It in hospitals & HIS
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It in hospitals & HIS

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It in hospitals & HIS It in hospitals & HIS Presentation Transcript

  • IT in Hospitals & HIS
    An overview
  • Changing role of IT professionals in Hospitals
    IT use to be a secondary dept. since need of It was not realized.
    The main work use to be troubleshooting and maintenance of network infrastructure.
  • Present Scenario
    Today IT professionals in health care or hospitals deals with analyzing the requirements of the hospitals to make their work more efficient & less time consuming and developing applications they need and implementation and maintenance of the same.
    IT in Hospitals has been used in following Applications:
    HIS
    EMR
    E-prescriptions
    E-health
    Telecommunication
    CDSS
  • Hospital Information System
    Hospital Information System (HIS) can be defined as a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital  that enable better quality of patient care, reduce the time spent for  clerical works, reduce  the overall  cost, increase the productivity and more important providing the more  reliable , correct  and regular  data.
    The computer hardware and software that processes a hospital's data, including financial, Pt-related, and 'strategic' management data, Pt accounts, Pt tracking, payroll, reimbursements, taxes, statistics
  • History
    Hospital information systems were first developed in the 1960s and have been an essential part in hospital information management and administration.
    The systems were used to manage patient finance and hospital inventory.
  • HIS is generally Used for-
    Operational management
    Functional Management
    Strategic Management
  • Operational Management
    • Creating Demographic details of the patient
    • Creating medical history
    • Creating Standardized process & documents
  • Functional MANAGEMENT
    Registration
    Admission
    OPD/IPD
    Pharmacy
    Laboratory
    Billing
    Blood Bank
    Medical Equipment Management
    Personnel Management
    MIS reporting & more
    Pharmacy
    Nursing
    HR
  • Strategic Management
    • MIS
    • Budget & Target Setting
    • Educational & Social Awareness
  • Objectives
    Capture & disseminate Information
    Analyze & validate Information
    Prioritize & Escalate Issues
    Provide Management overview
  • Actors/Stakeholders
    Doctors
    Administrators
    Patients
    Partners & providers
    Management & regulators
  • General Characteristics which One should look for in a good HIS
    • Modular
    • User Friendly
    • Integrated Functionality
    • Easy to customize
    • High level of security
    • Low Hardware Requirements
    • Low Cost of ownership
    • High ROI
    • Shortcut keyboard Function
  • System Characteristics
    • Support For maximum hospital procedure
    • GUI
    • Integration with the Third party accounting software
    • Auto Test result Generation
    • DICOM picture viewing
    • Integration with PACs
    • User defined Statistical Reports
    • Integration with TPAs
  • Organisation or companies in manufacture of HIS
    Napier
    Shrishti
    Wipro G(lot of small installations0
    Charak(Birlas)
    Medtrack(Fortis,Pushpanjali)
    Isoft(Medicity & Artemis)
    Accurate
    Akhil (Paras & BL Kapoor)
  • Additional applications required which are generally integrated with HIS
    It is required to facilitate the exchange of Information or patient records as none of them is stand alone application.
    PACS
    Back Office Applications(Asset & Inventory Mgmt,Billing,financial & administrative modules)
    EMR
  • Key Points you should look for to differentiate other HIS from the best one for your Hospital a good HIS
    Billing Module
    Inventory Module
    Consignment Module
    Discharge Summery
  • Billing Module
    All the operational processes applied to the patient and all the medicine and material used are listed in the billing screen.
    Last controls are performed in this module and if the processes are entered completely, the bill is saved. (Bookkeeping, diagnosis, provision, doctor etc)  
    Records about the patients are examined in the outpatient and inpatient billing departments depending on the health service the patient received, accruement procedures are completed and the bill is created.
  • Excellent billing module which can automate the steps of billing because after all its for revenue that a hospital is spending on IT
    • The most important aspect in a billing module is Payer & plan
    It should definitely have two categories to differentiate the patients at the time of entry in the HIS that will not cause problem at the back end- Cash patient & Credit Patient.
    • Should have three option in billing i.eservices with base tarrifs. For corporates,credit & cash. patients
    • It should have proper system to show the applicable tariffs correlated with tie-ups and insurance that automatically system can calculate the discounted rate on the base tariffs which are beforehand set for different categories of patients.
    • A user friendly option for cancellation & refund.
    • Capping/CoInsurance-The insurance company will likely not pay more than the coverage limits of the policy. It's the limit that is provided by the TPAs and insurance companies for the patients that they will bear only a fixed amount of patient’s cost and rest will be in the form of Copayment.
    • emergency cases –Bed charges
    • popup –services were charged or not, facility availed or not.
    • How exclusions are treated in the billing system that is very important
    • Integration with the ward management module for IPD pharmacy billing
    • Interim Billing-it calculates and reflects per day billing of services
  • Discharge summery
    After the discharge of patient discharge summary can be automatically generated with just few press of keys(i.e its preparation started fr0m the moment patient entered the IPD). Laboratory data can automatically be imported. Specialty wise standard format can be set.
  • Contents
    I.Basic Elements
    Date of admission.
    Date of discharge.
    Disposition location (eg, home, ecf, short-term rehab).
    Principal diagnosis for hospitalization.
    Secondary diagnoses addressed during hospitalization.
    Procedures performed during hospitalization.
    Consultants
  • II. History
    A succinct summary of the key events leading to hospitalization.
    The past medical history.
    Pertinent elements of the social history.
    Pertinent elements of the family history
    III. Physical Exam
    Findings (positive or negative) pertinent to history elements.
    IV. Data
    Pertinent (normal and abnormal) laboratory data.
    Pertinent results of diagnostic studies (e.G., Cxr, ekg).
  • V. Hospital Course
    Summary statement pertaining to the principal diagnosis.
    Problem list that parallels the diagnoses listed
    Separate paragraph dedicated to each problem listed.
    Brief discussion of the evaluation of each problem.
    Brief discussion of the treatment of each problem.
    Brief discussion of the outcome of each problem.
    Specific follow-up plan for each relevant problem
  • VI. Discharge Plan
    Future physician’s visits scheduled (or to be scheduled).
    Specific studies that require follow-up
    a list of discharge medications (names, doses, & frequency).
    mention of how information was/will be communicated to PMD.
    “cc” to treating physicians.
    VII. Additional comments or suggestions
  • Inventory Management system
    Hospitals need to actively manage what is bought, when it is bought, how much, as well as for what price, including discounts and rebates
    Inventory Management Module offers a time saving inventory solution that is precise and scalable, allowing you to monitor inventory usage more accurately and capture charges more efficiently by eliminating redundant data entry. Designed to support multiple facilities and multiple labs, the Inventory Management Module can be tailored to a hospital’s workflow.
  • Workflow of Inventory(Basic workflow)
    Purchase department
    Purchase Department
    Main store
    Central Medical store
    Central Pharmacy Store
    Sub holding store
    Consumed
    Chargeable
    Non chargeable
  • An Inventory Module Should facilitate the sequence wise Processes as follows
    Purchase Dept(Rate contract)
    Purchase Requisition from different dept
    Approved & authorized
    Order is placed
    Goods delivered
    Goods Checking
    Goods Receiving Note
    Stocked
    Central store
    Items Issued
    Departmental sub Store
  • Features
    FIFO format of System issue
    Stock Expiry Records
    Batch wise distribution List(Same expiry Date)
    Medicines should not be enlisted with the generic name but the Brand name as cost differs for both.
    Integration of Consignment Module .
    Item Mapping
    1) item number (most unique)2) inventory number (unique)3) catalog (unique to a group of inventory items)4) description (free flow text description of item)
  • ORDER MANAGEMENT(order entry, order review and/or validation, interdepartmental communication, order inquiry, and reporting requirements)
    Alerts system until confirmation of the receipt/delivery handles new drug orders
    Manages Material Resource Planning (MRP) Management
    Regulates Material forecast, Reservation management 
    Substitute Goods Management system
  • Conclusion
    We can conclude that a good HIS should be able to
    Increase-
    • No. of transactions
    • Inventory management
    • Sales
    • Productivity
    • Customer satisfaction
    • Market Share & penetration
    Decrease-
    • Administrative cost
    • Variable cost
    • Personnel expenses
    • Inventory losses