IT in Hospitals & HIS

1. IT in Hospitals & HIS An overview

2. 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.

3. 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

4. Hospital Information System Hospital 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

5. 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.

6. HIS is generally Used for- • Operational management • Functional Management • Strategic Management

7. Operational Management • Creating Demographic details of the patient • Creating medical history • Creating Standardized process & documents

8. Functional MANAGEMENT • Registration • Admission • OPD/IPD • Pharmacy • Laboratory • Billing • Blood Bank • Medical Equipment Management • Personnel Management • MIS reporting & more • Pharmacy • Nursing • HR

9. Strategic Management • MIS • Budget & Target Setting • Educational & Social Awareness

10. Objectives • Capture & disseminate Information • Analyze & validate Information • Prioritize & Escalate Issues • Provide Management overview

11. Actors/Stakeholders • Doctors • Administrators • Patients • Partners & providers • Management & regulators

12. General Characteristics which One should look for in a good HIS • Modular • User Friendly • Integrated Functionality • Easy to customize • High level of security • Low Hardware Requirements • Low Cost of ownership • High ROI • Shortcut keyboard Function

13. System Characteristics • Support For maximum hospital procedure • GUI • Integration with the Third party accounting software • Auto Test result Generation • DICOM picture viewing • Integration with PACs • User defined Statistical Reports • Integration with TPAs

14. 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)

15. 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

16. 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

17. 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.

18. 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.eservices 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.

19. 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

20. 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.

21. 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

22. 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).

23. 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

24. 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

25. 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.

26. Workflow of Inventory(Basic workflow) Purchase Department Purchase department Main store Central Medical store Central Pharmacy Store Sub holding store Consumed Chargeable Non chargeable

27. 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

28. 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)

29. 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

30. 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