Hospital Information System simplified

Hospitals today have evolved to be a multi-disciplinary, complex and interdependent industry that is built around highly capital intensive resources. In order to serve patients in an efficient way and to enhance revenue, hospitals are recognizing IT as a supportive arm to control cost and to improve operational efficiency.

Computers were introduced in the hospitals to in order to:

•increase organizational efficiency through reduction in the overall costs of delivering health care services;
•store, retrieve and exchange useful, accurate, complete and timely information to meet the requirements of the various departments requiring data;
•utilize the available resources effectively and optimally;
•improve medical care in order to provide high quality medical care at reasonable cost;
•have an improved Management Information System; and
•reduce clerical and administrative workload by automating processes and reducing paper work requirement
A need was also realized to create a health information system specifically for hospitals called the Hospital Information System or HIS which would automate and streamline some of the essential functions of the administrative and clinical departments in a hospital by computerizing the process of collecting, collating and retrieving patient information.

The words ‘data’ and ‘information’ are important for the understanding of an HIS system. ‘Data’ is a series of observations, measurements, or facts. It is a collection of facts from which conclusions may be drawn. Data which is meaningful to the end user is Information. Data in itself is Raw in nature. Information is crucial at all management levels from periphery to center for policy makers and care providers. Information system is a set of elements working interactively to gather and process input data and to disseminate output information.

Hospital Information System (HIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. This encompasses paper-based information processing as well as data processing machines.

Hospital Information System (HIS) is also said to be a set of components and procedures organized with the objective of generating information which will improve health care management decisions at all levels of health systems.

Collen in his book ‘Hospital Computer Systems’ writes that ” the goal of a HIS is to use computers and communication equipment to collect, store, process , retrieve and communicate patient care and administrative information for all hospital affiliated activities to satisfy the functional requirements of all authorized users and to provide decision support to the government and the politicians”.

‘Health Management Information System’ (HMIS) is defined as a set of interrelated components working together to gather, retrieve, process, store and disseminate information to support the activities of health system planning, control, coordination and decision- making both in management and services delivery. These terms HIS and HMIS are used interchangeably in the industry.

HIS primarily uses a network of computers to gather, process, and retrieve patient care and administrative information for all hospital activities. It has been developed with the objective of streamlining treatment flow of a patient in the hospital while allowing doctors and other staff to perform to their peak ability in an optimized and efficient manner. It also helps as a decision support system for the hospital administration in the form of automated reports from different departments and also MIS (Management Information System) and other statistical and administrative reports and data. HIS also provides an accurate electronically stored medical record of the patient. A database of such records can be utilized for statistical requirements and for research.

By using HIS, one can utilizes the power of computers in Medicare such that a network of integrated computers maintain an integrated record of all services provided to a patient in the hospital from departments such as laboratory, radiology, blood bank, nursing, clinical, emergency, in-patient ward, outpatient department, registration and billing, medical stores and pharmacy, finance and so on.

The software created for each department or process is called a module. A module is a software component with specialty-specific extensions as well as of a large variety of sub-systems in medical specialties like orthopedic, cardiology etc. A module is used to automate individual departments like laboratory, radiology, pharmacy, nursing, clinical and so on. All these modules when put together form the HIS. CIS (Clinical Information System) is sometimes separated from HIS. This distinction is based on the software vendor’s product packaging. Some sell an integrated HIS with the capability to automate most functions in a hospital, while others may sell individual department modules and their select processes like the Doctor Appointment Scheduling system as separate products which have the capability to integrate with other modules to provide an enterprise HIS. A CIS primarily automates clinical functions of a doctor and may have the Electronic Medical Record (EMR) also as its part.

The implementation of the above modules in an integrated fashion equips the medics, paramedics and other members of the health care delivery system of the hospital with a computerized environment for better patient care.

Authored by - Ranjeeta Basra K., Asst. Professor- International Institute of Health Management Research, New Delhi, on February 6, 2010.

Haiti survivor credits iPhone medical app

An NBC affiliate in Miami, Florida has a report about an American film producer, Dan Woolley, who was trapped in the ruins of a hotel in Port-Au-Prince, Haiti during last week’s earthquake. Woolley used the light from his digital camera to examine his broken foot and head wound. He then used a medical application on his iPhone to look up how to dress his wounds, which included a broken foot and a head wound, according to the report. Woolley said that during the 65 hours that he spent in the ruined hotel’s elevator shaft, he also looked up symptoms for shock using his iPhone medical app. Click on the title to read more...

No Electronic Patient Record: Good Quality Of Care, Bad Experience

Every time I get to go to a doctor myself or with a family member, I kind of have something inside me that starts immediately evaluating the experience. Not from an ordinary patient point of view but rather from a purely technical and electronic point of view. As if Mr. CPHIMS inside starts asking what if they did it this way? What if they had that? What if.. What if?

Usually I can't resist asking questions to the registration officers, doctors, nurses, even the admin staff sometimes. Not in a criticizing way, but rather I try to make it in an educative way because it wasn't their decision to work this way; most probably.

I recently had this hospital experience with my wife, she was admitted at the government Orthopedics hospital in Kuwait - Al-Razi Hospital, for a frozen shoulder operation. At first I must mention that we had the option to do the operation at well-known private hospital in Kuwait, but we choose to do it at the government hospital because we knew that she will get better quality of care during the operation, post operation, and the physiotherapy period; for free. Otherwise, we would have had to pay around $6,000 and she would have enjoyed a more quality stay in her sea side view room at the private hospital, but that did not weigh much in our decision because we are insured so money wasn't really an issue, and the stay in Kuwait government hospitals wasn't that bad from a personal experience.

My wife was referred to take an appointment with the doctor in mid October. She took a queue number and waited. When her turn came, the nurse came out of the doctor’s room and called her "number". She went in and because she doesn't have an electronic health record, had no file in the hospital, and the doctor had no access to her EHR if it existed; he asked her for the whole one year old history of her shoulder symptoms and other doctor's visits, reports, prescriptions, and opinions. Then he examined her and looked into her MRI and asked her to go open a file and come back. We left the room and went to the Medical Records office and opened a file and went back, waited outside tell the nurse came out and called us again. The doctor decided to operate on Oct 28th and asked her to be admitted on 27th.

We went on the 27th straight to the ADT office. The officer told us that we have to go to the doctor's office first to get the admission request. Back to the car and to the doctor's office which is in another building, we had to take a number, wait (it's a busy clinic BTW), see the doctor, out to get the file, back to the doctor, and got the request paper. Then back to ADT then finally admitted.

My wife was successfully operated and back to the word. She had an excellent treatment during her whole 5 days stay. So good that my wife – who is a very very picky person, upraised the quality of care she received and didn't blame her stingy husband for not doing it at the sea view private hospital :)

The doctor started the physiotherapy immediately after the operation because it was necessary. And before she was discharged the physiotherapist gave her an appointment to be back for physiotherapy session on Nov 4th. Of course we had to take the paper request from the word, go to the physiotherapy department, and register the date and time. But that was fine because we're going home.

On Nov 4th my wife took a taxi and went to the physiotherapy appointment because she wasn't allowed to drive. She went with all the good impressions about her experience so far, till she faced the true medical paper record experience.

She took a number and waited. While she is waiting they are supposed to get her paper file and put it ready for the physiotherapist. After a while an officer approached my wife and asked her: WHERE IS YOUR FILE? My replied how could she know where is her file! It should be in the hospital. WE CAN'T FIND IT AT THE MEDICAL RECORDS, GO CHECK IF IT'S AT THE WORD. My wife went to the word and found that they didn't have it, so she told the officer. IS IT WITH YOU? DID YOU TAKE IT? How on earth would I have it! Since when you let patients take their medical file? OK, GO CHECK IF IT'S AT THE DOCTOR CLINIC. How I am supposed to go, my wife replied. I don't have a car. OK, WE WILL SEND SOMEBODY TO CHECK IF IT'S THERE.

Of course my wife had to wait longer and her number was passed. After a while the officer came back to my wife again and told her that they can't find her medical record but she will see the therapist anyway. When my wife saw the therapist she had to tell her whole frozen shoulder history till she was discharged from the hospital, and yet! She couldn't do her therapy because there is no file. They decided to reschedule the session till they find the medical file.

Two days later the hospital called my wife telling her to come tomorrow for a physiotherapy session because they found the file at the doctor's office. Is that end of story? Or is it just the end of scene one? We don't know.

It's amazing how such a good healthcare experience take such a long and unnecessary time and turn into a total frustration because of ancient problems that could easily be solved by implementing an EHR or a document management system at least. Everything has advanced in the hospitals in terms of workflow and business process, equipment, quality, appointments efficiency, and medical staff, except for the paper work which has been the same since they opened the first hospital in Kuwait. This is a typical example how healthcare delivery can be improved by saving the very precious time of patients and medical staff by implementing Electronic Health Record. Not just at the hospital we visited, but at all the healthcare system in the country.

How Obama's Win May Impact Americans' Mental Health

Improved race relations and short-term relief from soaring stress levels are among the likely after-effects of Barack Obama’s Tuesday night victory, say experts in mental health and race relations.

Way to go Cerner!

Patients and clinicians at Ministry of Health hospitals and clinics in the United Arab Emirates (UAE) Northern Emirates are implementing healthcare IT Millenium Suite systems from Cerner.

Twelve hospitals and 60 clinics will implement a suite of Cerner Millennium solutions to automate paper-based processes. iCapital, a UAE-based company and consortium lead, will serve as the prime contractor for the implementations.

Healthcare of the Future,, NHS Example

I found this video at the Healthcare Informatics Blog by Chris Paton. It's amazing the difference between current healthcare services and how it will be with the right automation in use. Enjoy :) http://www.youtube.com/watch?v=YJxTznwRzs4

I Am LEGEND,, I am CPHIMS!

Finally.. I'm a Certified Pro in Healthcare Information Management Systems. Why finally?!!.. Not because that's it! I'm done with my career develoment, nore that now I land on my dream job (although I wish :) But because it was TouGH! And it was my second attempt :0) Why am I proud? I leave the answer to the Guru's:

“CPHIMS is more than just an acronym after my name,” said Ali R. Birjandi, MBA, MHA, CPHIMS, vice president of operational performance improvement at ProMedica Health System in Toledo, Ohio. “It is a designation that I have the technical knowledge and the required experience to use it. The largest causes of technology-project failures have not been the technology, but with the experience of the people leading the change. My CPHIMS Certification lets others know that when I talk about new technology, I speak from a position of both knowledge and experience.”

“Holding the CPHIMS, like other credentials, sets a baseline that fellow professionals understand,” said Jonathan D. Goldsmith, CPHIMS, FACHE, senior consultant at the International Bar Association. “Some may say a credential does not represent potential for future work, which is often true. However, it does represent a level of knowledge and understanding that immediately separates the ‘haves’ from the ‘have-nots,’ in first impressions and possibly later.”

Next project.. MBA. Let's go get it!