pawan patidar his assign

8/7/2019 Pawan Patidar HIS Assign

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DAVV, Indore.

Assignment

On

Hospital Information Systems

Submitted by: - Submitted by: -Mr. Piyush Kendurkar Pawan Patidar

Faculty IMS, DAVV Indore. BBA (HA) Vth

Sem

Roll No. 33731


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Contents

1.Introduction2. Concept of HIS3.Advantages of HIS4.Development And Future of HIS5. Types of HIS6.How HIS is organized7.Patient Documentation Systems8. Working with HIS9. Tools of HIS Development10.HIS development phases11.Examples of HIS


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Introduction

Hospital information systems are among the most important and mostcomplex information systems in health care. A hospital without clinicaldocumentation is scarcely conceivable. This is why you will never find ahospital information system without elements of clinical documentation.The electronic patient record is of growing importance for any Computer-supported hospital information system.

Concept of HISWhat is a hospital information system?

A Hospital Information System as a subsystem of the hospital thatprocesses and stores information. Much of the information stored andprocessed is an element of medical documentation that becomes, in turn,an integrated component of the hospital information system. Even ifcomputer systems and networks (the hardware) and the applicationsystems installed on them (the software) are of particular importance, thereis more at stake than that: the processing of data, information, and medicalknowledge in the hospital as a whole.

A hospital information system is supposed to provide:-

- Information of all kinds, especially about patients;- Medical knowledge, especially about diseases, but also about

health care interventions, e.g., the desired and undesired effects of drugsand the interactions between them.


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Advantages of HIS

Why all the fuss about Hospital Information Systems? What's so great

about them? A 1992 survey of executive nurses (Simpson 1992) listed

these benefits:

Increased time nurses spend with patients

Access to information

Improved quality of documentation

Improved quality of patient care

Increased nursing productivity

Improved communications

Reduced errors of omission

Reduced medication errors

Reduced hospital costs

Increased nurse job satisfaction


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Compliance with regulations of the Joint Commission on

Accreditation of Health Care Organizations (JCAHO)

Development of a common clinical database

Improved patient's perception of care

Enhanced ability to track patient's record

Enhanced ability to recruit and retain staff

Improved hospital image


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Development And Future Of HISEarly hospital computer systems developed from business computing

systems in the late 1950s and early 1960s, and were used for accounting,

billing, inventory and similar business-related functions.

Others were developed during the 1960s primarily for storing patient

information to be used by medical staff.

These types of systems have been slow to integrate. Surveys (Dorenfest1987, 1992) of hospitals since 1980 have shown that less than half of

community hospitals have full Hospital Information Systems, mainly

because few were available to integrate all the functions needed. Research

and teaching hospitals presumably have a much higher usage of Hospital

Information Systems.

The future is not certain. Several factors are at work:

Computer hardware is getting more affordable

Computer software is not getting any less expensive

Budgets for Hospital Information Systems are generally not

expanding


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Medical caregivers are under pressure to handle more patients on an

outpatient basis, reducing hospital census and generally reducing

hospital budgets

Standards for storing and exchanging patient information have not

been agreed on

An overall plan for national health care - which could have a big

impact on Hospital Information Systems - has been a political football,

leading to uncertainty in planning.


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Types of HIS

Hospital Information Systems come in many flavors, depending on whether

they are based on...

Centralized or decentralized plans

Software that was originally business-oriented or patient-oriented

Terminals or workstations

Centralized vs. Decentralized

This distinction is based on whether information is kept primarily in a

central computer, or is distributed over a number of workstations or servers

located around the hospital.

There are variations on this; for example, a system may be partially

centralized but integrated with powerful and somewhat independent

satellite systems. Examples:

Some systems may centralized certain functions like billing and accounting

in an administrative facility serving several affiliated hospitals, while other

functions like patient record-keeping are carried out at the individual

hospitals or medical units.

Other systems may centralize their patient record-keeping and have

smooth exchange of information with a specialized clinical laboratory

computer system which is mainly independent of the primary HIS.


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The trend in most types of computer work is toward decentralization, but

this trend is somewhat slower in hospitals because of the high risks

associated with failure in hospitals and the consequent reluctance tochange systems that are working now.

Still, workstation-oriented systems offer a number of advantages over

terminal-oriented ones:

Greater flexibility: information can be either centralized or

decentralized.

Workstations are much more independent: they can function to somedegree even when a central system is "down".

Since they are used by only one person at once, workstations don't

slow down when lots of people are using the system (except when

they are requesting information from a central database).

Workstations let people do many kinds of work, including word

processing and general calculation, which are not practical on

terminal-based systems.


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How HIS is Organized

Here are diagrams of some of the possible configurations discussed above.

Symbols used in these diagrams:

Fully centralized system:


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y Centralized with access to a parallel system in clinical lab andradiology:

Workstation oriented with centralized patient records:


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Fully distributed with workstations:


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Patient Documentation Systems

From the perspective of the medical caregiver, Hospital InformationSystems are tools for storing and retrieving patient information. What

information is kept in these systems?

y Basic patient information (name, address ...)

y Diagnostic information

y Physicians' orders

y Medication data

y Vital signs, intake/output, and physiological measurements

y Diet information

y Event reports

y Nursing notes

y Billable procedures; supplies consumed

y Care plans

y Discharge plans

y Case management information


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Working with His

What are the most important things a Hospital Information System does?

1. Order entry

2. Integrate care plans with charting functions

3. Prepared patient care plans

4. Track medication administration

5. Discharge planning

6. Determine patient acuity level (severity of patient's condition)

7. Provide flexibility to customize the system for your hospital

8. Report generator capability

9. Prepare nursing assessments

10. Patient education

11. Quality assurance

12. Access to information in many departments of the hospital

13. Admission interview

14. Patient acuity list

15. Cost tracking and reporting

16. Electronic mail to other departments

17. Graphical display of patient data

18. Automated medical record

19. Bedside capability (but only 29% said they had this)

20. Case management of critical pathways


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HIS development phases

Systems Development Life Cycle (SDLC) adheres to important phases that

are essential for developers, such as planning, analysis, design, and

implementation, and are explained in the section below. There are several

Systems Development Life Cycle Models in existence. The oldest model,

that was originally regarded as "the Systems Development Life Cycle" is

the waterfall model: a sequence of stages in which the output of each stage

becomes the input for the next. These stages generally follow the samebasic steps but many different waterfall methodologies give the steps

different names and the number of steps seems to vary between 4 and 7.

There is no definitively correct Systems Development Life Cycle model, but

the steps can be characterized and divided in several steps.

The SDLC can be divided into ten phases during which defined IT work

products are created or modified. The tenth phase occurs when the system

is disposed of and the task performed is either eliminated or transferred to

other systems. The tasks and work products for each phase are describedin subsequent chapters. Not every project will require that the phases be

sequentially executed. However, the phases are interdependent.

Depending upon the size and complexity of the project, phases may be

combined or may overlap.

Initiation/planning

To generate a high-level view of the intended project and determine the

goals of the project. The feasibility study is sometimes used to present the

project to upper management in an attempt to gain funding. Projects are

typically evaluated in three areas of feasibility: economical, operational, and


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technical. Furthermore, it is also used as a reference to keep the project on

track and to evaluate the progress of the MIS team. The MIS is also a

complement of those phases. This phase is also called the analysis phase.

Requirements gathering and analysis

The goal of systems analysis is to determine where the problem is in an

attempt to fix the system. This step involves breaking down the system in

different pieces and drawing diagrams to analyze the situation. Analyze

project goals, break down functions that need to be created, and attempt toengage users so that definite requirements can be defined. Requirement

Gathering sometimes require individual/team from client as well as service

provider side to get a detailed and accurate requirements.

Design

In systems design functions and operations are described in detail,

including screen layouts, business rules, process diagrams and other

documentation. The output of this stage will describe the new system as a

collection of modules or subsystems.

The design stage takes as its initial input the requirements identified in the

approved requirements document. For each requirement, a set of one or

more design elements will be produced as a result of interviews,

workshops, and/or prototype efforts. Design elements describe the desired

software features in detail, and generally include functional hierarchy

diagrams, screen layout diagrams, tables of business rules, business

process diagrams, pseudo code, and a complete entity-relationship


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diagram with a full data dictionary. These design elements are intended to

describe the software in sufficient detail that skilled programmers may

develop the software with minimal additional input.

Build or coding

Modular and subsystem programming code will be accomplished during

this stage. Unit testing and module testing are done in this stage by the

developers. This stage is intermingled with the next in that individual

modules will need testing before integration to the main project. Code will

be test in every section.

Testing

The code is tested at various levels in software testing. Unit, system and

user acceptance testing are often performed. This is a grey area as many

different opinions exist as to what the stages of testing are and how much if

any iteration occurs. Iteration is not generally part of the waterfall model,

but usually some occurs at this stage.

Types of testing:

Data set testing.

Unit testing

System testing

Integration testing

Black box testing

White box testing

Module testing


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Regression testing

Automation testing

User acceptance testing

Performance testing

Operations and maintenance

The deployment of the system includes changes and enhancements before

the decommissioning or sunset of the system. Maintaining the system is animportant aspect of SDLC. As key personnel change positions in the

organization, new changes will be implemented, which will require system

updates.


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TOOLS OF HIS Development


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EXAMPLES OF HIS

1. Health Care Software, Inc. (HCS), founded in 1969, is dedicated to

providing superior application software solutions designed exclusively

for the healthcare industry. HCS's product, INTERACTANT, is a fully

integrated clinical and financial management system for long-term

care, skilled nursing, sub acute, rehabilitation, behavioral and human

service organizations, and outpatient healthcare providers.

Information is entered once, edited on-line for accuracy and availableacross the facility, disciplines, or corporation in a real-time

environment, eliminating duplication of effort by your staff.

2. Claricode provides medical software development for healthcare

providers, medical device manufacturers, and medical software

companies. Claricode works exclusively on medical software

development. Medical software is a very complex area with its ownset of terminology, laws, and data integration standards. By focusing

on medical software development, Claricode believes that it is able to

provide more effective solutions their clients in less time than would

otherwise be possible.

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