The document discusses a checklist for selecting an optimal Hospital Management Information System (HMIS) for healthcare facilities in India, emphasizing the importance of usability, functionalities, integration capabilities, and support. It outlines critical areas to evaluate, such as user interface, key functionalities like billing and data management, and real-time reporting capabilities. Additionally, it highlights the necessity of proper implementation, security measures, and obtaining market feedback to ensure a well-rounded selection process.

1. Evaluating an optimal HMIS Solution
Checklist on evaluating an optimal HMIS for
Indian Healthcare Facilities
Mohanachandran, Healthcare Information Technology Specialist.
Regional IT Lead, Maharashtra. Apollo Hospitals Enterprise Ltd.
Abstract
Technology in healthcare has been in its transformational phase for quite a few years, but when it comes to the selection of an
optimal HMIS product for a hospital, it is always an area of concern. Workflows and requirements being different for
different facilities, may not be able to suggest a standard product for all requirements but will be able to match a product that
most suits our requirements. In this write-up, I’m trying to list down as many areas to be overseen while selecting an HMIS
product.
1. Usability
The evaluation can begin with the usability of the product.
This is a very much significant area when it comes to an
adoption point of view, post your successful implementation.
1.1 Easy Navigation & better UI
The product should allow the end-users to have easy
navigation of information across all modules of the
product. This has to be evaluated majorly in clinical
EMR and also in customer-facing end-user perspectives.
The user interface is also to be friendly to end users.
1.2 Lesser clicks
Lesser clicks to achieve a single action can be
evaluated, in this perspective. This will decrease the
complexity of hand-holding end users while on live
operations. 1.3 Consolidated Information Access
Should have an access to the consolidated information
both for clinical and non-clinical areas. This can be for
patient data episode-wise, or financial or inventory data
in a single view, to have a holistic approach.
2. Functionalities
Below are the major functionalities to be evaluated while
evaluating the product. The evaluation should be based on
your current workflows and the deficiencies noted should be
documented as a gap analysis. Haven't detailed each point, as
the same is self-explanatory in the healthcare IT context.
2.1 ADT (Admission/Discharge/Transfer)
2.2 Emergency Module
2.3 Billing (OP&IP), with cash/credit/package
2.4 LAB/Radiology functionalities
2.5 Pharmacy (OP&IP)
2.6 ICU Management
2.7 OT/Cath management including scheduling
2.8 Agreements & TPA
2.9 Ancillary modules (CSSD/Blood bank/ Diet/F&B/MRD)
2.10 Accounts Payable/Accounts Receivables
2.11 Inventory Management
2.12 OP/IP EMR
2.13 CPOE – Computerized physician order entry
2.14 Progress/SOAP Notes
2.15 Diagnosis capturing and mapping capability
2.16 Efficient Prescription/Order
2.17 Medication Administration including infusions.
2.18 Auto Discharge Summary
2.19 Support on Clinical Decision Support Systems
2.20 ICD/SNOMED/MIMS/LIONIC - Compatibility
2.21 Electronic Health Record / PHR capabilities
2.22 Vitals / Intake / Output - Capture
2.23 Complete charting of the patient
2.24 Handover /Take Over capturing capabilities
2.25 JCI&NABH documentation Capability
2.26 Availability of an ERP for backend process –
MM/Finance/HR
3. Integration Capabilities
Integration is another strong area that can hamper the
complete operations of the hospital, if not done completely
and efficiently. Issues in the proper flow of information in the
integrated systems can lead to clinical errors, operational
inefficiencies, and even revenue leakages. The below
interface areas have to be checked during evaluation.

2. 3.1 ERP(MM/Finance/HR) – Capability for ERP integration
3.2 PACS – Radiology Information Systems (Bidirectional)
3.3 LIS – Lab Information Systems (Bidirectional)
3.4 ICU Management Systems
3.5 EPABX – Call centre operations
3.6 QMS – Queue Management Systems
3.7 Patient Portal / Website/Mobile App
3.8 Tele ICU/Consult/medicine with standard APIs
3.9 DMS – Document management system
3.10 Payment Gateway
3.11 SMS & Email
From an evaluation perspective, as you can’t visualize these
as features in the application, the best option is to avail
feedback on these areas from any existing client.
4. MIS & Dashboards
Another critical area where the senior leadership at any
organization would be looking at is MIS reports and real-time
dashboards. For efficiency and instant remedial measures,
real-time dashboards are very much required. Many of the
systems available currently give dashboards, not in real-time,
which may not be useful all the time.
4.1 Real-time dashboards
4.2 Data consolidation from multiple systems – ERP&HIS
4.3 BI capabilities, including drill-down capabilities
4.4 Report Builder, which helps the in-house team to create
reports.
4.5 Automated reports, which can be triggered to end-users.
5. Hosting, Portability, Performance & Security
Once you're through with the product features and
capabilities, we need to look into the hosting and portability
capabilities of the product. Below are the points to be
considered for this.
5.1 Is the application platform independent?
5.2 Compatible with tablet/mobile/handheld devices
5.3 On premise / Cloud hostable
5.4 Physical / VM hostable
5.5 Secure outside access of the application to end-users
5.6 Encryption capability in the backup context
5.7 Data loss reduction plans
5.8 Reporting architecture, not from production.
5.9 Performance of the application with peak loads.
5.10 Data growth patterns
5.11 Compliance with medical standards such as HIPPA
6. Backup and DR capabilities
Another prime area of concern in a fully electronic setup is
the availability of the application for business without any
interruptions. Backup and disaster recovery should be
optimal in the application to have full business continuity in
any adverse situation.
6.1 Scheduled backup – Full + Differential with
minimum data loss strategy
6.2 Heartbeat / Replication server’s capability
6.3 DR – Hosting capabilities with minimum RPO/RTO
6.4 Near DR / Cloud DR supported
6.5 Quick Failover/Failback capabilities in case of any
incidents of breakdown
6.6 The capability of hosting to multi-DR setup – On-
premise + Near DR + Cloud DR
6.7 Provision to capture bulk manual entries done on a
downtime.
7. Implementation and support.
Even if the system has all the plus points we discussed
earlier, improper implementation and weak support can make
you inefficient in operations. In this case, the parameters of
implementation and support are to be looked into in detail.
7.1 Implementation Life cycle duration
7.2 Gap Analysis (ASIS vs Product) and BRS
documentation.
7.3 Capability to develop BRS requirements
7.4 Resource availability on-site post-implementation,
till stability.
7.5 Implementation to support conversion – Plans and
duration
7.6 Issue reporting methodology – Ticketing
7.7 SLA definition with business-critical
issues/Bugs/CR’s
8. Licencing model and cost
And another major aspect is the cost of the product.
According to the setup and budget, we need to optimize the
cost, and hence the below areas are to be overlooked.
8.1 Total Cost for required setup
8.2 Costing model -User / Bed /Unit
8.3 Restrictions on User/bed license counts
8.4 Can include BRS requirements?
8.5 Can include Integration efforts?
8.6 CR costing defined (man-hour cost) on the
agreement
8.7 Support / AMC cost agreed on the contract
8.8 Any ancillary modules cost, if applicable.
9. Market Feedback
Finally, it is required to get market feedback on the product
from fellow clients, who are with the product for at least a
year. This will help you to understand the challenges faced
by them and plan a mitigation strategy. This is only an
overall index for anyone to refer to in the selection process,
and there may be more areas to be covered w.r.t each
facility's requirements.
2

3. Acknowledgments
Thanking all healthcare IT publications/organizations/ journals
and MNCs who contribute to the digital healthcare technology
world and make the same a well-supported network. I would
like to express my sincere gratitude towards all the healthcare
organizations where I worked, and the leaders who inspired
and guided me.
Glossary
EMR – Electronic Medical Records
EHR - Electronic Health Records IoT
– Internet of Things.
HIMS – Healthcare Information Management Systems
ECG – Echo Cardio Gram
SPO2 – Oxygen Saturation
3