Hospital Information Systems (HIS)

• Lesson VII discusses Hospital Information Systems (HIS)

Hospital Information Systems

• HIS helps health care providers meet the expectation of efficiency for those seeking services.
• Clinical and operational records must be properly managed, which HIS assists with.
• Most hospitals use HIS instead of manual recording to maintain different institutional records.
• HIS is structured to manage health care provider records and make useful information and reports available for healthcare personnel to maximize efficiency.
• HIS was introduced in the 1960s and has evolved since to meet modern demands.
• HIS was mainly used for billing and inventory, but it now includes financial, scientific, and administrative programs.
• Modern HIS addresses nursing, pharmacy, finance, radiology, and pathology needs.
• Some hospitals integrate as many as 200 disparate systems into their HIS.
• Hospitals use HIS for efficiency in accessing patient information.
• High quality patient care and financial record management is delivered while remaining affordable, scalable, and patient-centered.
• HIS ensures adaptable to rapid technological changes.
• Effective HIS minimizes transcription errors, record duplication, and provides quick report turnaround times.
• Modern HIS links computers to quickly optimize operations and deliver quality service
• The HIS gathers, processes, retrieves patient information, and provides hospital stakeholders with relevant information through reports for better decision making.
• The system guarantees delivery of information by optimizing the core library.
• Customization towards departmental needs are also guaranteed, and centralized into the system.
• Hospitals are able to provide requirements to their HIS provider for specific configurations such as RDBMS or a multilingual interface.

HIS for Different Departments

• Nursing Information Systems (NIS) are developed to enhance patient care through accurate information to assist nurses and performs functions such as personnel schedules, patient charting, and clinical data integration.
• Agenda packages helps managers handle overtimes and absences to obtain cost-effective staffing and show staffing levels.
• Patient charting applications enable analysis of critical signs, care plans, and applicable nursing notes.
• Crucial information is kept and can be retrieved when needed for designing patients’ care plans.
• Medical information integration allows nurses to collect and examine retrieved medical records.
• Physician Information Systems (PIS) improve the practice of physicians.
• Deployment is common in Electronic Medical Records (EMRs) and Electronic Health Records (EHRs).
• Most systems offer support 24/7 for usage by health care professionals.
• Radiology Information Systems (RIS) billing services and appointment scheduling is also available aside from reporting and database storage.
• Modern advances has encouraged hospitals to address the commercial considerations of radiology departments.
• Pharmacy Information Systems (PIS) help monitor health institutions' use of medicines, handles information on medication-related complications, and drug allergies of patients.
• PIS Identifies potential drug interactions while considering the physiological conditions of the patients for appropriate drug administration.

Selecting A Hospital Information System

• Aspects to Consider include:
  • Total cost of package
    • HIS is available for all sizes and budgets.
    • Providers may reduce upfront and maintenance fees by using smaller hardware requirements.
  • Web-based system
    • HIS is available on the internet for authorized personnel to access information, data sharing between hospitals, and to facilitate access to information from other health facilities.
  • Implementation and Support
    • It is important that the system vendor provide adequate training and assistance.
    • Vendors should offer 24/7 support through telephone or web services.

HIS Providers in the Philippines

• BizBox, Inc.
  • Founded 25 years ago.
  • Its first hospital project completed in ‘94.
  • The company aims to improve work efficiency in health care institutions through software systems to produce advanced solutions.
  • Bizbox is a certified Microsoft Gold Partner- Awarded Independent Software Vendor (ISV) of the Year.
  • They have fully integrated systems such as Electronic Health Records (EHR) and Document Management System (DMS).
• Kaiser-dela Cruz Consulting, Inc.
  • Specializes in application development for hospitals, industrial clinics, and medical-related educational institutions in the Philippines
  • Products include Visual MEDSYS for hospitals and MEDSCHO for schools that provide integrated, comprehensive, and proven solutions for efficient health care.
• Comlogik Business Systems, Inc.
  • Philippine-based software development company established in 1999 with a global technology vision.
  • The company led development of innovative applications, like online hospital services, where patients can access billings, examination results; administrators can access reports; doctors can access patients' records anywhere.

HIS Functions

• Help Desk, Scheduling, Patient Registration
  • Help Desk
    • The help desk functions more efficiently because manual retrieval of information is no longer needed. Clients can be provided information and guidelines without any hassle.
  • Scheduling
    • Managers and employees can access work schedules from anywhere to discuss preferences with the HIS. Employee scheduling can save time and makes scheduling easier.
  • Patient Registration
    • The HIS patient registration form records personal patient information for record keeping and account management purposes.
  • The form is filled out during the patient's visit, consultation, or by a relative/guardian.

Admission, Discharge, and Transfer Procedures

• Admission
  • Counselors gather preliminary information, offer vital information, and answer questions concerning the hospital stay.
  • Physicians can schedule recurring medical exams like laboratory tests or X-rays before hospitalization.
  • Routine tests can also be carried out on the day of admission within HIS.
• Discharge
  • Through the HIS, discharge instructions provide services to be administered after the stay to ensure the patient's full recovery.
• Transfer
  • Is movement along with the discharge outside the hospital with instruction of any authorized personnel.
  • It does not apply to an individual declared lifeless or leaving without permission.
  • Transfer from the ER must fulfill the statutory requirements with the HIS for easy patient transfer details.

Billing, Contract Management, and Package Deal Designer

• Billing
  • Billing statements will show all records pertaining to invoices, payments, and balances.
  • HIS is useful for those requiring frequent health care services.
  • It is good procedure to generate billing statements regularly.
  • HIS lists outstanding balances to track receivables and identify overdue payments.
• Contract Management
  • Goodrich (2013) defines managing contract creation, execution, and analysis to maximize operational and financial organizational performances while reducing risk.
  • Automated contract management is a time-saving element of business.
  • Following a successful contract strategy implementations:
    • Realization of expected benefits and financial returns
    • Cooperation and responsiveness of supplier needs
    • With no disputes or surprises
    • Delivery of services to both parties
• Package Deal Designer
  • Diagnostic medical packages for inpatients, outpatients, and emergencies require the same process - post-diagnostic package deal to access information without the hassles of paperwork.

Laboratory Reporting

 - Regardless of the discrepancies in the documentation, there are common institutional- and company-mandated elements.
 - Supplementary items not specifically required may be included to aid in the interpretation of test results, such as:
  - Administrative or clerical information
     -  Patient name and ID
     -  Laboratory address
     -  Date printed
     -  Test report date
     -  Doctor’s name and signature
  - Information about the specimen and the test itself
     -  Specimen source when appropriate
      - Date/time of specimen
      -  Lab number
      -  Test name
      -  Test results
      -  Abnormal results
      -  Critical results
      -  Units of measurement
      -  Reference intervals
      -  Interpretation of results
      -  Condition of specimen
      -  Deviations for test perparations
      -  Patient medication and health supplements

Radiology Reporting

 - A radiology report is an official medical document containing details of the examination interpreted by a qualified physician.
 - The main objective is to address the queries in the request, accounting for both positive and negative findings.
 - Findings are followed by incidental findings.
 - The report, as defined by the ACR includes:
   - Administrative information
   - Patient ID
   - Clinical history
   - Technique
   - Comparison
   - Observations
   - Summary/impression
   - Signature of the radiologist

Cardiology Reporting

• Presents medical information from test results related to the patient’s history.
• Doctors write reports much faster via computer systems.
• Cardiology Information Systems (CIS) accurately create vascular sonography reports.
• Physicians provide automated reports with ultrasonic ultrasound and diagrams.
• Medical staff process lab reports for the physician.
• Results are generated more efficiently and improve the patient experience.

Material Management System

• Pharmacy, Main Stores, and Purchase
  • Material management involves planning, identifying, purchasing, storing, receiving, and distributing materials from a hectic health center in order to guarantee sufficient materials in the right place.
  • Automation of the inventory system is necessary to streamline the hospital supply chain.
  • Common tech used in the management include barcodes and RFID tags with precise identification assigned to inventory for accurate tracking and control.
  • It can assist heath care institutions in figuring out whether merchandise has been recalled or damaged and should not be given out.
  • Drugs and devices used regularly enable isolation and forecasts shortages.
  • Healthcare institutions maintain responsibility for receiving materials, retaining stock, and delivering supplies.

Management Reporting

• Not as simple as data retrival, but a platform for reporting and controlling of valuable data.
• Tech advancements help management reports to be non-monetary.
• Advancements pave the way for the emergence of management reporting systems which capture necessary data required by management.
• Data redundancy and quality issues are thus minimized.
• Systems enhance an institution with capabilities to be more responsible, efficient and effectiveness in decision making.
• These also offer a holistic view, highlights high value source, and reduces any visibility issues.

Tally Interface

• Tally.ERP9 provides simplified solutions to operations in health institutions such as registration, accounting, inventory management, tax management available and used by over 1,000,000 entities across the globe.

Key Points

• Hospital information systems are fundamental in managing information, which allows health care providers efficiently do their jobs.
• Nursing Information System (NIS), Physician Information System (PIS), Radiology Information System (RIS), and Pharmacy Information System (PIS) are useful for different departments.
• In selecting the HIS, consider the total cost of the package, if it is a web-based system, and the implementation and support.
• The top three HIS providers in the Philippines are Bizbox, Inc., KCCI Medsys, and COMLOGIK.
• The HIS address help desk, scheduling, patient registration, admissions, discharge/transfer procedures, billing, contract management, and package deals.
• Materials management is concerned with planning, identifying, purchasing, storing, receiving, as well as distribution of materials.
• Management reporting systems capture the data that is to run an effective enterprise.