HISataglance
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**MBA Student, College of Commerce and Business Management, Osmania University, Hyderabad, India
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ABSTRACT—Information is the foundation for policy making, planning, programming, and accountability. Health
informatics is the intersection of information science, computer science, and health care. It deals with the resources,
devices, and methods required to optimize the acquisition, storage, retrieval, and use of information in health and
biomedicine. Boddy et. al (2005) describes an information system (IS) as“a set of people, procedures and resources
that collects data which it transforms an`d disseminates”. Most professionally run hospitals and clinics now rely on
Hospital Information Systems (HIS) that help them manage all their medical and administrative information. A
health information system (HIS) can be defined as “comprising all computer-based components which are used to
enter, store, process, communicate, and present health related or patient related information, and which are used by
health care professionals or the patient themselves in the context of inpatient or outpatient patient care” (UMIT,
2005). It is also known as Healthcare Information System. In health organization such as hospitals, implementation
of HIS inevitable due to many mediating and dominating factors such as organization, people and technology.
Data for this paper were collected through bibliographic and internet research. Four key areas will be addressed in
this paper:
1. An analysis of HIS and its components.
2. Benefits of HIS
3. Phases Of Implementation Of HIS
4. Suggestions for selecting of HIS
Study showed that End-user training is crucial for the success of an HIS. Without the users being trained properly in
their assignments the chance of failure increases substantially. Training is not only important as a mean for teaching
the individuals how to perform certain tasks, it’s also one of the most pervasive methods of communicating
organization goals to the personnel.
Key Words: Hospital Information Systems, Hospital, System, Electronic Medical records
_________________________________________________________________________________________
1. INTRODUCTION
Healthcare is a very important part of our society. On the other word, One of the most important issues is health
services. In recent times, Health care concept of the people has undergone a tremendous change which has led to higher
expectations and an increased demand for high quality medical care and facilities. Hospitals provide a medical assistance
to people. Healthcare organizations of all sizes face a critical need to manage and integrate clinical, financial and
operational information. In order to accomplish this task, a Hospital Information System should be developed.
It is commonly defined as a comprehensive information system used to collect, store, process, retrieve, and
communicate patient care and administrative information for all hospital-affiliated activities and to satisfy the functional
requirements of all authorized users in a hospital (Van Bemmel J.H, Musen M.A. 1999). Therefore, Information Systems
are computer systems that collect, store, process, retrieve, display, and communicate timely information needed in
practice, edu- cation, administration and research (Malliarou, 2006; Malliarou et al., 2007). The benefits of using
Information Systems are many. They not only reduce errors and increase speed of care and accuracy but they also can
lower health costs by coordinating services and improving quality of care. The best introduction for hospital information
systems has been made in 2011 International Conference on Social Science and Humanity, which is: “Hospital
Information Systems can be defined as massive, integrated systems that support the comprehensive information
requirements of hospitals, including patient, clinical, ancillary and financial management”.
A Hospital Information System is essentially a computer system that can manage all the information to allow health care
providers to do their jobs effectively. It is also known as Healthcare Information System. Hospitals are becoming more
reliant on the ability of hospital information system to assist in the diagnosis, management and education for better and
improved services and practices. In health organization such as hospitals, implementation of HIS inevitable due to many
mediating and dominating factors such as organization, people and technology.
The technology changes quickly and if the system is not flexible it will not be able to accommodate hospital growth. A
good HIS offers numerous benefits to a hospital including but not limited to the delivery of quality patient care and better
financial management. The HIS should also be patient centric, medical staff centric, affordable and scalable. An effective
HIS also delivers benefits such as enhances information integrity; reduces transcription errors; reduces duplication of
information entries; and optimizes report turnaround times.
6. SUBSYSTEMS OF HIS
As Lippeveld T. (2000) stated Hospital information systems contribute to an "integrated effort to collect, process, report
and use health information and knowledge to influence policy-making, programme action and research .
There are different types of HISs including routine- and clinical HISs. Components of a hospital information system
consist of two or more of the following:
1. Picture Archiving Communication System (PACS)
2. Radiology Information System (RIS)
3. Clinical Information System (CIS)
4. Physician Information Systems (PIS)
5. Financial Information System (FIS)
Kling et al. (2000) say that a pure technological view on ISs will lead to failures, and gives the following explanation as
to why: ”It cannot adequately account for the interactions between ICT, the people who design, implement and use
them, and the social and organizational contexts in which the technologies and people are embedded”.
A lot of implementations of ISs fail, and the reasons for it are usually not pinned down to one cause. Abreu and Conrath
(1993) say that one can almost find as many reasons for IS failures as the number of failures themselves, and that a
significant proportion of new systems are underutilized, do not meet their potential, or fail to be used at all.
Phases of implementing an HIS are (Allan and Englebright, 2000):
1.Planning phase 2.Analysis phase 3.Design phase 4.Development phase
5. Implementation phase 6.Evaluation phase 7.Upgrade phase
a. Planning Phase
The planning phase involves the following steps:
1. Define problem and /or stated goal
2. Conduct feasibility study
State objectives
Determine scope
Determine information needs
Decide whether to proceed
Negotiate the project definition agreement
Write the project definition document
3. Allocate resources
b. Analysis Phase
In the Analysis Phase data must be collected in the form of written documents, questionnaires, interviews, observations.
After analysing data with data flowcharts, grid chart, decision tables, organizational charts a model can be made. Data
must be reviewed before proceeding to the design phase.
c. Design Phase
The design phase is divided into two parts:
I) Functional Design
1. Personnel 2. Time Frame 3.Cost and Budget
4.Facilities and Equipment 5. Data Manipulation and Output 6.Operational Considerations
d. Development Phase
The Development phase includes the following:
1. Select Hardware 2. Develop software 3. Test System
4. Document system
User’s manual
Operator’s manual
Maintenance manual
e. Implementation Phase
The implementation phase includes a detailed description of the system that specifies not only all hardware and software
components but implemen- tation, training, operation, and maintenance procedures as well. Includes the following steps:
1. Train users 2. Install System 3. Manage and Maintain System
8. Database access 9. Hardware and software reliability 10. Connectivity 11. System cost
h. Upgrade Phase
Some of the important considerations in upgrading a system include the following new technologies:
1. Bedside /point-of-care terminals 2. Workstations 3. Multimedia presentations
4. Desicion support systems 5. Artificial intelligence 6. Neural networks
7. Integrated systems architecture 8. Interfaced networks 9. Open architecture
Usage of the system is a crucial factor for success for HIS, and the users of the system use it on a voluntary basis. Barki
and Huff proposed in 1985 that use is an appropriate measure of implementation success when use is voluntary (Abreu
and Conrath, 1993). And also, Kimaro and Titlestad (2005) point out the problems if the communication between
developers and users is lacking: It will lead to insufficient capturing of design needs and thus system failures. Intended
users and developers need to agree on what is being designed by sharing technological and contextual understandings
and available design options.
8. CONCLUSION
End-user training is crucial for the success of an IS. Without the users being trained properly in their
assignments the chance of failure increases substantially. Training is not only important as a mean for teaching the
individuals how to perform certain tasks, it’s also one of the most pervasive methods of communicating organization
goals to the personnel (Gupta and Bostrom 2006).
Despite the benefits Hospital Information Systems have to offer, they are not widely used in healthcare and
where they have been installed, they have not been readily accepted. Many problems have been reported during the
implementation of health information systems in Healthcare environment. This could probably due to lack of adequate
training and failure of educate the end-user what the reasons are for their introduction. Problems that have been reported
when introducing computers to support health care are the lack of standardized medical terminology, computer anxious
users, fear of less individual care and too much control as well as unclear benefits (Goossen et al., 1997; Harris, 1990;
CNA, 2006; Reuss, 2007).
System developers, however, have been remiss in providing relevant, useful information to the various
healthcare professionals involved in the care of the patient. There is also a need for users to develop a framework of
understanding about how the systems function. To implement HIS for users who do not understand it may lead to the
failure of the system. Users are drivers of the system if they do not have reasonable knowledge about it, it is difficult for
it to be optimally driven to provide objectives. There is a general ignorance of information systems amongst health
workers. It is time to analyse the problems that exist in the development and use of ISs and to look for solutions to solve
them (Jeffrey, 1998).
The key for effective administration and management of the Service of a Hospital is the availability of reliable, valid, and
qualitative information. This fact predicates the existence and appliance of Hospital Information Systems, and makes
indisputable their superiority against the manual procedure. Organizations may need to redesign the computer interface,
to provide better hardware and to maintain a more reliable network function to meet the Users' needs during the adoption
process, as well as to modify or devise appropriate documentation regulations (Damigou, 2007).
The health sector still lacks the discipline of system thinking, shared vision and a team approach. Study of HISs
systems that have already been implemented need re-evaluation to determine not just whether they work, but how and in
what circumstances they work (Dowling, 1985).
A critical factor governing the sustainability of information systems is the availability of qualified and experienced
personnel. Information systems require active management if they are to succeed. Procedures need to be established for
data collection, reporting, follow-up of missing reports, data quality control, data summary and providing feedback (Jett ,
2007).
Finally, no hospital information system can be regarded as a success unless it has the full participation of its users. Thus
human and social factors would have to be considered in its design, more often than not, they can be easily addressed by
providing adequate training and education about the system.
9. SUGGESTIONS
Some of the important considerations in selecting a HIS include the following:
1. Total cost of package- Generally, HIS providers are happy to visit and discuss the requirements of your hospital
with you. Solutions are available for hospitals of all sizes and budgets. It is important to have a hospital information
system that has a low cost of ownership. Some vendors reduce costs by having a design that requires less hardware
and fewer servers. This type of design is known to cut upfront acquisition costs and also reduces maintenance in the
long run.
2. Web based system- In addition to the user friendly features, a good HIS system must be available on the web.
Availability on the web means authorized personnel can access the information whenever they want from anywhere.
This does not bind all caregivers to their office desks and also provides them with information when they need it
most. A web based system becomes even more important if it is used to share information between two or more
hospitals. Healthcare facilities in different geographic locations can share relevant data quickly if they use an internet
based HIS.
For instance, a hospital may decide to shift a patient to another facility for better care or specialty treatment. If the
present hospital has updated all the patient information in their HIS, the second hospital can instantly access the
information needed for treatment. The medical history of the patient will always be stored within these facilities and
can be readily retrieved if the patient is not able to provide it himself.
3. Implementation and support- Change is always resisted by humans and deploying or upgrading a hospital
information system may also invite employee criticism. It is always better to ask the vendor for support in an
implementation and request for staff training. Choose a vendor that offers 24x7 supports via the telephone or web, so
your hospital staff can immediately access support. Some hospitals also consult their staff while making a
purchasing decision, as the staff may be able to tell you something new or inform you about things others may have
overlooked.
4. User-Friendly : The interface should be user friendly and simple
10. REFERENCES
[1] Abreu A.F.d., Conrath D.W. “The role of stakeholders’ expectations in predicting information systems
implementation outcomes”, 1993.
[2] Allan, J. & Englebright, J. (2000). Patient-centered documentation: An effective and efficient use of clinical
information systems. J Nurs Adm, 30(2): 90-95.
[3] Boddy D., Boonstra A., Kennedy G. “Managing Information Systems, An Organizational Perspective”, FT
Prentice Hall, 2nd edition, 2005.
[4] Bussing, A. & Herbig, B. (1998). Recent developments of care information systems in Germany. Comput Nurs,
16(6): 307-310.
[5] Cibulskis, R.E. & Hiawalyer, G. (2008). Information Systems for Health Sector Monitoring in Papua New Guinea
available at: http://www.hsph.harvard. edu/takemi/RP191.pdf
[6] Clinical information systems definition in biohealthmatics.com, a US based career networking portal for
biotechnology and healthcare informatics. Biohealthmatics.com. 2006-08-10. Retrieved 2012-04-15.
[7] CNA Position Statement: Nursing and Information and Communication Technology July, 2006. available at:
www.cna-aiic.ca accessed on 20th May 2008.
[8] Damen W, Kilsdonk A, Vander WA.(1991), “Information networks. Hospital Management”, Sterling Publications
Ltd., Netherlands, p. 568.
[9] Damigou, D. (2007). Creation of web page with subject nursing informatics . Master thesis National and
Kapodistrian University of Athens, Nursing De- partment, Health Informatics, Athens.
[10] Damigou, D. & Malliarou M. (2007). Health information systems in clinical practice. Proceedings of the 34th Greek
Nursing Congress; Chania: Greece; pp. 82.
[11] Dowling, A. (1985). Nursing Information Systems. Journal of Medical Systems, 9: 1-2.
[12] Goossen, W., Epping, T. & Dassen, T. (1997). Criteria for nursing information systems as a component of the
electronic patient record. An international Delphi study. Comput Nurs, 15(6): 307-315.
[13] Gupta S., Bostrom R. “End-User Training Methods: What We Know, Need to Know”, 2006.
[14] Harris, B.L.(1990). Becoming deprofessionalized: One aspect of the staff nurse s perspective on computer-mediated
nursing care plans. Adv Nurs Sci, 13(2): 63-74.
[15] Healthcare information systems definition in Center for Development of Advanced Computing, an Indian research
center for health informatics". Cdac.in. 2011-09-22. Retrieved 2012-04-15.
[16] Jeffrey, M.A. (1998). Health information systems: improving nursing care and cutting costs. MedSurg Nursing.
available at: http://findarticles.com/p/ar- ticles/mi_m0FSS/is_n5_v7/ai_n18607985 accessed on 10th May 2008.
[17] Jett , S. (2007). Nursing classifications and computerized nursing information systems (CNIS): situation and issues.
Perspect Infirm, 4(4): 24-28.
[18] Kimaro H., Titlestad O. ”Challenges of user participation in the design of a computer based system: The possibility
of participatory customisation in low income countries”, 2005.
[19] Kling R., Crawford H., Rosenbaum H., Sawyer S., Weisband S. “Learning from Social Infrastructures: Information
and Communication Technologies in Human Contexts”, Centre for Social Informatics, Indiana University, 2000.
[20] Lippeveld, T. (2000). Approaches to strengthening health information systems. Eds.: Lippeveld, T., Sauerborn, R.,
Bodart, C. Design and implementation of health information systems. Geneva, WHO, pp. 243-252.
[21] Malliarou, M. (2006). Policy of safety and guarantee of medical secrecy in electronic health record of patients.
Master thesis National and Kapodistri- an University of Athens, Nursing Department, Health Informatics, Athens.
[22] Malliarou, M., Liaskos, J. & Mantas, J. (2007). Legislative issues in the processing of sensitive personal data in the
electronic patient record. Confer- ence Proceedings of 5th ICICTH International Conference on Information
Communication Technologies in Health; Samos: Greece; pp. 133-141.
[23] Olmeda, Christopher J. (2000). Information Technology in Systems of Care. Delfin Press. ISBN 978-0-9821442-0-6.
[24] Payne, P.R., Greaves, A.W., and Kipps, T.J. CRC Clinical Trials Management System (CTMS): an integrated
information management solution for collaborative clinical research, AMIA Annu Symp Proc. 2003:967.
[25] Reuss, E., Keller, R., Naef, R., Hunziker, S. & Furler, L. (2007). Nurses Working Practices: What Can We Learn for
Designing Computerised Pa- tient Record Systems? Ed.: Holzinger A. USAB, LNCS 4799, pp. 55-68.
[26] Shortliffe, E.H., and Cimino, J.J. eds. Biomedical Informatics: Computer Applications in Health Care and
Biomedicine (3rd edition). New York: Springer, 2006.
[27] UMIT (University for Health Sciences, Medical Informatics and Technology), 2005. http://evaldb.umit.at/ A web-
based inventory of evaluation studies in medical informatics 1982 – 2005.
[28] Van Bemmel H, Musen M.A. (1999), Handbook of Medical Informatics [Online] Retrieved from:
<http://www.mieur.nl/mihandbook/r_3_3/toc/toc.htm > [Accessed 04 May 2007].
[29] Wikipedia contributors 2010. Hospital information system. Wikipedia, The Free Encyclopedia. [Online] Retrieved
from: <http://en.wikipedia.org/w/index.php?title=Hospital_information_system&oldid=120447839> [Accessed May
30, 2011]