Hospitals today have evolved to be a complex, interdependent and multi-disciplinary sector that is built around in order to provided highly and intensive care to community authorities. Almost all hospital or health care centers need a vast amount of information. When a patient admitted to the hospital, the first things physician or nurses need is the information of the patient. Later patient need the result from clinical, laboratory and radiology examination. All of this is the frequent diagnostic procedure in all hospital around the world.
For that purpose, hospital today are recognizing IT as a supportive arm to control all the system require in the hospital to serve patients in an efficient way and to enhance revenue and also to improve operational efficiency.
Computer used is the one that introduced in the hospital in order to:
Increase organizational efficiency
Store, exchange useful, accurate and timely information
Improve medical care to high quality services at reasonable cost.
Improved Management Information System; and reduce clerical error
Administrative workload by automating processes.
From that it was realized to create one system that is health information system specifically for hospital called Hospital Information System or HIS. This system streamline the essential function in the hospital by computerizing the process of retrieved patient information, collating and collecting data .In order to understanding of an HIS system ,two main word need to be master first that is ‘data’ and ‘information’.
A series of observation or measurement or fact.
A set of element working interactively to process input data
A set of elements working interactively to gather input data and later to disseminate output information.
What is Hospital Information System (HIS)?
Hospital Information System is a set of component and procedures organized to generating information, manage administrative in order to improve health care management decision at all level of health system. hospital information system
The goal of this system is to use computer and communication equipment to collect, store, process and administrative information for all hospital activities to satisfy the functional requirement of all authorized users.
The main purpose of Hospital Information System is to use a technology network of computers to collect process and retrieve patient care and administrative information from various departments for all hospital activities to satisfy the functional requirement of the users.
As a decision support system for the hospital authorities for developing comprehensive health care policies in health care sector.
Comprises an electronic patient record which forms the core of the system and links it to all other department in the hospital.
Centralize the information, so no duplication occurs.
Hospital authorities can access the case sheets, order tests and later prescribe medication. Doctors can maintain notes and surgery record in the operation theatre and laboratory.
In the early starting of HIS, it is consists with the large central computers connected to the terminals ,in the progressing of technology, the latest HIS is replaced by networked microcomputers to manage all the hospital medical care information.
HIS can utilize the power used of computer in medical care that provided a network of integrated computer in record and services to a patient in the hospital from one department such as laboratory ,blood bank, nursing, radiology, clinical ,inpatient ward, outpatient and so on to other department.
The software created for each department or process is called a module.
This module used to automate all the individual department, when all these module put together it will from HIS.
In general, there are two or more component consists in this Hospital Information System that are:
Clinical Information System (CIS)
Collecting, storing, manipulating and making available clinical information.
This system provides and stores the clinical data such as patient history of illness and health care providers.
Some part of clinical information system are:
Clinical decision Support
Manipulate, apply and display appropriate information to making the correct clinical decision.
Electronic Medical Record (EMRs)
Provide personal information of patient such as name, age, address and all detail for every aspect of care given by the hospital.
Training and research
Available information for physician for training and research.
With some benefits, this system also have their own barriers that prevent them being use in several hospital.
Financial Information System (FIS)
Manage financial or business aspect in hospitals.
Several features of (FIS):
Handles all the recurring and non-recurring payment.
Maintain employee pay ratea,full salary and payroll history
Handles the payment within the hospital and processing of invoice
Concentrate on financial that include inpatient and outpatient charges.
Support all the maintenance of the client record payment and invoices.
Handles the collection, processing and reporting of financial data and status of the hospital at any time require.
Laboratory Information System (LIS)
Manages laboratory information from laboratory such as clinical chemistry, hematology and microbiology.
Provide patient data
System concerning the patient specimen including
Cross-referenced classification codes between Lan orders
Code catalogues and called up when the review
Ensure that the test currently uses that available standard result.
Nursing Information Systems (NIS)
Manage clinical data from patient all health care environment.
Provide patient admission and nursing assessments.
Provided shift modules and staff schedule.
Designed to handle absences, overtime and staffing level.
Clinical Data Integration:
Retrieved all clinical information from all disciplines.
Decision Support :
Provide prompts and reminders and also guides to disease linkage between signs, etiologies factors and patient population.
Access to medical resources via online
Pharmacy Information System (PIS)
Managed the need of pharmacy and monitoring of drug interaction.
Monitoring of drug interactions, drug allergic and other possible medication-related complication.
Inventory Management :
Continuous inventory culture need to ensure that drug donot go out of stock.
Manage prescription for inpatient or outpatient.
Patient Drug Profiles:
Provide patient detail of their current and past medication that is used for clinical screening at anytime.
Picture Archiving Communication System (PACS)
Systems that facilitate the archiving, processing and viewing of digital radiological images and their related information.
Improved digital imaging and computer network technologies in the hospital that included DICOM and HL7 :
Some of the image:
Radiology Information System (RIS)
Store and manipulation and retrieving of radiology information.
Some area in RIS:
Used to manage a patient’s entire workflow within the radiology department, images and reports.
Retrieved all image and report from electronic medical records (EMRs) and viewed by the authorized radiology staff.
Handle appointments for inpatients and outpatients can be scheduled when an order is received.
Provide scheduling from various available radiology staff with the allocated time slots can also be handled by the radiology information system.
Tracked patient from admission to discharge, with all the radiology procedures carried out recorded that include the patient past ,present and future appointment.
Reports the results of an individual patient, a group of patients or a particular procedure can be generated using a radiology information system.
Individual films can be tracked
From This all component it show that it is quite complex to manage of hospital information that comes from various branch of component. Thus the advancement in computer technology in development of information exchange between all components makes all the complex hospital information system a little more easily.
There are several types of HIS system apply in all around the world hospital such as:
Benefits of HIS:
Access to information.
Improved quality of documentation.
Improved quality of patient care.
Reduced medication errors.
Reduced hospital costs.
Development of a common clinical database.
Enhanced ability to track patient’s records
Improved hospital image
Zagazig University Hospitals, Egypt
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ZAGAZIG University Hospitals are one of most important hospitals in Egypt. An ever increasing flow of patient from various part of Egypt cause this hospital had earned good reputation and fame in a short span. Being one of the great hospital in the world, this hospital have been designed a computer system to manage all the hospital medical and administrative information in order to enable health professional perform their jobs effectively and efficiently.
Thus it must have its own Hospital Management System (HIS) which focuses on the integration of all clinical, financial and administrative application. This system also called Integrated Hospital Information Processing System (IHIPS).Through this technology development all around the world ZAGAZIG Hospital staff tried to build their Hospital Information System (HIS) by their all available resources which consist of :
Clinical Information System (CIS)
Financial Information System(FIS)
Laboratory information system (LIS)
Nursing information System (NIS)
Pharmacy Information System (PIS)
Picture Archiving Communication System (PACS)
Radiology Information System (RIS)
One of the strategic used by staff is to purchase an application from a compony.But by using the company application software it make most hospital staff to turn their computer off all day ,these problem is quite bad interface and there are a network problem bugs in this application. From that several of a system solving approach called a “system development life cycle (SDLC)” is used to solve this system problem. In this system development consists of following general purpose problem solving steps:
System development life cycle (SDLC)
There are five subsystem are integrated so that each group have its customer from another group or it is the customer of another group.
Flow between the subsystems
Used to monitor patients health one of it is ECG to get the electrocardiograph of patient.
Which this electrocardiograph of patient will be store in the memory of this device as a text or graph that can be transform from the patient room to the monitoring room using the hospital network.
Another set of sensors which are used to measure other patient’s parameters such as
-Temperature sensors which measure patient’s temperature and room temperature.
– Blood pressure sensor.
Serve some system database in the hospital so that there will integration between all the systems.
Hospital database system in this hospital consists all the general component in the common Hospital Information System.
Employee’s information system (EIS):
Contains information about employees in hospital.
Lab Information System (LIS):
Handles receiving, processing and storing information generated by medical laboratory processes.
Laboratory Information System (LIS):
Include hematology, Biochemistry, immunology, blood bank (Donor and Transfusion Management), surgical pathology, anatomical pathology, flow cytometry and microbiology.
A Radiology Information System (RIS):
Is a database used by radiology departments to store, manipulate and distribute patient radiological data and emergency. The system consists of patient tracking and scheduling, result reporting and image tracking capabilities.
A Clinical Information System (CIS):
Used for collecting, storing, manipulating and making available clinical information important to the healthcare delivery process (E.g. electronic medical records).
Financial Information Systems (FIS):
Manages the business aspect of a hospital “coasts and profits”.
Pharmacy information systems (PIS):
Controls the work in the pharmacy and keep track of orders from different systems.
Nursing information systems (NIS):
Contains clinical data from a variety of healthcare environments which used to aid nurses in improving patient care.
Picture Archiving Communication System (PACS):
Used for archiving, processing and viewing of digital radiological images and their related information.
This system need to interface with instrument and others information system in hospital information System (HIS).The data which is used in all these systems are coming from either the sensors or the SCADA system.
Listing the database of patients. History of reading for a specific patient.
Used to connect between all room in hospital including patient and employee room.
Transports sensors readings to controlling room.
Transports orders from controlling room to any available doctor to examine any required patient.
Transports orders from doctor to the pharmacy via controlling room.
Transports commands from controlling room to the robot to achieve a scheduled order via wireless connection.
Used to make the delivery job or doctor assistant job.
Help doctor for remote examining to the patient.
Used to put the stethoscope to the patient.
Hospital supervised management system (SCADA)
Manage all the previous four subproject and it control overall processes in the hospital using the business process control software called “Statechart”
The main function of statechart is to describe and control the overall operations with respect to the patient from entering the hospital
It also functions to achieving maximum profit by the arrangement of process execution.
SCADA system provides set operation such as:
Help registering information about patient and handles patient query.
Doctor Appointments ;
Provide the appointment time and number from the receptionist and accordingly visit the doctor.
Test Appointments :
Patient undergo the test after receives the appointment time and number from the receptionist.
Module that handling various operation by diagnosing the patients.
checks whether the person is a Doctor/Staff and then handless the activities associated to his work type.
Adding doctor/staff information into the database.
Delete Doctor /Staff:
Delete doctor/staff information into the database.
Edit Doctor /Staff:
Edit doctor/staff information into the database.
Handles activities such as Doctor Diagnoses the patient, gives treatment, gives suggestions to the patients and prescribes laboratory tests and medicines.
Ward Wise Bed Status:
Takes care of medical equipment, doctor visit, vitals recording, patient case sheet and diet ordering and blood requisition.
Helps in generating patient’s discharge summary, which includes patient’s health at the time of discharge, medical history, various diagnosis and drug prescriptions, history of present illness and course
Helps in generating the patient information which is provided by doctor.
A hospital consists of different organization units also know as department which conducts several specified activities. Thus it is becomes more important to all health care centers to conduct an effective communication and network technology by the wide range of software applications. Today there are many various modules or software have been developed to support the hospital information system all around the world hospital.
HIS comes with many distinctive advantages included improving the quality of patient care, Increase productivity, reduced cost and reduced chances of error ,improved communications within the hospital and many other advantages. This system help in providing improved clinical outcomes and better diagnosis care and as a result, the quality of healthcare is dramatically improved through efficiency and cost effectiveness.
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