Hospital information

1. Hospital Information System
( HIS)
Dr Kithsiri Edirisinghe
MBBS, MSc, MD ( Medical Administration)

2. 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.

3. 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

4. Evaluation method
• Modular exam Structured Essay and MCQ
• Assignment – Project report

5. 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

6. 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.

7. Data , Information , Intelligence
• Data
• Information
• Intelligence

8. Today Tomorrow
Location Hospital Decentralized, at home
Time Symptomatic, curative Preventive, lifetime
Focus On the process and provider On the patient
Scope Cure Patients Care for Citizens
Methods Invasive Less invasive
Healthcare is changing…

9. Order Process Manual Automated
Experience Individual Best Practices
The Process Fragmented, isolated disease mgt.
Clinical
Decisions Personal preferences Guide lines / evidence based
The processes are changing …
Information Fragmented, isolated Consolidated / complete
Today Tomorrow

10. Data
completeness
Fragmented Consolidated
Data integrity Manual/error prone Systematic mgt. and control
Data access Limited, Difficult Any time, any place
Technology Isolated systems Integrated systems
IT is changing …
Data availability Slow Real time
Today Tomorrow

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

12. The Hospital
Medical Knowledge
High Quality
Cost Effective
needs
Activities
Information
Assessment
needs
produces

13. Healthcare as a Process
Process
Output
Input
Society
subjective
objective
Medical
Community
Assesment
operational
Care Action
Therapeutic Action
Diagnostic Action
Planning

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

15. Input - Output
Information
Process
Clinical Desicions Workflow
Cure for the pain points – wave 1
PAS: Patient Adminstration
System
HIS: Hospital Information
System
Result Distribution
Action
Medical
Community
operational Society objective subjective Assesment Planning

16. 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
Input - Output
Information
Process
Clinical Desicions Workflow
Action
Medical
Community
operational Society objective subjective Assesment Planning

17. Cure for the pain points – wave 3
Information filtering
Decision support
Semantic driven UI
Clinical Pathways
Evidence based medicine
Clinical Trials (in- and exclusion criteria, data mining)
Terminology
feature extraction from unstructured or massive
information (images, free text)
Advanced connectivity
Content
Workflow optimization
Intelligent patient portals
Remote data capture
Community HealthCare
Input - Output
Information
Process
Clinical Desicions Workflow
Action
Medical
Community
operational Society objective subjective Assesment Planning
Common to all this is …

18. Adaptable Clinical Workflow
Framework
Society subjective objective
Medical
Community
operational
Assesment
Care Action
Therapeutic Action
Diagnostic Action
Planning

19. 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

20. 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.

21. 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

22. 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.

23. 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.

24. 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

25. 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

26. 5. Functional modules in a HIS
• There are two major categories in HIS
1. Clinical
2. Administrative.

27. 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

28. B. Administration
• Front office
• Registration
• Appointments
• OPD Administration
• OPD billing & IPD billing
• Stores
• Pharmacy
• Marketing
• Financial accounting
• HR

29. 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.

30. 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

31. 8. Key activities of HIS implementation
• Determination of
priorities
• Defining architecture
• Outsourcing needed
activities
• Evaluate & select solution
• Evaluate criterion of
applications
• Customize & implement
applications
• Building computer
premises
• Acquire the resources
• Install the equipment
• Establish task force
• Site visit
• Empower uses

32. 9. New Technologies
• Telemedicine
• Medical records
• Smart Card
• Digital library
• Multimedia

33. 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

34. Developing a hospital
information system in a hospital

35. The project
• Planning
• Implementation
• Monitoring
• Evaluation and feed back

36. 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

37. 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

38. 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

39. 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

40. OPD
• Reception
• Registration
• Payments
• Consultation
• Investigation
• Treatment
• Dispensing

41. 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

42. Activity 01
• Develop a process and the information need
for a IPD services

43. 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

44. 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

45. Administration modules
• Front office
• Registration
• Appointments
• OPD Administration
• OPD billing & IPD billing
• Stores
• Pharmacy
• Marketing
• Financial accounting
• Human resources
• Catering
• House keeping
• Purchasing
• Customer care
• Security

46. HIS modules

47. 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

48. Telemedicine

49. 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

50. V 07

51. Thanks

52. Thank You!