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Hospital IT


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Information Technology in Hospitals

Hospital IT

  2. 2. What is health information technology? • New ways for providers and their patients to readily access and use health information • “IT allows health care providers to collect, store, retrieve, and transfer information electronically” • Information technology (IT) has the potential to improve the quality, safety, and efficiency of health care
  3. 3. A well developed IT Department should have following Four Functional Units • Computer Services • Project Management Team • Information Technology Application Support and Training Department • Web Services
  4. 4. Computer Services • Helpdesk. • Technical Support • Networking (Networking encompasses both data and telephony requirements) Project Management Team • Projects undertaken range from the planning and implementation of major new systems such as a Patient Administration system through to more specialised clinical database systems
  5. 5. Information Technology Application Support and Training Department • Training in the use of these systems, as well as offering first line support should any problems arise whilst the system(s) are being used Web Services • The Web Services department maintains, supports, and promotes web based Information Technology systems
  6. 6. Benefits Achieved From a Well Developed IT Department and IT System in a Hospital
  7. 7. Benefits Achieved From a Well Developed IT Department and IT System in a Hospital 1. Patient Monitoring: With the help of a computerized system we can react much more quickly and accurately 2. Reduction of errors in patient care 3. Keeping detailed medical records for National and International Medical Studies 4. Assisting the physicians in medical diagnosis
  8. 8. Benefits Achieved From a Well Developed IT Department and IT System in a Hospital 5. Freeing skilled medical professional (clerical work is reduced for nurses; as much as 25% time can be saved) 6. Training hospital employees in a better and interactive way 7. Coordination in emergency situations (These systems have knowledge of location of all important equipments supplies and personnel, we can refer the system and respond in a better way) 8. Control of increase in the cost of information processing
  9. 9. Benefits Achieved From a Well Developed IT Department and IT System in a Hospital A well controlled inventory system can bring in savings of 10 to 15 per cent in the first year itself, thereby justifying the investment for a HIS product in big hospitals
  10. 10. Main Categories of Information Systems in Hospital • Administrative and financial systems that facilitate billing, accounting, and other administrative tasks; • Clinical systems that facilitate or provide input into the care process; • Infrastructure that supports both the administrative and clinical applications.
  11. 11. IT Applications can be used in following areas 1. Communication of Medical Information 2. Assistance in diagnosis 3. Assistance in evaluating prognosis 4. Patients Profile 5. Administrative Support 6. Medical research 7. Legal requirements 8. Linkage with other specialized computers
  12. 12. IT Applications can be used in following areas 9. Inventory management 10.Cost control, billing 11.Maintaining medical records 12.Patient Counselling 13.Medical Literature Archival 14.Image archival and processing 15.Interactive learning and CME
  13. 13. Computers in Hospital Administration • Helps to take quick and efficient decisions • Key to controlling costs and improving the quality of patient care
  14. 14. Computers in Finance and Accounts Department This department uses computer for – Payroll Accounting – Accounts Payable – Hospital Billing – Cash Flow Projections – Inpatient register
  15. 15. Computer in HR Department • Helps organization to combine Human resource information into a single database • Enables the HR dept to take a more active role in Organizational planning • Facilitates the easy storage and access of Personnel records • A payroll prepared manually takes 10 days while with help of a HRIS, it can be done in 2 Days
  16. 16. Current status of health information technology in hospitals across INDIA
  17. 17. Current status of health information technology in hospitals across INDIA • We lag behind by decades, as USA even in 1972, 81% of the hospitals had one or more in-house computers. • Today it is a norm in USA to allocate 10% of the hospitals budget for computerization
  18. 18. Current status of health information technology in hospitals across INDIA • The current healthcare system in India is in a state of transition • This transition is – Technological: For eg- from paper based patient medical records to electronic patient medical record – Organizational: The transfer of activities from Hospital care to ambulatory care (day care surgical centers)
  19. 19. All India Institute Of Medical Sciences, New Delhi It has around 2,500 indoor beds with over 1.5 lakhs admissions per annum and an annual out-patient attendance of around 20,00,000 patients. Advertisement for computerization of AIIMS
  20. 20. All India Institute Of Medical Sciences, New Delhi It signed a deal with Siemens Information Systems for a 22 month project to implement a complete hospital- management system. Plans to offer telemedicine service are also on the way. Satellite links to various hospitals in Lucknow and Chandigarh have already been established. Inputs from Dr R S Tyagi, Dy Dir and Head Computer Facility and Dr G S Rao, Dept of Biophysics
  21. 21. Tata Main Hospital, Jamshedpur BENEFITS KEY PERFORMANCE INDICATORS TMH is a 850 bedded hospital equipped with modern facilities and catering all specialities. Effective HIS has helped TMH administration in achieving and fulfilling their quality objectives
  22. 22. People International Hospital, Bhopal 3 Units PEOPLE’S HOSPITAL (742 bedded teaching hospital), Bhanpur, Bhopal PEOPLE’S GENERAL HOSPITAL (100 bedded), Berasia Road, Bhopal PEOPLE’S GENERAL HOSPITAL – HI-TECH DIVISION (100 bedded), Opp.Raj Bhavan, Bhopal:
  23. 23. People International Hospital, Bhopal The IT department of the group is one of the best departments and around 30 employees are working full-time in the department. The team capable of developing its own software and presently the medical college is running with the in house software developed by its own promising IT team. The new hospital will have paperless record system and will be well connected with the foreign hospital(Kinder Group, Singapore) in terms of diagnostic services and other technical aspects
  24. 24. A 1000 bedded Government teaching Goa Medical Hospital. The hospital has been College, Bambolim, G computerized recently. It marks the oa completion of the first phase of a comprehensive Goa Health Net Plan covering other government medical Institutes in Goa, two district hospitals, 36 rural and urban hospitals and 19 primary health centres across Goa
  25. 25. Government Hospital, Gandhinagar HMIS proved so successful in Gandhinagar, that the Gujarat government scaled up the initiative to cover all 25 district-level hospitals along with six other major hospitals in the State. All government-run hospitals are now connected to the State Health Commissionerate and the Secretariat in Gandhinagar. This not only makes for greater accountability and transparency, but also facilitates prompt and vital policy decisions to tone up the hospital administration and improve health services.
  26. 26. SMS Hospital, Jaipur “e-Sushrut”- C-DAC’s Hospital Information Management System is a complete ERP solution for Hospitals or a chain of Hospitals. A tripartite agreement was signed on 10 Dec. 2007, between Rajasthan Computerisation (RajCOMP)- A society of Government of Rajasthan , Sawai Man Singh Hospital (SMS) and C-DAC Noida to computerize the State Government Hospitals. The first hospital to get computerized as part of the state level heath computerization is SMS Hospital, the biggest hospital of the state located in the capital city Jaipur having approximately more than 2000 beds & 5000 patients hits every day in the Out Patient Department (OPD)
  27. 27. The ambitious plans of ISRO (Indian Space Research Organization) envisage connecting almost all the major hospitals in the country and in the next three years having even a dedicated health satellite.
  28. 28. Some terms and technologies you should know about
  29. 29. Electronic health record (EHR): • EHRs were originally envisioned as an electronic file cabinet for patient data from various sources (eventually integrating text, voice, images, handwritten notes, etc.). • Include automated order-entry and patient- tracking system providing real-time access to patient data, as well as a continuous longitudinal record of their care.
  30. 30. Computerized provider order entry (CPOE): • CPOE in its basic form is typically a medication ordering system • Also include lab orders, radiology studies, procedures, discharges, transfers, and referrals • CPOE significantly reduced (by 55 percent) serious medication errors (Bates et al. 1998) • Of the 11 most rigorous studies, at least 1 study showed that CPOE improved quality and safety through one of the following actions: – reducing medication errors, including adverse drug events; – decreasing dosage errors; – prescribing certain medicines more precisely; or – prescribing with improved accuracy by faculty and residents (Oren et al. 2003).
  31. 31. Clinical decision support system (CDSS): • CDSS provides physicians and nurses with real-time diagnostic and treatment recommendations. • The term covers a variety of technologies ranging from simple alerts and prescription drug interaction warnings to full clinical pathways and protocols. • CDSS may be used as part of CPOE and EHR • A 1998 review of the literature on the impact of 68 computer- based CDSS showed a beneficial impact on processes of care in 43 out of 65 studies and a positive impact on patient outcomes in 6 out of 14 studies (Hunt et al. 1998)
  32. 32. Picture archiving and communications system (PACS): This technology – Captures and Integrates diagnostic and radiological images from various devices(e.g., x-ray, MRI, computed tomography scan), – Stores them, – Disseminates them to a medical record, a clinical data repository, or other points of care • PACS can lower costs for acquiring and storing films by storing digitized radiology images, and may reduce the workload among radiology staff (Wiley 2003)
  33. 33. Bar coding: • An optical scanner is used to electronically capture information encoded on a product. • Initially, it will be used for medication (for example, matching drugs to patients by using bar codes on both the medications and patients’ arm bracelets), but other applications may be pursued, such as medical devices, lab, and radiology • Studies document that bar coding reduced ambulatory and inpatient medication error and the number of adverse drug events (Oren et al. 2003, Bates and Gawande 2003, GAO 2003)
  34. 34. Radio frequency identification (RFID): • This technology tracks patients throughout the hospital, and links lab and medication tracking through a wireless communications system. It is neither mature nor widely available, but may be an alternative to bar coding Automated dispensing machines (ADMs): • This technology is used in case of drugs which need closed monitoring while delivery • Eg: Digoxin, Adrenaline, NTG etc
  35. 35. Electronic materials management (EMM): • Health care organizations use EMM to track and manage inventory of medical supplies, pharmaceuticals, and other materials. • This technology is similar to enterprise resource planning systems used outside of health care
  36. 36. Interoperability: • This concept refers to electronic communication among organizations so that the data in one IT system can be incorporated into another. • Discussions of interoperability focus on development of standards for content and messaging, among other areas, and development of adequate security and privacy safeguards
  37. 37. Telemedicine: • Telemedicine is a system of health care delivery in which physicians examine distant patients through the use of telecommunications technology • Before transferring serious patients to Central Hospital where much specialised treatment can be given, from the remote areas, medical staff at the hospital, through X-ray pictures etc can receive information in regard to the patient which in turn enable to prepare for the oncoming surgical operation etc.
  38. 38. Medical Transcription • Accurately transcribing medical records dictated by doctors and other medical professionals • Includes – patient history and physical reports, – clinic notes, – office notes, – operative reports, – consultation notes, – discharge summaries, – letters, psychiatric evaluations, – laboratory reports, – x-ray reports and pathology reports and other similar kinds medical records. Medical transcription may be carried out for any medical professional operating out of a small clinic or a large hospital. These transcribed records are used for purposes of archives, reference or for serving as a legal proof of medical advise
  39. 39. Conversion from Paper Records to Computerized Records: Some Considerations 3 available options: 1. Summarizing the ‘active’ old record and entering it into the computerized medical record 2. Converting the existing paper record into digital pictorial format by means of a scanning device 3. A combination of both Which choice is made depends upon the policy of the hospital
  40. 40. HIS Design Considerations • Form a design team consisting of Functional managers and MIS experts • Analyze the information needs of the hospital • Set objectives and desired characteristics for an integrated HIS • Design systems major characteristics
  41. 41. System Development Life Cycle 1. Definition Phase: Functional requirements and constraints are defined 2. System Design: • System Architecture • Conceptual Database Design • Development and Implementation
  42. 42. Take home message
  43. 43. Garbage in garbage out
  44. 44. Computerization is the need of the present but compulsion of the future
  45. 45. Computers in an organization are tools for problem solving and not a solution by themselves
  46. 46. Return
  47. 47. Return
  48. 48. RETURN
  49. 49. Drivers of adoption • Hospitals consider both financial return on investment and nonfinancial benefits when making IT investment decisions • Competition to increase quality and lower costs
  50. 50. Barriers to adoption • Investment in IT is costly and must compete with other priorities, including investment in bricks and mortar, as well as in technologies with more direct application to clinical care and greater certainty for increased revenues, such as new imaging equipment • The availability of capital for investment in IT depends, of course, on hospitals’ ability to access capital in general, which may be easier for some hospitals (e.g., those with good financial performance, for profits, members of chains) than others
  51. 51. Problems with Information Technology Systems • Computerization involves access to the data by all the users • Additional protection from corruption and unauthorized access must be taken • For more sensitive data, more than one password can be used • The hardware needs protection from sabotage • Access to main computer machine should be limited • Malfunction problems need to be carefully monitored • Airborne dust, humidity, temperature variations and electrical fluctuation should be taken care of • Technology becoming obsolete (extract as much utility in the life span)
  52. 52. THANK YOU