intelligence
• Data
• Information
• Intelligence
 Healthcare is changing…

Today Tomorrow
Scope Cure Patients Care for Citizens

Focus On the process and provider On the patient

Time Symptomatic, curative Preventive, lifetime

Location Hospital Decentralized, at home

Methods Invasive Less invasive

 The processes are changing …

Today Tomorrow
Clinical Decisions Personal preferences Guide lines / evidence based

The Process Fragmented, isolated disease mgt.

Experience Individual Best Practices

Order Process Manual Automated

Information Fragmented, isolated Consolidated / complete

 IT is changing …

Today Tomorrow
Technology Isolated systems Integrated systems

Data access Limited, Difficult Any time, any place

Data integrity Manual/error prone Systematic mgt. and control

Data completeness Fragmented Consolidated

Data availability Slow Real time

 The health care is under
pressure ...
• Costs must decrease
• Quality must increase
– E.g. Medication
errors: in the US
80.000 people died in
2004. (=8th cause of
death)
 The Hospital

High Quality
Cost Effective

Medical Knowledge

Activities needs Assessment needs

Information

produces
 Healthcare as a Process
objective subjective Assesment Planning

Society operational Diagnostic Action Therapeutic Action

Input Process

Medical Care Action

Community

Output
Healthcare as a Process: pain points
Isolated information Complex desicions
Fragmented information Lack of training
Not accessable information Changing knowledge
Too much information Medical errors
Bad information presentation Inefficient workflow
Only clinical data is kept (no knowledge) Understaffing
Some information is not computer usable (free No operational information
text, image features, (genome in the future))
No infrastructure
No feed back to medical community and society information
Workflow
Information NoClinical
common language
Desicions

Medical operational Society objective subjective Assesment Planning

Input - Output Process
Community

Action
Cure for the pain points – wave 1
PAS: Patient Adminstration
System
HIS: Hospital Information
System
Result Distribution

Input - Output Process

Information Clinical Desicions Workflow

t
Medical llec
operational Society objective subjective Assesment Planning Action
Co
Community
 Cure for the pain points – wave 2
PACS: Picture Archiving And Communication Sytem
PAS: Patient Adminstration System
HIS: Hospital Information System
CIS: Clinical Information System
Care
Order Entry
Medication prescription
Result Distribution
Information Clinical Desicions Workflow
o rt Process n
Input - Output p tio
Medical llec
t
operational Society objective subjective sup Assesment iza
Co ion ptim
Planning Action
sic O
Community De
Cure for the pain points – wave 3
Information filtering feature extraction from unstructured or massive
information (images, free text)
Decision support
Advanced connectivity
Semantic driven UI
Content
Clinical Pathways
Workflow optimization
Evidence based medicine
Intelligent patient portals
Clinical Trials (in- and exclusion criteria, data mining)
Remote data capture
Terminology
Common to all this is … HealthCare
Community

Input - Output Process

Information Clinical Desicions Workflow

ge po rt tio
n
Medical led
operational Society objective subjective sup Assesment iza
ow ion ptim
Planning Action
Kn sic O
Community De
 Adaptable Clinical Workflow
Framework

Assesment Planning Diagnostic Action

Therapeutic Action

Care Action

Medical Society subjective objective operational

Community
 1. Introduction
• Hospital consists of multiple variety of function
performed by different categories of people
• With limited resources these personnel are
expected to produce an output with an
acceptable quality.
• Strict regulatory process and more
documentation in the hospital process have
hampered these personnel performing assigned
actual technical work, resulting unproductive low
quality service outputs. EX. Nursing care
 Justification
• Due to Scarce Human Resources, existing
Human resource should utilize in a most
productive and cost effective manner
• Hospital Information system will make people
more efficient by collecting & distributing
information faster, making use of the same
human resource.
• Efficient MIS essential for the hospitals in
today’s context.
 Primary objectives of HIS
1. To make a cost effective hospital
2. To provide quality services to their patients
3. To enhance the decision making process
4. To support user confidence
5. To boost hospital professionals commitment
 Requirement of a HIS in a hospital
• Daily management of operations
• Competitive planning strategy
• Controlling dissemination of information
• Processing volumes of data
• Providing information for medical & financial auditing
• Inventory management
• Interaction between department heads for planning,
coordination, & control activities
• Provision of information for national level policy,
decision making.
 2. Benefits of HIS
• Health administration: Per patient information administrative work
and making him more competitive in his work, prepared for
auditing & legal demands.
• Medical research & development for response & preparedness.
• Improvement in Quality & efficiency in patient management:
Pictorial & image data presentation increases for medical imaging
services
• Process coordination & improvement: Networking of units
• Increase efficiency of HR: It is estimated 40% of HR time is spent on
in formation gathering, processing & disseminating work.
• To identify & improve areas of inefficient areas in terms of service
delivery & cost.
 3. Current Gaps in HIS in hospitals
• Management & medical systems:
Underutilization of available data in day-to-day
management, unavailability of soft ware & hard
ware.
• Hospital & clinical systems: Incomplete data
sheets, low man power
• Hospital staff & data base developers: little or no
knowledge in respective personnel regarding IT &
hospital activities. Poor communication & lack of
interest of the mentioned categories
 4. Methodology
• There are several approaches to constructing HIS.
• Supporting activities of functions
– CEOs information system
• Point of scale method (POS)
– Build around the Patient
• Top down method
– Build around Cooperate plan, targets, to functional
goals
• Local Area Net work method (LAN)
• Analogous system
 5. Functional modules in a HIS
• There are two major categories in HIS
1. Clinical
2. Administrative.
 A. Clinical
• Ward management
• OPD management
• Operation Theater
• CSSD
• Transfusion services
• Ambulance services
• Medical records
• Special unit management: ICU, ETU,
• Labor room and PBU
• Diagnostic services:
• Laboratory, Radiology, ECG, & EEG
 B. Administration
• Front office
• Registration
• Appointments
• OPD Administration
• OPD billing & IPD billing
• Stores
• Pharmacy
• Marketing
• Financial accounting
• HR
 7. Implementation strategy of HIS
• Development of long-term plan for five-year
period with short tem, annual plans.
• Identification of current operational problems &
need for soft ware solutions, making phase wise
deployment of those solutions.
• Site visit & determining estimating how the soft
& hard wear enhance work process.
• Cost effective Method of the development of the
soft ware; Purchase, in-house development or
customization of developed soft ware.
 7. Implementation strategy of HIS
• Placement of computers, printers in points of
revenue generation & service centers and the
cost.
• Determine the net work configuration: local &
other connections
• Develop & plan for a training programme
• Introduce audit & review systems, operation
delivery systems
• Development of implementation strategy
8. Key activities of HIS implementation
• Building computer
• Determination of premises
priorities
• Acquire the resources
• Defining architecture
• Outsourcing needed
• Install the equipment
activities • Establish task force
• Evaluate & select solution • Site visit
• Evaluate criterion of • Empower uses
applications
• Customize & implement
applications
 9. New Technologies
• Telemedicine
• Medical records
• Smart Card
• Digital library
• Multimedia
 10. Resources for installing HIS
• Operating system
• Data Base management
• Antivirus soft ware
• Server
• Data base backup drive
• Ups
• Terminals
• Hub
• Manpower
• EDP room
• Cables ,Panels & outlets
 Developing a hospital
information system in a hospital
 The project
• Planning
• Implementation
• Monitoring
• Evaluation and feed back
 The project plan
• Identification of the “needs gap”
• Plan a system as per the requirement to
improve the quality , reduce cost and other
resource constrains
 Identification of the needs gap
• Study the process flow
• Identify the bottle necks and red tapes and
time , money and resource wasting area . Also
the high risk areas needs quality improvement
 Process flow
• Service industry
• Services process
• Core process – Direct Patient care services
• Support process – Administrative /support
services
• Consider core service initially and then move
on to support process ( depending on the cost ,
time , quality and other resource importance
 Patient care process
• Identify services units – OPD, IPD, CCU, ETU
etc.
• Select Key result areas – functions
• Functions – sub unit level
– OPD -reception Registration , Payment
• Activities
• Tasks
 OPD
• Reception
• Registration
• Payments
• Consultation
• Investigation
• Treatment
• Dispensing
 The process
• Study the process as per the core patient care services
• Identify the Key result areas
• Identify the functions
• Study the information flow
• Validate the current methods
• Identify gaps
• Propose the system support
• Also look at integration of each units
 Activity 01
• Develop a process and the information need
for a IPD services
 Selection of a system
• Select / modify or develop system as per the
need
• Step by step implementation - modular fashion
• Unit by unit as per the process flow – OPD to IPD
and then to CCU
• Closely follow the “ Human Response”
• Monitoring and feed back essential
• Clinical and administrative modules
 Clinical modules
• Ward management
• OPD management
• Operation Theater
• Ambulance services
• Medical records
• Special unit management: ICU, ETU, Labor room and
PBU
• Transfusion services, Ambulance services
• Diagnostic services: Laboratory, Radiology, ECG, & EEG
 Administration modules

• Front office • Catering

• Registration • House keeping
• Appointments
• Purchasing
• OPD Administration
•
• Customer care
OPD billing & IPD billing
• Stores • Security
• Pharmacy
• Marketing
• Financial accounting
• Human resources
HIS modules
 Assignment
• As a ward In- charge , you are requested
formulate a Project proposal to be given to the
IT specialist in order to construct a hospital
software to your Medical ward .
• 500 words
Telemedicine
 Tele Medicine
• Telemedicine is the use of telecommunication and
information technologies in order to provide
clinical health care at a distance. It helps eliminate
distance barriers and can improve access to medical
services that would often not be consistently
available in distant rural communities. It is also used
to save lives in critical care and
emergency situations.
• Diagnosis , treatment and monitoring and
rehabilatation
V 07
Thanks
Thank You!