Faculty of nursing

Hospital information system

Supervisor

Prof.Dr/ Safaa Mohamed Abd Elrahman

Dr/ Mona Thabet Abdelbaset

Prepared by

Doctorate student: Samar Hussien Khalaf Alah

2019-2020

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Objectives
At the end of the group discussion candidate will be able to:
• Define Hospital Information System (HIS).
• Mention types and importance of data base in HIS
• Discuss the component of HIS
• Identify tasks of HIS
• Discuss Examples for HIS
• Enumerate Advantages of HIS
• Discuss HIS life cycle
• Discuss HIS training
• Determine the obstacles and challenges facing HIS

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Out lines
• Introduction
• Definition of HIS
• Database in HIS
• Components of HIS
• Tasks of HIS
• Examples for HIS
• Advantages of HIS
• Hospital information system life cycle
• Health Information system training
• Challenges to HIS
• References

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Introduction

Modern hospital information systems (HIS) are comprehensive,

integrated and specialized information systems designed to manage the
administrative, financial and clinical aspects of hospitals and healthcare
facilities. They are considered one of the most important focal points on
which the delivery of healthcare within hospitals and different types of
medical institutions depends.

The importance of these systems emerges from the importance of their

role in keeping all types of patient data and information including key data
about the patient and other comprehensive medical data; recording all
medical services that have been provided to the patient such as
investigations, diagnoses, treatments, follow up reports and important
medical decisions.

Hospital information systems have the potential to improve the health

of individuals and the performance of healthcare providers, yielding
improved quality, cost savings, and greater engagement by patients in their
own healthcare. Despite evidence of these benefits, physicians’ and
hospitals’ utilization of HIS and electronic health records are still low. The
response of healthcare professionals to the use of hospital information
systems is an important research topic that can explain the success or failure
of any HIS development and implementation project.

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 Definition

Hospital information system (HIS) is a comprehensive,

integrated information system designed to manage all the aspects of a
hospital's operation, such as medical, administrative, financial, and legal
issues and the corresponding processing of services. Hospital information
system is also known as hospital management software (HMS) or hospital
management system.

Database in HIS

Database is the heart of Hospital Information system. It consists of an

orderly written document encompassing the patient's identification, health
history, physical examination findings, laboratory reports, treatment,
surgical procedure reports and hospital course. When complete, the record
should contain the data to justify investigations, diagnosis, treatment, and
length of stay, results of care and future course of action". Thus, it becomes
a tool:

 To provide a means of communication among physicians,

nurses and other allied health care professionals
 To provide Continuity of patient care, help in medical
education and research
 To provide information for the quality review of patient care
 To protect legally the physician, patient, hospital and helps in
third party payment.
 Failure to maintain an accurate, timely and complete database
spoils the usefulness of HIS.

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Components of HIS
Components of a hospital information system consist of two or more
of the following:
1. Clinical Information System (CIS).
2. Financial Information System (FIS).
3. Laboratory Information System (LIS).
4. Nursing Information Systems (NIS).
5. Pharmacy Information System (PIS).
6. Picture Archiving Communication System (PACS).
7. Radiology Information System (RIS).

 Clinical information system

A Clinical Information System (CIS) is a computer based system that
is designed for collecting, storing, manipulating and making available
clinical information important to the healthcare delivery process.
 Financial information system
Financial Information Systems (FIS) are computer systems that
manage the business aspect of a hospital.

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  Laboratory information systems
A laboratory information system (LIS) is a computer information
system that manages laboratory information for all the laboratory disciplines
such as clinical chemistry, hematology and microbiology.
 Nursing information system
Nursing information systems (NIS) are computer systems that manage
clinical data from a variety of healthcare environments, and made available
in a timely and orderly fashion to aid nurses in improving patient care.
 Pharmacy information systems
Pharmacy information systems (PIS) are complex computer systems
that have been designed to meet the needs of a pharmacy department.
Through the use of such systems, pharmacists can supervise and have inputs
on how medication is used in a hospital.
 Picture archiving communication system
Picture Archiving Communication System (PACS) is a term to describe
a set of systems that facilitate the archiving, processing and viewing of
digital radiological images and their related information.
 Radiology information system
A radiology information system (RIS) is a networked software system
for managing medical imagery and associated data. A RIS is especially
useful for tracking radiology imaging orders and billing information, and is
often used in conjunction with PACS to manage image archives, record-
keeping and billing

Tasks of hospital information systems:

 Storage and monitoring of patient‘s condition:

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  Accurate and electronically stored medical records of
patients (e.g. drug allergies) are provided
 Visual and auditory warning systems are generated in the
event of abnormal test results or other important data
 Data Processing and analysis for statistical purposes and
research oriented purposes

 Management and Data Flow:

 Support automated patient data transfers between

departments and institutions
 Digital signatures, in order to create internal orders
electronically
 Communication by Laboratory Information System
 Registration of human resources and their properties

 Financial Aspects:

 Efficient administration of finances

 Use and monitoring of medicines and the ordering process
 Expected and actual treatment costs are listed and reported
 Automated representation of the needs of the nursing staff
 Status analysis of bed occupancy and overall performance
in the hospital information system

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Examples for Health information systems:

(1) Electronic Medical Record (EMR) and Electronic Health Record

(EHR)
Electronic medical records replace paper patient records. Several
companies provide such information systems. Medical information on each
patient must now be collected and stored electronically. These records would
include patient health information, test results, doctor and specialist visits,
and healthcare treatments.

(2) Practice Management Software

Such information systems assist healthcare facilities and personnel
with the management of daily operations of the facility. This would include
things like scheduling of patients and medical services billing.

(3) Master Patient Index (MPI)

The software of this healthcare information system is aimed at
connecting patient records more than one databases. The MPI contains
records for any patient registered at a healthcare organization. MPI, as the
name suggests, creates an index all the records for that patient. The intent of
MPIs is to reduce duplicate patient records and avoid inaccurate patient
information that could result in patient claim denials.

(4) Patient Portals

This information system lets patients peruse their health data. They
are able to access: appointment information, medications they may be
receiving, and their lab results via the internet. Some of these patient portals
also facilitate patients to have active communication with healthcare

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professionals including physicians, pharmacists regarding their prescription
refill requests, and scheduling of appointments.

(5) Remote Patient Monitoring (RPM)

This is also termed telehealth. RPM provides medical sensors that
have the ability to transmit patient data to healthcare professionals who
might very well be halfway around the world. RPM can monitor blood
glucose levels and blood pressure. It is particularly helpful for patients with
chronic conditions such as type 2 diabetes, hypertension, or cardiac disease.
Data collected and transmitted via PRM can be used by a healthcare
professional or a healthcare team to detect medical events such as stroke or
heart attack that require immediate and aggressive medical intervention.
Data collected may be used as part of a research project or health study.
RPM is a life-saving system for patients in remote areas who cannot access
face-to-face health care.

(6) Clinical Decision Support (CDS)

CDS analyzes data from clinical and administrative systems. The aim
is to assist healthcare providers in making informed clinical decisions. Data
available can provide information to medical professions who are preparing
diagnoses or predicting medical conditions like drug interactions and
reactions. CDS tools filter information to assist healthcare professionals in
caring for individual clients.

Advantages of HIS:

1. Hospital Information System helps in maintaining a totally secured

database of Patients and business information. This information can be
available at your fingertips.

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 2. Hospital 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. Hospital 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. Hospital 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.
5. Hospital 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. Hospital Information System helps to educate patients about their
diseases of surgical procedures through pictures and animations.

Hospital information system life cycle:

The selection and implementation of an information system occurs
through a well -defined process known as life cycle, this cycle is divided
into four phases:
• Needs assessment.
• System selection.
• Implementation.
• Maintenance.

I. Needs assessment

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 This process is done through several steps by committee or group
of expertise to analyze the overall needs of the organization of
developing health care information system.

II. System selection

The information gathered during need assessment phase is the basis
for system selection process. It is the decision to purchase a new
information system, done through:
System selection criteria
 Over all costs: hard ware, software, network costs, implementation
costs, support and maintenance cost
 Vender characteristics: Vender is accompanying that design,
develop, sells and support system. Reputation, experienced staff.
 Software feature: ease of use.

III. System Implementation

Once the organization has purchased the information system, the
implementation phase starts .the implementation phase is done by
steering committee and controlled by the committee leader, through
thesis steps:
 Defining how the information system should be built (i.e., physical
system design)
 Ensuring that the information system is operational and used,
 Ensuring that the information system meets quality standard

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 IV. Maintenance phase
After implementing the health information system, continuous system
maintenance is provided, through:
 The help desk:
 The help desk is done by trained personnel from information
system, who have special training and are familiar with all of
the system in use
 Technical maintenance : through
 Problem solving.
 Maintain back up supply of hardware as monitors, printers and,
cables.
 Performing file back up.
 Monitoring the system for adequate file space.
 Upgrades the used system.
 Develop disaster recovery plans.
Health Information system training
 Planning
A well prepared training plan provides comprehensive approaches that
ensure proper system use; the training plan should be in alignment with the
organizational objectives.
 Determining users' needs:
This is done by analysis of their job responsibilities and its needs.
 Training class content:
Training class should address the following areas:

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  Computer –related polices: training is an excellent time to
discuss client confidentiality, ethical computing, and
inappropriate system access.
 Human factor: the implementation of an information system
may create great change in the working setting, as some
employees are uncomfortable with change and computers
because they fear job loss and cannot adapt new change.
 Basic computer literacy: some employees lack fundamental
computer skills and knowledge.
 Work flow: outline the new system in details to help the users
understand how the new system works.
 Help screen and online tutorials: help screen" list specific
actions to complete a particular tasks, online tutorials" on line
step by step instructions for how to use software.
 Error messages: are texts communications produced by the
computer to warn the users that information is missing or
improperly used.
 Training schedules:
Training schedule should consider number of personnel who need
training, as when a large number will be trained in a short period, around the
clock training may be used. Short time between training and implementation
of the new system should be considered.
 Hard ware and software requirements:
The best way to learn how to use information system is to train under
similar setting as working condition, as trainee the employees on the same
hard ware and software present in their work environment.

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  The budget: training is expensive because of the personnel hours, also
the cost of training activities including.
 Trainers cost: trainers spend many hours reviewing and developing
education materials.
 Employees undergo training: compensation for time spent in training
may be at the regular hourly rate.
 Replacement staff: clinical units must be staffed while regular
employees undergo training.
 Support staff: theses employees perform jobs such as typing,
copying, and allocation instructional materials, preparing class
room and document attendance.
 Training approaches: determining the class room, methods of
teaching.
Challenges to hospital information system implementation
 The challenge of user acceptance.
 The challenge of data redundancy.
 The challenge of costs.
 The challenge of privacy and security
 The challenge of terminology

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References
1- "Hospital information systems definition given by US based".
Consultant.com. Retrieved 2012-04-15.
2- Balaraman, P., & Kosalram, K. (2013). E-hospital management &
hospital information systems-changing trends. International Journal
of Information Engineering and Electronic Business, 5(1), 50.‫‏‬
3- Educational Center of Kermanshah. Adv. Environ. Biol., 8(11): 748-
753.
4- Khalifa, M., & Alswailem, O. (2015). Hospital information systems
(HIS) acceptance and satisfaction: a case study of a tertiary care
hospital. Procedia Computer Science, 63, 198-204.‫‏‬
5- Nasiripour, A.A., M. Mahboubi, S.H. Mousavi, A. Arash, m. Alireza,
E. Afshin, A. Saeed, M. Ehsan and M. Mohsen, 2014. Evaluating
hospital information system (HIS) of Imam Reza Therapeutic
6- PayamHomayounfar. (2012). Process mining challenges in hospital
information systems.Proceedings of the Federated Conference on
Computer Science and Information Systems. – FEDCSIS, Wroclaw,
Poland, pp. 1135–1140.
7- Types of Information Systems Used in Healthcare Facilities Oct 1,
2018 available @ https://www.scott-clark.com/2018/10/01/types-of-
information-systems-used-in-healthcare-facilities/

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