Computerization of Hospitals

Introduction. Hospitals are the key institutions in providing relief against sickness and disease. They have become an integral part of the comprehensive health services in India, both curative and preventive. Significant progress has been made in improving their efficiency and operations. Effectiveness of a health institution - hospitals or nursing homes, depends on its goals and objectives, its strategic location, soundness of its operations, and efficiency of its management systems. The administrator's effectiveness depends upon the efficiency with which he is able to achieve the goals and objectives. Some of the major factors determining the effectiveness of a health institution includes patient care management and patient satisfaction. Hospitals are very expensive to build and to operate. Administrators and professionals have to be extremely cost conscious. Effective computerized systems and procedures need to be implemented to ensure proper utilization of limited resources toward quality health care. Hospital Information System A Hospital Information System (HIS) can be defined as a computerized system that is designed to meet all the information needs within a hospital. This includes diverse data types such as patient information, billing, finance and accounting, staffing and scheduling, pharmacy ordering, prescription handling, supplies, inventory, maintenance and orders management, diagnostic reports related to laboratory, radiology and patient monitoring and decision support. The massive and critical role of hospitals and data can be managed by using computers as a tool. Various software companies are catering to the needs of the hospitals and are offering comprehensive software which covers all aspects of computerization. Most of the companies have customized software and some of the companies are offering tailor made packages as per the need and budget of the hospital. A hospital information system (HIS), variously also called clinical information system (CIS) is a comprehensive, integrated information system designed to manage the administrative, financial

and clinical aspects of a hospital. This encompasses paper-based information processing as well as data processing machines. As an area of medical informatics the aim of an HIS is to achieve the best possible support of patient care and administration by electronic data processing. It can be composed of one or a few software components with specialty-specific extensions as well as of a large variety of sub-systems in medical specialties (e.g. Laboratory Information System, Radiology Information System). Advantages of electronic medical records over paper records An Electronic Health Record includes any of an individual's health documents of the types listed above. Medical records may be on a physical media such as film (X-rays), paper (notes), or photographs, often of different sizes and shapes. Physical storage of documents is problematic, as not all document types fit in the same size folders or storage spaces. In the current global medical environment, patients are shopping for their procedures. Many international patients travel to US cities with academic research centers for specialty treatment or to participate in Clinical Trials. Coordinating these appointments via paper records is a time-consuming procedure and may violate the patient's HIPAA privacy. Ideal characteristics of an electronic health record (EHR)

Information should be able to be continuously updated. The data from an electronic health records system should be able to be used anonymously for statistical reporting for purposes of quality improvement, outcome reporting, resource management, and public health communicable disease surveillance.

The ability to exchange records between different electronic health records systems ("interoperability") would facilitate the co-ordination of healthcare delivery in nonaffiliated healthcare facilities.

HIPAA The Health Insurance Portability and Accountability Act (HIPAA) was passed in the US in 1996 to establish rules for access, authentications, storage and auditing, and transmittal of electronic medical records. This standard made restrictions for electronic records more stringent than those for paper records. However, there are concerns as to the adequacy of implementation of these standards. An electronic medical record might include:
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

Patient demographics. Medical history, examination and progress reports of health and illnesses. Medicine and allergy lists, and immunization status. Laboratory test results. Radiology images (X-rays, CT Scans, MRIs, etc.) Photographs, from endoscopies or laparoscopy or clinical photographs. Medication information, including side-effects and interactions. Evidence-based recommendations for specific medical conditions. A record of appointments and other reminders. Billing records. Eligibility Advanced directives, living wills, and health powers of attorney.

Modules Available in HIS

Availability of Modules
6 Decision support System ( MIS) Doctor accounting 2 Financial accounting Clinical support management Operation Theatre ICU management IP Billing Casualty ( Emergency ) Registration 0 0 0 20 0 0 6 0 0 3 2 7 4 3 4 6 5 8 34 32 34 35 38 36 40 40 37 38 33 36 37 40 40 34 40 40 40 60

No Yes

Suggested model for the Computerization of Hospitals

Conclusions Based on Study and Observations It can thus be seen that deploying IT can help the medical profession in improving its quality of service and thus automatically increasing the preparedness and defensiveness. Of course, it is of vital importance that the software must have the right type of modularity and openness so that it is manageable, maintainable and upgradable. The hardware should also be reliable, available and

have the necessary performance capacity. Certainly, computers with their intrinsic power can play a major role in a hospital. Computers can act as a communication link between departments and allows the common database to be shared by them. They can perform the complex task of matching, tabulating, calculating, retrieving, printing and securing the data as required. Well designed, integrated computer system can be a great tool in the hands of the hospital management in improving services, controlling cost, and ensuring optimal utilization of facilities

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