M9

HOSPITAL INFORMATION SYSTEM

A computerized management system for handling
three categories of tasks in a healthcare
environment

1. Support clinical & medical patient care activities in the hospital
2. Administer the hospital’s daily business transactions (financial, personnel, payroll, bed census, etc)
3. Evaluate hospital performances & costs, project the long-term forecast

three categories of tasks in a healthcare environment;

1. Electronic Medical Record (EMR) and Electronic Health Record (EHR)
2. Practice Management System
3. Master Patient Index (MPI)
4. Patient Portal
5. Clinical Decision Support (CDS)
6. Remote Patient Monitoring (RPM)

TYPES OF HOSPITAL MANAGEMENT SYSTEM

ELECTRONIC MEDICAL RECORD (EMR) & ELECTRONIC HEALTH RECORD (EHR)

 These two terms are almost used interchangeably.
 The "electronic ____ record" replaces the paper version of a
patient’s medical history.
 The "electronic ____ record" includes more health data, test
results, and treatments.
 It also is designed to share data with other electronic health
records so other healthcare providers can access a patient’s
healthcare data.

PRACTICE MANAGEMENT SOFTWARE

 Helps healthcare providers manage daily operations such as scheduling and billing.
 Healthcare providers, from small practices to hospitals, use practice management systems to automate many of the administrative tasks

MASTER PATIENT INDEX (MPI)

 Connects separate patient records across databases.
 The index has a record for each patient that is registered at a healthcare organization and indexes all other records for that patient.
 Used to reduce duplicate patient records and inaccurate patient information that can lead to claim denials.

PATIENT PORTALS

 allow patients to access their personal health data such as appointment information, medications and lab results over an internet connection.
 Some, allow active communication with their physicians, prescription refill requests, and the ability to schedule appointments.

REMOTE PATIENT MONITORING (RPM)

 Telehealth, allows medical sensors to send patient data to healthcare professionals.
 It frequently monitors blood glucose levels and blood pressure for patients with chronic conditions.
 The data is used to detect medical events that require intervention and can possibly become part of a larger population health study.

CLINICAL DECISION SUPPORT (CDS)

 A system that analyze data from various clinical and administrative systems to help healthcare providers make clinical decisions.
 The data can help prepare diagnoses or predict medical events — such as drug interactions.
 These tools filter data and information to help clinicians care for individual patients.

 The healthcare industry constantly produces data.
 Health information systems help gather, compile and analyze health data to help manage population health and
reduce healthcare costs.
 Then the healthcare data analysis can improve patient care.

BENEFITS OF HEALTH INFORMATION SYSTEMS
Data Analytics:

- Patients often need to treatments from different healthcare providers.
- Health information systems —such as health information exchanges (HIEs) —allow healthcare facilities to access common health records.

BENEFITS OF HEALTH INFORMATION SYSTEMS Collaborative Care:

- Using digital networks to exchange healthcare data creates efficiencies and cost savings.
- When regional markets use health information exchanges to share data, healthcare providers see reduced costs.
- On a smaller scale, hospitals aim for the same efficiencies with electronic health records.

BENEFITS OF HEALTH INFORMATION SYSTEMS
Cost Control

- Health information systems can aggregate patient data, analyze it and identify trends in populations.
- The technology also works in reverse.
- Clinical decision support systems can use big data to help diagnose individual patients and treat them.

BENEFITS OF HEALTH INFORMATION SYSTEMS
Population Health Management:

AAROGYA

 A hospital management system that aims to streamline the daily operations of a hospital for maximized performance output.
 This system offers a comprehensive set of tools that enables to manage of all aspects of a hospital — from administrative to clinical, and financial tasks.
 It is best suited for large- or- mid-sized hospitals.

e-HOSPITAL

 A hospital information system developed by one of
the IT product development companies — Adroit Infosystem.
 Best suited for clientele like multi-specialty clinics, healthcare facilities, and medical practitioners.
 Some of its functionalities include electronic sharing of patient records, scheduling facility to book the next appointment, and more
 Doctors can even view lab results and past medical records of the patient online to save time and provide quick treatment.

e-VISIT

 Considered as one of the best hospital information systems
 Aims to improve patient care and satisfaction
 Offers an intuitive and interactive platform, suitable for all
sizes of healthcare centers — from small private medical practice to a large hospital.
 Simplifies the complex operations of running a hospital. Some of its core functionalities are medical charting, data collection, billing, reimbursement management, payment processing, and ePrescription.
 A cloud-based application.

CARESOFT HOSPITAL INFORMATION SYSTEM

 Streamlines the entire workflow of managing a
healthcare center.
 Uses the latest technology to deliver the best in
quality patient care.
 Enables easy integration of data exchange
between different interfaces and users, thus
prevents duplication of data entry.

HOSPITAL INFORMATION SYSTEM

1. myNapier
2. Insta HMS
3. SoftClinic HIS
4. Intelligent Medical Software (IMS)
5. Medstar HIS
6. MMI Mediface
7. ProMed
8. MocDoc HMS
9. MediSteer by Adroit
10. Mediware

Radiology Information System

 A networked software system for managing
medical imagery and associated data.
 Especially useful for tracking radiology
imaging orders and billing information
 Used in conjunction with PACS & VNAs to
manage image archives, record-keeping and
billing.

1. Patient Management
2. Scheduling and Sharing
3. Patient Tracking
4. Result Reporting
5. Image Tracking
6. Billing

BASIC FUNCTIONS OF
RADIOLOGICAL INFORMATION SYSTEM (RIS)

PATIENT MANAGEMENT

 RIS can track a patient’s workflow within the
radiology department.
 It can add images and reports to EHRs where
they can be viewed by authorized radiology
staff.
 It facilitates patient management as processes
like patient registration, scheduling, and Patient
Tracking is digitized.

SCHEDULING AND SHARING

 Radiological Information System (RIS) allows staff to make appointments for patients and other people.
 It enables the distribution of patient data and medical images.
 The interaction between physicians is made easier by allowing access to documents within the computer system

PATIENT TRACKING

 With the RIS system, providers can
easily track patients’ radiology
history from admission to discharge
and coordinate with past and future
appointments.

RESULT REPORTING

 A RIS can generate statistical reports
for a single patient, group of patients or
particular procedures.

IMAGE TRACKING

 Radiology providers use RIS to track the
patient’s associated data.
 Like EHRs have become a standard to use in the
healthcare sector, PACS is widely adopted in the
medical enterprise
 RIS provides a detailed financial report of
automated claims and electronic payments

BILLING

 RIS systems provide detailed financial record-keeping and process electronic payments and automated claims, though these functions are becoming incorporated into medical organizations' overall EHR systems.

Interfacing

The exchange of information between a Radiology
Information System (RIS), Hospital Information System
(HIS) and PACS in order to optimize the utility of PACS for
sharing of information, its retrieval, etc. with the help of a
common platform.

Database-to-Database Transfer and Interface Engine

2 METHODS OF TRANSMITTING DATA BETWEEN INFORMATION SYSTEMS

Database-to-Database Transfer

 Allows 2 or more networked information systems to share a subset of data by storing them in a common local area
 Most often used to share information between the HIS and the RIS

Interface Engine

 Provides a single interface and language to access distributed data in networked heterogeneous information systems

NECESSITY OF INTERFACING

1. Avoidance of mistyped data entry
2. Development of compatible data bases
3. Development of more automated, more
intelligent PACS

BENEFITS OF INTERFACING

1. Prevents repetitive data entry
2. Sharing of Information
3. Reduction in workload

Trigger Mechanism Between Two Databases or Query Protocol

THE RIS-PACS INTERFACE CAN BE IMPLEMENTED
BY EITHER:

Level 1-4

Application Level of the interface software waits for the occurrence of one of these events & triggers the corresponding data to be sent.

Level 5-7

Communication Level transfers the HL7 file to the PACS server

TRIGGER MECHANISM BETWEEN TWO DATABASES

The PACS is notified of the following events in HL7 format when they occur in the RIS: ADT,
order received, patient arrived, examination cancelled, procedure completed, & report approved.

QUERY PROTOCOL

 Allows access to information from the HIS, RIS and PACS databases by using an application-layer software on top of these heterogeneous database systems
 From a PACS Workstation, user can retrieve information uniformly from any of these systems & automatically integrate them to the PACS database

RECONCILIATION PROFILE

 IHE patient information can be used to combine different data: ADT in HIS, RIS in radiology, and DICOM image management archive in PACS
 This integration profile can extend the scheduled workflow profile by providing the means to match images acquired for an unidentified patient’s registration & order history.
 Example: Emergency room patient (trauma)

imaging center

The _____ is a part of the hospital,
thus is the RIS a part of the HIS.

Patient Registry

 New patient data, updating data of existing patients

Examination of the Patient

 Which type of review is requested, who requested radiological examination, the diagnosis, urgency, etc.

Status of Examination and Reports

 Radiological findings, report of a specialist, laboratory findings, etc.

Synchronization of data in HIS and RIS

 (methods of examination, doctors, departments, etc.) and other pieces of information

HEALTH LEVEL 7 STANDARD

 Enables the exchange of medical
information between different
information systems of healthcare
organization units within one hospital
regardless of the written program
language and the platform they are
realized at.
 (Cardiology, Radiology, Laboratory, Eye
Department, Otolaryngology, Surgery,
Etc.)

Level 7

 Data, time of data exchange and
communication are shared at this
level, where errors between certain
applications can be seen.

PACS

 A modern system for image archiving and communication
 It is designed as a computer system for paper and film archiving
 It is based on the web technology
 It deals with medical records and information
 Provides archiving, viewing and distribution of medical images to radiologists, physicians of
other specialties, doctors in other hospitals.
 Communicates with HIS, RIS & DIS, and allows data to be accessed from different locations
within a health facility or outside the health care facility.

PACS

• can be integrated into RIS & HIS or other medical information systems; most used in RIS
• combines the functions of teleradiology services and systems for archiving, searching and reviewing of medical images and patient data
• stores images from various medical devices (modalities): ultrasound (color Doppler, ultrasound, etc.), MRI, CT, mammography, angiographic, digital X-ray machines, PET scanners, nuclear medicine cameras and other devices

Internet Protocol (IP)

 makes sure the pieces arrive at their
destination address

Transmission Control Protocol

 puzzle assembler on the receiving side who
puts the pieces together in the right order