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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.