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A PROJECT REPORT
ON
HOSPITAL MANAGEMENT SYSTEMS
SUBMITED
BY
SAIKIRAN.M
ROLLNO: 10-37
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ACKNOWLEDGEMENT
The satisfaction that accompanies that the successful completion of any task would be
incomplete without the mention of people whose ceaseless cooperation made it possible.
Whose constant guidance and encouragement crown all efforts with success.
We are grateful to Ms. Zeba and Ms. Shaista Akbar for the guidance and suggestions that
helpful in the preparation of this project.
I also thank my friends and college faculty who have helped in successful completion of
the project.
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TABLE OF CONTENTS
3
S no Contents Page nos
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
ABSTRACT
INTRODCUTION
HMS BENFITS
WHY COMPUTERS INHEALTH CARE
DOCTORSDILEMMAS
LAN
STATEMENT OF
PROBLEMS ANDOBJECTIVES
METHODOLGY
OBSERVATION AND
DISCUSSION
SUGGESTEDMODULES
4
5-6
7
8
9
10
11
12
13-19
20-37
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ABSTRACT
Hospital management System (HMS) is vital to decision making and plays acrucial role in the success of the organization. Computerization of the various
departments, documentation has resulted in efficient data management and
information dissemination for the users. Managers, Clinicians and other
healthcare workers can now access the information without delay or errors.
Present study reveals, the existing system requires up gradation to meet the
requirements of the managers and the clinicians. Participants feel HMS assists in
decision making, and medical audit. Participants felt that the existing HMS
resulted in longer time for OPD consultation and delay in investigation results.
Majority of the participants feel that HMS helps in education and research.
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HOSPITAL MANAGEMENT SYSTEM (HMS)
A management system in a Hospital would require to very precise and must result into
cost cutting and efficient management. Which should be accurate in its approach and suit
all environments including large, medium or small.
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INTRODUCTION TO HOSPITAL MANAGEMENT
SYSTEM (HMS)
Designed to improve the quality and management of clinical care and hospital health
care management in the areas of clinical process analysis and activity-based costing.
HMS enables you to develop organization and improve its effectiveness and quality of
work. Managing the key processes efficiently is critical to the success of the hospital.
HMS consist process management tool elements: modeling, analysis, and simulation.
Documentation though an important part of a Hospital, is a non-productive exercise for
the intellectual human being, whose ability lies in core areas of excellence. Hence a
systematic approach to the way documents are managed, can transform your Hospital
resources to its highest utility and advantage.
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HMS Benefits:
Enables hospitals and doctors to better serve their patients.
Improved quality of patient care.
Increased nursing productivity reducing the time spent by staff filling out
forms, freeing resources for more critical tasks.
Better quality of care, procedures and service to Patients.
Control over the costs incurred by diagnosis-related groups.
Why computers in health care systems?
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There is hardly any area today, which has not been influenced by computers, and health
care systems are no exception. Health sector, in fact is field where computers could make
maximum social impact. There are human beings today who are half computers and half
human e.g. patients with Pacemaker, Computerized precision made artificial heart,
computerized hearing aid, and computerized dialysis machine. The present day hospitals
are able to understand the complex processes and manage materials, money and
manpower effectively and efficiently only due to computers.
We lag behind by decades, as USA even in 1972, 81% of the hospitals had one or morein-house computers. Today it is a norm in USA to allocate 10% of the hospitals budget
for computerization. I wonder if any hospitals management in India would do so?
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Doctor's Dilemmas
Nothing on this earth is more complex than the human body the processors used in the
most powerful super computers doesnt come close to matching any of the human organs.
Doctors can understand the human body, but are afraid/hesitant in using computers. This
hesitancy/phobia/fear/lack of awareness is the main hurdle in the utilization of computers
in health.
The awareness amongst health professionals has certainly increased over the past few
years but still many continue to shy away from computes - some are hesitant, some are
unsure about their utility and quite a few procure it for a status symbol. Applications in
health
Wide applications of computers in health care include hospital management, patient care,
billing, counseling, appointments, curriculum planning, research, study, communication
etc. Most of the diagnostic instrument e.g. X-rays, CAT scan, Blood gas analyzers,
ultrasound, automatic analyzers are based on computers, and have made the monitoring
of patients and interpretation of diagnostic tests easy. It is not uncommon to see qualified
professionals being utilized in clerical tasks for maintenance of records etc. at the cost of
patient care. Computers could help solve some of the problems like:
1. Relieving physicians from routine documentation and other clerical functions.
2. Cutting down on the paper work; sparing more time for patient care, reducing
errors and increasing accuracy in transmission and storage of data.
3. Establishment of consistent standards and continuous monitoring or transactions
4. Easy and direct access to various information regarding patient through remotely
located terminals.
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Local Area Networking (LAN)
Has made Hospitals Management System easy, fast, accurate and comfortable. The
patient's data, x-rays, sonograms, CT Scans and other investigation reports can be
brought to the terminals in the operations theatres, patients' bed, the consulting room or
the desk of administrators, just at the press of a button.
In the hospitals and medical related organization the computers can be utilized through
LAN for
a. Communication of Medical Information
b. Assistance in diagnosis
c. Assistance in evaluating prognosis
d. Patients Profile
e. Administrative Support
f. Medical research
g. Legal requirements
h. Linkage with other specialized computers
i. Inventory management
j. Cost control, billing
k. Maintaining medical records
l. Patient Counseling
m. Medical Literature Archival
n. Image archival and processing
As 75% of the activity of hospitals is concerned with the processing of information.
Computers can help improve the efficiency of this information processing that too at low
cost.
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Statement of the Problem:
A study on Computerization of Departments of a tertiary care teaching hospital with
special reference to the Hospital Management System.
Objectives:
1. To study the existing Hospital Management System.
2. To identify the shortcomings, if any, in the existing Hospital management System.
3. To suggest the necessary steps to improve the existing Hospital Management System.
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Methodology:
The study was conducted in 1050 bedded tertiary care teaching hospital. The Whole
Departments of the hospital was studied for assessing the Hospital Management System.
Descriptive research approach as adopted for this study. Descriptive statistics have been
used to find out the deficiencies, if any, in the existing Hospital Management System.
The target population consisted of managers, doctors and patients in the hospital. The
data were collected from a sample of 50, consisting of 5 managerial heads, 5doctors and
20 patients,10 administrative staff selected by the disproportionate stratified sampling
technique. The inclusive criteria for selecting the sample, were the managers who
involved in decision making process, doctors with experience of more than one year, andthe computer literate patients, willing to participate in the study.
The tool used to collect the data was a structured, closed ended questionnaire. The
questionnaire was constructed with emphasis on the content, clarity and simple language.
The scoring has been given according to the nature of the questions.
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Observation & Discussion:
It was observed that the complete Hospital management system has been not utilized.
Having so many resources the hospital people are following the same old technique of
manual writing of records.
The staff who are using the computers to do their daily work are not well trained which
is causing delay in time.
The storage of the manual records is a big problem the data which is written in them
cannot be accessed easily.
The staff is willing to do their work with the use of computers , which will save their
time and chance of doing mistakes is minimal which is very high in case of manual work.
The department should be provided with the computers and the essential software
required to their work and necessary training should be provided.
The staff who are using the present software Aristotle Medics are well satisfied with the
package what they are using, because they got habituated to their work and they doesnt
want any change.
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THE INFORMATION OR MODULES AVAILABLE IN
ARISTOTLE MEDICS WHICH IS PRESENTLY USEDIN OHRC INCLUDE
Administration
Current Bill amt of admitted patients, amt. recd. and balance amt. HR
management, Asset management, Ward Management, Public Relation,
Marketing, Special Tools & Controls.
Patients :Patient gets immediate attention, A complete history for the proper selection
of treatment.
Doctor :
Patient history, Disease, complaint, medication wise, clinical
report: includes tabular charts & graphs. Pre entered complaints,
general & systemic examination, diagnostic & medicine templates.
In-Patient reading to pay attention to Patients without visiting any
dept. even from remote locations. Easy preparation of Discharged
Summary.
Nurses :Nurse chart acts as worksheet for all activities & take inputs to maintain the
clinical records.
Accounts :
Automatic generation of indoor patients bill which includes establishment,
nursing, consultant, service, pathological etc. charges, complete
accountancy up to balance sheet, Investigation Book, Requisition Book,
OPD Register.
Other staff :
Reception: Admitted patient list with referred by information, Patient
Registration / Bed Allocation / Pathology / Radiology / O. T. Records /
Pharmacy stores.
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WHAT IS BEING ACTUALLY USED BY OHRC
ADMINISTRATION: Current Bill amt of admitted patients, amt. recd. and balance
amt, Discharge process.
Accounts :
Automatic generation of indoor patients bill which includes establishment,
nursing, consultant, service, pathological etc. charges, complete
accountancy up to balance sheet, Investigation Book, Requisition Book,
OPD Register.
Other staff :
Reception: Admitted patient list with referred by information, Patient
Registration / Bed Allocation / Pathology / Radiology / O. T. Records /
Pharmacy stores.
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Table 1Due you think that their is need ofcomputerization of departments .
Out of total sample size of 50. 37 respondents feel that there is need of computerization
of departments in hospital for the better and efficient usage of the available resources.
16
No of
respondents (n=50)
Yes No Total
Doctors 4 1 5
Managers 5 - 5
Administrativestaff
13 7 20
Patients 15 5 20
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Table 2 Opinion about the existing Hospital
Management System
Category
(n=50)
Response
Good Moderate Poor Total
Managers 4(80%) 1(20%) 5
Doctors 3(60%) 2(40%) 5
Patients 15(75%) 5(25%) 20
Administrative staff 8(80%) 2(20%) 10
Total no of
respondents(%)30(60%) 20(40%) 50
0
5
10
15
20
2530
35
40
45
50
Good poor
Managers
Doctors
Patients
Clerkcial staff
Total no ofrespondents
This hospital has a good Hospital Management System which is not properly/ completely
in use. The study reveals that the department is providing information to the health
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authorities regularly. The overall opinion of the managers, doctors and patients about the
existing Hospital Information System in the hospital is satisfactory (60%) and 40% feel
that the system is poor. (Table-2)
Table 3 Disadvantages of the existing Hospital
Management System HMS
Disadvantages of existing
Hospital Information System
responses regarding the existing system
StronglyAgree
Agree Disagree Stronglydisagree
Non-Existence of ward
Computers is affecting
patient care
37(74%) 13 (26%)
OPD consultations take
longer time 35 (70%) 10 (20%) 5 (10%)
System break down 10 (20%) 15 (30%) 25(50%)
The majority of the Respondents (85%) feel that the nonexistence of ward computers is a
hindrances in providing the expected patient care. They also feel that the existing
Hospital Management System does not help either in making the OPD consultations
quicker or in generating quick laboratory reports.
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Modules of Hospital Management System (SUGGESTED
FOR OHRC)
Patient Registration
Appointment Scheduling
Admission Discharge Transfer
Bed Management
Wards Management Module
Patient Relations
Doctors Workbench
Nursing Workbench
Operation Theater
Electronic Medical Record
Clinic Specialties
Laboratory Information System
Radiology Information System
Pharmacy
Central Sterilized Supply Department
Blood Bank
Housekeeping/Laundry
Equipment Maintenance System (EMS)
Healthcare Packages
Patient Billing
Insurance and Contracts Management
Hospital Administration
Roster Management
HRMS
Financial Accounting
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Goals of proposed system
1. Planned approach towards working: - The working in the organization will be well
planned and organized. The data will be stored properly in data stores, which will help
in retrieval of information as well as its storage.
2. Accuracy: - The level of accuracy in the will be higher. All operation would be done
correctly and it ensures that whatever information incoming from the center is accurate.
3. Reliability: - The reliability will be high due to the above stated reasons. The reason for
the increased reliability of the system is that now there would be proper storage of
information.
4. No Redundancy: - the utmost care would be that no information is repeated anywhere, in
storage or otherwise. This would assure economic use of storage space and consistency
in the data stored.
5. Immediate retrieval of information: - The main objective is to provide for a quick and
efficient retrieval of information. Any type of information would be available whenever
the user requires.
6. Easy to Operate: - The system should be easy to operate and should be such that it can be
developed within a short period of time and fit in the limited budget of the user.
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Hospital Management System - Registration
The Registration module is an integrated patient management system, which captures
complete and relevant patient information. The system automates the patient
administration functions to have better and efficient patient care process.
Patient Registration Details
Inpatient and Outpatient Registration
Medical Alerts Details
Appointment Scheduling (Patient / Doctor wise)
Doctor's Schedule Summary
Doctors Daily Schedule List
Patient Visit History
Medical Record Movements
Appointments for Radiology tests and Operation Theatre
Patient Visit Slip
Sponsorship Details
It provides for enquiries about the patient, the patient's location, admission, and
appointment scheduling and discharge details. Furthermore, this system even takes care
of package deals for a patient for a fixed cost. Medical Record keeps an abstract of
clinical data about patients. It allows easy retrieval of medical records on patients.
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Hospital Management System - Electronic Medical Record
The EMR Module is a fully integrated knowledge repository that caters to Medical and
clinical records of patients in the hospital. The system supports medical professionals of
various departments of the hospital with relevant information like medical examinations,
diagnoses, treatment histories, test results and so on. The module provides access to
critical and complete patient data that leads to high quality cost effective and efficient
patient care. The EMR should have the following features
Patient Search with Various Search Strings
Patient Demographic Viewing
Previous Visit Details
Medical History of the Patient
Billing Details of Patient
In addition the user should be able view investigation requests, prescriptions, reports
and other clinical details. The system should provide separate access rights for each part
of the EMR. The patient medical file can be securely retrieved from this module and sent
across LAN and WAN and also can be E-mailed
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Hospital Management System - Billing
The Patient Billing module should handle all types of billing for long-term care. This
module facilitates cashier and billing operations for different categories of patients like
Outpatient, Inpatient and Referral. It provides automatic posting of charges related to
different services like bed charges, lab tests conducted, medicines issued, consultant's fee,
food, beverage and telephone charges etc. This module provides for credit partly billing
and can be seamlessly integrated with the Financial Accounting Module. The billing
module is extensively flexible by which each of your billing plans can be configured to
automatically accept or deny. The system is tuned to capture room and bed charges along
with ancillary charges based on the sponsorship category. The Billing Screens is used for
In-patient and Outpatient Billing and Invoicing. Further more the charges for various
services rendered can be recorded through service module and this can be used for billing
purposes.
Payment Modes / Details
Sponsorship Conditions Details
Patient Billing Details
Package Installment
Approval from Sponsor
Company Sponsorship Details
Package Registration
Sponsor Verification
Retroactive Processing
User-defined Billing cycles
Automatic Room and Board chargesRecurring Ancillary charge capability
Auto-generated Codes and Billing Criteria
Provision for Pre-billing
Extensive third-party Billing
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Hospital Management System - Financial Accounting
The Financial Accounting Module should deals with Cash/Bank, Receipt/Payments,
Journal Voucher and General Ledger etc. Books like Cashbook, Bankbook and Ledger
book can be generated. This module should generate reports like Trail Balance, Balance
Sheet and Profit and Loss statement. The Financial Accounting Screens should describe
about the Account Payable, Account Receivable and General Ledger. Also describe the
activities related to IP, OP, Bank related activities and provision to clearing the Supplier
Invoice and keep track of the Account Receivable and Revenue related activities. The
services that are covered by the sponsor companies, Insurance Agencies, Family
Accounts, Individual Accounts, sponsorship details of the patient, Health Card Insurance
are should be recorded in the system.
Hospital Management System - Fixed Assets
The Fixed Assets Module should deals with all the activities that are related to the Fixed
Assets Part of Financial Accounting.
This describes activities that are related to:
Identifying an item as a Fixed Asset
Allocating depreciation
Managing its movement Maintenance
Revaluation and Disposal etc.
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Hospital Management System - Payroll
The Payroll & Personnel module should deal with Pay (and deduction) calculation,
printing of salary slip, salary certificates, and PF statements, Gratuity Statement and
provides a monthly analysis.
The maintenance of employee bio-data, 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.
Hospital Management System - Outpatient Management
The Outpatient module should serve as an entry point to schedule an appointment with
the Hospital Resident Doctor or Consultant Doctor for Medical Consultations and
diagnosis. This module should support doctors to take better and timely consultation
decisions by providing instant access to comprehensive patient information. Patient visits
are divided into New, Follow-up and Review. The module also handles requests and
results of laboratory tests and other examinations. External Doctors visit to in patients can
be defined as "Call on". Some patients may avail only the hospital facilities like Lab,
Radiology, Nuclear Medicine, and Physiotherapy and so on.
Medical Alerts Details
Consultation Duty Roster
Diagnosis Details
Triage Parameters
Patients Appointments
Daily / Weekly Schedule Summary
Appointment Scheduling / Rescheduling Facility
Outpatient Medical Observation Details
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Hospital Management System - Inpatient Management
The inpatient module should be designed to take care of all the activities and functions
pertaining to Inpatient Management. This module automates the day-to-day
administrative actives and provides instant access to other modules, which leads to a
better patient care. It should provide comprehensive data pertaining to Admission of
Patients & Ward Management. Availability of beds, Estimation, Agreement preparation,
Collection of advance, planned admission, Emergency admission and so on. The
Inpatient module should also deals with Ward Management Shifting from one ward to the
other, Bed availability, Surgery, Administration of drugs, nursing notes, charge slip and
so on.
Admission Cost Estimation
Admission Approval
Admission Request
Doctor Transfer Details
Nursing Notes
IP Medical Observation
Pending Drug Request
Surgery Scheduling Details
Discharge Notification Summary
Expected Date and Time of Discharge
The module tracks every visit made by the patient and caters to follow-up visits of
patients, along with multiple appointments.
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Hospital Management System - Pharmacy
Pharmacy module should deal with the automation of general workflow and
administration management process of a pharmacy. The pharmacy module should equip
with bar coding facility, which makes the delivery of medical items to the patient more
efficient.
Enquiry
Quotation
Purchase order
Online approval,
Pharmacy drug configuration
Pharmacy stores configuration
Drug issue to patients and billing
Unit dosage facility
Supplier information
Maintenance of drug inventory
Automatic reorder level setting
Purchase Requisitions
Purchase Order
Online request for stock from various sub-stores
Online stock transfer
Maintenance of stock at different sub-stores
Return of items nearing expiry
Destruction of expired itemsPhysical stock verification and adjustment
Goods receipt
Stock Transfer (inter store stock transfer)
Stock Adjustment
Stock in Hand reports
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Hospital Management System - General Store & Inventory
General Stores and Inventory module should deal with Purchase of Items, Issue of Items,
Maintenance of Stock, Automatic Reorder level Setting, Online request for stock from
various sub-stores, Online stock transfer, maintenance of stock at different sub-stores,
Physical stock verification and adjustment, Return of items to supplier etc.
Stock management
Stock control
Stock Purchase through Enquiry generation
Sub stores issues and receipt of stocks
External hospital stock issues and receipt
Option to include and track gift or donation of stock
Stock requisitions from sub-stores and corresponding management
Quotations and Purchase Requisitions
Purchase order generation and processing- LPO, Emergency Purchase order, Principal
and Blanket PO
Advance payment requisitions to Finance
Goods Receipt Note and Purchase returnsAutomatic stock updates on receipt of goods
Stock returns and destruction tracking
Invoice verification
Supplier management and supplier payment bucket facility available
Supplier invoice management
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Hospital Management System - Laboratory
The Laboratory module should automate the investigation request and the process
involved in delivering the results to the concerned department/doctor of the hospital.
Laboratory module starts with receiving the online request from doctors and also allows
laboratory personnel to generate requests. The Laboratory module should support to
perform various tests under the following disciplines: Biochemistry, Cytology,
Hematology, Microbiology, Serology, Neurology and Radiology. 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 entered based on the
sample type either to one test or multiple tests. If the test result requires approval, the
supervisor has to approve the result and it is made available to concerned doctors.
Sample Result Entry
Test Report Entry
Specimen Association Details
Antibiotic Details
Result Range for Test
Investigation Request
Bulk Sample Request
Sample Details
Samples Received from External Laboratory
Samples Dispatch to External Reference LaboratoryInvestigation and Treatment History
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Hospital Management System - Radiology
Radiology module should cater to services such as X-ray, Scanning, Ultra sound etc.
Scheduling of Radiology resources is possible. The system should store 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 should store 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.
Hospital Management System - Physiotherapy
This module should facilitate tracking the services given to patients depending on the
consultant's recommendations.
Physiotherapy sessions are carried out both for Inpatient and Outpatient. Appointment
has to be fixed by the patient for these sessions.
All the Appointments to the Physiotherapy will be through the consultant. There will be
no direct appointment.
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Hospital Management System - Dental
Dental module should cater to the services rendered by the dentists. Treatment and
follow-up treatments are tracked using this module. Progress readings can be recorded
through this module.
Hospital Management System - Service
The service module should deal with all the services available in the hospital and the
charges for these services are stored through this module. There are various services that
are available in the hospital can be seen.
SERVICE MASTER: This master gives the details about package details, Group detail
ROOM TYPE MASTER: This gives the details about Room Type (Ex: Private, Semi-
private, Deluxe, ICU, Suite etc) and their charges.
CONSULTATION CHARGE MASTER: This gives the details about Doctor and the
charges (like new visit, Follow-up, Review and Call-on).
REVENUE TYPE MASTER: This gives the predetermine charges for various service
given by hospital (Like Ambulance, Anesthetists Fee, Baby Cot etc).
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Hospital Management System - Help desk
The Help Desk Module should automate the day-to-day functions of the Front office
management of a hospital. This module helps in assisting patient with accurate
information and supports in handling patient related enquiries efficiently.
Patient related enquiries
Bed Allotment
Admission Details
Demographic Details
Payment Details and
Discharge Details.
Doctor related enquiries
Availability Details
OP Clinic Details
Appointment Schedules
Operation Schedules and
Charge Details
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Conclusion
THE PRESENT SCENARIO IN INDIA IS THAT MOST OF THE HOSPITALS ARE
PARTIALLY COMPUTERIZED. THIS SYSTEM EXISTS IN SOME HEALTH CARE
FACILITIES, WHERE ENTRIES ARE MADE BY DIFFERENT HEALTH CARE
PROVIDERS, SUCH AS PHYSICIANS, NURSES AND THERAPISTS, INTO THE
COMPUTER IN DIFFERENT NODES IN A LOCAL AREA NETWORK. THE
SURVEY CONDUCTED IN THE HOSPITAL REVEALS THE IMPORTANCE OF
INFORMATION NETWORKING BETWEEN THE DEPARTMENTS. MAJORITY OF
THE BENEFICIARIES OF HOSPITAL MANAGEMENT SYSTEM, ARE AWARE
ABOUT THE ADVANTAGES OF COMPUTERISATION IN THE HMS IN
PROVIDING BETTER HEALTH CARE. ALL OF THEM AGREE THAT ONLY IN
AN EFFICIENT SYSTEM THE INFORMATION CAN BE READILY AVAILABLE.