Date post: | 19-Jun-2015 |
Category: |
Healthcare |
Upload: | himssindia |
View: | 220 times |
Download: | 5 times |
Hospital Information System Checklist
for Small & Medium Hospitals
Page 1 of 29
Hospital Information System Checklist
for Small & Medium Hospitals
Page 2 of 29
DISCLAIMER
HIMSS Asia Pacific India Chapter has exercised professional care and diligence in collection and processing of the information
in this report.
This report is intended to be of general interest only and does not constitute professional advice.
HIMSS Asia Pacific India Chapter makes no representations or warranties about the accuracy of the data in this report. HIMSS
Asia Pacific India Chapter is not be liable to any user of this report or to any other person or entity for any inaccuracy of
information contained in this report or for any errors or omissions in its content, regardless of the cause of such inaccuracy, error
or omission.
Furthermore, to the extent permitted by law, HIMSS Asia Pacific India Chapter, its members, employees and agents accept no
liability and disclaim all responsibility for the consequences of you or anyone else acting, or refraining from acting, in relying
upon the information contained in this report or for any decision based on it, or for any consequential, special, incidental or
punitive damages to any person or entity for any matter relating to this report even if advised of the possibility of such
damages.
This document is NOT aligned with the HIMSS Analytics EMRAM (EMR Adoption Model). The checklist will be aligned to EMR
Adoption Model in the next phase of work.
Hospital Information System Checklist
for Small & Medium Hospitals
Page 3 of 29
Hospital Information System Checklist
for Small & Medium Hospitals
Page 4 of 29
CHAIRMAN’S MESSAGE
I am happy that HIMSS Asia Pacific India Chapter has come out with the much needed HIT Checklist for
small and medium size hospitals.
Having served on the board of medium and large size hospitals, I have seen the pain of failure of HIT/HIS (Hospital Information
Technology/ Hospital Information Systems), the transition to a new system and the financial loss to the organizations for the
failure of the HIS. In three organizations, I have at the board level, written off about Rs. 10 Cr (approximately USD 2 million) due
to an ill-conceived HIT/ HIS system.
The problem starts at the ordering stage itself, as a wrong RFP for a HIT/ HIS solution would lead to a wrong solution being
developed, and the vendor may not be responsible for the failure. To make the job easier for the hospital administrators, experts
at HIMSS have come out with a checklist which has been reviewed by a leading panel of experts. We hope that using this HIT
checklist as a reference, the hospitals can design the right HIT /HIS solution .This is the first HIT checklist and we will await your
feedback and improvise on the next version.
Pankaj Vaish, Vice President, Board Member - HIMSS Asia Pacific India, deserves credit for taking out time from his busy
schedule and making this happen with the help of other board members, and our deep heart-felt thanks to the eminent expert
panel for their review and feedback.
HIMSS is committed to the transformation of healthcare using IT, and we look forward to your feedback on this initiative
Rajendra Pratap Gupta
Chairman,
Board of Directors
HIMSSS Asia Pacific India Chapter
Hospital Information System Checklist
for Small & Medium Hospitals
Page 5 of 29
HIMSS ASIA PACIFIC INDIA CHAPTER
Rajendra Pratap Gupta Chairman , Board of Directors
Vishal Gupta President, Board of Directors
Pankaj Vaish Vice President, Board of Directors
Manick Rajendran Vice President, Board of Directors
Madhubala Radhakrishnan Treasurer
Dr Pankaj Gupta Joint Secretary
Vamsi Chandra Kasivajjala Member, Board of Directors
Amit Mishra Secretary, Board of Directors
Shailendra Ravi VP, Senior Director, Business Strategy EMC
Email: [email protected]
Hospital Information System Checklist
for Small & Medium Hospitals
Page 6 of 29
ACKNOWLEDGEMENT
HIMSS Asia Pacific India Chapter is pleased to publish this document that is intended to serve as a checklist for Small & Medium
Hospitals in India while they embark on their journey to choosing the right Healthcare IT Solution in the form of a Hospital
Information System (HIS). This document can be used by most small and medium hospitals across public and private sector
settings in India and to a certain extent can also be extended to hospitals outside of India in neighbouring regions with similar
level of maturity of adopting Health IT and a comparable socio economic status as that of India. This checklist covers key
functional areas for IT automation in hospitals and addresses both functional and technical requirements.
The initial draft was prepared by members of the board of HIMSS Asia Pacific India Chapter. This report also bears the efforts of
significant contributions through review and revision of the document and hence it is important to place on record
appreciation to the following members whose contribution has resulted in finalizing and publishing this checklist.
Expert Review Panel
1. Mr. Praneet Kumar CEO, BL Kapoor Hospital, New Delhi, India
2. Dr. Mahesh Inder VS CEO, Saket City Hospital, New Delhi, India
3. Dr. Dharminder Nagar Managing Director, Paras Healthcare Pvt. Ltd., India
4. Dr. Karanvir Singh Chief Medical Information Officer, Apollo Healthcare, India
5. Dr. Gayatri Mahindroo Director, NABH, New Delhi, India
6. Dr. Kiran Venugopal Vice President – Product Management, HealthFore Technologies, Bangalore, India
7. Mrs. Neena Pahuja Independent HIT Consultant, NCR Region, India
8. Mr. Rajesh Batra Kokilaben Dhirubhai Ambani Hospital, Mumbai, India
9. Mr. Aditya Mani Pushpanjali Crosslay Hospital, NCR Region, India
10. Mr. J P Dwivedi CIO, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India
11. Mr. R S Bapat Adtiya Birla Memorial Hospital, Pune, India
Hospital Information System Checklist
for Small & Medium Hospitals
Page 7 of 29
DEFINITIONS
1. EMPI Enterprise Master Person Index
2. MRN Medical Record Number
3. EMR Electronic Medical Record
4. CPOE Computerized Physician Order Entry
5. IV Intra Venous
6. OPD Out Patient Department
7. OT Operation Theatre
8. OR Operating Room
9. ICU Intensive Care Unit
10. SaaS Software as a Service
11. TAT Turn Around Time
Hospital Information System Checklist
for Small & Medium Hospitals
Page 8 of 29
FUNCTIONAL REQUIREMENTS
Legend
G: Indicates the proposal fully comply the
requirement/ clause
A: Indicates the proposal partially meet
the requirement / clause; supported
with remarks
R: Indicates the proposal does not meet
the requirement / clause; supported
with remarks
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/1 Patient Registration & EMPI
HIS/1.1 General The system shall auto generate a unique Patient ID (aka
MRN or UHID) which shall use alpha numeric characters.
The logic used to generate the Patient ID should be
definable by the Hospital.
Critical
HIS/1.2 General Types of Registration - General, VIP, Emergency and
External. General registration is used in all normal cases.
VIP is registration that is used for VIP patients or can be a
part of general registration with a separate Flag/Indicator.
Emergency registration should take only approximate age
and gender as an input. External registration can be used
for patients visiting for Diagnostic services and/or
Pharmacy services only.
Critical
HIS/1.3 General Flexible fields to capture unique Patient Identifier like PAN
card, Aadhar Card, Passport, Referral Source etc.
Important
Hospital Information System Checklist
for Small & Medium Hospitals
Page 9 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/1.4 Patient
Search
Patient Search shall have multiple search capabilities. It
shall be able to qualify searches by name, date of birth,
sex, national individual identifiers (such as Aadhar, PAN
Card, Passport etc.). The index shall support a variety of
possible internal identifiers such as Patient ID (MRN/UHID),
case number, multiple account numbers, etc., for each
patient and be able to maintain cross reference to other
existing identifiers in each of the facilities used by the
patient in the same site or in other locations.
Critical
HIS/1.5 Patient
Search
The HIS shall support a EMPI at multi-site, multi-institutional,
district, or national levels that links existing patient indices
together.
Critical
HIS/1.6 Patient
Search
The EMPI shall support multiple names so that patients who
change their names can still be located with a EMPI
search.
Critical
HIS/1.7 Patient
Search
Ability to search patient name using soundex as well as
multi-part names.
Desirable
HIS/1.8 Patient
Search
Name alert search. Patients with same last name and
same first name and initial shall be flagged to alert users of
possible conflict.
Critical
HIS/1.9 Patient
merge
The system should have the capability to merge 2 records
under a single record and allow searching for either
record resulting in one final search result of merged
identity.
Desirable
HIS/1.10 Patient
merge
The system should have the capability to let the end user
choose the visits and records which need to be merged.
Desirable
HIS/1.11 Patient
merge
During the merge process, across the system except for
super users, the normal users should be able to see only
one record.
Desirable
HIS/1.12 Patient
Unmerge
The system should have the capability to unmerge the
merged records
Desirable
Hospital Information System Checklist
for Small & Medium Hospitals
Page 10 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/1.13 The system should have the capability to control if end
user is allowed to choose the visits and records which
need to be unmerged and also the association of all the
transactions to the right Patient Unique ID and the visits
and if access is not granted, system should automatically
decide unmerge rule.
Desirable
HIS/1.14 Demographi
c Profile
The system should have capability to capture dependant
information against a patient profile and also maintain a
family tree association where applicable to enable
reviewing family records where necessary. Linking of
mother and child record or donor and recipient record
should also be supported.
Desirable
HIS/1.15 Pre-
Registration
The system must have support for bulk registration in case
of mass patient enrolment from medical camps as well as
have a provision to perform pre-registration which can
later be converted to a permanent registration
Desirable
HIS/1.16 Eligibility The system must have support for capture of patient
eligibility along with registration process which can include
payor plans, authorizations, effective dates for eligibility
etc. that will impact encounter wise invoicing
Important
HIS/1.17 Tagging The system must support tagging of patients as either VIP,
Free patient, staff etc.
Desirable
HIS/2 Appointment Scheduling
HIS/2.1 General The System shall support integrated scheduling of
appointments and resources across the organisation.
Critical
HIS/2.2 General System shall be able to retrieve the patient’s demographic
data captured with capability to update/make changes.
Critical
HIS/2.3 General System should allow different kinds of appointments
namely Appointments with Doctors, Multi Appointment
(Appointments across multiple dates with a single doctor,
or appointments with multiple doctors on a single day or a
Critical
Hospital Information System Checklist
for Small & Medium Hospitals
Page 11 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
combination), Diagnostic appointments, Check-up
appointments, follow up visits.
HIS/2.4 General The Appointment Scheduling module will be used:
• To minimise patient’s waiting time.
• To flag No-Show patients.
• To optimize resource utilization
Critical
HIS/2.5 General System shall allow online booking of appointments. Desirable
HIS/2.6 General Upon confirmation of an appointment, notification must
be sent to the patient via SMS and email/Fax. Also
reminders via SMS should be sent x no of hours before the
appointment. This is applicable only to those cases which
are not walk ins.
Important
HIS/2.7 General The System will allow for multi-step appointments to be
created. For ex: if the patient first has to get a lab test
completed and only after the report is available, the
patient’s appointment with the doctor needs to get
confirmed.
Desirable
HIS/2.8 General The above multi-steps cancellation and/or re-scheduling
rules needs to be taken into consideration.
Desirable
HIS/2.9 General System shall alert in the event of any appointment clashes
or future appointments including during admission.
Important
HIS/2.10 General System shall generate appointment slips with details
including Date, Time, Room No, Doctor Name, Token
number, etc. These details should be configurable by the
end user.
Critical
HIS/2.11 General It is preferable that the scheduling screen depicts a
calendar view similar to outlook or mac calendar
Important
HIS/2.12 General Alert or prompt rules should be configurable and by
default should consist of conflict rules, duplicates, etc.
Important
Hospital Information System Checklist
for Small & Medium Hospitals
Page 12 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/2.13 General The system should handle resource planning and this
should include resource definition, resource time slot
planning, appointment transfers, appointment slot
swapping features, etc.
Critical
HIS/2.14 General Types of appointments include one-to-one, one-to-many,
many-to-one and many-to-many combinations and all of
them needs to be handled by the system
Critical
HIS/2.15 General The system should accommodate overbooking and
forced booking functionalities based on configurable
rules.
Critical
HIS/2.16 Reports System should have inbuilt reports for Daily appointment
lists, no show lists, cancellation lists, etc.
Critical
HIS/2.17 Communica
tion
System should have support to generate reminder
messages to be sent to patients/attendants based on
context of schedule or appointment – e.g. Reminders on
confirmed consultation appointments, reminders based
on vaccination schedule
Desirable
HIS/2.18 Booking System must allow for bulk management of appointments
including bulk booking of multiple patients into a slab /
timeframe or allow for bulk re-scheduling or cancellations
based on resource constraints that are unplanned – e.g.
Doctor on emergency leave or delayed due to other
critical cases outside of the OPD setting
Important
HIS/3 Outpatient Management
HIS/3.1 Billing System should cater to both Pre-Billing and Post-Billing
scenarios.
Critical
HIS/3.2 Billing System should auto alert cashier desks/stations for a
patient's bill collection.
Important
HIS/3.3 Registration System should have the ability of Pre-Registration (Online),
Self-Registration (Kiosk and/or Web), and interfacing with
payment gateway.
Desirable
Hospital Information System Checklist
for Small & Medium Hospitals
Page 13 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/3.4 Triage The system should have the ability to capture basic clinical
information from a nursing desk or by a junior doctor.
Critical
HIS/3.5 EMR The ability to view the patient's EMR by the consulting
doctor at any point of time is a must. Also, the EMR should
be accessible by multiple doctors at the same time but
only the first doctor would have read/write rights and rest
all would have read only rights. Provision to have intuitive
user interface to see the continuity of care in case sheet
style and book flip style.
Critical
HIS/3.6 CPOE The consulting doctor should have access to the order
entry module.
Critical
HIS/3.7 Information Through the system, users must be able to pass information
securely similar to a messenger or a chat application. The
same should be stored and audited.
Desirable
HIS/3.8 Quality It is desirable that the system can track turnaround times
for various activities and escalates when the TAT are
missed.
Desirable
HIS/3.9 Worklist Doctors OPD patient worklist should be configurable
based on various criteria
Desirable
HIS/4 Admission, Discharge & Transfer
HIS/4.1 Admission System should be able to handle different kinds of
admission namely Pre-Admission(online), Direct Admission,
Emergent Admission, Walk-in Admission, Referral Admission
and Planned admission
Critical
HIS/4.2 Admission System should have the ability to provide with a bill
estimation at the time of admission. Further system must
also have capability of admitting under joint
management such that billing and apportioning of
expenses is possible to respective medical
conditions/disciplines.
Important
Hospital Information System Checklist
for Small & Medium Hospitals
Page 14 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/4.3 Admission The system should show a graphical representation of
available and occupied beds in the hospital. The system
should be able to
search for beds based on multiple criteria, e.g. vacant
bed, vacant beds user a particular speciality, beds of a
particular class (e.g. deluxe) that are under housekeeping
– about to become vacant, etc.
Important
HIS/4.4 Admission The system should capture details of the guarantor and/or
Insurance/TPA/Corporate/CGHS/ESIC details.
Critical
HIS/4.5 Transfer The system should have the ability to transfer a patient
from one ward to another based on configurable business
rules.
Critical
HIS/4.6 Transfer The system should have the ability to transfer the patient
from one admitting consultant to another.
Critical
HIS/4.7 Transfer The system should have the ability to transfer based on
configurable billing rules like retrospective billing, etc.
Desirable
HIS/4.8 Discharge The system should have configurable workflow based
discharge. From Clinical discharge to Physical discharge,
there could be multiple steps involved based on each
individual hospital's workflow and they should be
configurable in the system. Ex: Pharmacy Discharge,
Diagnostic discharge, Financial discharge, etc.
Critical
HIS/4.9 Discharge The system should send alerts about the discharge status in
real time to the relevant actors.
Critical
HIS/4.10 Discharge The discharge summary/detail report should be
configurable and should have the ability for the hospital to
decide which transactions during the patient's journey
should become a part of the discharge.
Critical
HIS/4.11 Transfer The system should support transfer of care from ER/EM
(emergency care) to Inpatient care without having to
close and re-open a new encounter – this should also
Desirable
Hospital Information System Checklist
for Small & Medium Hospitals
Page 15 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
support combining of charges into a single IP Invoice
HIS/5 Bed & Ward Management
HIS/5.1 Bed Mgmt. The system should have the ability to create different kinds
of bed and associate it with multiple attributes. Ex: Normal
bed which is billed on a daily (24 hour) basis and has a
bassinet and ventilator attached to it which will be
charged at a certain value.
Critical
HIS/5.2 Beds should be billed either on a hourly basis or daily basis Critical
HIS/5.3 Bed Census report is required Critical
HIS/5.4 The available, occupied and under maintenance beds
should also be shown in a graphical representation
Desirable
HIS/5.5 Ward Mgmt. The system should provide the ability to certain users to
order, track and return consumables, medications, etc.
from the ward management screen
Important
HIS/5.6 Ward Mgmt. The system should track diet/food orders and returns. Important
HIS/5.7 Ward Mgmt. The system should provide the overall status of a ward at
any given instance in terms of pending orders, bed status,
housekeeping requests, etc.
Critical
HIS/5.8 Bed Mgmt. Scheduling of housekeeping and maintenance activities Critical
HIS/5.9 Bed Mgmt. Should facilitate the estimation of appropriate waiting
times for patients
Important
HIS/5.10 Bed Mgmt. Forecasting of bed availability based on all vacant beds
and all potential beds that can be made available based
on planned discharges and planned maintenance tasks
on blocked beds
Desirable
HIS/6 CPOE
HIS/6.1 General The system should gave the ability to handle different kind Critical
Hospital Information System Checklist
for Small & Medium Hospitals
Page 16 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
of orders namely medications, IV, Radiology, Laboratory,
Blood, Procedures, Nursing, Diet, etc.
HIS/6.2 General The system should track the orders - ordering, status,
administration (where applicable) and results without
losing information and in real time.
Critical
HIS/6.3 General Orders should be processed by the relevant actors by
providing them the information through worklists/
dashboards or similar functionalities.
Critical
HIS/6.4 General Orders progress needs to be recorded through relevant
screens and the same should be visible in real time to the
relevant actors. For ex: Lab order when processed and the
report is available, the same should be visible to the
ordering doctor in the EMR.
Critical
HIS/6.5 Results The system should have the ability to enter multiple levels
of results. Ex: Unverified results, Verified results and
authorized results.
Critical
HIS/6.6 Results Based on configurable rules, the results should appear in
the EMR at the right stage (Unverified/Verified/Authorized)
Critical
HIS/6.7 Order Sets The ability to create order sets based on problem,
diagnosis, doctor or pathway is desirable.
Desirable
HIS/6.8 Medication
Orders
The ability to order for medications based on types of
medications is critical. Ex: Variable dosing, Sliding Scale,
Tapering dose, etc.
Important
HIS/6.9 Medication
Orders
The system should interface with drug database to
provide both default dosage details while prescribing
medications as well as provide decision support alerts for
contraindications or interactions
Important
HIS/6.10 IV Orders The system should have the ability to order for the right
kind of IV and with built in rules depending on the drip
rate, type of IV, and the mode of delivery - Bags, Infusion
pumps, etc.
Important
Hospital Information System Checklist
for Small & Medium Hospitals
Page 17 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/6.11 Radiology The system should mandatorily send basic clinical
information along with the radiology order as per HL7
guidelines.
Critical
HIS/6.12 Laboratory The system should be able to handle different kind of lab
orders and the results, such as Pathology, Histopathology,
Microbiology, Cyto-Genetics, Immunology, etc.
Important
HIS/6.13 Results The results should have the ability contain text, images,
audio and video and should be stored in the EMR.
Desirable
HIS/6.14 Results The results should be sent to EMR in real time. Critical
HIS/6.15 Results The system should have the ability to create reports based
on the due date of results.
Important
HIS/6.16 Surgical
Procedures
System should support workflow to order/initiate surgical
procedures and schedule such procedures within a
surgical theatre complex
Important
HIS/6.17 Diet Module Recording of Dietics Visit (Prescription) & Billing Critical
HIS/6.18 Diet Module View of Treating Doctor's recommendations Important
HIS/6.19 Diet Module Diet/Meal Plan Critical
HIS/6.20 Diet Module Interface with F&B Module for Diet preparation Important
HIS/6.21 Diet Module Alerts of new Admissions, Transfers and Diet
recommendations
Important
HIS/6.22 Discharge
Summary
Multi-Level Templates (Unit, Department, User Group, User) Critical
HIS/6.23 Speech to Text Support Important
HIS/6.24 Macro based Reporting Feature Important
HIS/6.25 Import EPR entries (Investigation Results, Illness History,
Treatment Record etc.)
Important
HIS/6.26 Capture Pictures and Annotations Important
HIS/6.27 Diet Module Preparation of meal tickets that can be used to affix on
meals for delivery that contain patient and location
details for smoother management of logistics of meal
delivery
Important
Hospital Information System Checklist
for Small & Medium Hospitals
Page 18 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/7 Pharmacy
HIS/7.1 General The worklist show the Inpatient, Outpatient, Emergency
orders against the patient/ward
Critical
HIS/7.2 General The system should show the return requests against a
patient/ward in a worklist.
Critical
HIS/7.3 General The dispensing should be based on closed loop of
medication principles.
Critical
HIS/7.4 General It is desirable to have the drug details including
monograph, interactions, etc. shown to the pharmacist on
the relevant screens.
Desirable
HIS/7.5 General Drug and Patient search capabilities to be available Critical
HIS/7.6 General The system should be able to show the available drugs
based on batch details and should be dispenses on First
Expiry First Out principle. (FEFO Model)
Important
HIS/7.7 General Controlled substances and narcotics should be stored
separately and should be accounted for based on
governmental regulations. Reports for the same to be
available.
Critical
HIS/7.8 Stock Stock movement should be tracked Critical
HIS/7.9 Stock Stock requests, indentation, receipt functionalities to be
available
Important
HIS/7.10 Label The ability to print labels in multiple languages and the
data that needs to be printed on a label should be
configurable.
Critical
HIS/7.11 Label Labels should be printed automatically on pre-defined
network printers in real time or in batch mode.
Critical
HIS/7.12 Label Directions for usage of medications should also be
available and should be configurable.
Important
HIS/7.13 OTC It is desirable to have Over the Counter sale functionality Desirable
HIS/7.14 Inpatients It is desirable to have medication list functionality at a
ward level
Desirable
Hospital Information System Checklist
for Small & Medium Hospitals
Page 19 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/7.15 Reports Reports are extremely important and at the minimum
should print patient (OP) bills, stock lists, regulatory reports,
etc.
Critical
HIS/7.16 General Bar Code Enabled Important
HIS/7.17 Medication Maintenance of Generic and Brand Mapping Important
HIS/7.18 Medication Drug Substitution based on common attributes across
trade names/brand names of drugs / medications
Critical
HIS/7.19 Medication Interface with Third Party Drug Database Critical
HIS/7.20 Medication Batch, Expiry Management Critical
HIS/7.21 Pharmacy Dispensing & Inventory management - Should support all
the standard processes of In-Patient and Out-Patient
Pharmacy within a Hospital. This module should also
support processes of sub-stores like Operation theatre,
Procedure rooms etc. A robust inventory control with audit
trail should form the backbone of the system. The standard
processes to be supported include Material Receipts,
Issues, Transfers, Dispensing, Stock Tracking, Stock Taking,
Automatic Indenting
Critical
HIS/8 Nursing Management
HIS/8.1 General The nursing personnel should have access to their worklists
based on their activity within OPD, Inpatient wards,
OT/Surgical wards and/or ICU.
Critical
HIS/8.2 General The nursing personnel based on access control should
have access to EMR
Critical
HIS/8.3 Orders The nursing personnel should be able to place orders on
behalf of a doctor or due to verbal orders after
documenting the same.
Critical
HIS/8.4 Orders The nursing personnel should be able to start the
discharge process on behalf of a doctor based on verbal
orders, and after documenting the same.
Critical
Hospital Information System Checklist
for Small & Medium Hospitals
Page 20 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/8.5 Documentat
ion
Clinical documentation features in terms of Triage notes,
Progress notes, visit notes should be available.
Critical
HIS/8.6 Care Plans It is desirable to have Nursing Care Plans functionality. Desirable
HIS/9 Laboratory
HIS/9.1 Worklist All lab orders should be reflected in the respective
user/sub-department worklist
Critical
HIS/9.2 Worklist The status of all the lab orders should be reflected in real-
time within the worklist
Critical
HIS/9.3 Workflow As the workflow of the lab process within each sub
department typically differs from hospital to hospital, it is
important to have configurable workflows or desirable to
have an inbuilt workflow engine.
Important
HIS/9.4 Rules The rules for TAT, result validation, result entry, etc. differ
and hence it is important to have configurable rules or
desirable to have an inbuilt rules engine.
Important
HIS/9.5 Results Results must be in real time updated in the EMR and also
the configurable alerts need to be sent to the respective
users.
Critical
HIS/9.6 Laboratory Customizable workflows Critical
HIS/9.7 Laboratory Customizable alerts for critical values Critical
HIS/9.8 Laboratory Laboratory KIT Management Critical
HIS/9.9 Laboratory Support for Digital Signatures Important
HIS/9.10 Laboratory Standards based Uni Direction / Bi Directional interface to
Various Analyzers
Critical
HIS/9.11 Reports List of reports need to be available and at the minimum
Individual Test reports, consolidated detail/summary
patient report, stock report, worklist reports, etc.
Critical
HIS/9.12 Reports Ability to compare previous results and perform a delta
check
Important
HIS/10 Billing & Insurance
Hospital Information System Checklist
for Small & Medium Hospitals
Page 21 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/10.1 Integration Billing module needs integration with almost all the
modules within the system starting from Registration and till
Finance, Procurement and Inventory. So the interfaces
need to be robust and well tested.
Critical
HIS/10.2 Integration Integration to orders, registration, appointment, admission
is a must
Critical
HIS/10.3 Integration Integration with AR, AP and GL is important Important
HIS/10.4 General The main worklist should have the ability to filter the list
based on type of patient (IP, OP, A&E, Day-care, External,
etc.), type of Payer (Insurance, Cash, TPA, Corporate,
CGHS, etc.)
Critical
HIS/10.5 General Cash Counter tracking and auditing functionalities
including reports
Critical
HIS/10.6 General The system should able to generate Trial, Instant and Final
invoices in real time.
Critical
HIS/10.7 General The system should have the full-fledged functionalities of
Invoice, Deposits, Refunds, Settlements, and interfaces to
credit and debit notes
Critical
HIS/10.8 General It is desirable to have a patient ledger functionality, where
the billing details of a patient across all his/her visits are
stored
Desirable
HIS/10.9 Reports Reports are critical and at the minimum should consist of
Patient Invoice, Patient Settlement, Deposit, Refund,
Counter wise - Shift wise collection report, Day wise
summary/detail report, etc.
Critical
HIS/10.10 Reports Dashboards are a desired functionality Desirable
HIS/10.11 Insurance The ability to define different types of payers is critical Critical
HIS/10.12 Insurance The system should handle pre-authorizations, claim
preparation, claim submission and reconciliation
functionalities.
Critical
Hospital Information System Checklist
for Small & Medium Hospitals
Page 22 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/10.13 Insurance The system should be able to handle different charges for
the same order (test/service/consumable/etc.) different
payers through configuration and also manage printing of
payer specific terminology(Codes and descriptions)
Critical
HIS/10.14 Packages The ability to define fixed and variable packages based
on configurable billing rules is critical
Critical
HIS/10.15 Rules It is important that the billing rules are configurable and
desirable that system has an inbuilt rules engine.
Important
HIS/10.16 General System should support collection of advance
payments/deposits either at a patient level which can be
later utilized across visits or at a specific visit level for
adjustment during closure of visit
Important
HIS/10.17 General System should support definition of alternative
Nomenclature of services and products based on payer
guidelines in order to generate payer invoice based on
such specific nomenclature or grouping.
Important
HIS/10.18 General System should be able to allow customization of invoice
formats based on payer preferences
Desirable
HIS/10.19 General System should be flexible to define various levels of
taxation and other applicable surcharges based on
regulatory guidelines in the region
Important
HIS/10.21 General System must support charging for one or more surgical
procedures performed within the surgical care setting with
flexible rules to determine charge dynamics based on
primary procedure, surgeon preferences and packages
assigned
Important
HIS/10.22 Billing (RCM) Multi-Dimensional Tariff structure Desirable
HIS/10.23 Billing Support for Multiple versions of tariff Desirable
HIS/10.24 Billing Facility to create multiple Tariffs Desirable
HIS/10.25 Billing Support for Hospital / Company (CGHS, Arogyashree, ESI)
nomenclatures for services
Critical
Hospital Information System Checklist
for Small & Medium Hospitals
Page 23 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/10.26 Billing Flexible settlement options (Credit, Cash, Cards, and
Coupons etc.)
Critical
HIS/10.27 Billing Interface / Integration with Swipe card machines Critical
HIS/10.28 Billing Facility to accept deposits against Patient ID (MR No) and
subsequently apply the same to all types of bills
Critical
HIS/10.29 Billing Support Tariff conversions for OP, IP, Day Care and
Emergency Billing
Critical
HIS/10.30 Billing Support for Bills in Process (BIP) for inter-unit Transfers Critical
HIS/10.31 Billing Alerts for Pending bills Critical
HIS/10.32 Billing Alerts / reminders for deposit collection Critical
HIS/10.33 Billing Support for comprehensive discount/Concessions process
with ability to authorize partial or full write off in case of
non-payments
Critical
HIS/10.34 Billing &
Collection
Advance Collection (Patient Specific or Multi-patient)with
ability to allocate advances to a specific visit or utilize the
advance across multiple visits.
Important
HIS/10.35 Settlement of Deposits Critical
HIS/10.36 Billing based on Corporate or PSU (Price and Naming) Important
HIS/10.37 Bill Submission and Receivable Tracking Important
HIS/10.38 Aging of Receivables Important
HIS/10.39 Localization of Tax's (VAT, Services etc.) Critical
HIS/10.40 Refunds from Advances Critical
HIS/10.41 Refunds against Billed Items (with Approval workflows) Critical
HIS/10.42 Visitor Pass (Interfaced with Billing) Important
HIS/10.43 Clearance for Surgery/Procedure, Discharge Important
HIS/10.44 TPA/Insurance Workflow Important
HIS/10.45 Insurance Authorization Amount Interface with Billing Important
HIS/10.46 Date wise Billing to Patient Important
HIS/10.47 Contracts Inclusion and Exclusion of Service Items based on Payer
(Quantity and Amount Based)
Critical
Hospital Information System Checklist
for Small & Medium Hospitals
Page 24 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/10.48 Contracts Price Master Important
HIS/10.49 Contracts Billing override tracking Important
HIS/10.50 Contracts Billing of combined and dependent Items (Surgery, Re-Do,
OT, Anaesthesia charges)
Important
HIS/10.51 Doctors
Payout
Service based definition of Fee Structure Important
HIS/10.52 Doctors
Payout
Recording of Services rendered from
Billing/Ordering/Payment Realization
Important
HIS/10.53 General Automated and Manual Discounting based on Business
Rules with feature to define discounts for a period,
discounts with user based limits etc.
Essential
HIS/10.54 OT Billing Billing Enquiry for OT Cases (Surgery Clearance) Important
HIS/10.55 Patient
Billing
Package subscription with support for managing a single
package across multiple visits/encounters
Critical
HIS/10.56 Patient
Billing
Billing Estimates and Counselling Forms Important
HIS/10.57 Payor Billing Credit Billing for PSU and Insurance customers Important
HIS/10.58 Payor Billing Receivables Management (Aging and Collection) Important
HIS/10.59 Payor Billing EDI Gateway Desirable
HIS/10.60 Payor Billing Eligibility Inquiry and Response Important
HIS/10.61 Payor Billing Claim Status Inquiry and Response Important
HIS/10.62 Payor Billing Request from Provider and Response from Health Plan or
Administrator
Important
HIS/10.63 Payor Billing Claims Management / Adjudication Important
HIS/10.64 Package
Billing
Flexibility to define mode of revenue recognition on
package invoices and also support for managing consults
within package where doctor is assigned dynamically at a
later stage once all results are available for consultation in
case of OPD packages
Important
HIS/10.65 Package
Services
Ability to track incomplete package services and prompt
for such services to be completed in a forthcoming visit
Desirable
Hospital Information System Checklist
for Small & Medium Hospitals
Page 25 of 29
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/10.66 Ad-hoc
Billing
Ability to allow miscellaneous billing (in case some masters
are yet to be configured and billing needs to be done
immediately) with restriction in terms of access rights
Desirable
HIS/11 Reporting Services
HIS/11.1 General System must have capability to generate various statistical
and analytical reports based on key performance
indicators of the organization
Critical
HIS/11.2 General System must allow representation of report related
information in multiple formats including a combination of
tabular and graphical outputs with ability to drill down
from summary based reports
Important
HIS/11.3 General System should allow personalization of dashboards that
consolidate specific set of reports based on user
preference
Desirable
HIS/11.4 General Multi-format reports like tabular, graphical etc. from
RDBMS, XML Based Data Source
Critical
HIS/11.5 General Use for Scheduling Report Processing or accessing Reports
on Demand
Critical
HIS/11.6 General Use for publishing various Reports Important
HIS/11.7 General Reports can be exported to various formats HTML,PDF,XML,
E-Mail etc.
Important
HIS/11.8 General Add interactive features by providing links to sub reports
and drill through reports
Important
HIS/11.9 General Ability to customise and personalize individual user
dashboards and configure alerts/reminders upon
dashboards being populated with relevant information
that requires immediate attention
Desirable
Hospital Information System Checklist
for Small & Medium Hospitals
Page 26 of 29
TECHNICAL REQUIREMENTS
S. No. Module Sub Module/
Function Requirement Importance Weightage
Vendor
Remarks
HIS/Tech
/1
User Interface
HIS/Tech/
1.1
Client The system should be web based and should be browser
agnostic i.e. it must be able to run on most popular
browsers such as Microsoft Internet Explorer, Apple Safari,
Mozilla Firefox and Google Chrome browsers
Critical
HIS/Tech/
1.2
Client Must support multi lingual interfaces Important
HIS/Tech/
1.3
Client Should be able to run in multi windows Desirable
HIS/Tech/
1.4
Client The system should have the capability where the end users
can define keyboard shortcuts in real-time.
Important
HIS/Tech/
1.5
Client able to suspend use after a present period of inactivity Critical
HIS/Tech/
1.6
Client Usage of icons is strongly recommended Critical
HIS/Tech/
1.7
General Ability to reach the desired functionality in less than 4 clicks
is strongly recommended from login completion step.
Important
HIS/Tech/
1.8
General Ability to achieve single sign on in case of multi-solution
environment
Desirable
HIS/Tech/
1.9
General Password management to prompt users to manage their
password changes on periodical basis based on password
policy
Desirable
HIS/Tech
/2
Architecture
HIS/Tech/
2.1
General The system should have the ability to be hosted on a
private/public cloud infrastructure
Critical
HIS/Tech/ General The system should have been designed to be modular and Critical
Hospital Information System Checklist
for Small & Medium Hospitals
Page 27 of 29
2.2 scalable
HIS/Tech/
2.3
General It is preferable that the system was designed to handle
multi tenancy and multi-location requirements.
Important
HIS/Tech/
2.4
General It is desirable that the system has inbuilt workflow and rules
engines
Important
HIS/Tech/
2.5
General Ability to run on clustered environments to provide high
availability
Important
HIS/Tech
/3
Database
HIS/Tech/
3.1
General It is preferable that the system uses industry standards like
ANSI SQL
Important
HIS/Tech/
3.2
General It is preferable that system provides a full-fledged data
dictionary.
Important
HIS/Tech/
3.3
General Referential integrity must be enforced Critical
HIS/Tech/
3.4
General Central master tables should be used by multiple modules Critical
HIS/Tech/
3.5
General Please mention the database backup features and how
they are used by the system natively.
Critical
HIS/Tech/
3.6
General All activity in the system, be it related to patient
registration, EMR, CPOE, stock management, etc. should
be auditable.
Critical
HIS/Tech/
3.7
General System must allow configuration to control which activities
must log audit data so at to optimise the overhead and
disk storage space used. This should be feasible using end
user interface without having to programmatically extract
such data each time.
Important
HIS/Tech
/4
Integration & Interfaces
HIS/Tech/
4.1
Integration It is desirable that the system has an inbuilt integration
engine
Desirable
HIS/Tech/
4.2
Integration It is critical that the system has the ability to communicate
with other Healthcare Informatics systems via HL7 V2.x
Critical
Hospital Information System Checklist
for Small & Medium Hospitals
Page 28 of 29
messages
HIS/Tech/
4.3
Integration It is Desirable that the system has the ability to
communicate with other Healthcare Informatics systems
via HL7 V3 messages
Critical
HIS/Tech/
4.4
Integration It is desirable that the system has pre-built interfaces with
SAP, Oracle and/or Tally
Desirable
HIS/Tech/
4.5
Integration It is important that the system has the ability to
communicate with lab equipment (Uni/Bi Directional
interfaces)
Important
HIS/Tech/
4.6
Integration It is desirable that the system has the ability to
communicate with Patient Monitoring devices, Infusion
pumps and/or other medical devices
Desirable
HIS/Tech/
4.7
Integration System must have capability to adhere to national
guidelines and standards that are in use to contribute
towards interoperability of EMR/EHR data as well as
standard related to patient safety and quality (e.g. NABH,
NABL)
Important
HIS/Tech/
4.8
Integration System must have capability to integrate with third party
systems to enable adoption of digital signatures, speech to
text conversion, drug database decision support,
electronic claim management etc. and facilitate
compliance to standards that warrant error free
transactions.
Desirable
HIS/Tech
/5
Deployment
HIS/Tech/
5.1
General It is critical that the system can be deployed on a
private/public cloud environment
Critical
HIS/Tech/
5.2
General It is desirable that the system can work as a SaaS model Desirable
HIS/Tech/
5.3
General It is critical that the system has at least 99.9% uptime. Critical
Hospital Information System Checklist
for Small & Medium Hospitals
Page 29 of 29
COMPLEMENTING SERVICES
S. No. Functional
Service
Sub Module/
Function Remarks Importance
HIS/Comp/1
HIS/Comp/1.1 Training HIS Modules Vendor should extend effective training sessions on all the HIS
modules supplied. Training personals must be from healthcare
domain background with relevant implementation
experience
Critical – For a
complete /
successful
implementation
HIS/Comp/1.2 Post
Implementation
Support/
Maintenance
Constant Client
Interfacing
24/7, well defined / structured service levels to be extended
by the vendor for post implementation maintenance. The
levels of support should be determined keeping 99.99% of
uptime of the application without disturbing hospital
operations. Extensive / elaborated support models to be
offered with defined team members coming from healthcare
implementation / support experience
Critical
HIS/Comp/1.3 Data Migration
Services
Masters/
Demographics
Vendor should extend the minimum master / demographic
data migration required to use the new application.
Important
HIS/Comp/1.4 Mater Data
Mgmt.
Starter Data Sets Vendor should extend support in providing pre-populated
master data / starter data sets based on a combination of
industry standard code sets as well as best practices of other
institutes where information on master data structures can be
exposed to other clients. This will result in reducing turnaround
time on system configuration
Desirable
-- END OF DOCUMENT --