What is HIS?Cloud computing of HIS in FortisModules of HIS in FortisFunctioning and Gap AnalysisRecommendations
A hospital information system (HIS), variously also called clinical information system (CIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. This encompasses paper-based information processing as well as data processing machines.
Cloud computing refers to the delivery of computing and storage capacity as a service to a heterogeneous community of end-recipients These services are broadly divided into three categories: Infrastructure-as-a-Service (IaaS), Platform-as-a-Service (PaaS) and Software-as-a-Service (SaaS)
(eg: Gmail, Google Calendar,...) (eg: Google Apps (eg: Amazon EC2
1. Private Cloud2. Public Cloud 3. Hybrid Cloud
Fortis has private cloud model Infrastructure as a Service - A robust data centre providing virtualized hardware and connectivity for all Fortis locations with full disaster recovery and backup infrastructure Platform as a Service - Fortis IT and Fortis software vendors to develop, maintain, deploy and deliver software applications for various Fortis functions. Software as a Service - As part of the cloud, Fortis has centralized its Hospital Information System: Trakcare from InterSystems and created a central analytics and MIS platform
OPD billing moduleIPD billing moduleStore moduleHousekeeping moduleAdmin. ModuleNursing or ward moduleDiet modulePurchase moduleMedical RecordLIS AND RIS
Housekeeping module of Fortis hospital mainly deals with the bed status of the ward in which firstly the beds from which patient ready to move are shown and then the information through phone is being delivered to the floor supervisor about the room that has to be cleaned which is also shown in the HIS housekeeping module then when the room is cleaned the information is being passed by the supervisor to the housekeeping desk that room has been cleaned and the person attending the call mark in the HIS that the room has been cleaned and vacant and ready to be occupied by other patient. GAP ANALYSIS
Bed status to be filled by the nurse when the patient is about to move Information of bed to be cleaned should be displayed on the screen which is to be installed in the house keeping department. The beds which are to be cleaned should be displayed on the screen just like status which is shown on the railway station showing train status. Then, through phone message is to be send to the concerned floor supervisor regarding the cleaning of the room and then the supervisor should tell to the nursing station to mark it vacant in the system. Housekeeping module should be a part of ward module The status of the beds other then the floor wards like (micu, ccu) which is being shown on the housekeeping module should not be shown as it is to made vacant by the nurse The housekeeping module should be designed to forecast the total number of housekeepers needed each day in the future based on current guests in-house and expected arrivals/departures
The housekeeping module can automatically create a cleaning schedule each day for each housekeeper based on the number of dirty rooms, estimated clean time per room, and number of housekeepers. It is possible to measure the performance of each housekeeper by tracking the estimated clean time and actual clean time, as well as variance. We can also track each time a room was cleaned and by whom
The other technique which can be used to increase the efficiency and effectiveness of the HIS is implementation of the RFID(Radio frequency identification) technique to track the location the assets and to improve the quality of the hospital services Radio Frequency Identification (RFID) is a method for remotely storing and retrieving data using devices called RFID tags or transponders.
CONT..NURSING MODULE IS BEINGCONNECTED TO THEFOLLOWING
Ist part contain the use of Tablet PC’s by the nurse and medical professionals which can be connected to HIS of the hospital. Tablet PC’s should be connected with each bed (one tab to one bed or two bed) Patient history and other details can be easily shown in the pc and it should be PACS and DICOM enabled to see the images of ultrasound, x- ray etc. Tablet pc will help in entering correct prescription which should be entered by doctor only to reduce medication error and patient activity sheet can be prepared. Nursing and doctor notes can also be written in the tablet PC’s. Since paper work takes lots of time and chances of error are more Tablet pc’s will be connected to ward module which can be cut short and contains only diet module and discharge intimation process, also we can view information about the patient through patient IPID PC’s will function as doctor will enter the prescription right from the patient bed which will directly go through HIS to store department and radiological department
Tablet PC’s will contain all the patient history which will be entered into it along with DICOM enabled images viewer it will help in reducing chances of error and time . On the spot report can be generated and send to the IPD billing department for billing procedures ELECTRONIC MEDICAL RECORD DEPT…
Order is being given through HIS in the form of Indents to IP store by the Data entry operator (nursing Station) Person in the IP store checks the Indents Depending upon the type of indents (New, Stat, Normal) Medicines are recorded, quantity is checked and the medicines are Dispatched to the respective stations
Connected with PC tablet E-prescribing through CPOE (Computerized physician order entry) RFID technology or bar coding technology should be implemented (more emphasis on RFID technology) to reduce ambulatory and inpatient medication error and the number of adverse drug events. RFID technology tracking the assets as medicines are one of the important assets in the hospital and it can be combined with the existing HIS of the hospital.
PATIENT ENTERS INTO THE HOSPITAL PATIENT APPROACHES THE OPD REGISTRATION DESK PATIENTS FILLS THE REGISTRATION FORM INFORMATION IS ENTERED IN TO THE HIS OF THE HOSPITAL THEN, UHID (UNIQUE HOSPITAL IDENTIFACTION) IS GENERATED BILLS ARE PROCESSED AND NEW INVESTIGATION ORDER OR DOCTOR VISIT ARE ENTERED INTO HIS THEN, HARD COPY OF THE BILL IS TAKEN WHICH IS GIVEN TO THE PATIENT FOR FURTHER PROCEEDINGS
Customers appointed are scheduled for the desired PHC package & the appointment date & time is informed as per the process of booking. PHC customers are informed about the precautions they need to take fasting (12 hrs) medication etc and other information related to packages. For scheduled appointments, all concerned department (lab, radiology, NIC) are informed about the no. of appointments. Customers arrive at OPD/PHC reception as per their appointment. Clients are registered and billed As required customers are escorted to various departments like lab, radiology, NIC All investigation reports are compiled and appointment for final consultation with doctor is fixed
The biggest problem which faced by the PHC department is the waiting time in X-Ray and ultrasound. Patients becomes irritated as it takes long time for them for the test to be done
Regarding the waiting time in ultrasound, it can be reduced by redirecting some patients to the other test which has to be done with fasting Use of PACS and DICOM in the hospital If patient want to see the report or want to take the report it can be printed at one station or it can be directly viewed by the patient on the website through the UHID with password given by hospital as happens in the lab report. With this implementation it will help in reducing the cost incurred in the films produced and processing of that films and reports thereby reducing the waiting time
The last and the foremost thing for improving the waiting time is implementation of the RFID technique for patient tracking These patient tracking systems can provide data which have significant effect on improving patient tracking, patient flow and provide valuable insight into patient flow improvements that can impact patient care:o Measure patients waiting longer than 15 minuteso Detail the percentage of patients waiting longer than 15 minuteso Determine lab turnaround times to hold them accountable
The module is multidisciplinary and is meant for the administration It includes the details of the employees and doctors in specific. The revenue details, availability timings, contacts etc. and other relevant record of every doctor are mentioned here Any person from the top management has the option of looking into the personal details of any of the staff. Diet module is a part of ward module Diet info. Of the patient in being entered into the HIS by data entry operator and F &B department delivers the order to the patient
Medical record department should be made electronic ( Implementation of the electronic medical record) which will help to ◦ Improve quality and convenience of patient care ◦ Increase patient participation in their care ◦ Improve accuracy of diagnoses and health outcomes ◦ Improve care coordination ◦ Increase practice efficiencies and cost savings