Hospital Management Information System Benefits

INTRODUCTION BENEFITS NFRASTRUCTURE BLOCK DIAGRAM FUNCTIONAL REQUIREMENTS PROJECT MANAGEMENT ASSUMPTION

INTRODUCTION

The LCS -Hospital Management Information System addresses the entire major functional areas of modern multi-specialty hospitals. The package enables improved patient care, patient safety, efficiency and reduced costs. It provides easy access to critical information, thereby enabling management to make better decisions on time. The LCS -Hospital Management Information System is developed on the latest relational database system technology ORACLE 8.x and Visual Basic 6.0.The LCS - Hospital Information Management System provides the benefits of streamlining operations, enhanced administration and control, improved response, cost control and improved profitability. The LCS -Hospital Management Information System can be easily customized to the requirements of any hospital. Benefits of LCS-Hospital Management Information System Software BENEFITS 1.LCS - Hospital Management Information System helps in maintaining a totally secured database of Patients and business information. This information can be available at your fingertips. 2.LCS - Hospital Management Information System helps in improved healthcare delivery by providing medical personnel with better data access, faster data retrieval, higher quality data and more versatility in data display. 3.LCS - Hospital Management Information System helps in improving efficiency, both on the cost and the clinical care perspective. This is achieved by avoiding duplications, repetitions, delays, missing records and confusions. 4.LCS - Hospital Management Information System helps to force orderliness and standardization of the patient records and procedures in the clinic and increasing accuracy & completeness of medical records of Patient .Patient Registration

5.LCS - Hospital Management Information System helps as a good managerial tool to provide total, cost-effective access to complete and more accurate patient care data to offer improved performance and enhanced functions. 6.LCS - Hospital Management Information System helps in gathering information to meet management challenges. 7.LCS - Hospital Management Information System helps to educate patients about their diseases of surgical procedures through pictures and animations

INFRASTRUCTURE System Details Architecture Two Tier Architecture (Client Server Setup) Hardware Server Intel Server Class High End Server Client Thick Client with PII or higher, 20+ HDD, 128 MB RAM Production Windows NT Server Windows NT Client/9x Oracle 8.x Server, Oracle 8.x clients

Software

Development VB 6.0

FUNCTIONAL REQUIREMENTS MODULES Patient This module facilitates the capturing of patient-related data at different entry points, enables queries at different workstations and generates reports at required frequency. The following details are part of this module: Patient Registration

OPD, IPD and Investigation Cases Ward Allocation Patient Admission Patient Transfer Deposits and Advances Automatic Charge Calculation Estimate and Final Billing Operation Theatre Scheduling Receipts and Refunds Discounts and Concession Doctor Register Patient Discharge Patient Inquiries Comprehensive Search Engine for Patient Search and Analysis

Patient Registration This function of the Hospital Management Information System deals with registering new patients, for either OPD or IPD and issuing unique identification numbers to the patients. These numbers are unique throughout the system. A patient can be registered either at the IPD front office or at the OPD reception. The OPD or IPD identification number is also created for each of the patient's separate visits. This also serves as a part of patient registration. The IPD/OPD ID is used for tracking the medical records of the patient for that particular OPD visit or IPD admission. All medical records of the patient are identified by a combination of numbers, i.e. Patient ID and OPD/IPD ID. The numbers allow for a flexible search in terms of finding the patient's history record.

OPD / IPD Investigation Cases This module of the Hospital Management System deals with all kinds of investigations suggested by doctors. The function enables the entry of investigations /procedures for a particular patient. The entered investigations are rooted through the billing/cash office and once the patient pays for the investigations, the entries of the same go to their respective diagnostics centers. This flow is not compulsory for IPD patients since the billing for IPD patients is done at the time of discharge. Investigation requisition is created and printed with function and the same is available at respective diagnostics centers for the preparation of reports.

PD Admission and Ward Allocation This function, Patient IPD Admission, facilitates the process of patient admission and the allocation of beds to patients. The system identifies the patient as either a new IPD patient, or an intern referred from hospital OPD/CMO. This function gives information on vacant beds in a hospital. Occupancy status on that particular position can be ascertained while allocating the bed. The main function, Patient Admission, facilitates the admission of patients according to requirements, considering the type of admission and the patient's condition. The admission of a patient can be direct, or be a referral from a consultant or hospital. The category of the patient can be Company, Self, Government Schemes, Insurance or MLC ,depending on which the admission procedure is completed. Once the patient is admitted to the hospital, the room charge starts from the time of admission. The case paper of the patient is printed from the system and is sent to the proper nursing station. Once the admission of the patient is completed, an IPD identification number is created by the system for that particular admission of the patient. The IPD Admit Card is also printed along with the case paper. The system informs, with audio visual alerts ,the respective nursing station of the admission of the patient under them, allowing them to prepare room for the patient. In the case

of MLC, the system stores the details of the police station, as well as the name of the official informed about the Medical Legal Case.

Patient Transfer This function of the Hospital Management System is to facilitate the transfer of a patient from one room to another within the hospital. With this function, the patients actual position can be updated online so that internal functions such as billing, investigation and surgery can be planned. The position of the patient is very important since charges for surgery procedures and investigations are related to room category. Deposits, Advances, Refunds, Discounts and Concessions This function of the Hospital Management System facilitates all types of payments received from the patient. This function plays a vital role in payment recovery from patients throughout their stay.

The advances from the patient depend on the type of admission and the patient category is prompted by the system. The interim bill versus advances ratio is also maintained in order to carry out recovery planning. Advances and deposits accepted by the billing/cash counter are directly posted into Accounts. Refund cases are considered when excess advances have been paid. The accounts official authorizes this transaction, after which a refund is processed. In the case of company category patients, the ratio analysis between the interim bill and the amount stated in the authority letter from the company is compared for further action. If a patient is to be given a discount, then the amount is authorized and the discount is processed. The discount categories are flexible and can be changed by the administrator. Reports Following are the main reports / outputs

Patient List Admitted/Discharged. This report gives information on admitted/discharged patients during a certain time period. This facilitates keeping track of the admissions vs. discharges ratio. Bed occupancy Reports. This report gives information on bed occupancy at any given time room category-wise. Ward Allocation Reports. This report gives allocated room reports for tracking of patients. Interim Bill v/s Advance Report. This report gives the ratio of interim bill vs. advances paid by the patient with the percentage of payment. Admission / Discharge Register. The admission and discharge register is maintained by the system. This report gives details regarding patient admissions and discharges during specific period. Patients/ by Doctor This report categorizes patients by attending physician at any point of time. Appointment List The appointments for consultants are maintained on the system. Performed operation list. Patient follow-up report. Prescriptions Discharge Card

Diagnostic Centers This module enables the retrieval of the patients investigation and procedure record from different locations i.e. IPD, OPD, Casualty. The module covers a laboratory system for Pathology, Radiology, Cardiology, Neurology, and Chest Medicine. Prescriptions written by doctors are routed through a billing system to the respective diagnostic centers. Functions The following areas are covered in this module: Pathology The laboratory module starts with the receipt of online requests from doctors. Laboratory personnel can also generate requests. This facilitates investigations for referral patients. Tests are grouped under various sections and sample types (specimens). Based on the request, the user can input a sample and generate a sample number. Results can be based on the sample type. Results can be entered for either one, or multiple tests. If the test result requires approval, the supervisor has to approve the result. Test results are available to concerned doctors. Test reports can be made confidential. Tests can be performed only after the billing is done. This rule is exempted when the case is declared as urgent.

Integration of tests Ordered from Clinical Modules Comprehensive online laboratory reports Fast Entry of Results Enables Doctors to see the Results On-Line from any Location at any time Up-to-date status about request Provision for templates of Input of test Results

Radiology The Radiology module caters to services such as x-ray scanning, ultra sound, etc. The scheduling of radiology resources is possible. The system stores all the result details of various tests and makes a report based on the test results. These tests are carried out for both inpatients and outpatients. The system stores all the details (such as patient number, test reports and x-ray scanning details). The system generates a unique image number for each scan.

Investigations can be undergone only after the billing is done. This rule is exempted when the case is declared as urgent.

CT Scanning Direct capturing of CT scanned images -easy reporting facility MRI -easy reporting X-rays -direct capturing of x-ray images

Sonology

Sonography Reporting Capturing of Images

Cardiology

ECG Notes

Neurology

EMG Reporting

OPRATION THEATRE SCHEDULING Operation booking The Theatre Booking module facilitates the booking of a theatre for surgery on OPD/IPD patients. The system enables theatre scheduling, ascertaining the consultant's OPD schedule and the availability of equipment necessary for surgery. An intimation note is printed a day prior to a planned surgery, confirming both the patients and surgeon's awareness of the procedure. OT Scheduling The OT Scheduling module enables OT time slot scheduling for specific surgeries. Preoperative Check Preoperative notes are an essential part of surgery and are stored in the system once the preoperative anesthesia assessment is done. Name of surgeon, details regarding preanesthesia, type of anesthesia , investigations required, risk assessment, as well as preoperative instructions are maintained in the system. The system also gives facility to store details regarding conduct under anesthesia. Recording Operation details Facility to store details of operation notes during surgery such as vital signs, BP, pulse, IV fluids, R.R., drugs, etc. are also maintained in the system. This information is available at any time following surgery. The entry of complications, events, etc. are specifically added as Special Notes on Surgery. Recording Item Issue Details Items used during surgery are recorded by the system as consumption, to be charged to the patient. The chargeable items are then transferred to Billing and the remainder is stored as information. Recording Nursing Order for Postoperative Care Postoperative details such as investigations, recovery conditions, problems, pain management, etc. are recorded into the system.

Reports

OT booking list Circular for Operations List of patients operated(IPD/OPD) List of operations done Item issue register etc.

Equipment Operation and Maintenance This module maintains a list of surgical/general equipment used in the hospital. It will take care of overall accounting with respect to spare parts, utilization and maintenance. The following are the broad features:

Complaint Recording (for department or ward) Complaints from the department are recorded into the system and the downtime is used to calculate usage of the equipment. This is directly linked with depreciation calculation.

Job Card Creation Job cards for each individual piece of equipment is maintained on the system for identification and tracking

Work allocation and monitoring Monitoring of equipment for its performance based on hours used. Allocation planning for certain equipment is done on the system for specific surgeries or procedures. This eliminates confusion in the transferring of equipment from one location to another.

Identification and Scheduling of High Priority Complaints Some hospital equipment, such as life-saving devices, are vital, therefore the complaints data regarding such equipment is kept on high priority. The scheduling of such equipment is available in this module. The complaints logged on because of problems are given high priority and are always shown on the system, allowing the user to carry out further action to correct the

problem. The details regarding problem analysis are also stored in the system for future reference and downtime calculation.

Issue and Consumption of Spares Issue and return transactions of spares are maintained on the system from location to location. Spares required for certain equipment are maintained as an accessory item to the capital item. When the capital item is moved to any location of the hospital, the accessory items belonging to that equipment are also moved automatically. This facilitates keeping an accurate stock at all locations. The main store maintains the stock of accessory items and spare parts.

Monitoring of third party maintenance contracts for equipment. Third party maintenance contracts are also maintained along with item stock. The period of maintenance with the number of fixed visits and other details on the maintenance contract are maintained in the system.

Maintaining Vendor information Vendor information such as preliminary data account details, PAN/TAN numbers and supplied items are maintained on the system.

BLOOD BANK This module was developed keeping in mind the legal and other requirements of operating the blood banks. It deals in detail with blood transfusion centers as well as component laboratories and works as an interactive online system. It also generates legal as well as internal operation records. Functions Donors data entry

Details of donors such as name, address, contact number and blood group are maintained in the system through Donor Data Entry The details can be printed as and when required. A mailing list from the available donor data can be printed for correspondence

Investigation Data Entry

Various tests details are stored in the system as per rules of the blood bank Maintains data of tests Tests data details required for blood bank records are stored into the system with specific results on HIV, HB details Facilitates component level administration of the blood units Keeps track of distribution / disposal of the whole blood and the components Signals expiry dates and components characteristics The system signals the expiry date of components. Such a report can be printed for reference to manage shortcomings.

Reports

Blood Stock Register Donor register as per FDA requirements Investigation Report Blood Issue Register Demographic data of Donors

FINANCIAL ACCOUNTING An online link with the accounting department helps management to control the activities of the hospital completely and meaningfully. To facilitate hospital management decisions, the prompt back up from the accounting department gives a sound foundation for success. Function Captures front office transactions such as billing data, collections etc. automatically Front office transactions include IPD/OPD billing, cash/check/credit card receipts. The effect of the transaction carried out at the front office is routed through an authorized person into Accounts. Detailed daily cash collection reports are made available to the accountant. The front office staff receives reports concerning receipt numbers and the total receipts from a specific time period.

Provides for online booking of cash transactions and bank transactions at multiple points.

Multiple point transaction levels are maintained on the system to facilitate the entry of all transactions to Accounts.

Facilitates the status of accounts receivables from patients, employees, companies or government departments having credit for their employees medical treatments.

The reports on receivables are available with the Accounts, as well as with the Billing office. This enables the PRO of the Hospital to plan recoveries from outside patients.

Details availability bill-wise, period-wise or doctor wise in the case of private patients or voucher-wise in respect to other transactions. Provision in the accounts payable module regarding full details of the partys bills, type of services or goods provided, payment terms, etc. Focus on cash outflow with emphasis on the prevention of outflows occurring sooner than necessary.

Reports

Trial Balance General Ledgers Accounts payable Accounts Receivable Cash Register Bank Register Cash Flow Statutory Reports / Data Balance Sheet Income / expenditure statement activity wise Doctor-wise Professional Charges IPD / OPD-wise Professional Charges

Stores This module facilitates the accounting of general purchases, stock items, tenders and generation of store related transactions such as receipts, issues, different order levels and spare parts. This will also facilitate the replenishment of stock.

Functions

Vouchers generation for issue, receipts, returns and adjustments Inventory control and store accounting Vendor History / Appraisal Preparation of Purchase Orders Inquiries for Stock Level / Vendor / Items Inquiries for Quantity available / ordered / to be ordered Inventory ABC Analysis Trend Analysis for Purchase price / Consumption Conversion of Units for Receipts, Issue and Consumption Automatic weighted average stores pricing of stocks and issues Automatic reminder system for placing orders and follow ups Billing from Vendors

Reports

Item Listing Item Issue and Return List Receipt Registers Issue and Return Summaries

Reports

Purchase order listing Purchase orders Inquiry reports MIS reports Slow, fast moving items Location wise stock statement Daily GRN register Purchase per vendor during the year Tender preparation Lowest selected tenders with approved rates Lowest selected tenders iI tem wise, vendor wise Purchase register Issue of items during the Patients Stay

Costing A hospital has a philanthropic mission to render services to alleviate human suffering on a priority basis. Service to humanity, along with the utmost effort to save precious life remain the guiding principle. Still, the cost reports provide management with important tools to ensure this mission on a long-term basis. In the normal course, cost control is a relevant factor in ensuring efficient management. At a point in time, management would like to know the cost of the services and utilities provided in order to ensure timely control, thereby avoiding a potentially disastrous situation. It may provide an indication and/or a guideline for revision or restructuring. A proper analysis of costs on a regular basis then becomes unavoidable. Functions

Classification of cost centers Determining tests, services and technical details for allocating material, technical labor and a rational method for allocating other overheads. Reporting method for extraordinary costs. Method of analysis of various activities to ensure the long term survival of the hospital

Reports

Department-wise income /expenditure statement Service /test-wise cost reports Cost per bed Comparisons of general services costs such as electricity, water, waste disposal, etc.

Payroll and Administration The Payroll & Personnel module deals with pay (and deduction) calculation, printing of salary slips, salary certificates, PF statements and gratuity statements, providing a monthly analysis. It also deals with the maintenance of employee attendance/overtime details, along with reports on absenteeism, leave encasements, etc. The personnel & payroll department is responsible for employee related activities such as staff appointment, maintaining the employee database, fixing

allowances and deductions, leave entitlements, leave sanctions, loans, termination processes, maintenance of hospital documents, insurance details, tenancy contracts, vehicle registration, etc. Function

Creation of master data PF calculation Loans and advances Employee time sheet Employee work allocation Pay calculations Performance-based incentives planned

Reports

Employee listing Loans and advances Listing and summaries Pay slips Employee IT reports Incentive summary

System Security The Security and Administration module deals with controlling access to information available in the application. User-defined error messages and help messages are also maintained and customized in this module. The User Manager module basically deals with security through controlling access to information available in the application. Any user associated with a user group is able to access only those screens for which the user group has rights. It also deals with system related activities such as user monitor, creating a user group master, database, maintenance of company documents, user defined error message, generating daily statistical summary, etc.

Function

Group creation User creation Assigning user writes User authentication

PROJECT MANAGEMENT Project Execution The success of a project is dependent upon an efficient and effective project management approach. A professional project management approach is ensured throughout the execution of the project. The following steps are involved in Project Execution:

Planning and Scheduling the Project Defining Milestones and tasks. Estimating task wise time required Tracking task wise actual time v/s estimated. Ensuring instant corrective action in case of Project Schedule overrun. Information sharing with clients concerning the progress of the project / issues and concerns by way of a status report at a certain frequency. Ensuring mock process audits by Senior staff members at every milestone Stage wise reviews and corrective action.

The following software development life cycle stages will be followed:

Requirement gathering and opting final sign off by the client. Designing application and preparing Design document with WBS. Functional specification / test case creation. Code Construction. Unit testing and Integration testing.

Quality aspect In order to ensure ultimate product quality, concepts such as configuration management, work product reviews, root cause analysis of defects identified, defect prevention activity etc., are inducted into Project Management.

Risk Management approach Probable Risks are well identified; Mitigation and Contingency plans are in place. The risks identified are as below Risk Responsibility Absence of expected response by the client for our queries / sign offs on Client documents / various approvals / testing and acceptance. Resource availability with Vendor vendor because of attrition. Natural Disaster Both Testing Methodology Program level testing and system level testing will be carried out using test cases. Test cases will be created taking into account functionality, user behavior, and various boundary conditions. There will also be test data preparation based on a live scenario. ASSUMPTIONS

Contingency / mitigation Plan

Follow up and get a response up to a pre-defined time period

Ensure and document proper job handover process between resources Mutual action

Infrastructure requirements, actual efforts and schedule will be finalized only after a requirement study. Detailed requirement document will be prepared after onsite study and will be signed by the Client within a specified time period. Changes to the signed requirement document would be treated as a Change Request and modifications will be carried out against additional charges. Performance issue is subject to availability of recommended infrastructure at Clients end