This document discusses a hospital management information system (HMIS). It describes the key features of the HMIS, including patient registration, medical records, scheduling, inventory management, billing, and reporting. It also discusses some common issues with healthcare information systems, such as interfaces that are not suitable for interruptive environments and inflexibility in reflecting real-life workflows. Finally, it proposes solutions like education, system design improvements, and qualitative research to address these issues.

1. IE 328
Eyhem Hazzuri 201566019 1st
Ethem Kadir 201440092 1st
Abdulrahman Alrawi 201564136 1st
Kübra Alacacı 201700052053 1st
Directed by Dr. Fatih Balcı

2. Introduction:
The use of information systems in healthcare (HIS) has been recognized as having crucial importance
in improving the efficiency, cost-effectiveness, quality, and safety of medical care delivery. HIS has
the potential to improve individuals’ health and providers’ performance by producing better quality,
cost savings, and greater patient involvement in their own health.
With the rapid technological advances, remote monitoring is considered as a vital component of
future Health management information systems, The techniques of the Internet of Things (IoT) offer
the opportunity to change the nature of health services and due to these new technologies which
have made this area more difficult to manage and manipulate, our need has appeared to have
efficient and effective MIS(management information system).
Moreover, in this report we are going to discuss with the most important issues which are related with
the MIS of Hospital.
Our HMIS is a comprehensive application that integrates various functions to enhance the
operational efficiency, making it one of the most effective healthcare software developments.
Our HMIS provides the following feature list:
• Patient Registration: System generates unique registration number.
• Medical Records: Medical record is a document that becomes a communication tool
between health workers in providing health services to patients. medical record center data
store much complete historical information about the health condition of a patient or a
disease that had previously suffered, it is also used to accurately diagnose the illness suffered
by the patient.
• Hospital Scheduler: There are four types of schedules:
1-Out Patient Consultation: Booking of OP Appointment, Modify Appointment.
2-Patient Visit: Referring Doctor/Hospital details, Mode of payment of the patient,
patient history.
3-Consultation: Access to patient medical record including previous visit record.
4- Post Consultation: Refer to hospital admissions for day case treatment.
• Duty Roster.
• Biomedical Maintenance.
• Fixed Assets: History of Assets like depreciation, Tax allowances, location and cost centers.
• Medical Stores and Purchases: Management of procurement and inventory of inventory of
drugs, medical and surgical supplies, and laboratory items.
• Lab and Pharmacy.

3. • Blood Bank: User definable codes for blood group, genotypes, antibodies, anticoagulants,
additives, blood products, fat codes/ Registration of donors.
• Clinical Manager.
• Central Sterile Stores Department (CSSD):CSSD maintains a master file containing all sterile
items/ Grouping of items are grouped into sets depending on type of surgery or procedure/
Maintains.
• Diet & Nutrition: date and time/ department/ patient’s details.
• Management Information Services (MIS) Reports:
▪ List of Patients Registered OPD/ IPD daily, across date range, Monthly.
▪ List of Patients consulting Doctor wise.
▪ Investigations Report.
▪ List of Tests Carried out Daily, across date range.
▪ List of Emergency cases Treated in Casualty – Monthly or across date range.
▪ Department wise/ Unit wise Billing Report.
▪ Incidence of diseases- ICD coded.
▪ Incidence of diseases- Age wise.
▪ Stock Statement.
▪ Material Requisitions.
▪ Material Issues Report.
▪ Consolidated Hospital incomes from various Departments/ Unit Report.
▪ Inquiry on Billing rates for various Services.
▪ Purchases & Return Statement.
▪ Other required reports.
• Finance and Accounts: Single currency system/Two financial years can be kept open/Online
integration with all other HIS modules.
• Human Resource Management and Payroll: Access to complete vendor, invoice information/
Leave records: nature of leave, duration/ Payment Schedules/ Goods received note/ Vendors
information/ Material supply information from different vendors.
• Recovery of Data/Transaction Logging and Recovery: The application enables setting up a
duplicate database and updating it throughout the normal operations of the system. In case
of a failure of any of the two databases, the system will be able to continue to operate
uninterrupted.
• Security & Administrator: Different authorization levels for access and use/ Different levels of
accessibility at the file, record and field levels.

4. HMIS Components:
Organization: the organizational followed is hierarchy organizational. Because in our organization
(hospital) information are used by different management levels.
People: (physician, staff, doctors, lab-staff and all others staff who need to use the systems)
information system require skilled people to build and maintain them, and needs people who can
understand how to use the information system to achieve our organization objective .
Technology: (computer software, computer hardware, data management, networking and
telecommunication technology, other technologies elements such as internet and intranets and
extranets).
Information System-Related Problems:
In this section, we discuss two main categories of errors that occur at the interface of the information
system and work practice that are the result of a failure to grasp this nature of health care work. First,
we discuss errors in the process of entering and retrieving information in or from the system. Second,
we discuss errors in the communication and coordination processes that the PCIS is supposed to
support.
Errors in the process of entering and retrieving information consist of:
• A Human–Computer Interface That Is Not Suitable for a Highly Interruptive Use Context
• Fragmentation: the need to switch between different screens can result in a loss of overview
Errors in the communication and coordination processes consist of:
• Inflexibility: These systems often fail to reflect some of the basic real-life exigencies of care
work
• Urgency: in the case of urgent medication orders, nurses could already give a medication
before the physician formally activates the order
• Transfers: Similar problems abound when transferring patients between wards or when
admitting new patients.
• Misrepresenting Communication as Information Transfer Loss of Communication
• Decision Support Overload: They could trigger an overdose of reminders, alerts, or warning
messages. These messages can be sent to the computer user even if the message is not
relevant for that user at that moment
• Loss of Feedback: nurses are often alerted to new orders by the printer, but this assumes the
nurse is nearby and that the printer functions correctly
We have outlined a number of issues within a framework describing two major kinds of silent errors
caused by health care information systems, those related to entering and retrieving information and
those related to communication and coordination. Because the potential causes of these errors are
subtle but insidious, the problems need to be addressed in a variety of ways through improvements in
education, systems design, implementation, and research

5. So that the suggested methods used to solve such mentioned problems above are:
Education: Health professionals need to be educated with a critical perspective toward what PCISs
can do for them. People tend to project ‘‘intelligence’’ and ‘‘objectivity’’ onto computers, and
physicians and nurses are no exception.
Systems Design: Systems developers and vendors should be clearer about the limitations of their
technologies. When speaking of ‘‘order entry’’ and ‘‘intelligent’’ systems.
Implementation: During the implementation process, clinical informaticians need to assure not only
that clinicians are heavily involved so that the implementation goes more smoothly
Qualitative research techniques: on the other hand, can provide deep insight and can both identify
problems and answer the ‘‘why’’ and ‘‘how’’ questions that quantitative studies cannot answer.
Here, we are going to explain how different hospitals management groups could be associated to
each other then, we can see how the system serve these management groups, and how the linked
enterprise improves the organizational performance:
Example of TPS: nurses in a hospital
we have already background about the information system and what are its activities, now we are
going to show the main function and role of HMIS (Hospital Management Information System)
HIS Hospital Information Systems , health institutions and organizations , administrative, financial ,
reliable medical information electronically stored correctly , the security and privacy of data ,
ensuring the necessary follow-up achieved this data in electronic form , the relevant health
institutions and organization of the data to be integrated with other units, In other words,
Management Information Systems is to report on business operations with the purpose of supporting
decision making.

6. This is to ensure that the organization is managed in a better and more efficient way so that it can be
able to achieve full potential thus gain competitive advantage.
To provide information readily to company decision makers & Management Information Systems also
help in data collection & To run possible scenarios in different business environments & Management
Information systems give accurate projections of the company’s standing in the short and long term
& Management Information Systems help track the implementation of particular decisions in a
company & To improve on the company’s reporting.
Role of (BPM) in Enhancing Competitiveness:
Business process management (BPM) helps firms become more competitive by providing large
number of benefits. Some of them are given below:
Cost reduction: BPM is helpful in reduction of the costs of the firms because it helps in aligning the
work flow. which reduces the cost.
Raise in revenues: BPM makes customer satisfied and increase profit.
With Business Process Management, a company takes a step back and looks at all of these
processes in total and individually. It analyzes the current state and identifies areas of improvement
to create a more efficient and effective organization.
Here are some of the primary benefits of using BPM in your business:
• Gain control of chaotic and unwieldy processes.
• Create, map, analyze, and improve business processes.
• Run everyday operations more efficiently.
• Realize bigger organizational goals.
• Move toward digital transformation.
• Improve and optimize tangled operations.
• Closely track individual items as they move through a workflow.
quality and design:
As we know that it is hard to measure the quality of service for many reasons:
• A service is intangible, can only be felt and not touched
• Quality of a service depends on the service provider who shapes it
• A service cannot be returned to the seller
• It is difficult to compare the quality of services offered
So that to understand how the HIS effect the service quality and design, a survey was done and
statistical analysis was used to answer this question and the results was shown below.

7. The convenience sampling method was applied to the information system users of three hospitals in
southern Taiwan.
A total of 500 copies of questionnaires were distributed, and 283 returned copies were valid and
according to this survey we conclude that:
that system information quality will positively influence service quality (γ11= 0.55) and job satisfaction
(γ21= 0.32) among information system users and system performance (γ31= 0.47)
The results show that only security, one of the system quality factors, has an insignificant influence on
service quality, job satisfaction, and system performance.
A possible reason is that most of the system users are physicians, nursing personnel and pharmacists
who are less familiar with the safety measures that protect the system, unlike professional information
personnel.
Ethical Decisions in Hospital:
• Autonomy: freedom to choose.
• Justice: similar cases do not receive similar treatments.
• Nonmaleficence: first do no harm, benefit only.
• Beneficence: benefit only.
Components of IT Infrastructure:
the term infrastructure in an information technology (IT) context refers to an enterprise's entire
collection of hardware, software, networks, data centers, facilities and related equipment used to
develop, test, operate, monitor, manage and/or support information technology services.

8. Hardware Technologies:
Personal computers: each doctor and section manager has his own computer to use the hospital
applications to manage his patients information and his schedule.
Servers: the hospital has one or more server to store and analysis the data of patients.
Tablets: healthcare workers use tablets to follow any fluctuations on the patient’s situation.
Software Technologies:
Operation systems:
• Windows operating system for servers and computers.
• IOS operating system for tablets.
Windows application: designed to manage all the areas of a hospital such as medical, financial,
administrative and the corresponding processing of services.
Web application: system designed to support patients by providing accessibility to their information,
schedule, finance and reports about their situation.
Database Management System (DBMS):
DBMS is a system software to manage the database and allow users to create, read, update and
delete data in database and it’s usually located between the database and the applications.
The hospital uses API (Application Programming Interface) as a database management system that is
a set of functions contains sql queries to control the data in the database and send them to the
hospital applications (Web and mobile apps).
Very big data coming from different sectors so the hospital use a data warehouse which is a big
database that receive all data and combine them then store them, so the database will contain the
current and historical data that the analysts uses to assume about future conditions, such as the
probability that a specific disease will spread in some area or country.

9. Telecommunications & Networking Technologies:
Instead of tracking patients with a file folder and a clip board, the hospital uses Electronic Medical
Records (EMRs) which allows electronic storage, retrieval, and modification of patient information that
helps the departments within the hospital collaborate when providing care.
The doctors in each department use tablet devices at the bedside to access Computerized Physician
Order Entry systems (CPOE). These orders are communicated over the network to the medical staff in
other departments, such as radiology, giving them treatment instructions on a specific patient.
LAN and WLAN equipment and devices are used to connect departments with each other through
wired to exchange data and accessing the warehouse database, while they use wireless
technologies to control various medical devices and access information through portable devices.
Internet Technologies:
Providing patients with an Internet service offer a far less boring stay for their inpatients and their visitors.
Portable laptop computers can be used in the patient’s own wards to surf the Internet, chat, play
games and for many other purposes, thus helping relieve the boredom of a hospital stay and use the
internet to share information across a complete healthcare system such as clinics, laboratories,
pharmacies, and emergency response units.
Staff and doctors are able to view the electronic health record of patients to know the patient’s full
diagnosis and give correct treatment accordingly. With the use of internet, traditional paper-based
system will be negligible.
Wireless Networking:
Hospital has an effective wireless network that tracking devices via wireless radio frequency
identification (RFID), and support clinicians to access information on their personal mobile devices,
such as smart phones and tablets, while patients and visitors access Internet for social networking
and entertainment and IoT devices and sensors reach the network by wireless too that heavily affect
clinician and patient experiences in the hospital as well.
802.11 network standard is used in hospital this provides users faster speeds and an increased
capability to transmit large amounts of data without slowing down the connection.
Wireless networks carry a wide variety of traffic, so the hospital has distinct channels or virtual local
area networks (VLANs) for each type of traffic within the network: a VLAN for visitors, another for IoT
medical devices, another for medical records and images, and so on.
Vulnerabilities of HIMS:
First, we need to understand the vulnerabilities types to specifically determine vulnerabilities in our
HIMS, there are different types of vulnerabilities in system:
•Hardware problems
•Breakdowns, configuration errors, damage from improper use or crime
•Software problems

10. •Programming errors, installation errors, unauthorized changes)
•Disasters Power failures, flood, fires, etc.
•Use of networks and computers outside of firm’s control E.g., with domestic or offshore outsourcing
vendors.
Data centers are very vulnerable to attacks both inside and against outsiders on the system.
Required patient control over access based on the attribute of each user at the time of registration
to the medical record through a website-based medical record information system that has been
integrated into the server, The system requires encryption to access data in the data center to
protect data from illegal users .data encryption method is proposed before storing it in storage.
With Attributed Based Encryption integrity to the medical system so that when the data is encrypted
with an access structure that has a policy then when the user wants to decipher the ciphertext if the
secret key has an attribute that meets the access policy.
Security & Control:
data security design for patient medical record information involves 5 participants (admin, users
consisting of doctors, nurses, patients, and managers).
Users (doctors, nurses, and patients) and managers can read data uploaded to the data center by
decrypting it first using the private key and attribute corresponding to the access policy.
The physician has access to all patient data which he holds accountable for records made on the
medical record. The nurse has access to information on all patient data he is responsible for. Patients
have access to their own medical records.
Data Center: lot of information related to the patient's highly confidential medical information and is
obliged to be protected legally.
Access policy: are made based on departments in the hospital, (The process of supplying
information data related to the process of registration when the patient enrolled, examination of the
patient's progress while being treated by a doctor and nurse then medical resume. When the
medical data is uploaded the encryption, process occurs subsequently stored on the server).
mechanism of encryption: data is encrypted using the access policy. Only registered users in those
departments that meet attributes can access medical data. Medical data previously stored in the
form of Ciphertext in the data center will be downloaded by users who have the right permissions for
data can be decrypted. Ciphertext can only be read using the private key and public key and
attribute of the user.
The encryption process is performed when medical record data is uploaded to the data center by
the admin on duty. In the CP-ABE scheme (Ciphertext-policy Attribute Based Encryption), the admin
encrypts medical record data using a public key (PK) and access policy that connects with user
attributes resulting in ciphertext CT. When the request process is done, the data center responds by
sending the contents of the data in the form of CT where the user must decrypt it. Only users who
have a set of attributes that meet the access policy can decrypt the message.

11. Safeguarding Information Resources:
Authentication: the ability to know that a person is who he or she claims to be. Established through
passwords.
Passwords :known only to HIS authorized users. uses specific word to long on to a computer system
and for accessing specific systems and files.
Token: a physical device, similar to an identification card, that is designed to prove the identity of a
single user. Small gadgets that typically fit on key rings and display passcodes that change
frequently.
Smart Card: a device about the size of a credit card that contains a chip formatted with access
permission and other data.
Antivirus software: prevents, detects, and removes malware, including computer viruses, computer
worms, Trojan horses, spyware, and adware. Most are effective only against malware already known
when the software was written. Must be continually updated. Not always effective because some
malware can evade antivirus detection. Need to use additional malware detection tools for better
protection.
Firewall: prevent unauthorized users from accessing private networks.
A combination of hardware and software that controls the flow of incoming and outgoing network
traffic.
Generally placed between the organization's private internal networks and distrusted external
networks, such as the Internet, although firewalls can also be used to protect one part of a
company's network from the rest of the network.
Role of Enterprise Systems:
• Increase operational efficiency.
• Provide hospital information to support decision making.
• Enable rapid responses to users (doctors, nurses, patients, and managers) requests for
information.
• Include analytical tools to evaluate overall organizational performance.
Supply Chain Management Systems (SCM):
SCM is a strategy for optimizing the overall supply chain by sharing information among material
suppliers, manufacturers, distributors and retailers, the key element of SCM is information sharing.
Programs like JIT (Just-In-Time), CRP (Continuous Replenishment Process), and QR (Quick Response) in
retail rely on the dissemination of scheduling, shipment or manufacturing information to the supply
chain.
VMI (Vendor-Managed Inventory), which is one of important applications of SCM, has been adopted
for managing hospital drug warehouses. In addition, online procurement system or CAO (Computer
Aided Ordering) system is also developed for the departments that consume drugs and place orders
and implemented to improve material handling efficiency

12. the developed SCM system enables hospitals to improve the procurement processes and inventory
control of pharmaceutical products, which results in decreasing total inventory more than 30%. By
sharing information with hospitals, the wholesaler can gather more timely and exact data about
inventory status and drug usage volumes of hospitals, so it can forecast the demand more
accurately, which enables needed products to be supplied timely and cost-effectively. With the SCM
system, total supply chain cost of pharmaceutical products has been decreased significantly.
Customer Relationship Management Systems (CRM):
patients are considered as the main customers of hospital who receive and feel the health services
directly. CRM is able to reduce the gap between customers and organizations so that the main goal
of CRM is better behavior with customer in order to increase loyalty and interests. Fostering
relationship between providers and patients leads to maintain loyal customer, greater mutual
understanding, trust, patient satisfaction, and patient involvement in decision-making. the results of a
research indicate that customer is 70% of complained customers remain loyal if they are dealt
accurately
Evaluation of customer relationship management effect on organizational productivity, customer
loyalty, satisfaction, and trust

13. Factor loadings of customer relationship management tasks and effects
Among the dimensions of CRM effects, productivity had the highest average score and loyalty and
trust had the lowest. Among the tasks of CRM, customer interaction has the lowest average score
(2.7) and the variety of services had the highest (2.9).
Among the components of CRM tasks, acquisition has had the lowest impact (0.57) and the variety
of services had the highest (0.83). CRM had the highest level of impact (0.83) on customer
satisfaction and the lowest on productivity (0.59).
REFRENCES
• http://www.binaryspectrum.com/expertise/overview.html
• https://www.uml-diagrams.org/examples/hospital-domain-diagram.html
• Book is PRINCIPLE OF THE HEALTH CARE EDITTED BY RAANAN GILLON
• AKGÜN Hospital Information Systems
• An Integrated Supply Chain Management System: A Case Study in Healthcare Sector (Dongsoo
Kim)
• A study in the Iranian hospitals (The impact of the customer relationship management on
organizational productivity, customer trust and satisfaction by using the structural equation
model) edited by Maryam Yaghoobi, Hamed Asgari,1 and Marzieh Javadi
• Indimedi Solutions Pvt. Ltd (providing Enterprise Resource Planning (ERP), Hospital Management
System (HMS), Office Management Software for CA, Odoo ERP Software Development,
Implementation and Customization, Odoo System Administration, Web Application Development,
Odoo eCommerce Website Development, Responsive Website Designing and IT Infrastructural
Designing, Domain Registration, Odoo Cloud Hosting, Implementation as well as Enhancement.)
• Secure Attribute-Based Encryption with Access Control to Data Medical Records

14. • Secure Attribute-Based Encryption with Access Control to Data Medical Records which is done by
Ministry of Research, Technology and Higher Education of Indonesia