HIS aka Hospital Information System is very important for Hospital Administration courses.

1. Module 4

2. Module 4 - Syllabus
Hospital Information System - Hospital
Information System Management and software
applications in registration, billing, investigations,
reporting, ward management and bed
distribution, medical records management,
materials management and inventory control,
pharmacy management, dietary services
,management, information processing. Executive
information system; expert support systems;
security and ethical challenges.

3. Hospital
• Hospital is an institution providing medical and
surgical treatment and nursing care for sick or
injured people
• WHO defines Hospital as “ An integral part of
social and medical organization, the functions of
which are to provide the population complete
health care, both curative and preventive with
out patient services reaching out to the family in
its own environment and also to carry out
training of health workers/ functionaries and the
bio social research”

4. Hospital System
• Hospital is an organisation that mobilises the
skills and efforts of widely divergent group of
professionals, semi- professionals and non-
professionals so as to provide highly
personalised services to individual patients
• It is therefore , essential to bring together the
various components to a unified whole to
achieve the objective through the authority of
control and co-ordination
• This warrants a systemic functioning of
hospital as an Institution.

6. Hospital System
• Hospital system consists of co-ordinate activities
provided by a variety of categories of hospital
staff utilising different skills and equipments
• Quality of output in the system is an important
variable that affects input and process at any
level of function
• Patient being from out side of the hospital system
attention has also to be directed towards the
external environment of the hospital
• Hence the hospital system is not a closed system.

7. • Hospital is an interaction point between the
hospital staff and the patient and his relatives
• On arrival of the patient , group of people
from inside the hospital as well as from out
side engage themselves for his care and early
recovery
• Therefore hospital is an open system
Hospital System

8. Essential
Services
• OPD
• IPD
• Emergency
and Casualty
• OT
Administration
Services
• Personnel
management
• Financial
Management
• Material
Management
Support
Services
• Radiology
• Laboratory
• CSSD
• Laundry
• Blood bank
• Mortuary
• PMR
• MRD
• Pharmacy
Utility
Services
• Dietary
• Hospital
engineering
• Transport
• Medical
store
• PR
• Fire and
security
Hospital Services

9. Hospital System
• The hospital system can be broadly classified
into 2 main categories
Organizational
System
Hospital
System
Clinical System

10. Information and Service Links of Hospitals

11. Information Subsystems in a Hospital
There are eight information subsystems in a hospital
according to Gillette et. al.
Patient
diagnosis and
treatment
system
Patient record
system
Patient
scheduling
Patient
accounting
system
Personnel
system
General
supportive
services
Management
control
system

12. Computers in Hospitals
• According to Rowland et. al. computers are
used in hospitals at three levels
1. Administrative data processing
2. Clinical data processing
3. Medical information system

13. Reasons for computerization of
hospitals
• To increase organizational efficiency through
reduction in the overall costs of delivering health
care services
• To provide useful, accurate, complete and timely
information to meet the requirements of the
various departments requiring such data
• To improve managerial effectiveness in planning,
allocating and controlling the scarce and
expensive resources of the organization

14. • To improve medical service to ensure high
quality of medical care at a reasonable cost
• To improve the management information
system
• To reduce clerical workload
A good hospital must have an efficient real
time communication network ensuring the
pertinent data needs for medical care,
business office, hospital management and
support activities

15. Hospital Information Systems

16. Hospital Information System (HIS)
• A Hospital Information System (HIS) is an
element of health informatics that focuses mainly
on the administrational needs of hospitals
• A HIS is a comprehensive, integrated information
system designed to manage all the aspects of a
hospital's operation, such as medical,
administrative, financial, and legal issues and the
corresponding processing of services.

17. Computerized Hospital Information System
• A computerized hospital information system is a
high speed, computer controlled, multi station,
authorized access, information flow network for
the hospital
• It provides patient medical histories, current
medical records, statistical summaries, and legal
records
• Scheduling of medical services, maintain
inventory control, and automate information flow
in hospitals

18. • HIS is highly important for hospital
management to monitor progress, measure
performance, detect trends, evaluate
alternatives, and make decisions to take
corrective actions well in time
• Thus, HIS improves functioning of hospitals in
a cost effective way

19. Aims of HIS
• To improve the quality of healthcare delivery
• To reduce the administrative work, and
• To provide better data for use by managers
and health care professionals

20. Classification of HIS
Ball and Boyle (1980) classified HIS according to the degree of
integration and the communication present in the systems
• Individual systems addressing specific
requirements of single departments
• Laboratory, Pharmacy
Class A
• Systems that span across departments
• Transfer of patient information across
departments
Class B
• System oriented towards patient
medical record
Class C

21. Classification according to functionality
4 Categories
Clinical IS used to
primarily support
direct patient care
activities
MIS assists in
strategic planning,
controlling and
evaluating
activities
A DBMS, which
collects
interrelated data
and with least data
redundancy
Operational
administrative
system to support
management in day-
to-day non-patient
care activities

22. Kolenaty’s - Classification of HIS
• Stand alone, single purpose systems that supports one or more
functions
• Redundancy and inconsistencies of data exist
• Huge investments in software, hardware and application design
Category 1
• These are modular, Component-oriented and integration capable
• Basing on needs, they can operate independently or integrated
• Advance planning is needed. Available on ready made basis from
several vendors
Category 2
• Architecturally robust and simple batch processing
• The acquisition of the system involves selection and customization of
ready made software package there by serving the information needs
of a single group of users mostly from accounts and general
administration areas
Category 3

23. HIS - Database

24. HIS - Modules

25. Registration
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 THIS
THEN, HARD COPY OF THE BILL IS TAKEN WHICH IS GIVEN TO THE
PATIENT FOR FURTHER PROCEEDINGS

26. Registration Module

27. Billing

29. Investigations and
Reports

31. Ward Management and Bed Distribution

33. Medical Records Management

35. Material Management & Inventory
Control

37. Pharmacy Management

38. Dietary Services

39. Management Information Processing

40. Security and Ethical Challenges

41. Security Challenges
Computer crimes that exist in the present
society are:-
• Hacking
• Cyber Theft
• Unauthorized use at work
• Software Piracy
• Piracy of intellectual property
• Computer viruses and worms

42. Hacking
• Hacking is the obsessive use of computers, or the
unauthorized access and use of networked
computer systems.
• Hackers usually
Steal or damage data
Get unauthorized access to computer files
Monitor e-mails or web server access
May use remote services that allow one
computer to execute programs on another
Plant data that will cause system to welcome
intruders

43. Cyber Theft
• Cyber theft involves theft of money by
unauthorized network entry and fraudulent
alteration of computer databases.

44. Unauthorized use at Work
Unauthorized use of computer resources
especially by employees
Playing video games
Unauthorized use of internet
Non-work related upload/download
Transmission of confidential data
Moonlighting

45. Software Piracy
Unauthorized copying of software is called
software piracy or software theft
Software is protected by copyright law and
user license agreement that allows only
limited copies to be made

46. Piracy of Intellectual Property
• Materials other than software are also pirated
by making multiple copies
• Piracy of music, video, images, articles, books
etc.
• Dissemination of these material through
internet websites

47. Computer viruses and worms
• A virus is a program code that cannot work
without being inserted into another program
• A worm is a distinct program that can run
unaided
• They enter a computer through e-mail or file
attachments, or through illegal software. A virus
usually copies itself into the OS, and then
spreads to main memory and thus hard disk and
any inserted external memory.

48. Privacy Issues
• Privacy on the internet
• Computer Matching
• Privacy Laws
• Spam e-mail
• Flame e-mail

49. Other Challenges
• Employment challenges because a lot of tasks
have been automated
• Computer monitoring causes intrusion in
personal space for workers
• Challenges in working conditions are caused
by tasks which are monotonous in nature. But
it also automates most of the work and gives
way to more challenging jobs
• Challenges to individuality as they eliminate
the human relationships between people

50. Health issues
• The use of IT in the workplace raises a variety
of health issues .
• Heavy use of computers is reportedly causing
health problems such as:
Job stress
 Damaged arm and neck muscles
 Eye strain
 Radiation exposure

51. Ethical responsibility of business
professionals
• Business ethics are concerned with
Equity
Rights
Honesty
Exercise of corporate power

52. Categories of ethical business issues
Equity
• Executive salaries
• Intellectual
property rights
• Service pricing
Rights
• Patient privacy
• Patient
confidentiality
• Right to
information
• Equal opportunity
Honesty
• Health care
provider
accountability of
act
• Standards and
norms of health
care profession
• Patient safety
Exercise of
corporate
power
• Ethical practices
• Service motto
• Competitive
Strategies
• CSR

53. Principles of technology ethics
• Proportionality of benefits to risk
• Informed consent to risks
• Justice in distribution of risk with benefits
derived to each sub unit
• Minimized risk by the selected option

54. Ethical guideline
• Acting with integrity
• Increasing your professional competence
• Setting high standards of personal
performance
• Accepting responsibility for your work
• Advancing the health, privacy, and general
welfare of the public

55. Security management of IT
• Encryption
• Firewalls
• Denial of service attacks
• E-mail monitoring
• Virus defence
• Security codes
• Backup files
• Security monitors
• Biometric security
• Computer failure controls
• Fault tolerant systems
• Disaster recovery
• System controls and audits

56. Encryption
• The concept of private key and public key can
be extended to authentication protocols.
• There are three types of authentication
protocols followed by organizations.
Password Authentication protocol
Challenge Handshake authentication Protocol
Extensible Authentication Protocol

57. Firewall
• Firewalls are used to restrict access to one
network from another network. Different
types of firewalls exist

58. Denial of Service Defences
• The Internet is extremely vulnerable to variety
of assaults by criminal hackers, especially
denial of service (DOS) attacks.
• In computing, a denial of service attack is an
attempt to make a network resource
unavailable to its intended users

59. e-Mail Monitoring
• Internet and other online e-mail systems are one
of the favourite avenues of attack by hackers for
spreading computer viruses or breaking into
networked computers.
• E-mail is also the battleground for attempts by
companies to enforce policies against illegal,
personal, or damaging messages by employees,
and the demands of some employees and others,
who see such policies as violations of privacy
rights.

60. Virus Defences
• Many companies are building defences against
the spread of viruses by centralizing the
distribution and updating of antivirus
software, as a responsibility of there IS
departments.
• protection responsibility is to their Internet
service providers or to telecommunications or
security management companies

61. Security Codes
• Typically, a multilevel password system is used
for security management.
• First, an end user logs on to the computer
system by entering his or her unique
identification code, or user ID.
• The end user is then asked to enter a
password in order to gain access into the
system.
• Next, to access an individual file, a unique file
name must be entered

62. Backup Files
• Backup files, which are duplicate files of data
or programs, are another important security
measure.
• Files can be protected by file retention
measures that involve storing copies of files
from previous periods.
• Several generations of files can be kept for
control purposes

63. Security Monitors
• System security monitors are programs that
monitor the use of computer systems and networks
and protect them from unauthorized use, fraud, and
destruction
• Security monitor programs provide the security
measures needed to allow only authorized users to
access the networks
• Security monitors also control the use of the
hardware, software, and data resources of a
computer system .
• Security monitors can be used to monitor the use of
computer networks and collect statistics on any
attempts at improper use.

64. Biometric Security
• These are security measures provided by computer
devices, which measure physical traits that make
each individual unique.
• This includes:
Voice verification
Fingerprints
Hand geometry
Signature dynamics
Keystroke analysis
Retina scanning
Face recognition