IT IN HOSPITAL

S & HIS

An overview

Changing role of IT professionals in Hospitals

IT use to be a secondary dept. since need of It was not realized.

The main work use to be troubleshooting and maintenance of network infrastructure.

Present Scenario

Today IT professionals in health care or hospitals deals with analyzing the requirements of the hospitals to make their work more efficient & less time consuming and developing applications they need and implementation and maintenance of the same.

IT in Hospitals has been used in following Applications:

HIS EMR E-prescriptions E-health Telecommunication CDSS

Hospital Information SystemHospital Information System (HIS) can

be defined as a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital  that enable better quality of patient care, reduce the time spent for  clerical works, reduce  the overall  cost, increase the productivity and more important providing the more  reliable , correct  and regular  data.

The computer hardware and software that processes a hospital's data, including financial, Pt-related, and 'strategic' management data, Pt accounts, Pt tracking, payroll, reimbursements, taxes, statistics

History

Hospital information systems were first developed in the 1960s and have been an essential part in hospital information management and administration.

The systems were used to manage patient finance and hospital inventory.

HIS is generally Used for-

Operational management

Functional Management

Strategic Management

Operational Management

Creating Demographic details of the patientCreating medical historyCreating Standardized process & documents

Functional MANAGEMENT

Registration Admission OPD/IPD Pharmacy Laboratory Billing Blood Bank

Medical Equipment Management

Personnel Management

MIS reporting & more

Pharmacy Nursing HR

Strategic Management

MISBudget & Target SettingEducational & Social Awareness

Objectives

Capture & disseminate Information Analyze & validate Information Prioritize & Escalate Issues Provide Management overview

Actors/Stakeholders

Doctors Administrators Patients Partners & providers Management & regulators

General Characteristics which One should look for in a good HISModularUser FriendlyIntegrated FunctionalityEasy to customizeHigh level of securityLow Hardware RequirementsLow Cost of ownershipHigh ROIShortcut keyboard Function

System Characteristics

Support For maximum hospital procedureGUI Integration with the Third party accounting

softwareAuto Test result GenerationDICOM picture viewing Integration with PACsUser defined Statistical Reports Integration with TPAs

Organisation or companies in manufacture of HIS

Napier Shrishti Wipro G(lot of small installations0 Charak(Birlas) Medtrack(Fortis,Pushpanjali) Isoft(Medicity & Artemis) Accurate Akhil (Paras & BL Kapoor)

Additional applications required which are generally integrated with HIS

It is required to facilitate the exchange of Information or patient records as none of them is stand alone application.

PACS Back Office Applications(Asset & Inventory

Mgmt,Billing,financial & administrative modules)

EMR

Key Points you should look for to differentiate other HIS from the best one for your Hospital a good HIS

Billing Module Inventory Module Consignment Module Discharge Summery

Billing Module

All the operational processes applied to the patient and all the medicine and material used are listed in the billing screen.

Last controls are performed in this module and if the processes are entered completely, the bill is saved. (Bookkeeping, diagnosis, provision, doctor etc)  

Records about the patients are examined in the outpatient and inpatient billing departments depending on the health service the patient received, accruement procedures are completed and the bill is created.

Excellent billing module which can automate the steps of billing because after all its for revenue that a hospital is spending on IT

The most important aspect in a billing module is Payer & plan It should definitely have two categories to differentiate the patients

at the time of entry in the HIS that will not cause problem at the back end- Cash patient & Credit Patient.

Should have three option in billing i.e services with base tarrifs. For corporates,credit & cash. patients

It should have proper system to show the applicable tariffs correlated with tie-ups and insurance that automatically system can calculate the discounted rate on the base tariffs which are beforehand set for different categories of patients.

A user friendly option for cancellation & refund.

Capping/CoInsurance-The insurance company will likely not pay more than the coverage limits of the policy. It's the limit that is provided by the TPAs and insurance companies for the patients that they will bear only a fixed amount of patient’s cost and rest will be in the form of Copayment.

emergency cases –Bed charges popup –services were charged or not, facility availed or not. How exclusions are treated in the billing system that is very

important

Integration with the ward management module for IPD pharmacy billing

Interim Billing-it calculates and reflects per day billing of services

Discharge summery

After the discharge of patient discharge summary can be automatically generated with just few press of keys(i.e its preparation started fr0m the moment patient entered the IPD). Laboratory data can automatically be imported. Specialty wise standard format can be set.

Contents

I.Basic Elements Date of admission. Date of discharge. Disposition location (eg, home, ecf, short-term

rehab). Principal diagnosis for hospitalization. Secondary diagnoses addressed during

hospitalization. Procedures performed during hospitalization. Consultants

II. History A succinct summary of the key events leading to

hospitalization. The past medical history. Pertinent elements of the social history. Pertinent elements of the family history

III. Physical Exam Findings (positive or negative) pertinent to

history elements.

IV. Data Pertinent (normal and abnormal) laboratory data. Pertinent results of diagnostic studies (e.G., Cxr,

ekg).

V. Hospital Course Summary statement pertaining to the principal

diagnosis. Problem list that parallels the diagnoses listed Separate paragraph dedicated to each problem

listed. Brief discussion of the evaluation of each

problem. Brief discussion of the treatment of each

problem. Brief discussion of the outcome of each problem. Specific follow-up plan for each relevant problem

VI. Discharge Plan Future physician’s visits scheduled (or to be

scheduled). Specific studies that require follow-up a list of discharge medications (names, doses, &

frequency). mention of how information was/will be

communicated to PMD. “cc” to treating physicians.

VII. Additional comments or suggestions

Inventory Management system

Hospitals need to actively manage what is bought, when it is bought, how much, as well as for what price, including discounts and rebates

Inventory Management Module offers a time saving inventory solution that is precise and scalable, allowing you to monitor inventory usage more accurately and capture charges more efficiently by eliminating redundant data entry. Designed to support multiple facilities and multiple labs, the Inventory Management Module can be tailored to a hospital’s workflow.

Workflow of Inventory(Basic workflow)

Purchase department

Main store

Sub holding store

Consumed

ChargeableNon

chargeable

Purchase Department

Central Medical store

Central Pharmacy Store

An Inventory Module Should facilitate the sequence wise Processes as follows

Purchase Dept(Rate contract)

Purchase Requisition from different dept

Approved & authorized

Order is placed

Goods delivered

Goods Checking

Goods Receiving Note

Stocked

Central store

Items Issued

Departmental sub Store

Features

FIFO format of System issue Stock Expiry Records Batch wise distribution List(Same expiry Date) Medicines should not be enlisted with the

generic name but the Brand name as cost differs for both.

Integration of Consignment Module . Item Mapping 1) item number (most unique)

2) inventory number (unique)3) catalog (unique to a group of inventory items)4) description (free flow text description of item)

ORDER MANAGEMENT(order entry, order review and/or validation, interdepartmental communication, order inquiry, and reporting requirements)

Alerts system until confirmation of the receipt/delivery handles new drug orders

Manages Material Resource Planning (MRP) Management

Regulates Material forecast, Reservation management 

Substitute Goods Management system

Conclusion We can conclude that a good HIS should be able to

Increase- No. of transactions Inventory management Sales Productivity Customer satisfaction Market Share & penetration

Decrease- Administrative cost Variable cost Personnel expenses Inventory losses