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Q.1. Explain various modules in HIS.


 Answer:
The following is a list of various hospital management and information modules and their respective functions and salient features.

Central Registration Module
  • Registration of cases: New, accident and emergency, and new-borndirect/referred by telephone;
  • Demographic data, sponsor information, billing information (insurance company, organization, etc.) and several other statistical codes;
  • Issues a unique registration number to each patient, eliminating the opening of a duplicate file;
  • Admission/discharge/transfer/observation/disposed of the cases depending upon the requirement and existing culture of the hospital, some systems have a separate module for admission, discharge and transfer of the patients;
  • Entering patient profiles into database for subsequent queries;
  • Reservation for indoor patients;
  • Admission from multiple sources;
  • Patients awaiting discharge;
  • Discharge summary in standard format including clinical findings, investigations, treatment given and prescription at the time of discharge;
  • Advance payment deposit-if there is such an existing system in the hospital;
  • Re-admission after discharge if needed;
  • Daily bed availability;
  • Online bed allocation and choice of ward/different qualities of rooms;
  • Transfer to other beds/wards/cabins/ICU/hospitals;
  • List of reservation, admission, discharge and transfer of patients;
  • Census by patient name, religion, and physician, etc. in different formats and combinations; and
  • Department and professional master list;
  • Birth and death records;
  • New born information-from pre-natal to post-natal stages, personal and medical details of parents and other siblings, new registration number but related to mother's number;

  • Daily, monthly, annual, maternity, death, disease and discharge reports;
  • Admission and death analysis reports of adults, newborns, and by age groups;
  • Certification;
  • Online inquiry of patients by locating patient information from its database by name, surname, religion, date of birth, city, state, country and combination of several other fields;
  • Web-based enquiry facility;
  • Linked with OPD, IPD, and billing modules;
  • Monthly statistical reports of births, deaths, admissions, discharges, etc. and
  • Printing of patient ID cards, bar codes label and registration form.
Advanced countries are striving to have a patients' database on their national computer network. Doctors can browse the record of the incoming patients through the network on the basis of the cards issued to them.

OPD/Consultant Clinic/Polyclinic Module
This is applicable for different specialties, sub-specialties, and super specialties like internal medicine, general surgery, obstetrics and gynecology, ophthalmology, otolaryngology, pediatrics, orthopedic, dermatology, dentistry, gastroenterology, cardiology, nephrology, plastic surgery, physiotherapy etc. and includes:
  • Facility to set up an unlimited number of clinics;
  • Clinic and doctor schedule including doctor's non-availability;
  • Doctor's diary;
  • Entering of disease code based on WHO standards (ICDS codes) or hospital's own codes;
  • Patient's clinical data, drug administration, vaccination, family history, past history, personal history, allergies, baseline parameters, blood transfusions, etc.;
  • Prescription of drugs and advice for pathology laboratory, radiological investigations and other procedures;
  • Outpatients' appointment, pre-registration, registration and discharge;
  • Reporting on outpatient schedule;
  • Name inquiry for outpatients;
  • Linked with central registration module, pharmacy, laboratory, radiology, billing and medical procedure modules, etc.;
  • Issue invoice and accept payments in local and/or foreign currency at OPD and/or centralized cash counter; and • Billing on the day of visit or posted to patient's account.

Indoor Patient Module
  • Facility to create unlimited general and specialty wards' databases like neo-natal, VIP, A&E, ICU medical, ICU surgery, ICU pediatric, post-operative, maternity, medical, surgery, orthopedic, eye & ENT, etc.;
  • Patient's personal details;
  • Clinical history and examination;
  • Investigations report;
  • Provisional/final diagnosis;
  • Monitoring progress in status-daily investigations, medication, vital parameters, intake/output charts, and other required observations as per the specialty and doctors' instructions;
  • Profile details of surgery, blood transfusion, serious diseases, vaccination, allergy, baseline parameters;
  • Options to reserve clinics and operation theatre; II Visiting doctors' notes;
  • Dietary requirement;
  • Certification; and
  • Scheduling of nursing duties.

Patient Care Module
  • Enter, cancel/renew patient's orders;
  • Enter results of the investigations ordered;
  • Inquire about patient's orders and results;
  • Diet for the patient;
  • Details of the procedure performed on the patient;
  • Lists of the radiology and laboratory work;
  • Schedule and list of the physiotherapy and procedures advised;
  • Lists of the requisition, reason code and synonym cross-reference;
  • On-line Investigation schedule like ECG, EEG, and TMT etc.; and
  • Referral to other centers for special investigation.

Transfer Module
  • Ability to transfer patients between beds, wards and nursing stations
  • Transfer of consulting physicians to a patient
  • Discharges
  • Discharge of patients and discharge summary edition

Nursing Inpatient Care
  • Accessing all the patients at a particular nursing station
  • Recording and monitoring patient progress
  • Graphical representation of temperature, pulse and respiration (TPR) charts
  • Drug administration and recording
  • Viewing and processing doctor's orders for Viewing archived reports
  • Intake and output recording
  • Bed transfer
  • Nursing sub-store management

Critical Care Module
  • Accessing all the patients at a particular critical/intensive care unit
  • Viewing and processing doctor's orders
  • Drug administration and recording
  • Intake and output recording
  • Bed transfer
  • Unit sub-store management

Laboratory Module
o Request handling of a patient and computer-generated sticker printing;
o Worksheet printing of various sections like biochemistry, histology, clinical and hematology, etc.;
o Linked with auto-analyzer for data transfer eliminating data entry and increasing data accuracy and timeliness;
o Linked with admission and billing modules; II Integration with medical instrumentation;
o On-line inquiry facility;
o Graphical reports; and
o Statistical analysis of data.

Operation Theatre Module
  • Schedule, re-schedule or cancel the surgery;
  • Maintain the current schedule of all the OTs within the hospital;
  • Reserving OT for surgeon/for holidays/for repair and maintenance;
  • Search on patient name, operation procedure, attending surgeon, anesthetist, to know the details like bed/ward/room number, admission date;
  • Available time for surgery for a particular date for an OT
  • Scheduling OT facilities;
  • Scheduling of surgeons, anesthetists, nurses, paramedical and other technical personnel;
  • Type of surgery: major or minor;
  • Pre-anesthetic checkup;
  • Complications;
  • Notes: clinical, operative and anesthesia;
  • Options to enter actual resources, material and time used for surgery;
  • Names of the surgeons, anesthetists, and nursing staff involved in the surgery;
  • Equipment/maintenance;
  • Inventory; and
  • Safe disposal of wastes.

Medical Stores Module
  • Issue of medicines driven by expiry of items;
  • Batch details inquiry facility;
  • Auto-purchase requisition generation;
  • Improved vendor control supported by VED/ABC analysis; II Vendor rating facility;
  • Online stock inquiry facility;
  • Linked with billing, pharmacy and radiology, etc.; and
  • Statistical analysis of movement, consumption and indent data.

Pharmacy Module
  • Patient orders for regular drugs, compound drugs, IV, etc.;
  • Change or delete pharmacy orders;
  • Display/print drug preparation index, label, and pharmacy orders for patient;
  • Confirm the administration of drugs;
  • Facilities to record special handling requirements: Dispensing of special penicillin, aseptic dispensing, intravenous additives and emergency cupboards;
  • Adjust order schedule;
  • Display inventory of drugs and refill inventory of drugs at various stock locations like nursing stations, clinics and pharmacy and take home drugs;
  • Transfer inventory of drugs from one stock location to another; III Maintain generic record of drugs: Record controlled drugs and narcotic drugs identifiers;
  • Drug formulation codes and pharmaceutical codes can be attached to drugs for classification;
  • Daily stock accounting of medicines at sub-store and counters;
  • Control medicine overdoses;
  • Drug to drug interaction facility;
  • Auto indenting facility;
  • On-line stock inquiry facility;
  • Linked with medical store, and other modules so that prescriptions for consultant clinics, wards, and operation theatre are automatically transferred to pharmacy; II Statistical analysis available doctor-wise/ drug-wise; and

  • Reports of price list, dispensing profile, order renewal list, medication activity, inventory adjustments, pharmacy inventory status, medication summary of patients, and medication schedule of patients.

Inventory Module
  • Control, maintain, and analyze multi-location (location store, substores, pharmacies, wards, etc.), and multi-warehouse stocks and its movement;
  • Undertake the LIFO/FIFO costing;
  • Tracks expiring stocks;
  • Control lot number and narcotic drugs identifier; and
  • Support pharmacological codes and seasonal drugs.

Radiology Module
  • Support for services provided for x-ray, ultrasound, CT scan, mammography and MRI;
  • Auto-scheduling function for appointment of patients;
  • Registration of patient and result;
  • Link with admission, billing and medical stores modules, etc.;
  • Accounting of radiology consumable for proper accountability;
  • Online test result entry and retrieval;
  • Graphical reports on film utilization, wastage, etc.; and
  • Statistical analysis of data doctor-wise/unit-wise/type of x-ray film wise utilization wastage.

Medical Records Index Module
o Online storage and retrieval of patient records; Maintaining skeleton patient record;
o Maintaining demographic, personal and previous stay information;
o Search for a patient by name, medical history number and national health register number;
o Information retrieval of all the patients as per the search criteria with required fields like patients' name, last admission date, medical history number and national health register number; and
o Any amount of additional patient information of the selected case can be retrieved as per the requirement.

Administration Module
  • Management information system, training details;
  • Equipment maintenance and work project;
  • Budget, billing, costing and reimbursements;
  • Reporting of activities;
  • Human resources and personnel-extensive reports on all activities pertaining to an employee, and considering local labour laws while calculating employee benefits;

  • Consultants and special references; Public grievances and feedback; and Geographical information system (GIS).

Personnel Registration Module
  • Register the entry, location and exit of the medical, para-medical and non-medical staff;
  • Inform professionals of their outstanding messages;
  • Details of checked-in staff members; and
  • Entry and display of messages like call, contact and or wanted by the person or at particular location.

Employee Information Module
  • Maintain database of the all the categories of employees;
  • Enter/update the record of any employee;
  • List of different types of employees like medical, para-medical, administrative, financial, and technical personnel;
  • Department-wise list of various professionals; and
  • Monthly report of hospital manpower of various departments required by the hospital.

Financial Modules
  • Financial modules include commercial and financial transactions like purchasing, importing, inventory management, payroll and personnel, general ledger accounts (receivable and payable):
  • User-defined multiple transaction types and letter of credit details;
  • Purchase order, goods receipt and level suppliers discounts;
  • Controls purchase limits and maintains purchase budgets;
  • Tracks actual lead time, suppliers' performance for reliability, post sale services, and timely deliveries;
  • Integrated import costing: tracks local/foreign currency costs, calculates landed cost and other costing factors;
  • Provides options for cost multiple orders in one consignment;
  • Offers hospital-department-wise profitability;
  • Debtors ledger, creditors ledger and nominal ledger supporting multicurrency accounting; and
  • Several financial statements and management information reports.

Account Billing Module
  • Instant bill calculation for paying cases;
  • Consultation, medicine, laboratory, radiology, physiotherapy, special investigations, bed charges, operations, special procedures and other facilities and service charges available on-line for billing;
  • On-line money receipt/money refund;
  • Recovery facility in case of employees and associated contractor companies or government employees;
  • Cash/credit-single/split, interim, final and on-demand bills;
  • Discounts, refunds, and cancellations can be entered by authorized officials only; II Facilities to accept advance deposits and track available balance;
  • Options to bill sponsors, organizations, insurance companies;
  • Back-dated transactions;
  • Linked with admissions, laboratory, radiology and medical store module, etc.;
  • Monthly statistical reports; and
·         Debtor’s ledger/bad debt account report.

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