Hospital management and administration are very complex processes. This is because of the sheer amount of data to be processed and analyzed in order to come to a conclusion. This results in misallocation of resources such as time and money. Hence, in order to save on these resources, a system is required, which integrates all the data, and simplifies it, so as to take decisions in an easy, simple and cost effective process.
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HMIS is the solution which simplifies hospital management. It enables automation of complex tasks, which enables the staff to spend more time on patients and other related services. Another issue regarding MIS is that it should be designed to work on any software platform, and should be compatible with hospitals of any size. The HMIS should be flexible enough to incorporate the unique priorities of any hospital, it should be intuitive, so that learning the system is an easy job, and should be comprehensive enough. These facilities when incorporated into a comprehensive MIS system will help achieve goals of reduction in costs and improvement in efficiency which will ultimately help in increasing profits.
OBJECTIVE OF THE STUDY
The purpose of this study is to find out how MIS has helped in the decision making process and how effective it has been and what can be the future scope of improvement.
PROBLEM DEFINITION
The initial setup cost and the running costs of hospitals are very high. Hence, the scope of inefficiency in the processes is very low. Running a hospital will not be affordable then. Apart from that, there are many complex processes involved in hospital management, and analyzing them at the same time, is a very lengthy and time consuming process. This result in increased costs combined with low levels of satisfaction among the patients.
INTRODUCTION
Hospitals provide relief against sickness and disease. They play an important role in both curative and preventive, health services in India. With help of continuous progress, their efficiency and operations have improved significantly. The effectiveness of a hospital depends on the service provided to the patients, patient care management and patient satisfaction.
HMIS is used for simplifying hospital management by providing access to the right information at the right (required) time and by automating complex tasks. It helps in sparing staff’s time which can be spent to care more for patients and increasing the reach of services to all patients. A MIS for a hospital is supposed to be very precise and should reduce operational cost, cause improvement in processes and allow efficient management. HMIS can be used by small, medium or large hospitals.
The main purpose of using HMIS is for the automation of the hospital.
It maintains two levels of users:
Administrator Level – doctor
User Level – data entry operator
The HMIS can be used for:
Maintaining patient details
The patient details can be electronically stored and maintained. This will facilitate in efficient information flow within the hospital. The information can be easily updated and maintained. The patient’s record can be searched by a user or an administrator with the help of patient’s name or their registration date.
Providing Prescription, Precautions and Diet advice
Information regarding patient’s health history will facilitate doctors in generating prescriptions, precautions and diet advice to patients easily.
Providing and maintaining all kinds of tests for a patient
It has the ability to store large amount of information regarding health history of patients.
Billing and Report generation
All the details regarding the expenses for a particular service can be retrieved for billing as and when necessary. It helps in maintaining backup data as per requirements of the user.
A wide range of hospital management and administration processes are covered by the HMIS. HMIS is an integrated client server application and runs on almost all standard hardware platforms. To suit the requirements, it can be customized easily. It also reflects the priorities of a hospital management team. The HMIS provides enhanced administration and control, improved profitability, cost control, improved response to patient care and the benefits of streamlined operations. Requirements and priorities of every hospital are unique. Hence, to allow easy customization, flexibility has been built into the HMIS. The features of HMIS are scalability and flexibility, drill-down capabilities, customization and interactive graphics that simplify complex data.
The HMIS solution is designed as a three-tier application and is built on the model-view-controller architecture. The view tier includes the interfaces to all external actors on the system. This includes the graphical user interfaces to the application, interfaces to external software applications and interface to equipment as well as APIs.
DOMAIN KNOWLEDGE
Hospital Management is a direct link between the various healthcare facilities and those supplying the services required by them. To facilitate well functioning of hospitals HMIS systems are used
The HMIS modules are designed according to three categories – core modules, supporting modules and enterprise-enabling modules. These modules can be customized according to hospital needs
As mentioned above regarding the core modules and the supporting modules, the below gives a gist of the standard modules and the operational modules used by a hospital
Standard Modules
Reception Management
This module is used for completing different types of reception enquiries.
Patient Registration
This module is used to deal with the registration details of the patient which is the first activity in the hospital.
Out Patient Management
This module is used to manage all records and history of patients.
Billing Management
It is used to manage the billing procedure for all services provided.
Indoor Patient Management
It is used to manage a list of all the services from various departments to the patient.
Optional Modules
Hospital Store
It is used to maintain stock and inventory of stores.
Pharmacy
It is used to maintain medicines and other consumables.
Financial Accounting
It provides financial accounting along with billing.
Payroll
It is used to maintain and update employees records and is also used to calculate salary.
Online Diagnostic Reporting
This module is used for diagnostic maintenance and reporting on the website of the hospital.
TPA Management
Keep track of all patients from a particular penal their authorization amount and payment status.
Imaging Recording & Management
All Diagnostic Reporting made available on Hospital Website
Description
The functions of Hospital Management System are:
Storing and maintenance of details and registration of patients
Information regarding consultations
Effective management of Pharmaceuticals
Effective management of billing details and payment information
User interface conforming to usability guidelines
Maintenance of a database containing records of all consultations
Generation of management reports
Following are the qualities required in a good HMIS:
Systematic approach: The data should be stored securely in databases which will help in retrieving the information.
Accuracy: The system should have a high level of accuracy. It should ensure that the information retrieved from the system is accurate.
Reliability: The reliability of the proposed system should be high.
No Redundancy: In the system utmost care should be that no information is repeated anywhere. This would ensure that there is consistency in the storage of data.
Retrieval of information: The system should allow quick and efficient retrieval of information. Any type of information should be available whenever the user requires the same.
Efficient storage: The system should be able to store large amount of information.
Easy to Operate: The system should be user friendly and it should be easy to operate. It should also be developed within a short period of time and fit in the limited budget of the user.
HMIS provides various benefits such as:
It enables the hospitals to serve the patients in an effective manner.
The quality of patient care is highly improved
Increased productivity
It reduces the time spent on manually maintaining forms, This enables the hospital to focus on more critical tasks
It helps in providing better quality of services to patients.
It helps in controlling the costs incurred in diagnosis-related groups.
The problems faced while using an HMIS are:
A very expensive process for a small scale hospital
Training is required to personnel using it
Regular maintenance is called for
Technical failures can affect functioning of entire hospital
Hardware requirements
Hardware Requirements
Processor
RAM
Disk Space
Pentium II, Pentium III,
Pentium IV or higher
64 Mb or Higher
130 Mb
Software requirements
Operating System
Database
Win-98, Win-XP, Linux or any other
higher version
Ms Access
Use of HMIS at Tata Main Hospital
Tata Main Hospital (also known as TMH) at Jamshedpur caters services to the employees of Tata Steel and their families. TMH is an 835 bedded hospital equipped with modern facilities and all specialties catered. Computerization at TMH started in 1985 but in a limited way, when standalone systems were used to take care of routine local area needs Medicare areas were not computerized.
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An Information System Planning (ISP) study was conducted, realizing a need for an integrated patient management system. Since 1996, an integrated information system has been implemented in the areas of Pathology, Radiology, Medical Research, Medical Stores & Pharmacy, Inpatient Admissions & Billing. Information sharing on-line has helped make extension of the existing system to ICU and to possible wards, whereby test results can be made available on-line enabling prompt remedial action by doctors. Effective procedures and systems have helped TMH administration to achieve and fulfill their quality objective.
Process Flow
The entire HMIS software is presented in front of the user on a computer screen. Here, the screen contains information like facilities, OPD schedule, health checkups, investigation rates, hospital holidays, etc. It also contains different reports like the lab reports of the patient, the patient information, his admission and medicare details and the surveillance report. The comprehensive software also contains details like circulars issued to the staff, references and a list of ongoing events in the hospital.
When a new patient enters the hospital, all the relevant data disclosed by the patient and other data obtained through check-ups, will directly be fed into the system. This data can be viewed for future references. The data includes the personal details of the patient and details like where he is admitted and what medication is currently on.
Many reports have different sub-groups like clinical lab reports, bio-chemistry reports, pathology reports and blood bank reports. When the user wants to access any report, he has to just enter the patient no. and select whether he wants all the previous reports or only the last report. On selecting the option, the report is generated to be given to the patient.
Similarly, the user may require to just access some information. So, say for example, he requires some information about the top management and their schedules, he can simply select that particular option from the software and retrieve all the information available. This helps the user decide whether the management/doctor is available for a particular time slot and thus make appropriate decisions.
The circulars section of the report contains information about the hospital orders to the staff and all the new developments in the regulatory process. This section is updated on a real time basis, such that any new information is included into the system as soon as possible. It also contains the information of the daily duties to be performed by a particular staff member. This section is updated on a daily basis.
The references section gives information on drug query or any adverse reaction reports. The user just has to enter the name of the drug, and he will get all information about the drug. The information includes the manufacturer name and the advantages & disadvantages of a particular drug. If any patient has experienced an adverse reaction due to some drugs, the information is inputted into the system so that it won’t be prescribed to him in the future.
Thus, the process starts from when the relevant information about the person is fed into the database, and the reports of the person are generated, and it continues upto circulars and references which can be used to stay updated.
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