Nursing informatics integrates nursing, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. Nursing informatics enhances the information available to nurses for clinical practice, management, education, and research and facilitates nurses' role as communicators. An effective hospital information system collects, stores, and distributes patient data from various departments to support clinical decision making, administration, and other hospital functions. Key components of a hospital information system include laboratory, radiology, clinical, financial, pharmacy, and nursing information systems.

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Nursing Informatics
Management of Information &
evaluation system
M.Viswanathan
viswanthrissur@gmail.com
Mob: 9447614792

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Silence & Smile are two powerful tools,
Smile is the way to solve many problems &
Silence is the way to avoid many problems

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Nursing Informatics?
Nursing informatics (NI) is a
specialty that integrates
nursing science, computer
science, and information
science to manage and
communicate data, information,
knowledge, and wisdom in
nursing practice.

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In all types of health care organizations, nursing is the
hub of the information flow.
“Developing the science and technology of nursing
informatics will enhance the information available to
nurses for clinical practice, management, education,
and research and will facilitate the role of nurses as
communicators."
- Patricia F. Brennan (1996),
American Medical Informatics Association
Nursing Informatics: The Emerging Field

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The Value of Nurse Informatics
• Analyze clinical and financial data
• Promote and facilitate access to
resources and references
• Provide nursing content to
standardized languages
• Enhance continuity of care
• Improve relationships between
providers and recipients of health
care
• Enable cost savings and
productivity goals
• Facilitate change management

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Data?
Data are streams of raw facts representing events
occurring in organizations before they have been
organized and arranged into a form that people can
understand and use.
Data are raw facts or observations, typically about
physical phenomena or business transactions.
For example, a patient admitted in the hospital can
produce a lot of data. Name, address, age, health
condition, BP etc. of the patient are data.

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Information?
Data that have been shaped into a form that is
meaningful and useful is the information.
Thus information is the processed form of data.
Information is a critical resource in the
operation and management of organizations.
Timely availability of relevant information is vital
for effective performance of managerial
functions such as planning, organizing, leading,
and control.
An information system in an organization is like
the nervous system in the human body: it is the
link that connects all the organization's
components together and provides for better
operation and survival in a competitive
environment.
Indeed, today's organizations run on
information.
Data
Information
Transformation

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A system can be defined as a group of interrelated or
interacting elements forming a unified whole.
Many examples of systems can be found in the
physical and biological sciences, in modern
technology, and in human society.
For example, the physical system of the sun and its
planets, the biological system of the human body, the
technological system of an oil refinery, and the
socioeconomic system of a business organization.
What is a System?

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Management Information System (MIS)
Management Information System (MIS) can be defined as a set of
interrelated components that collect (or retrieve), process, store
and distribute information to support decision making and control
in an organization.
In addition to supporting decision making, coordination and
control, information system may also help managers and workers
analyze problems, visualize complex subjects and create new
products.
MIS provides the right information in the right form to the right
person at the right time.
Information systems contain information about significant people,
places, and things within the organization and outside the
organization.
Management Information System (MIS) can be understood by
understanding the three terms that are inclusive in MIS viz.,
Management, Information and System.

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Management Information System (MIS)
Management is simply the process of decision-making and
control over the action of human beings for the expressed
purpose of attaining the pre-determined goal decisions
regarding planning, operation and control of an organization.
Information is data that has been processed into a form of
that is meaningful to the recipient for action or decision
making.
System is a complex set of interrelated functions and
processes that are arranged in a definite sequence to
achieve the predefined objectives.
According to Davis and Olsan, “Management information
system is an integrated user machine system for providing
information to support the management, analysis and
decision-making functions in an organisation."

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Characteristics of MIS
1. Management-oriented
2. Management directed
3. Integrated
4. Common data flows
5. Heavy planning-element
6. Sub System concept
7. Common database
8. Computerized
9. User friendly/Flexibility
10.Information as a resource

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Components of MIS
Control of System Performance
Network Resources
Communication media &
Network support
System Activities
Input of
Data
Resources
Processing
Data
into
Information
Output
of
Information
Products
Storage of Data Resources

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Hospital Information System
Registration Consulting Ward Nursing
Pharmacy
Stores & Purchase
Radiology
Laboratory
OT Blood Bank
Diet & Kitchen
And more...

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Hospital Management Information
System (HMIS)
The HMIS has been defined as a system that provides an
appropriate information support to each decision making
level of the health care delivery system.
It supports all hospital functions and activities such as
patient records, scheduling, administration, charge-back
and billing, and often links to or includes clinical
information systems such as RIS (Radiology Information
System).

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The Information of the hospital
comes from
• Front office
• Doctors consultation room
• Ward
• Laboratory
• The service providers like financial
and insurance service provider
• And so on

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This information can be
categorized as

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Aim of HIS
To adequately enable the execution
of information processing functions
– for patient care, including
administration as well as
– for research and education
considering economic hospital
management, as well as legal and
other requirements.

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Aim of HIS
HIS should provide
• information, primarily about patients, in a
way that it is correct, pertinent and up to
date, in time, accessible by the right
persons at the right site in a usable format
• knowledge, primarily about diseases, but
also, for example, about the effects of drug
interaction, to support diagnosis and
therapy
• information about the quality of patient
care, hospital performance and costs

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Components of HMIS
• The HMIS is a group of interrelated sub systems in
medical specialties
• Laboratory Information System (LIS)
• Radiology Information System (RIS)
• Clinical Information System (CIS)
• Financial Information System (FIS)
• Nursing Information Systems (NIS)
• Picture archiving Communication System (PACS)
• Pharmacy Information System (PIS)

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Laboratory Information System (LIS)
Laboratory Information System (LIS), is a class of
software which handles receiving, processing and
storing information generated by medical laboratory
processes.
These systems often must interface with
instruments and other information systems
LIS include haematology, Biochemistry, immunology,
blood bank (Donor and Transfusion Management),
surgical pathology, anatomical pathology, flow
cytometry and microbiology.

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Radiology Information System (RIS)
Radiology Information System (RIS), is a
computerized database used by radiology
departments to store, manipulate and distribute
patient radiological data and imagery.
The system generally consists of patient tracking
and scheduling, result reporting and image tracking
capabilities.

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Clinical Information System (CIS)
Clinical Information System (CIS) is a
computer based system that is designed for
collecting, storing, manipulating and making
available clinical information important to the
healthcare delivery process. (e.g. electronic
medical records)

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Financial Information System (FIS)
Financial Information System (FIS) are
computer systems that manage the business
aspect of a hospital.
While healthcare organizations’ primary
priority is to save lives and not making profits,
they do acquire running costs from day to day
operations; including purchases and staff
payroll.

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Pharmacy Information System (PIS)
Pharmacy Information System (PIS) are
complex computer systems that have been
designed to meet the needs of a pharmacy
department.
Through the use of such systems, pharmacists
can supervise and have inputs on how
medication is used in a hospital.

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Nursing Information System (NIS)
Nursing Information System (NIS) are
computer systems that manage clinical
data from a variety of healthcare
environments, and made available in a
timely and orderly fashion to aid nurses
in improving patient care.

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Picture Archiving Communication
System (PACS)
Picture Archiving Communication
System (PACS) is a loose term to
describe a set of systems that facilitate
the archiving, processing and viewing
of digital radiological images and their
related information.

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Modules Involved
• PATIENT REGISTRATION
• PATIENT RELATIONS
• APPOINTMENT SCHEDULING
• BED MANAGEMENT
• WARD MANAGEMENT
• ADMISSION, DISCHARGE,
TRANSFER
• MEDICAL RECORDING
• LABORATORY INFORMATION
• RADIOLOGY INFORMATION
• PHARMACY
• CENTRAL STERILIZATION SUPPLY
DEPARTMENT
• BLOOD BANK
• DIETRY
• HOUSE KEEPING
• EQUIPMENT MAINTAINANCE
• HEALTH CARE PACKAGES
• PATIENT BILLING

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Advantages of HMIS
Savings – Substantial savings in manpower, time
and costs through improved productivity
Effectiveness – Increased administrative &
operational effectiveness and improved
communications between the peripheral labs with
the central lab
Simplification – Improved and simplified work /
process flow through automation
Quality – Reduced errors and duplication of work.
GENERAL BENEFITS

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Advantages of HMIS
Savings – Substantial savings in manpower, time and costs
through improved productivity
Effectiveness – Increased administrative & operational
effectiveness and improved communications between the
peripheral labs with the central lab
Simplification – Improved and simplified work / process flow
through automation
Quality – Reduced errors and duplication of work.
Centralization – Consolidation of information into a single
point
Optimization – Empowers better use of existing resources
(people, time and money) at the organization
Competitive Advantage – Improved customer satisfaction
and market position.
GENERAL BENEFITS

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Advantages of HMIS
• Aid in faster decision making (eg. X- ray ,lab
investigations)
• Saves time
• Can give suggestion directly
• Ideal for keeping track of patient records
• Can prepare discharge summary easily
• Provide accurate information about symptoms and
health background
• Help to decide on a course of treatment
• Capture referring doctor's data
BENEFITS - DOCTOR

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Advantages of HMIS
• Communicate fastly and effectively
• Do in patient billing
• Can refer reports immediately
• Can get patient information
• Can clarify patient doubt
• Can be used in training new staffs
• Can report adverse drug reactions
BENEFITS - NURSE

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Advantages of HMIS
• Prepare online (up-to-date) patient bill
when the patient is discharged
• Daily collection report for OPD & Indoor
patient wise -cash / check collected
• Inventory management
BENEFITS - MANAGERS

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Advantages of HMIS
• Better treatment (faster)
• Adequate information regarding treatment
and tests
• Can do OPD booking
• Can access special packages
• Can contact health team
• Can foresee the cost of treatment
• Can give feed backs
BENEFITS - PATIENTS

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Advantages of HMIS
• Management can convey their message to all
workers regularly (hospital orders , events,
circulars)
• Can get feed back from employees and
patients
• Can assess the current functioning of
hospital
BENEFITS - ADMINISTRATORS

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Disadvantages of HMIS
• Costly in maintenance and upgrading
• Difficult to train all the workers
• Misuse of data stored
• Hardware and software problems will have a
tremendous effect in hospital functioning

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System Development
A new information system is built as a solution to some type
of problem or set of problems the organization perceives it is
facing.
The activities that go into producing an information system
solution to an organizational problem or opportunity are
called systems development.
Systems development is a structured kind of problem
solving with distinct activities.
These activities consist of systems analysis, systems
design, programming, testing, conversion, and production
and maintenance.

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System Development
A new information system is acquired by the following ways:
1. By use of their own IT Personnel
2. By purchasing from vendors
3. Outsourcing
4. End user development

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The development of effective information systems is
a necessary precursor to managerial improvement.
A health information system (HIS) is a process
whereby health data (input) are recorded, stored,
retrieved and processed for decision-making (output).
Decision making broadly includes managerial aspects
such as the planning, organizing and control of health
care facilities at the national, state and institution
levels and clinical aspects which can be subdivided
into
(1) providing optimal patient care,
(2) training of medical personnel to generate appropriate
human resources, and
(3) facilitate research and development activities in
various fields of medicine.
Evaluation of Information Systems

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A health information system (HIS) may consists the
following components/sub-systems.
1. Epidemiological surveillance
Identification/notification of diseases and risk factors,
Investigation, follow-up, control measures
2. Routine service reporting
3. Specific program reporting
4. Administrative systems
Account and financial systems
Drugs management (procurement, storage and delivery)
Personnel management
Asset management (equipment/buildings etc)
Maintenance system
5. Vital registration
Birth, deaths, migration etc.,
Components/sub-systems of
Information Systems

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A health information system (HIS) is evaluated based on
1. Ease of Use
2. Impact on Patients and Safety
Does it provide the patient’s complete list of current
medications?
Does it provide assistance with appropriate dose
verification, including a dosing calculator
3. Technological Considerations
Does it have the capability to interface with other
systems?
Does it interface with patient monitoring instruments to
download patient monitoring data?
What are its reporting capabilities (internally and
externally)?
Is it easy for researchers and clinicians to query for data ?
Evaluation criteria of Information
Systems

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4. Finance and Investment
Does the system ultimately save money?
What is the cost and potential return on investment (ROI)?
What are the costs for routine support and maintenance?
5. Configurability
The likelihood that a system exists that can be applied to
any health care system
6. Usability
The system must be “usable” to all present and future
users.
7. Automated Decision Support
If well-designed and powered by real-time data, it can
increase patient safety and has been shown to decrease
improper usage of medications.
Evaluation criteria of Information
Systems

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8. Current and Future Technology Capability
The system should allow for future technological advances like
wireless data entry, barcoding etc., to be easily integrated as well.
9. System Speed and Security
The system must provide information quickly and reliably to the
clinician .
10. Accuracy and Reliability of data
The clinician accessing the patient data must be confident that
the information they are receiving is accurate and truly reflective
of the patient’s condition
11. Scalability
A HCIS should possess properties that allow it to work on a small
or large scale.
12. Vendor
A thorough vendor evaluation including their reputation, their
history of service, support, etc. should be considered when
choosing a HCIS.
Evaluation criteria of Information
Systems