My presentation of hospital management information systems (hmis) in the medical syndicate

1. Hospital
Management
Information
Systems (HMIS)
Mahmoud eldefrawy
2012

2. Why ??

3. Management of
information
• We manage information to make and take decisions

4. Why and How ?

5. Management ??
• Planning
• Directing
• Organizing
• Motivating
• Controlling

6. Where is the change?
stop

7. The new system approach

8. How to change ??

9. expressions
• Flat organization??
• Team work
• Automated system

10. Where do We Find IT ?!
Information Technology (IT)
• Factory
• Office
• Home
• Bank
• Supermarket
• Garage
• Hospital

11. Carry out Transactions
Provide Information
Record Data
Make Decisions
Perform Tasks
The Use of IT
IT used for

12. • Information Technology (IT)
• Information Systems (IS)
• Management Information Systems (MIS)
The Differences between
IT, IS & MIS…?

13. Definitions
“The acquisition, processing, storage
and dissemination of vocal, pictorial,
textual and numeric information by a
micro-electronics based combination of
computing and telecommunications”.
IT:

14. What is IT?
Acquisition DisseminationProcessing Storage
IT
Vocal
Pictorial
Textual
Numeric
INFORMATION

15. “They are the tools which convert
data to information relevant to the
user”.
IS:
Definitions

16. MIS:
“A system to convert data from internal and
external sources into information and to
communicate that information, in an
appropriate form, to managers at levels in all
functions to enable them to make timely and
effective decisions for planning, directing
and controlling the activities for which they
are responsible.”
Definitions

17. IS
Image
Processin
g
Word
Processing
Voice
Processing
Data
Processing
Human
Resources
Human
Resources
Human
Resources
Human
Resources
What is IS?
Networking

18. What is MIS?
P
R
O
C
E
S
S
I
N
G
U
S
E
R
S
INFORMATION
FLOW
DATA FLOW DECISIONS
MIS

19. Watch Out The Problems?!
Problems with MIS:
• Lack of Management Involvement.
• Inappropriate Emphasis of computers.
• The concentration on Data Processing Applications.
• Lack of Management knowledge.
• Lack of Top-Management Support.
• No Appreciation by Information Specialists of
Management’s Information Requirements.

20. MANAGEMENT & MIS
Strategic
Management
Tactical
Management
Operational
Management
Raw Data
The Flow of Information

21. Operational Management
Day-to-Day Activities
I
N
P
U
T
O
U
T
P
U
T
Data from operational
Transactions
Reports
The Flow of Information

22. Why Do We Need Information?
DATA
INFORMATION
PURPOSES
Efficient
Management
Business
Planning

23. Outputs From Level One
Some Examples:
• Bed Reservations.
• Doctors/ Nurses on duty.
• Patients Admissions.
• Patients Discharged.
• Medicines on Stock.
• Out-door Patients Records.
• Statistical Reports.

24. Required Configuration at Level One
Real Time
Computer System
Hardware Networking Application
Software

25. Required Configuration at Level One
…(cont’d)
Hardware PCs/ Mini Computer
Network LAN/ WAN
Application In-House Development
Software Ready Made Package

26. Characteristics of Real Time Computer
System:
• Reliable
• Inbuilt Recovery
• Speed
Required Configuration at Level One…
(cont’d)

27. Level Two
Tactical Level
Implement
Objectives
Monitor
Operations
• Budgetary Control
• Medical Treatment Control
• Equipment Control
• Medicine Inventory Control
• Human Resources Control
Improves
Healthcare

28. Required Configuration at Level
Two …(cont’d)
a) Control System
Monitors
Hospitals
Activities
External
Information
Internal
Sources
• Medicines
• Doctors
• Equipment
• Diseases
• Legislation
• Prices
Internal
Reports

29. b) Database Systems Process & Store
Internal & External
Information
“Hospital Memory”
Required Configuration at Level Two…
(cont’d)

30. c) Enquiry Systems Planned Databases
External
Information
Internal
Information
Forecasting
Required Configuration at Level Two…
(cont’d)

31. Outputs From Level Two
Some Examples:
Reports:
• Patients Analysis & Profiles
• Clinic Profitability
• Number of Patients Handled/ Doctor/Clinic
• Number of Operations/ Day
• Wages & Salary Analysis
• Doctors Turn Over Statistics

32. Outputs From Level Two…(Cont’d)
Some Examples:
Reports:
• Accident/ Death Reports
• Absentee Reports
• Training Reports
• Joint Consultation And Minutes Reports
• Expenditure Analysis/ Ward/ Clinic/ Dept… etc
• Standard Costs & Variance

33. Ready Information
Level Three
Strategic Management
Immediate Decisions

34. Required Configuration at Level
Three
• Decision Support System
• Expert Systems
• Executive Information System
Computing Packages

35. Dental Clinic
Cardiology Clinic
Orthopedic Clinic
Pediatrics ClinicsEcho
Cardio-Graphy
GP.
Medical Imaging
Interfacing
With Lab
Equipment
MEDICAL RECORDS
13
Patient data base

37. Software Package
Integrated Application
Software Package
Word
Processing
Data
Processing
Image
Processing
Voice
Processing
Networking

38. How To Build An Application?
• How Needs
• Who Top Management
• Where Top-to-Bottom
or bottom-to-top

39. What to Study?
• Needs
• Volumes
• Workflow
• Relationships
• Current System

40. What to Study? ...(Cont’d)
• Deficiencies
• Requirements
• Reporting System
• Layout of Reports
• Expectations

41. What To Evaluate?
• Easiness
• Integration
• Features > Requirements
• Modularity
• Flexibility
• Documentation
• Training

42. What To Evaluate? …(Cont’d)
• Language
• Platform
• Customization
• Speed
• Maintenance
• Compatibility
• Cost

43. How To Implement?
Implementation
Prototype

44. (Planning Overview)

45. How To Plan?
• Deliverable
• Milestone
• Responsibilities
Implementation
Plan

46. Where is the Technology Growing in
Healthcare abroad ?
Future Trends
• Super Highway
• Video Conferencing
• Internet/ Intranet
• Image Processing
• Electronic Mail
• Electronic Commerce
• Smart Cards

47. How To Create a Request for
Proposal?
RFP
1. Introduction
2. Objectives
3. Enterprise Profile
4. Current Operational System
5. Problems

48. How To Create a Request for
Proposal? ...(Cont’d)
RFP
6. Required System
7. Functionality or Required System
8. General Terms & Conditions
9. Enclosures

49. RFP Contents
1. Introduction
Why am I issuing this RFP?
2. Objectives
What are the objectives which I am trying to
achieve?
3. Enterprise Profile
A brief history about the hospital.

50. RFP Contents … (Cont’d)
4. Current Operational System
A brief description of the current system in usage.
5. Problems
What are the deficiencies of the current systems?
6. Required System
Detailed Description of the required system.

51. RFP Contents … (Cont’d)
7. Functionality of Required System
What are the functions which the new system will provide?
8. General Terms & Conditions:
 Delivery
 Installation
 Warranty
 Maintenance
 Training
 Acceptance Criteria
9. Enclosures
Any technical reports or attachments related to the
enterprise to be enclosed for more clarifications if required.

52. How to Study the Needs of the
Technical Products?
1. Define the Needs
2. Functionality
3. Features
4. Determine the Users
5. Number of the Users
6. Integration
7. Input/ Outputs
8. Expected Future Needs

53. Needs Definition
WHO DEFINES THE NEEDS ?
Technical Products Services
1. Users
2. Technical Staff
3. Middle Management
4. Top Management
1. Concerned Department
2. Middle Management
3. Top Management

54. Technical Products
1. Lab Equipment
2. Computer Hardware
3. Computer Application Software
4. Telephone Switches/ Equipment
5. Medical Equipment
6. Networking
7. X-Rays Equipment
8. Etc.

55. Types of system

56. Open System
An open system in an organization is the
system which is connected or related to other
systems within the same organization.
13

57. Closed System
The closed system does not accept interaction
with other systems. It is designed to exist on
an island. It does one job only. No input and
no output.
14

58. Interactive System
Therefore in any business or any service
there are certain objectives to be achieved. It
could maximize profit, increase the market
share…etc.
We cannot achieve this objective except if
there is a proper interactive system.

59. System Interaction Definition
Interactive system means that it links with
other system, it compliments other systems,
and it works with other systems to achieve an
objective.

60. Sub-Systems
Therefore in any organization there are a
number of sub systems which compliment
each other and react with other external
systems to serve the needs of the
surrounding society.

61. Sub-Systems… (Cont’d)
Each system requires a subsidiary system,
like for example:
• Production system requires distribution
outlets.
• Construction system requires buying
materials and designers to build an infra-
structure.
• Vehicle manufacture requires stores,
materials and control.

62. Systems Types
We have to understand the nature of
systems. There are two types of systems:
• Rigid systems which are closed and do
not interact with any other systems.
• Flexible systems which are open and
interact with other systems.

63. Organization
Having understood the nature of systems we
have to understand the nature of organizations
as well.
An organization is a group of people working
together within a system to achieve an
objective.

64. Empowerment
When we talk about a system in an
organization we have to take into
consideration two aspects:
1. The authority of each individual within the
system, and
2. The responsibilities of each individual
within the same system.
Without defining these two parts we
cannot implement any system.

65. System Creation
In the closed system you design the system
and then put the people within the system
without understanding their capabilities and
background.
However, in the open system you find out
what people can do. Then, you design the
system based upon their capabilities and
backgrounds.

66. System Function
Any system within an organization has 3 main
functions:
1. Planning for the future to accomplish the
vision of the organization.
2. Doing things, the service itself, and
3. Controlling the execution of planning and
operation.

67. Planning, System Operation &
Monitoring
• Planning means looking into the future to
achieve objectives.
• Operating systems means doing things to
meet the needs of organizations.
• Control Systems means planning +
operating to achieve the objective of the
organization.

68. cost

69. Cost and Benefit Patterns
Return
Time
$
Investment Benefits
Costs

70. System Cost
The costs involved fall into four categories:
1. Hardware
2. Software
3. Installation
4. Maintenance

71. System Cost …(Cont’d)
1. Hardware
• Equipment
• Supplies
2. Software
• Operating System
• Application Software

72. System Cost …(Cont’d)
3. Installation
• Stationery
• Training
• Integration with present systems
4. Maintenance
• 10% of the total hardware and
software/annum
• Increase

73. System Benefits
Benefits fall into two board categories:
1.Quantifiable
2.Unquantifiable

74. Quantifiable Benefits
Quantifiable Direct increase in profits
If project did not occur would not take place

75. Unquantifiable Benefits
Unquantifiable General Improvements which
are not associated with an
Increase in profits.

76. Unquantifiable Benefits
• Improvements in information on stock and sales.
• Better information for production planning.

77. When?
Time Scale
How long it will take for the benefits to be
realized?
“ It is not uncommon for the benefits of
computer based systems take several years
to appear.”

78. System Division
“Systems should be subdivided so that
management do not have to wait too long
before benefits appear.”

79. 1
2
3
Phase Benefits start here
Development
Installation
Time

80. Watch Out?!
Problem!!
Performance lags behind the plan
Costs Accumulates
Benefits become harder to produce

81. Watch Out?!...(Cont’d)
Therefore:
We have cost of failure!!

82. Cost of Failure
What is cost of failure?
• Failure to develop the system within the
costs levels agreed. So, benefits created
are inadequate.
• Failure to produce the benefits predicted.
• Failure to produce a working system.

83. Management Agreement
“ No system should be designed and installed
unless it has been full justified and agreed
by Management.”
Why??

84. Management Agreement…(Cont’d)
• Management must share the responsibility
for failure.
• Management must be fully committed to
the new system.
• Management must take full responsibility
for the success of the implementation.

85. Management Agreement…(Cont’d)
Management Agreement Involvement in all
stages of system
design.

86. Management Support
Management Support
Sharing Failure
Taking Responsibility

87. How To Obtain Management
Agreement?
• Discussion
• Demonstration
• Explanation

88. How To Obtain Management
Agreement?
Discussion
Formal
Informal
Designers listen and
learn
Ad hoc conversation
Meetings
Managers give
opinions and ideas

89. How To Obtain Management
Agreement? … (Cont’d)
Explanation
Discussion
Written report

90. Training & Education
User Education and Training
Training is concerned with 2 factors:
1.Knowledge
2.Skill

91. Training & Education…(Cont’d)
Knowledge
Skill
What to do?
Being able to do it.
Training program should cover both these factors.
How ??
31

92. Phases of Training
Essential rules for successful training:
•Training should be carried out by local
management, this gives confidence to the
staff that supervisors are fully aware of the
system.

93. Phases of Training…(Cont’d)
• User manuals should be available
during training.
• Training should be phased with the
final session taking place immediately
before the live data.

94. Phases of Training…(Cont’d)
Phases of training:
Level1: General overview of the system.
Level2: Specific procedures and activities, including
use of reports.
Level3: Controls, error procedures and recovery
procedures.

95. System Testing
Levels of Testing:
• Program testing
• Run testing
• Systems testing

96. System
Testing…(Cont’d)
Program testing
Run testing
Tools to test performance.
Several programs working
Together form a run.

97. System
Testing…(Cont’d)
User
Computer Personnel
Systems Analyst
Data (actual)
Run
Check
System Testing

98. Report Testing
1. Changes
• Nature of change
• Effects on the system
• Reasons for the change
2. Operating requirements
3. Summary of tests
38

99. Report Testing…(Cont’d)
4. Monitoring
5. Go – No go
6. Implementation (Steps)

100. Changeover
“When a new system is being installed
replacing an existing system. This means that
existing documentation and procedures have
to be changed.”
40

101. Changeover
Changeover can be carried out in 4 main
ways:
Parallel
 Phased
 Direct
41

102. Changeover…(Cont’d)
Parallel New system parallel to the old
system
Phased Stages
Direct Immediately

103. Data Conversion
Case Study
A courier service company decided to change
the manual system to a computer-based
system.
43

104. Data Conversion…
(Cont’d)
The problems were:
1. How was it to be done?
2. Should history documents be converted?
3. If a history, for how long?
4. What would happen to movements in the
accounts during the changeover?
44

105. Data Conversion…
(Cont’d)
•New files have to be verified with the old
files.
•Data conversion provides an opportunity to
clean the records and make a fresh start.

106. Documentation
Manuals
Training
procedures
Operating

107. Implications of
Change
• Physical
• Psychological

108. Implications of Change …(Cont’d)
Physical
Psychological
Equipment, furniture offices layout
Resistance to new system
Overcome
Training Involvement