1. Hospital Information System ( HIS) Dr Kithsiri Edirisinghe MBBS, MSc, MD ( Medical Administration) Cert. IV in TAE Master Trainer ( Australia)

2. Topic Outcomes 1.Introduction to HIS 2.Use of HIS in hospitals

4. TodayTomorrow Location Hospital Decentralized, at home Time Symptomatic, curative Preventive, lifetime Focus On the process and providerOn the patient Scope Cure Patients Care for Citizens Methods Invasive Less invasive Healthcare is changing…

5. Order Process ManualAutomated Experience Individual Best Practices The Process Fragmented, isolated disease mgt. Clinical Decisions Personal preferencesGuide lines / evidence based The processes are changing … Information Fragmented, isolatedConsolidated / complete TodayTomorrow

6. Data completeness Fragmented Consolidated Data integrity Manual/error prone Systematic mgt. and control Data access Limited, DifficultAny time, any place Technology Isolated systemsIntegrated systems IT is changing … Data availability SlowReal time TodayTomorrow

7. Costs must decrease Quality must increase –E.g. Medication errors: in the US 80.000 people died in 2004. (=8th cause of death) The health care is under pressure...

8. The Hospital Medical Knowledge High Quality Cost Effective needs Activities Information Assessment needs produces

9. Healthcare as a Process Process Output Input SocietysubjectiveobjectiveMedical Community AssesmentoperationalCare ActionTherapeutic ActionDiagnostic ActionPlanning

10. Healthcare as a Process: pain points Isolated information Fragmented information Not accessable information Too much information Bad information presentation Only clinical data is kept (no knowledge) Some information is not computer usable (free text, image features, (genome in the future)) No feed back to medical community and society Complex desicions Lack of training Changing knowledge Medical errors Inefficient workflow Understaffing No operational information No infrastructure information No common language Input - Output Information Process Clinical Desicions Workflow Action Medical Community operationalSocietyobjectivesubjectiveAssesmentPlanning

11. Input - Output Information Process Clinical Desicions Workflow Cure for the pain points – wave 1 PAS: Patient Adminstration System HIS: Hospital Information System Result Distribution Action Medical Community operationalSocietyobjectivesubjectiveAssesmentPlanning Collect

12. Cure for the pain points – wave 2 PACS: Picture Archiving And Communication Sytem PAS: Patient Adminstration System HIS: Hospital Information System CIS: Clinical Information System Care Order Entry Medication prescription Result Distribution Input - Output Information Process Clinical Desicions Workflow Action Medical Community operationalSocietyobjectivesubjectiveAssesmentPlanning Collect Desicion support Optimization

13. Cure for the pain points – wave 3 Information filtering Decision support Semantic driven UI Clinical Pathways Evidence based medicine Clinical Trials (in- and exclusion criteria, data mining) Terminology feature extraction from unstructured or massive information (images, free text) Advanced connectivity Content Workflow optimization Intelligent patient portals Remote data capture Community HealthCare Input - Output Information Process Clinical Desicions Workflow Action Medical Community operationalSocietyobjectivesubjectiveAssesmentPlanning Knowledge Desicion support Optimization Common to all this is …

14. 1. Introduction Hospital consists of multiple variety of functions performed by different categories of people With limited resources these personnel are expected to produce an output with an acceptable quality.

15. 1. Introduction Strict regulatory process and more documentation in the hospital process have hampered these personnel performing assigned actual technical work, resulting unproductive low quality service outputs. EX. Nursing care ( more time spent on documentation )

16. Justification for proper information system Due to Scarce Human Resources, existing Human resource should utilize in a most productive and cost effective manner Hospital Information system will make people more efficient by collecting & distributing information faster, making use of the same human resource. Efficient MIS essential for the hospitals in today’s context.

17. Justification for proper information system Due to Scarce Human Resources, existing Human resource should utilize in a most productive and cost effective manner Hospital Information system will make people more efficient by collecting & distributing information faster, making use of the same human resource.

18. Primary objectives of HIS 1.To make a cost effective hospital 2.To provide quality services to their patients 3.To enhance the decision making process 4.To support user confidence 5.To boost hospital professionals commitment

19. Requirement of a HIS in a hospital Daily management of operations Competitive planning strategy Controlling dissemination of information Processing volumes of data

20. Requirement of a HIS in a hospital Providing information for medical & financial auditing Inventory management Interaction between department heads for planning, coordination, & control activates. Provision of information for national level policy, decision making.

21. 2. Benefits of HIS Health administration: Per patient information administrative work and making him more competitive in his work, prepared for auditing & legal demands. Medical research & Development for response & preparedness. Improvement in Quality & efficiency in patient management: Pictorial & image data presentation increases for medical imaging services

22. 2. Benefits of HIS Process coordination & improvement: Networking of units Increase efficiency of HR: It is estimated 40% of HR time is spent on in formation gathering, processing & disseminating work. To identify & improve areas of inefficient areas in terms of service delivery & cost.

23. 3. Current Gaps in HIS in hospitals Management & medical systems: Underutilization of available data in day-to- day management, unavailability of soft ware & hard ware. Hospital & clinical systems: Incomplete data sheets, Lower man power

24. 3. Current Gaps in HIS in hospitals Hospital staff & data base developers: little or no knowledge in respective personnel regarding IT & hospital activities. Poor communication & lack of interest of the mentioned categories

25. 4. Methodology There are several approaches to constructing HIS. Supporting activities of functions – CEOs information system Point of scale method (POS) – Build around the Patient Top down method – Build around Cooperate plan, targets, to functional goals Local Area Net work method (LAN) Analogous system

26. 5. Functional modules in a HIS There are two major categories in HIS 1. Clinical 2. Administrative.

27. A. Clinical Ward management OPD management Operation Theater CSSD Transfusion services Ambulance services Medical records Special unit management: ICU, ETU, Labor room and PBU Diagnostic services: Laboratory, Radiology, ECG, & EEG

28. B. Administration Front office Registration Appointments OPD Administration OPD billing & IPD billing Stores Pharmacy Marketing Financial accounting

29. 7. Implementation strategy of HIS Development of long-term plan for five-year period with short tem, annual plans. Identification of current operational problems & need for soft ware solutions, making phase wise deployment of those solutions. Site visit & determining estimating how the soft & hard wear enhance work process. Cost effective Method of the development of the soft ware; Purchase, in-house development or customization of developed soft ware.

30. 7. Implementation strategy of HIS Placement of computers, printers in points of revenue generation & service centers and the cost. Determine the net work configuration: local & other connections Develop & plan for a training programme Introduce audit & review systems, operation delivery systems Development of implementation strategy

31. 8. Key activities of HIS implementation Determination of priorities Defining architecture Outsourcing needed activities Evaluate & select solution Evaluate criterion of applications Customize & implement applications Building computer premises Acquire the resources Install the equipment Establish task force Site visit Empower uses

32. 9. Future Technologies Telemedicine Medical records Smart Card Digital library Multimedia

33. 10. Resources for installing HIS Operating system Data Base management Antivirus soft ware Server Data base backup drive Ups Terminals Hub Manpower EDP room Cables,Panels & outlets

34. Thank You!