by aditya varshneya

1. By: Aditya varshneya

2. What is HIS?
Cloud computing of HIS in Fortis
Modules of HIS in Fortis
Functioning and Gap Analysis
Recommendations

3.  A hospital information system (HIS), variously also called clinical
information system (CIS) is a comprehensive, integrated information
system designed to manage the administrative, financial and clinical
aspects of a hospital. This encompasses paper-based information
processing as well as data processing machines.

4.  Cloud computing refers to the delivery of computing and
storage capacity as a service to a heterogeneous community
of end-recipients
 These services are broadly divided into three categories:
Infrastructure-as-a-Service (IaaS), Platform-as-a-Service
(PaaS) and Software-as-a-Service (SaaS)

5. (eg: Gmail, Google Calendar,...)
(eg: Google Apps
(eg: Amazon EC2

6. 1. Private Cloud
2. Public Cloud
3. Hybrid Cloud

7.  Fortis has private cloud model
 Infrastructure as a Service - A robust data centre
providing virtualized hardware and connectivity for all
Fortis locations with full disaster recovery and backup
infrastructure
 Platform as a Service - Fortis IT and Fortis software
vendors to develop, maintain, deploy and deliver
software applications for various Fortis functions.
 Software as a Service - As part of the cloud, Fortis has
centralized its Hospital Information System: Trakcare
from InterSystems and created a central analytics and
MIS platform

8. OPD billing module
IPD billing module
Store module
Housekeeping module
Admin. Module
Nursing or ward module
Diet module
Purchase module
Medical Record
LIS AND RIS

9.  Housekeeping module of Fortis hospital mainly deals with the bed
status of the ward in which firstly the beds from which patient
ready to move are shown and then the information through phone
is being delivered to the floor supervisor about the room that has
to be cleaned which is also shown in the HIS housekeeping module
then when the room is cleaned the information is being passed by
the supervisor to the housekeeping desk that room has been
cleaned and the person attending the call mark in the HIS that the
room has been cleaned and vacant and ready to be occupied by
other patient.
 GAP ANALYSIS

10.  Bed status to be filled by the nurse when the patient is about to move
 Information of bed to be cleaned should be displayed on the screen which
is to be installed in the house keeping department. The beds which are to
be cleaned should be displayed on the screen just like status which is
shown on the railway station showing train status.
 Then, through phone message is to be send to the concerned floor
supervisor regarding the cleaning of the room and then the supervisor
should tell to the nursing station to mark it vacant in the system.
 Housekeeping module should be a part of ward module
 The status of the beds other then the floor wards like (micu, ccu) which is
being shown on the housekeeping module should not be shown as it is to
made vacant by the nurse
 The housekeeping module should be designed to forecast the total
number of housekeepers needed each day in the future based on current
guests in-house and expected arrivals/departures

11.  The housekeeping module can automatically create a cleaning schedule
each day for each housekeeper based on the number of dirty rooms,
estimated clean time per room, and number of housekeepers.
 It is possible to measure the performance of each housekeeper by tracking
the estimated clean time and actual clean time, as well as variance. We can
also track each time a room was cleaned and by whom

12.  The other technique which can be used to increase the efficiency and
effectiveness of the HIS is implementation of the RFID(Radio
frequency identification) technique to track the location the assets and
to improve the quality of the hospital services
 Radio Frequency Identification (RFID) is a method for remotely storing
and retrieving data using devices called RFID tags or transponders.

14. CONT..
NURSING MODULE IS BEING
CONNECTED TO THE
FOLLOWING

15.  Ist part contain the use of Tablet PC’s by the nurse and medical
professionals which can be connected to HIS of the hospital. Tablet PC’s
should be connected with each bed (one tab to one bed or two bed)
Patient history and other details can be easily shown in the pc and it
should be PACS and DICOM enabled to see the images of ultrasound, x-
ray etc. Tablet pc will help in entering correct prescription which should
be entered by doctor only to reduce medication error and patient activity
sheet can be prepared. Nursing and doctor notes can also be written in
the tablet PC’s. Since paper work takes lots of time and chances of error
are more
 Tablet pc’s will be connected to ward module which can be cut short and
contains only diet module and discharge intimation process, also we can
view information about the patient through patient IPID
 PC’s will function as doctor will enter the prescription right from the
patient bed which will directly go through HIS to store department and
radiological department

16.  Tablet PC’s will contain all the patient history which will be entered into it
along with DICOM enabled images viewer it will help in reducing chances
of error and time . On the spot report can be generated and send to the
IPD billing department for billing procedures
ELECTRONIC
MEDICAL
RECORD
DEPT…

17.  Order is being given through HIS in the form of Indents to IP store by the
Data entry operator (nursing Station)
 Person in the IP store checks the Indents Depending upon the type of
indents (New, Stat, Normal)
 Medicines are recorded, quantity is checked and the medicines are
Dispatched to the respective stations

18.  Connected with PC tablet
 E-prescribing through CPOE (Computerized physician
order entry)
 RFID technology or bar coding technology should be
implemented (more emphasis on RFID technology) to
reduce ambulatory and inpatient medication error and
the number of adverse drug events.
 RFID technology tracking the assets as medicines are
one of the important assets in the hospital and it can be
combined with the existing HIS of the hospital.

19. PATIENT ENTERS INTO THE HOSPITAL
PATIENT APPROACHES THE OPD REGISTRATION DESK
PATIENTS FILLS THE REGISTRATION FORM
INFORMATION IS ENTERED IN TO THE HIS OF THE HOSPITAL
THEN, UHID (UNIQUE HOSPITAL IDENTIFACTION) IS GENERATED
BILLS ARE PROCESSED AND NEW INVESTIGATION ORDER OR DOCTOR VISIT ARE
ENTERED INTO HIS
THEN, HARD COPY OF THE BILL IS TAKEN WHICH IS GIVEN TO THE PATIENT FOR
FURTHER PROCEEDINGS

20.  Customers appointed are scheduled for the desired PHC package
& the appointment date & time is informed as per the process of
booking.
 PHC customers are informed about the precautions they need to
take fasting (12 hrs) medication etc and other information related
to packages.
 For scheduled appointments, all concerned department (lab,
radiology, NIC) are informed about the no. of appointments.
 Customers arrive at OPD/PHC reception as per their
appointment.
 Clients are registered and billed
 As required customers are escorted to various departments like
lab, radiology, NIC
 All investigation reports are compiled and appointment for final
consultation with doctor is fixed

21.  The biggest problem which faced by the PHC
department is the waiting time in X-Ray and ultrasound.
Patients becomes irritated as it takes long time for
them for the test to be done

22.  Regarding the waiting time in ultrasound, it can be
reduced by redirecting some patients to the other test
which has to be done with fasting
 Use of PACS and DICOM in the hospital
 If patient want to see the report or want to take the
report it can be printed at one station or it can be
directly viewed by the patient on the website through
the UHID with password given by hospital as happens
in the lab report.
 With this implementation it will help in reducing the
cost incurred in the films produced and processing of
that films and reports thereby reducing the waiting time

23.  The last and the foremost thing for improving the
waiting time is implementation of the RFID technique
for patient tracking
 These patient tracking systems can provide data which
have significant effect on improving patient tracking,
patient flow and provide valuable insight into patient
flow improvements that can impact patient care:
o Measure patients waiting longer than 15 minutes
o Detail the percentage of patients waiting longer than 15 minutes
o Determine lab turnaround times to hold them accountable

24.  The module is multidisciplinary and is meant for the administration
 It includes the details of the employees and doctors in specific. The
revenue details, availability timings, contacts etc. and other relevant
record of every doctor are mentioned here
 Any person from the top management has the option of looking
into the personal details of any of the staff.
 Diet module is a part of ward module
 Diet info. Of the patient in being entered into the HIS by data
entry operator and F &B department delivers the order to the
patient

25.  Medical record department should be made electronic
( Implementation of the electronic medical record) which will help
to
◦ Improve quality and convenience of patient care
◦ Increase patient participation in their care
◦ Improve accuracy of diagnoses and health outcomes
◦ Improve care coordination
◦ Increase practice efficiencies and cost savings