Hospital Management Information System

Hospital Management Information System

1. INTRODUCTION

2. BENEFITS

3. INFRASTRUCTURE

4. BLOCK DIAGRAM

5. FUNCTIONAL REQUIREME REQUIREMENTS NTS

6. PROJECT MANAGEMENT

7.  ASSUMPTION

INTRODUCTION

LCS - Hospital Management Information System, which addresses the entire major functional areas of modern multi-specialty hospital. Package enables better patient care, patient safety, efficiency and reduced costs. It provides easy access to critical information there by enabling the management to take better decisions on time.

LCS - Hospital Management Information System is developed on the latest relational database system technology ORACLE 8.x and Visual Basic 6.0. LCS - Hospital Information Management System provides the benefits of streamlining of operations, enhanced administration and control, improved response, cost control and improved profitability.

LCS - Hospital Management Information System can be easily customized to the requirements of any hospital.

BENEFITS

1.

LCS - Hospital Management Information System helps in maintaining a totally secured database of Patients and business information. This information can be available at your  fingertips.

2.

LCS - Hospital Management Information System helps in improved healthcare delivery by providing medical personnel with better data access, faster data retrieval, higher quality data and more versatility in data display.

3.

LCS - Hospital Management Information System helps in improving efficiency, both on the cost and the clinical care perspective. This is achieved by avoiding duplications, repetitions, delays, missing records and confusions.

4.

LCS - Hospital Management Information System helps to force orderliness and standardization of the patient records and procedures in the clinic and increasing accuracy & completeness of medical records of Patient.

5.

LCS - Hospital Management Information System helps as a good managerial tool to provide total, cost-effective access to complete and more accurate patient care data to offer  improved performance and enhanced functions.

6.

LCS - Hospital Management Information System helps in gathering information to meet management challenges.

7.

LCS - Hospital Management Information System helps to educate patients about their diseases of surgical procedures through pictures and animations.

INFRASTRUCTURE System Details

 Architecture

Two Tier Architecture (Client Server Setup) Hardware

Software

Block Diagram

Server

Client

Intel Server Class High End Server

Thick Client with PII or higher, 20+ HDD, 128 MB RAM

Development

Production

VB 6.0

Windows NT Server Windows NT Client/9x Oracle 8.x Server, Oracle 8.x clients

Module Data Flow Diagram

FUNCTIONAL REQUIREMENTS MODULES PATIENT This module facilitates of capturing Patients related data at different entry points, enables queries at different workstation and generates reports at required frequency. The following details are part of this module: Functions

Patient Registration

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.

OPD, IPD and Investigation Cases Ward Allocation Patient Admission Patient Shifting Deposits and Advances  Automatic Charge Calculation Estimate and Final Billing Operation Theatre Scheduling Receipts and Refunds Discounts and Concession Doctor Register  Patient Discharge Patient Inquiries Comprehensive Search Engine for Patient Search and Analysis

Patient Registration

This function of Hospital Management Information System deals with registering the new Patient either for OPD or IPD and giving unique Identification Number to the Patient. This number is unique through out the System for identifying the patient.

The patient can be registered either at IPD Front Office or at OPD Reception. The OPD or IPD identification number is also created for each separate visit of the patient. This is also a part of  registering patient. IPD/OPD ID is used for tracking of medical records of the patient for that particular OPD visit or IPD admission. All the medical record of the patient are identified by combination of numbers i.e. Patient ID and OPD/IPD ID. The numbers gives flexible search in terms of finding patient's History Record.

OPD / IPD Investigation Cases

This Module of Hospital Management System deals with all kinds of Investigations suggested by Doctors. The function enables the entry of Investigations /Procedures for a particular patient. The entered investigations are rooted through the Billing/Cash office and once the patient pays for the Investigations the entries of the same goes to respective Diagnostics Center. This flow is not compulsory of IPD patients since the Billing for IPD patients is done at the time of Discharge. Investigation requisition is created and printed with function and the same is available at respective diagnostics center for preparation of Reports.

IPD ADMISSION AND WARD ALLOCATION

This function Patient IPD Admission gives facility to process patient admission and allocate Bed to patient. System identifies the patient as new IPD patient or internal referred from hospital OPD/CMO. This function gives information on vacant beds in a Hospital. Occupancy status on that particular position can be find out while allocating the Bed. The main function Patient Admission facilitates admitting the patient according to requirement, considering the type of admission and the patient condition. The admission of the patient can be direct / Referred from a consultant / Hospital. The category of the patient can be Company, Self, Government Schemes, Insurance, MLC depending on that the admission procedure is completed. Once the patient is admitted in the Hospital the Room charge starts from the time of Admission. The case paper of the patient is printed from the system and is send to the respective Nursing Station. Once the Admission of the patient is completed the IPD Identification Number is created by the system for that particular Admission of Patient. The IPD Admit Card is also printed along with the Case Paper. The system informs with Audio Visual alert to the respective Nursing Station about admission of the patient under them and to prepare Room for patient. In case of MLC, system stores the details of the Police Station, Name of the official informed about Medical Legal Case.

PATIENT SHIFTING

This function of Hospital Management System facilitates to Shift patient from one Room to other inside the Hospital.

With this facility patient¶s actual position can be updated on line so that the internal functions such as Billing, Investigations, Surgery are planned. The position of the patient is very important since all the charges like Surgery. Procedures, Investigations are related to Room Category. DEPOSITS, ADVANCES, REFUNDS, DISCOUNTS AND CONCESSIONS

This function of Hospital Management System facilitates all kind of financial transactions from the patient. Function plays vital role in payment recovery from patients time to time during the stay.

The Advances from the patient depends on the Type of Admission and the Patient category is prompted by the System. The Interim Bill vs. Advances ratio is also maintained to carry out recovery planning.

 Advances and the deposits accepted by the Billing/Cash counter are directly posted into Accounts.

Refund cases are considered for excess Advances from the Patient. The Accounts Official authorizes this transaction and then refund is processed. In case of Company category patient the ration analysis between Interim Bill and the Authority letter amount by the company is compared for further action.

If patient is to be given Discounts then the authorized person authorizes the Amount and the discount is processed. The discount categories are flexible and can be changed by the administrator. This facilitates easy way to keep track on the discounts and concession. Reports

Following are the main reports / outputs y

Patient List ± Admitted / This report gives information on admitted/discharged patients during certain time period. This facilitates management to know the Admission vs. Discharges ratio.

y

Bed occupancy This report gives information on Bed Occupancy at any given time room category wise.

Reports.

y

Ward This report gives allocated rooms report for tracking of patient.

Reports.

Allocation

Discharged.

y

y

y

y

Interim Bill v/s This report gives the ration of Interim Bill vs. Advances paid by the patient with the percentage of payment.

Advance

Report.

  Admission /  Admission and Discharge register is maintained by the system. This report gives details of patient Admission and discharges during specific period.

Discharge

Consultant wise This report gives Doctor wise patients at any point of time to know referring or In-charge doctor.

patients

  The appointments for consultants are maintained on the system.

y

Performed operation list.

y

Patient follow-up report.

y

Prescriptions Discharge Card

Register

Appointment

DIAGNOSTIC CENTRES

This

module

enables

to

get

patient¶s

investigation,

procedure

record

from

different

locations

i.e.

IPD,

OPD,

Casualty.

The module covers Laboratory System for Pathology, Radiology, Cardiology, Neurology, and Chest Medicine. The prescriptions given by the Doctors are routed through billing system to respective DiagnosticCenters. Functions

Following areas are covered under this Module: Pathology

Laboratory module starts with receiving the online request from doctors. Laboratory personnel can also generate requests. This facilitates investigations for referral patients. Tests are grouped under various sections and sample type (specimen). Based on the request the user can input the sample and generate the sample number. Results can be inputted based on the sample type. Results can be inputted either to one test or multiple tests. If the test result requires approval, the supervisor has to approve the result. Test results are available to concerned doctors. Test report can be made confidential. Tests can be performed only after the billing is done. This rule is exempted when the case is declared as Urgent.

y y

Integration of tests Ordered from Clinical Modules Comprehensive On-line Laboratory Reports

y

Fast Entry of Results

y

Enables Doctors to see the Results On-Line from any Location at any time

y

Up-to-date status about request

y

Provision for templates of Input of test Results

Radiology

Radiology module caters to services such as X-ray, Scanning, Ultra sound etc. Scheduling of Radiology resources is possible. The system stores all the result details of various tests and makes a Report based on the Test Results. These Tests are carried out both for Inpatient and Outpatient. The system stores all the details (like patient number, Test Report like X-Ray, Scanning details) and for each scan the system generates a unique number for the image.

Investigations can be done only after the billing is done. This rule is exempted when the case is declared as Urgent. y

CT Direct Easy Reporting facility

y

MRI Easy reporting

y

X-Rays Direct Capturing of X-Ray images

Sonology

y

Sonography Reporting

y

Capturing of Images

Cardiology

Capturing

of

CT

Scanned

Scanning images.

y

ECG Notes

Neurology

y

EMG Reporting

OPRATION THEATRE SCHEDULING

Operation booking

Theatre booking facilitates the booking of a theatre for surgeries on OPD/IPD patients. The system enables theatre scheduling effectively to manage consultant¶s schedule and availability of all equipments necessary for the surgery.

time depending on his/her OPD

Manage waiting list & generate intimation to patients.

The intimation note is printed before a day from the system for every surgery planned to confirm both the Patient¶s and Surgeons knowledge about the surgery.

Operation theatre transfer: in/out

OT Scheduling

The OT Scheduling enables the OT time slots scheduling for specific surgeries.

Pre-operative check.

Pre operative notes are essential part of Surgery and are stored into the System once the per-operative anesthesia assessment is done. The system gives facility to

write Surgeon. Detail on

Pre-Anesthesia, Anesthesia type, Investigations required, Risk Assessment, Pre-operative instructions are maintained on the system. System also gives facility to store Detail regarding conduct of Anesthesia.

Recording Operation details

Facility to store details of operation notes during surgery like Vital signs, BP, Pulse, IV Fluids, R.R., Drugs are also maintained on the system this information is surgery is over. The entry of complications events is specifically added as Special notes on Surgery.

available any the time after the

Recording item issue details

Items used during surgery are recorded by the System as consumption against the patient. The chargeable items are then charged into Billing and other is stored as

information.

Recording nursing order for postoperative care

Postoperative details such as Investigations, Recovery conditions,Problems, Pain Management are recorded into the system.

Reports

y

OT booking list

y

Circular for Operations

y

List of patients operated(IPD/OPD)

y

List of operations done

y

Item issue register etc.

EQUIPMENTS OPERATION AND MAINTAINANCE

This module maintains the list of Surgical / General equipments used in Hospital. It will take care of over all accounting with respect to Spare

parts, utilization, maintenance. It will also take care of depreciation andreason code wise idle hours

Following are the broad features

y

Complaint recording (for department or ward)

Complaints from the department are recorded into the system and the idle hours during the problem are used to calculate Usage of the equipment. This is directly calculation.

y

linked with the depreciation

·Job Card Creation

Job cards for each individual equipment is maintained on the system for identification and tracking

y

Work allocation and monitoring

Monitoring of the equipment for its performance depending on used hours. Allocation planning for certain equipment is done on the system for specific surgeries or confusions in transferring of equipment from one location to another location.

y

procedures. This eliminates

Identification and Scheduling of High priority Complaints

Some equipments in Hospital are life saving and complaints data of those equipment is kept on high priority. The scheduling of such equipments is available in this module. The complaints logged on because of problem are given high priority and are always shown on the system for user to carry out further action on the problem. The details on the problem analysis are also stored into the system for future reference and down time calculation.

y

Issue and Consumption of Spares

Issue and return transactions of Spares are maintained on the system from location to location. Spares required for certain equipments are maintained as a accessory item with the Capital item. When the capital item is moved to any location of the Hospital the other accessory items with that equipment are also moved automatically with it. This facilitates accurate stock at any location. The main store maintains the stock of the accessory items and spare parts.

y

Monitoring of third party maintenance contracts for equipment.

The third party maintenance contracts are also maintained along with item stock. The period of maintenance with the number of fixed visits and other details on maintained on the system.

y

maintenance contract are

Maintaining Vendor information

Vendor information such as the preliminary data, Account details, PAN/TAN numbers, and supplied items are maintained on the system.

y

BLOOD BANK

This module is developed keeping in view the legal and other requirements of operating the Blood Banks. It deals in detail with blood

transfusion centers and the component laboratories and works as is online interactive system. It also generates legal as well as internal

operation records.

Functions

Donors data entry

Details of Donors such as Name, Address, Contact Numbers, Blood group are maintained in the system through Donors data entry.

The details can be printed as and when required. The mailing list from the available data of donors can be printed for Correspondence.

Investigation Data Entry

Various tests details are stored in the system for as per rules of Blood Bank.

Maintains data of tests

Tests data details required for Blood Bank records are stored into the system with specific results on HIV, HB details.

Facilitates component level administration of the blood units

Keeps track of distribution / disposal of the whole blood and the components

Signals expiry dates and components characteristics

System Signals the expiry dates of components. Such report can be printed for reference from the system to manage the shortcomings.

Reports

Blood Stock Register 

Donor register as per FDA requirements

Investigation Report

Blood Issue Register 

Demographic data of Donors

y

FINANCIAL ACCOUNTING

Online link with the Accounting activity helps the management to control the activities of the Hospital completely and meaningfully. To facilitate the Hospital Management decisions, the prompt back up from the accounting department gives sound foundation for success of the mission

Function

y

Captures the Front office transaction like billing data, collections etc. automatically

The Front office transaction includes IPD/OPD Billing Cash / Cheque / Credit Card Receipts. The effect of the transaction carried out at Front office is routed through authorized person into  Accounts. Daily Cash collection reports are available to Accounts person with cash details depending on Profit Centers. The Front office staff gets report reflecting Receipt Numbers and the total receipts from specific given time slot.

y

Provides for on line booking of Cash transactions and bank transactions at multiple points.

Multiple point transaction levels are maintained on system to facilitate to get on line effect of all transaction to Accounts.

y

Facilitate status of accounts receivables from the patients, employees, companies or Government departments enjoying credit facility for their employee¶s medical treatments.

The reports on receivables are available with Accounts as well as with the Billing Office. This enables the PRO of the Hospital to plan the recoveries from outside patients.

y

Details availability bill-wise, period-wise or doctor ±wise in case of private patients or voucher wise in respect of other transactions.

y

Provision in the account payable module regarding full details of the party¶s bills, kind of services goods provided payment terms etc.

y

Focus on the cash out flows with the emphasis on the control that the cash floes should not occur sooner than necessary

y

General Ledger with all necessary details with self supporting reference avoiding waste of time in referring to the details

y

Trial Balance

Reports

y

General Ledgers

y

 Accounts payable

y

 Accounts Receivable

y

Cash Register 

y

Bank Register 

y

Cash Flow

y

Statutory Reports / Data

y

Balance Sheet

y

Income / expenditure statement activity ± wise

y

Doctor wise Professional Charges

y

IPD / OPD wise Professional Charges

y

STORES

This module facilitates accounting of General Purchases, Stock Items, Tenders and Generation of Stores related transactions such as Receipts, Issues, Different Order levels, Spare Parts. This will also facilitate for replenishment of Stock.

Functions

y

Vouchers generation for Issue, Receipts, Returns and Adjustments

y

Inventory Control and Stores Accounting

y

Vendor History / Appraisal

y

Preparation of Purchase Orders

y

Inquiries for Stock Level / Vendor / Items

y

Inquiries for Quantity available / ordered / to be ordered

y

Inventory ABC Analysis

y

Trend Analysis for Purchase price / Consumption

y

Conversion of Units for Receipts, Issue and Consumption

y

 Automatic weighted average stores pricing of stocks and issues

y

 Automatic reminder system for placing orders and follow ups

y

Billing from Vendors

y

Item Listing

y

Item Issue and Return List

y

Receipt Registers

y

Issue and Return Summaries

y

Purchase Orders Listing

y

Purchase Orders

y

Inquiry Reports

y

MIS Reports

y

Slow, Fast Moving Items

y

Location wise Stock statement

y

Daily GRN Register 

y

Purchase per Vendor During the Year 

y

Tender Preparation

y

Lowest Selected Tenders with Approved Rates

y

Lowest Selected Tenders Item wise, Vendor wise

y

Purchase Register 

y

Issue of items during the Patients Stay

y

COSTING

Reports

Reports

Hospital activity has philanthropic mission to render services to alleviate human suffering on priority basis. Service to the humanity, utmost efforts to save the precious life remains guiding principle.

Still the cost reports provide the management important tools to ensure this mission on long-term basis.

In the normal course, the cost is a relevant factor to ensure the efficient management. At a point of time, management would like to know the cost of the services and utilities provided to ensure timely control to avoid disastrous situation. It may provide the clue and guidelines for revisions or restructuring. A proper analysis of the costs on regular basis then becomes unavoidable.

Functions

y

Classification of Cost Centers

y

Deciding the tests, services ad the technical details for allocating material, technical labor and rational method for allocating other overheads.

y

Reporting method for extraordinary cost.

y

Wherever feasible, fix standards of cost to keep regular watch on the actual

y

Method of analysis of the contribution of the various activities to ensure long term survival kit for the Hospital

y

Department wise Income / Expenditure Statement

y

Service / Test wise cost report

y

Per bed cost

y

Comparisons of general services cost like Electricity, Water, waste disposal etc.

y

PAYROLL AND ADMINISTRATION

Reports

The Payroll & Personnel module deals with Pay (and deduction) calculation, printing of salary slip, salary certificates, and PF statements, Gratuity Statement and provides a monthly analysis. It

deals with the maintenance of employee Attendance / Overtime details. It also reports on absenteeism, leave encasements etc. The Personnel & Payroll department is responsible Employee Related Activities like appointing the staff, maintaining the employee database, Fixing allowances and deductions, Leave entitlements, Leave sanctions, Loan, Termination Process, Maintenance of Hospital documents, Insurance details, Tenancy Contracts and Vehicle Registration etc.

Function

y

Creation of Master Data

y

PF Calculation

y

Loans and Advances

y

Employee Time Sheet

y

Employee Work Allocation

y

Pay Calculations

y

Performance based incentives planned

y

Employee Listing

y

Loans and Advances

y

Listing and Summaries

y

Pay Slips

y

Employee IT Reports

y

Incentive Summary

y

SYSTEM SECURITY

Reports

The Security and Administration module deals with controlling the access to the information available in the application. It deals with the user level security to the different modules/functions. User  defined error messages and help messages are also maintained and customized in this module.

The User Manager module basically deals with security through controlling the access to the information available in the application. Any user associated with a user group can access only those screens for which the user group has rights. It also deals with the System Related Activity like User Monitor, Creating User Group Master, User Master and view the User Group Lookup of  employee database, Maintenance of company documents, User defined error message, Generating Daily Statistical Summary

Function

y

Group Creation

y

User Creation

y

 Assigning User writes

y

User Authentication

y

System Log

Reports

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1. 2. 3. 4. 5. 6. 7.

INTRODUCTION BENEFITS INFRASTRUCTURE BLOCK DIAGRAM FUNCTIONAL REQUIREMENTS PROJECT MANAGEMENT  ASSUMPTION

PROJECT MANAGEMENT Project Execution

Success of the Project always depends upon efficient and effective Project Management approach. Professional Project Management approach is ensured while executing the project.

Following steps are involved in Project Execution:

1. 2. 3. 4. 5. 6. 7. 8.

Planning and Scheduling the Project Defining Milestones and tasks. Estimating task wise time required Tracking task wise actual time v/s estimated. Ensuring instant corrective action in case of Project Schedule overrun. Information sharing with Client about the progress of the Project / Issues and concerns by way of Status Report at a certain frequency. Ensuring mock process audits by Senior staff members at every milestone Stage wise reviews and corrective action.

Following Software Development Life Cycle stages will be followed:

1. 2. 3. 4. 5.

Requirement gathering and opting final sign off by the client. Designing application and preparing Design document with WBS. Functional specification / test case creation. Code Construction. Unit testing and Integration testing.

Quality aspect

In order to ensure ultimate product quality, the concepts like Configuration Management, Work product reviews, Route cause analysis of defects identified, defect prevention activity etc., are inducted in to Project Management. Risk

Management

approach

Probable Risks are well identified; Mitigation and Contingency plans are in place. The risks identified are as below

Risk

Responsibility Contingency / mitigation Plan

  Absence of expected response by the Client for our queries / sign offs on documents / various approvals / Client Testing and acceptance.

Follow up and get the response up to pre-defined time period

Resource availability with vendor because of attrition.

Vendor

Ensure and document proper job handover process between resources

Natural Disaster

Both

Mutual action

Testing Methodology

Program level testing and system level testing will be carried out using test cases. Test cases will be created taking in to account functionality, user behavior, and various boundary conditions.

There will be no of iterations for converting bugs in to success. There will also be Test Data Preparation based on live scenario.

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 ASSUMPTIONS 1. 2.

Infrastructure requirements, actual efforts, Schedule will be finalized only after Requirement Study. The scope an Hospital Management Information System in this document is worked out considering general functionality in Hospitality Domain.

3. 4. 5.

Detailed requirement document will be prepared after on site study and will be signed off by the Client in a specified period. The changes on the signed off requirement document would be treated as Change Request and modifications would be carried out at extra billable efforts. Performance issue is subject to availability of recommended Infrastructure at Clients end.