Health Information System for a Hospital

International Institute of Health Sciences

Assignment

Program and Batch: EMSc in Healthcare Administration 03rd Batch

Module: Health Information Systems: MGT 494

Title: Development of a proposal for an information system for a Medical ward for SUWA SAVIYA; a 100 bed Hospital

Name: Dr. A.K.J.M. Wijayarathne

Registration Number: EMHA03/14/011

1 EMHA03/14/011 Hospital Information Systems

Assignment HIS- EMSc HA Programme 2015- 03 rd batch

Introduction - Hospital Information System (HIS)

Hospitals are information-rich organizations and pay an immense consideration on information management and processing, which has to be done using appropriate information systems. HIS is a computer-based system designed to assist the management of the administrative and medical information within a hospital (Trimmer et al. 2002). It helps to improve operational efficiency, quality of care and helps decision making (Spathis and Ananiadis, 2005). HIS systems give comfortable access to patient data (N.ghosh, 2010). Increasing customers’ expectations and regulatory boundaries also necessitates the need for clinical information and administrative tools that are immediately available. Furthermore, by increasing operation efficiency, the adoption of the systems could also reduce the costs (Spathis and Ananiadis, 2005). As stated by Hegji et al. (2007) serving patients with quality of care would guide for better return in the future. Despite its extensively accepted benefits, HIS adoption is still slow in certain countries due to lack of computer skills and training (Meinert and Peterson, 2009). The inability of individual user to strengthen their knowledge in the information systems application has caused considerable barriers to wider adoption of HIS.

Healthcare is an essential part of day to day lives where most people nowadays prefer to find a hospital that offers better healthcare services. Population demands for good-quality services force these organizations to improve their services by adopting information systems (Burke, 2009). In hospital environment, the implementation of hospital information systems is quite tremendous since many hospitals are able to increase their service quality to compete with other healthcare entities (Puay and Nelson, 2000). This is seen in many developed countries like United States of America (Smith and Swinehart, 2001; Trimmer, Pumphrey and Wiggins, 2002; Ovretveit et al. 2007; Meinert and Peterson, 2009; Caccia-Bava, Guimaraes and Guimaraes, 2009; Lee and Meuter, 2010), United Kingdom (Procter and Brown, 1997), and some developing countries like in Malaysia. However; adoption of information systems in hospitals in Sri Lanka is still at an early stage. Public sector hospitals has introduced few initiatives like in Dompe Hospital but mostly they focus on public health information systems which are mostly used in collecting, processing and tracking public health data using open source software like DHIS2 (District Health Information System). And the lack of funds and lack of motivation to initiate such systems playing a big role to with hold the systems being put to action. But private sector hospitals maintain a good trend by automating many of their processes. Most of the private hospitals use information systems for billing, channeling, HR and administrative purposes where as electronic health record systems are still not positively adopted here in Sri Lanka.


Hospital and Information Systems (IS)

Hospitals around the world have widely utilized IS for over many years. For example, US government has made the adoption of the electronic medical records as mandatory to all healthcare providers by 2014 (RAND Health, 2005). At the beginning of IS implementation, it focused only on improving efficiencies in areas such as billing and financial reporting (Trimmer et al. 2002). However, as the need to manage and integrate clinical, financial and operational information grows and evolves, HIS gives many benefits such as it could provide the best possible support of patient care and administration by electronic data processing (Ammenwerth, Kaiser, Wilhelmy and Hofer 2003). Realizing these benefits, most of the private sector hospitals adopt HIS at a trending fashion. The adopted HIS is the systems that can help those hospitals to become the benchmark of modern, automated hospitals and realize the goals of becoming a model “e-hospital” in Sri Lanka in near future.

Introduction – “SUWA PIYASA” Hospital, Kottawa

SUWA PIYASA is a 100 bed hospital located in the heart of the city of Kottawa, which is a highly urbanized area at the suburbs of Colombo City. It is a multi disciplinary hospital with wards (Medicine, Surgery, Paediatrics, Gynaecology and Obstetrics), 24 hour Out Patient Department, ETU, PCU and Day Care, ICU, Operation Theatre, blood bank and physiotherapy facilities. It also provides channeling facilities, Ambulance services and 24 hour pharmacy and Laboratory facilities.

Its Mission is to prevent diseases and cure patients through health promotion, patient education, professional training and proper treatment.

And its vision is to be the leader in providing high quality care and enhancing the lives of individuals nationally and regionally and also to take part in contribution to research, technology development, and novel programs in education and training.

The organization is basically categorized in to two sections according to the services which are needed.

Medical Services

Non Medical Services

Under medical services; the basic departments are;

Wards (Surgical, Medical, Paediatric, Gynaecology and Obstetrics)

ICU


PCU & OPD

Operating Theatre

Labour room

Channeling

Ambulance

Clinics

Laboratory

Pharmacy

Radiology

Physiotherapy

Blood Bank

CSSD

Non-Medical

HR

PR

Marketing

Finance

Plant and House Keeping

IT

Kitchen

Janitorial

Administration


Under each category, the bed capacity is as follows;

Category Bed Number

Wards 75

Sur-20,Med-22, G/O-15, Pd-18

ICU 5

PCU & Day care 5

ETU 5

OPD 5

Labour room 5

Medical ward- Description

Our aim is to grant a high standard of medical and nursing care in a relaxed and friendly environment, in which patients and their family members are considered as the centre of attention and the main priority.

The patient should retain his or her individuality and should be cared for physically, psychologically, and socially while maintaining privacy and confidentiality and dignity.

Care will be planned and carried out jointly by doctors, nurses, the multidisciplinary team, and family where appropriate.

Our staff, through their expertise, professional development and clinical supervision, is bound to provide a high standard of care, acting as one of the family at all times.

EnvironmentMedical Ward is a 20 bed General Medical ward. Within the ward there are 4 low acuity Cardiac beds which are attached to monitors.

The patient population includes patients with wide range of medical conditions, including Cardiac, Respiratory, Endocrine, Gastroenterology and infectious conditions. Most of the patients are older adults.

Care is provided by a multidisciplinary team. We have an experienced Nursing staff, with Registered nurses providing routine care, assisted by other junior attending staff. Medical care is provided by specialist Physicians and Medical officers, who work in conjunction with the ward staff. The patient's stay in the ward is monitored closely which ensures that their investigations occur in a timely manner, and management is


done according to latest treatment methods and finally aiming for a safe and timely discharge.

A full range of health services are provided as needs are identified by medical and nursing staff. Physiotherapy, Speech therapy, Dietetic advice and clinic follow ups are provided in collaboration with the other units of the hospital. Referral to other services also arranged on a needs basis. All staff involved in patient care meet regularly to review patient care goals and identify particular needs post discharge.

The floor area is organized as follows:

PLANNING

Identifying the “Needs” (Justification):

Basic inefficiencies of the existing system at the medical ward:

Current ward registration is paper based and there are lots of errors and duplications occur in entering patient’s data. It is also time consuming.

An admission through OPD, ETU and channeling is not integrated, so the duplication of patient registration work.

Relevant consultant physicians can be informed by an automated SMS/email system if the registration process is automated.

Junior medical officers and consultants have to physically come to the ward and manually go through the patient details and relevant investigation reports


Doctor’s and Nurses Rest Area

Reception

each and every time which is a time consuming and a waste of resources and irrelevant at times.

Emergencies in the ward are not informed to every person who is responsible at the time of emergency which may result in a fatal outcome. With an automated alarm system/ pager system it will be much easier to alert the care team at once.

Coordinating and getting the reports on time from the laboratory is manually done in the current setting, it’s a time consuming and tedious job.

Coordinating and getting the reports on time from the radiology department is manually done in the current setting, it’s a time consuming and tedious job.

Coordinating and issuing of drugs from the indoor pharmacy, alerting of out of stock drugs, inventory management of the pharmacy will be more efficient with a integrated system

Referrals and transfers to other wards or consultants has to be arranged manually which is time consuming and tedious. With an integrated system it’ll be easier to find an available consultant and refer the patient where necessary.

Ambulance service has to be arranged manually which can be cumbersome for the person who is coordinating.

Follow ups are not arranged in a proper manner and the follow up of the patient from medical clinic is not properly tracked from the ward and the doctors cannot get an idea about whether the patient is properly followed up or not.

It is a cumbersome effort to get the reports done manually; which are necessary for day to day administration processes of the ward.

Difficulty in handling the discharges from the ward as there are number of places to be searched and inquired before making the final bill at the discharge such as laboratory, radiology department, pharmacy etc.

Inability to efficiently reach data for research and audit processes with the help of the current paper based system.

Record keeping of the discharged patients is a tiresome process with the paper-based system

Patient satisfaction is high if they can access and arrange their medical profile, their consultancy appointments, next clinic appointments from their home, and also health insurance and other payments can be done at the ease of their home.

Even if a patient has misplaced his previous records, it will be easier to access their old health records at ease with an automated system.

Broad objectives of having a HIS is to make a cost effective processes at medical ward of SUWA SAVIYA hospital; which boosts hospital professionals’ commitment to provide quality services to the patients and to support decision making of professionals.


Specific objectives of the system:

The project will be carried out in basically two phases.

Phase I

The project is aimed to develop to maintain the day –to - day state of admission/discharge of patients to each unit, reports generation, laboratory, radiology and pharmacy integration, accounting and audit, list the staff and payrolls and general information (HR), channeling services, ambulance services and to maintain inventories of each unit of the hospital etc. It is designed to achieve the following objectives:

1. To computerize all details regarding patient details & hospital details.

2. Scheduling the services of specialized doctors properly so that facilities

provided by hospital are fully utilized in effective and efficient manner.

3. Scheduling channeling appointment of patient with doctors to make it

convenient for both.

4. If the pharmacy issues medicines to patients, it should reduce the stock status

of the medical store and vice-versa.

5. It should be able to handle the test reports of patients conducted in the

laboratory of the hospital.

6. It should be able to handle the test reports of patients conducted in the

radiology department of the hospital.

7. The inventory of each unit should be updated automatically whenever a

transaction or addition is made.

8. It should generate reports which are used in administrative purposes.

9. It should maintain accounting data pertaining to the all areas of the hospital

and its staff and patients.

10. It should maintain the HR database and the payroll status of each staff

member.

11. It should co-ordinate the ambulance service offered to patients and outside


12. The information of the patients should be kept up to date and there record

should be kept in the system for historical purposes.

Phase II

Development of a complete Electronic Medical Record (EMR) system integrating all the above features along with a fully automated clinical care (Paper-less Hospital concept).

Benefits:

The benefits will be directed mainly towards the health administration; patient information administrative work and making the administrator more competitive in the area of responsibility, prepared for auditing & legal demands. It will immensely improve the quality & efficiency in patient management. Integration of units will contribute to better process co-ordination and smooth running of processes as well as efficiency in HR management. It will also help to identify the areas of inefficiency in the areas of service delivery and cost effectiveness. It will be a great benefit for data readiness; especially in the areas of research and audit.

Feasibility study:

Four primary areas of interest in feasibility study are:

Economic Feasibility: An evaluation of development cost compared against the final

income of benefit derived from the development of product. cost benefit analysis is

done to evaluate the expected cost and benefits.

Cost and Benefit Analysis:

Developing a hospital Information system is an investment. After implementation, it

provides the organization with profits. Profits can be financial or in the form of an

improved working environment.

In performing cost and benefit analysis it is important to identify cost and benefits

factors. Cost and benefits can be categorized into the following categories:

1. Development Costs – Development costs is the costs that are incurred during the

development of the system. It is one time investment.


2. Operating Costs – Operating Costs are the expenses required for the day to day

running of the system. Examples of Operating Costs are Wages, Supplies and

Overheads.

3. Hardware/Software Costs – It includes the cost of purchasing or leasing of

computers and it’s peripherals and software.

4. Personnel Costs – It is the money spent on the people involved in the

development of the system.

5. Facility Costs – Expenses that are incurred during the preparation of the physical

site where the system will be operational. These can be wiring, flooring, acoustics,

lightning, and air-conditioning.

6. Supply Costs – These are variable costs that are very proportionately with the

amount of use of paper, ribbons, disks, and the like.

BenefitsWe can define benefits as Profit or Benefit = Income – Costs

Benefits can be acquired by:

Increasing income, or

Decreasing costs, or

Both

When considering the time factor, human resources and increased patient satisfaction

and good turnover rates of patients, it will be beneficial to adopt a HIS in this

scenario.

Technical feasibility:

Technical Feasibility includes ability to acquire and audit of existing and new H/W

and S/W requirements that are required to operate the project.

Operational feasibility:

Operational feasibility is mainly concerned with issues like whether the system will

be used if it is developed and implemented.

Legal Feasibility:

A determination of any infringement, violation, or liability that could result from

development of the system. Legal feasibility tells that the software used in the project


should be original purchased from the legal authorities and they have the license to

use it.

The process flow and key result areas of the medical ward (from patient reception to follow up at clinic after discharge)

• Reception

• Registration and admission

• Consultation

• Investigation

• Treatment (Drugs/ procedures)

• Transfer

• Ambulance

• Discharge

• Follow up

• Payments

• Other services not related to medical process but essential in - HR/ Housekeeping/ Accounts and Finance/ Administrative/ kitchen etc.


As per the diagram we can see the collaborative work to be done by several departments to keep the work flow alive and consistent and hassle-free.

Scope of the proposed system for whole hospital and Medical ward:

Considering the needs and the details distributed from the IT department regarding the project scope and resources for the whole hospital; following is a brief description of the scope, resources and planning of the floor area of the proposed system for the medical ward.

The hospital information system will consist of the following modules as informed by the IT department.


The modules are described in brief; with reference to the key result areas in the medical ward.

Patient Registration (OPD & Ward): Every patient who visits the hospital has to get registered prior to getting any consultation, treatment or investigations done. Registration of patients involves accepting certain general and demographic information about the patient. The patient is allocated a unique Registration number and a Patient Identification number. The Patient ID will remain same for his all subsequent visits to the hospital whereas he will be allocated a new registration number on every visit.

The following information is required for the registration of OPD Patient

i. Patient Demographic Details like Name, Age, Sex, Address, Contact number, Nationality, etc.

ii. Referring Sourceiii. Department & Consultant to be visited.

For Inward patients the additional information requirements are:

iv. Room / bed requirement.v. Consultant In-charge

vi. Treatment required (optional)

After registration a BHT (bed head ticket) is printed for the inward patients, which list all his registration information. This is used to record the information in the ward till discharge.


CLINICS TRANSFER HR

Note: After implementing EMR module at phase II; all the information will be recorded in the computers on wheels (COW) in wheel and at discharge the summary and diagnosis card will only be printed to be handed over to the patient.

Ward/room Management

This will help in ward clerk/ nurse in-charge to manage the rooms and ward and bed allocation

Emergency/ ETU module

Records ETU data and integrates the ETU with the other units with reference to patient s details, bed allocation, vitals recording of in house patients, doctor alert system etc.

Doctor’s work bench Module

Provides the private and restrictive logging for doctors who are in- charge of wards/patients to visualize data and order investigations as well as view investigation reports.

Laboratory and Radiology information systems allow authorized users to view and order investigations form lab and the radiology department.

Pharmacy- The Pharmacy Module deals with the Retail Sale of medicines to OPD patients and Issue of medicines to the Inward patients in the hospital. Its function includes, online drug prescription, inventory management and billing of drugs, consumables and sutures. This module is closely linked to the Billing Module and ward Modules.

Certificate module is responsible for issuing medical certificates according to requests made by patients

Roster module allows editing and integrating all the rosters of the staff working in the hospital by relevant heads and administrative staff. Rosters can be viewed by every staff member.

Communication module is used for circular issuing, policy circulating, message forwarding, making announcements, alert systems and all the relevant communication processes of the staff.

Inventory and fixed asset module is there to manage the ward assets by the relevant authority.

Diet and kitchen module collects all the data regarding inward patients and staff diet plans and manages them.


Blood bank, ambulance, CSSD, dental and physiotherapy modules will handle the relevant departments and collaborate with other relevant departments.

Clinic module will arrange appointments in hospital clinics which are held in a monthly basis.

HR module will keep track of all the employee details and collaborate with the relevant modules like payroll and financial/accounting modules.

Billing - For billing of any service like Pathology Tests, or any imaging investigation, the patient moves to billing counter. Here the services are charged as per the rates already defined for various categories to the patient with his Patient ID. The Payment is collected for the service provided and a receipt is generated.

For inward patients; the entries for billing are automatically transferred to the patient bill by the respective departments, which provide the service.

Financial and accounting module integrates all the expenditures of the hospital and income with reference to department and time frames.

Payroll module can calculate, edit and organize the pay rolls of each individual and secure and timely payments can be arranged.

User Management module provides the essential option of managing users and providing users with user names and passwords as well as editing and deleting them per the requirement. It is critical to keep the privacy of the patient and hospital data.

**EMR Module will be functional at the end of the successful implementation of the first phase of the project.

And the basic networking architecture for the HIS system can be illustrated as follows;


Database/ email/ web/back up servers are connected to internet through a firewall and the other computers of the network are connected to the servers via switches, and there will be wireless access points separately for the use of wireless computers and laptops and tablets.

For the medical ward; the planned networking architecture and placement of computers is illustrated below;

The medical ward will connect to the hospital network via a switch which is situated in the ward floor and there will be an integrated wireless access point as well.

Placement of computers:


Java SE MySQL

Equipment and resources needed for the Proposed System (As discussed with IT department)

Software Perspective:The application will be web-based software product. Front end- HTML/ Java ScriptBack end- Java SE, database server- MySQLThis will be out-sourced to an IT company to be developed and maintained. Source code will be available to the company.Software System Attributes will be Reliability, Availability, Security, Maintainability and Portability.

Hardware perspective (minimum requirement)/equipment needed

Processor: Pentium IV or aboveRAM: 512MB or aboveHard Disk: 40GB or aboveInput Devices: Keyboard, MouseOutput Devices: Monitors


Computers on Wheels

Tablet devices/ laptopsPrinters/ Scanners/UPSAcquiring servers/firewallRent an leased line from a service providerNetworking- wiring/routers/switches/hubs

Human resources:As we have a trained IT staff already; the training aspect of the other staff is the main worry. This can be acquired via scheduled workshops/ training sessions. Responsibilities should be allocated to each staff member. Maintenance can be done in collaboration with the IT Company and our IT department.

IMPLEMENTATION

Introduction:

In accordance with Ovretveit, et al. (2007) early system implementation phase is very vital. During this phase, there are many changes occurring to the existing system. According to Stefanou and Revanaglou (2006) when a new system is introduced such as HIS, there will be changes in the manner of the medical staff approaching their tasks. So, bad management during the implementation phase can cause users’ resistance towards the new system. Also, these researchers also found that the level of resistance towards new system implementation was quite high as they were familiar with manual practices. Trimmer, Pumphrey and Wiggins (2002) stated that the medical staffs tend to resist and look at the new system as a threat that could affect their work and potential. Therefore users should be educated regarding the importance of fully utilizing the system and its good effects towards a better working environment.

Implementation strategy of HIS

It includes developing a Policy schedule & responsibilities for programme implementation, Establishment of task force & assigning responsibilities, Identify & train user group and encouragement by the top management level.

This is planned to be carried out in a unit by unit basis and finally integrating each unit with each other.

Key activities of implementation


• HIS testing by user groups and proper evaluation of the modules has to be done in the initial phase. So the needed changes can be carried out before final steps f implementation.

• Determination of priorities should be done because of the tight schedule in implementing the HIS

• Architecture of the system should be defined and

• Acquiring of the software/ hardware/ human resources should be planned beforehand.

• Also the site visit and building the floor area as per the requirements should be done at the initial phase.

• After that; the integration and installing of the hard ware and installing of software can be done at the site.

• Outsourcing of needed activities could be done according to the demands and time schedule. The IT company which is providing the solution can manage this aspect

• Create a task force to carry out the implementation activities and training activities.

• Empower uses using motivation techniques and rewarding and celebrating successes is essential.

• Change management planning is also critical because it directly affects the successful implementation of HIS and acceptance of HIS by staff.


Implementation timeline

Timeline (weeks)Task 1 2 3 4 5 6 7 8 9 10 11 12 13 14Implementation planning studyKey process mapping and redesign Policy development

Implementation sequence planningChange management planningBenefits management planningDevelopment of training materials/trainingAssigning Responsibilities

Education and training plans should include:

• development, sign-off and production of the education and training materials

• the availability and support of any online learning management system used to support training

• the approach to training; for example, vendor training or in house training

• the types of training, including informal and formal, pre-implementation, HIS system and refresher training

• the number of trainers required, the length of time they will be required and their skill sets, including clinical experience

• identification and booking of training facilities, including dedicated training areas

• development, availability and support of the ‘sandpit’ for consolidated learning

• the timing of training in relation to HIS go-live

• detailed costs, including expectations from the business regarding cross-charging for clinical time.

Proposed Policy outline

1 Introduction


The HIS used by the SUWA PIYASA Hospital represent a considerable investment and are valuable assets to the Hospital. The assets comprise equipment, software and data, essential to the effective and continuing operation of the Hospital.

Much of the data used in HIS is of a confidential nature, and it is necessary for it to be protected against any events, accidental or malicious, which may put at risk the activities of the Trust or the investment in information.

All staff are required to adhere to this policy.

2 Policy Statement

The purpose of this policy is: To bring to the attention of all staff the need to improve and maintain

security of information systems, and to advise managers of the approach being adopted to achieve the appropriate level of security.

To bring to the attention of all managers and staff, their responsibilities under the requirements of relevant legislation, including Data Protection and Human Rights legislation and guidance, and the importance of ensuring the confidentiality of personal and sensitive data.

To ensure that the hospital complies with current legislation To minimize the risk of security breach and prosecution.

3 Policy

3.1 Overall

Our hospital is committed to maintaining and developing an information systems infrastructure, which has an appropriate level of security and data protection.

HIS is mainly managed by IT department of the hospital. In the case of departmental or stand alone systems it is the responsibility of the relevant Manager to ensure compliance with this policy.

3.2 The purpose of information systems security is to ensure an appropriate level of Confidentiality, Integrity and Availability

3.3 Passwords and Access Control

Each individual is responsible for keeping their own password secure, and must ensure it is neither disclosed to nor used by anyone else, under any circumstances. Staff must only access systems using their own login and password. All staff are accountable for any activity carried out under their login and password, and this is audited.


Access is controlled on the basis of service requirements. Procedures are in place for allocating and controlling access, and passwords.

3.4 Management and Staffing Arrangements

Information security should be addressed at recruitment stage for all staff, and a confidentiality clause included in contracts of employment.

There is a formal procedure for reporting, investigating and recording Information security incidents. Any incidents should be reported to the IT department immediately.

Delegation of responsibilities is outlined in detail in the Information Security and Data Protection Procedures.

3.5 Network Connection

Network Management is the responsibility of the IT department. All devices connected to the hospitals network must meet the required standards. Failure to do so will result in immediate disconnection.

3.6 Security of Assets

All major IT assets should have a nominated owner who is responsible for security measures.

Availability of data should be maintained by taking back ups.

Departmental based systems are the responsibility of departmental managers. The IT department will provide guidance and advice to departmental managers to ensure that information security is sufficient.

3.7 Computer Operations

Responsibilities and procedures for the management and operation of all computers and networks should be established, documented and supported by appropriate operating instructions. This refers to both hospital-wide systems and Department based systems.

Procedures should include: Back-up, media control, event logging, monitoring, protection from theft and damage, unauthorized access and capacity planning.

3.8 Systems Development, Planning and Procurement.

Security issues must be considered and documented during the requirements phase and the procurement phase of all system procurements and


developments. All changes to the system should be passed through a formal change control procedure.

3.9 Legal Requirements and Regulations

The hospital and the HIS is governed by government laws & regulations including:

Data Protection act

Computer crime act

3.10 Process Continuity Planning

There is a process to develop and maintain appropriate plans for the speedy restoration of all critical IT systems. All systems will have threats and vulnerabilities assessed to determine how critical they are to the Trust. Individual departments should have procedures in place to maintain essential services in the event of IT system failure.

3.11 Data entry Computers

They shall be specified and purchased via IT Services, in accordance with current recommendations on software and hardware.

Precautions must be taken to prevent and detect computer viruses. ICT Technical Services will provide advice and support on virus control.

3.12 Personal Use

Personal use of IT equipment is strictly prohibited.

3.13 Awareness

Managers are responsible for ensuring that all staff are aware of, and adhere to this policy.

4 Implementation and Monitoring Plans

Delegation of responsibilities is the responsibility of the managers of each department. Managers may seek help from the IT department where necessary.

Assigning responsibilities

The HIS system will be used by nursing staff, junior medical officers, consultants, and other staff.

The responsibilities of should be assigned with respect to the key roles of key result processes in the ward.


The existing responsibilities can be similarly assigned in accordance to the modules of the HIS.

MONITORING AND EVALUATION

Monitoring should be done by relevant leaders and managers where necessary in order to get an idea about the motivation among the staff to utilize the system and adhering to policies and maximum usage of assets.

It involves establishing indicators of efficiency, effectiveness and impact; Setting up systems to collect information relating to these indicators; Collecting and recording the information; Analyzing the information; Using the information to inform day-to-day management.

Evaluation components should include:

• an evaluation framework

This is done as a combined effort from the IT staff and the relevant ward staff. IT department should come out with a proper framework for evalution.

• expected outcomes following implementation of the HI system

It should reflect the basic requirements of the staff regarding key processes of the ward and whether they are met or not met with using the HIS

• baseline indicators

Example of baseline indicators for paper-based medication charts and expected changes when using an HIS


Paper-based chart indicator Expected changes in a HIS Whether error-prone abbreviations were present in the medication order

Error-prone abbreviations will not be configured in the HIS. so this indicator will be 100%

Whether the medication order was clearly legible

Legibility will not be an issue in the HIS, so this indicator will be 100%

Which nurse had done the administration of the medicine

The signature of nurses and midwives administering medications will be defaulted within the HIS with the logging in

Whether allergies were recorded The HIS can make recording allergy and adverse drug reaction information mandatory at the time of prescribing, so this indicator would be 100%

Whether the patient medicines information in the discharge summary reflected medicines on admission, medicines prescribed during the admission and medicines on discharge, and listed reasons for any changes between admission and discharge

Alignment of patient medicines information according to time intervals and the discharge summary is generated, by the HIS

• evaluation activities

Should be guided by the IT department in collaboration with the medical ward staff

• Post-implementation review planning

This is essential in getting a feedback from the real life users (ward staff) to get an idea about the functional and non-functional requirements of the system which basically results in smooth run of the HIS.

References

Trimmer, KJ., Pumphrey, LD., & Wiggins, C. (2002), “ERP implementation in rural health care,” Journal of Management in Medicine, 16 (2/3), 113-132.

Spathis, C., & Ananiadis, J. (2005), “Assessing the benefits of using an enterprise system in accounting information and management,” The journal of enterprise Information Management, 18 (2), 195-210.

N.ghosh (2010), “Benefits of Hospital Information System,” Retrieved September 12, 2011, from http://www.healthcare-digital.com/categories/benefits


Hegji, C., E. et al. (2007), “The link between hospital quality and services profitability,” International Journal of Pharmaceutical and Healthcare Marketing, 1 (4), 290-303.

Meinert, DB. & Peterson, D. (2009), “Peceived importance of EMR functions and physician characteristics,” Journal of System and Information Technology, 11 (1), 57-70.

Burke, R. J., Eddy, N. S. W., Fiksenbaum, L. (2009), “Virtues, work satisfactions and psychological wellbeing among nurses,” International Journal of Workplace Health Management, 2 (3), 203-219.

Puay, C., L. & Nelson, K. H. T., (2000), “A study of patients’ expectations and satisfaction in Singapore hospitals,” International Journal of Healthcare Quality Assurance, 13 (7), 290-299.

Smith, ES. & Swinehart, KD. (2001), “Integrated systems design for customer focused health care performance measurement: a strategic service unit approach,” International Journal of of Health Care Quality Assurance, 14 (1), 21-28.

Ovretveit, J., Scott, T., Rundall, TG., Shortell, SM. & Brommels, M. (2007), “Improving quality through effective implementation of information technology in healthcare,” International Journal for Quality in Health Care, 1-8.

Caccia-Bava, MDC., Guimaraes, VCK, & Guimaraes, T. (2009), “Testing some major determinants for hospital innovation success,” International Journal of Health Care Quality Assurance, 22 (5), 454-470.

Lee, OF., & Meuter, ML. (2010), “The adoption of technology orientation in healthcare delivery: Case study of a large-scale hospital and healthcare system’s electronic health record,” International Journal of Pharmaceutical and Healthcare Marketing, 4 (4), 355-374.

Procter, S. & Brown, AD. (1997), “Computer-integrated operations: the introduction of a hospital information support system,” International Journal of Operations & Production Management, 17 (8), 746-756.

Ammenwerth, E., Kaiser, F., Wilhelmy, I, & Hofer, S. (2003), “Evaluation of user acceptance of information systems in health care: the value of questionnaires,” Studies in Health Technology and Informatics Europe, 95, 643-648.

Stefanou, CJ. & Revanoglou, A. (2006), “ERP integration in a healthcare environment: a case study,” Journal of Enterprise Information Management, 19 (1), 115-130



Date post:	17-Jul-2016
Category:	Documents
Upload:	jayathri-wijayarathne
View:	14 times
Download:	5 times

Health Information System for a Hospital

Documents