Introduction to Hospital
Information System (HIS)
Prepared by:
Ass. Prof. Dr. Amal Diab Ghanem Atalla
Assistant Professor in Nursing Administration Department
Faculty of Nursing
Alexandria University
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Introduction
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
healthcare.
What is a Hospital Information System (HIS)?
The HIS is a comprehensive, integrated information system designed to manage
the administrative, financial and clinical aspects of a hospital. the aim of a hospital
information system is to achieve the best possible support of patient care and
administration by electronic data processing
Benefits of Hospital Information System
The benefits of using Hospital Information System are:
Easy access to doctors’ data to generate varied records, including classification
based on demographic, gender, age, and so on. It is especially beneficial at
ambulatory (out-patient) point, hence enhancing continuity of care. As well as,
Internet-based access improves the ability to remotely access such data.
Improved quality of patient care.
It helps as a decision support system for the hospital authorities for developing
comprehensive health care policies.
Efficient and accurate administration of finance, diet of patient, engineering, and
distribution of medical aid. It helps to view a broad picture of hospital growth.
Improved monitoring of drug usage, and study of effectiveness. This leads to the
reduction of adverse drug interactions while promoting more appropriate
pharmaceutical utilization.
Improved quality of documentation.
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Enhances information integrity, reduces transcription errors, and reduces
duplication of information entries.
Hospital software is easy to use and eliminates error caused by handwriting. New
technology computer systems give perfect performance to pull up information from
server or cloud servers.
Development of a common clinical database.
Stakeholders: who benefits from hospital information system
The information regarding hospital information system are gathered from the staff
members and patients, the computer user and the administration staff. Hospital
information systems can be characterized by their benefits; their functions; their
types of processed information and their types of services offered. The following
groups benefit from Hospital Information System:
A) Physicians
Introduces Computerized Provider Order Entry (CPOE)
Improves accuracy & legibility of, and access to, the required patient
medications
Improves clinicians’ efficiency & effectiveness through provision of key patient
information (e.g., allergies) at
time of ordering, plus conflict checking, order checking and online access to best
practice information
Improves care through the logging of all orders
Reduces medication error rates
B) Nurses
Will allow immediate access to orders and results
Will provide immediate access to patient demographics, medication and test
results
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Will provide improved access to information on line (i.e.: suggested medications
or drug alerts)
Will decrease the need for paper, decrease errors and increase patient safety
C) Allied Health Professionals (Paramedical staff)
Will allow immediate access to orders and results
Will provide immediate access to patient demographics, medication and test
results
Will provide improved access to information on line (i.e.: suggested medications or
drug alerts)
Will decrease the need for paper, decrease errors and increase patient safety
D) Ward and Registration Clerks
Will provide a single point of contact for patient registration information and
reduce duplication of effort
E) Clinical Benefits
Provide a common source of information about a person’s health history
Enhance the ability of health care professionals to coordinate care by providing
a person’s health information
and visit history at the place and time that it is needed
Link information from diagnostic information systems such as X-ray and
laboratory into the EPR
Strengthen internal and external communication among health care providers
Eventually be accessible for use in all of Manitoba’s academic and community
hospitals, as well as long term care facilities
Allow care providers access to the patient’s health history and results between
facilities
Will provide improved access to information on line (ie: suggested medications
or drug alerts)
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Will decrease the need for paper, decrease errors and increase patient safety
F) Administrative Benefits
Will provide improved access to information on line (i.e. suggested medications or
drug alerts)
Will decrease the need for paper, decrease errors and increase patient safety
Strengthen internal and external communication among health care providers
Will decrease the need for re-registrations of patients across multiple sites
Components of hospital information system
Hospital Information System is a comprehensive, integrated computer system.
Within this umbrella system, there are varieties of subsystems in medical
specialties, there are five key components or “modules” in the system, include:
1. Registration
The system captures and records patient demographics and visits at the point-of-
care. Registration data will be displayed consistently and automatically on screens
in the clinical system.
2. Order Entry and Results Reporting
All clinical orders will be listed with indications of what has been completed and
what is pending. Electronic alerts will appear for orders duplication and errors and
provide information to assist clinical decision-making. All test results in the
patient’s electronic chart will be filed with alerts for abnormal results.
3. Clinical Documentation
This module provides on-line documentation of clinical encounters such as
flowcharts and structured notes. Eventually this information will be shared across
health care facilities within Manitoba.
4. Scheduling
Patient scheduling schedules patients for appointments with clinicians or for tests
and procedures.
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5. Patient Billing
All billable health services will be accessible and processed in this system.
Examples: private rooms, out of country coverage.
Subsystems of HIS
Hospital information systems contribute to an "integrated effort to collect, process,
report and use health information and knowledge to influence policy-making,
programmer 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)
6. Laboratory Information System (LIS)
7. Nursing Information Systems (NIS)
8. Pharmacy Information System (PIS)
Picture Archiving and Communication System (PACS):
a PACS is a medical imaging technology which provides economical storage of,
and convenient access to, images from multiple modalities. Electronic images and
reports are transmitted digitally via PACS; this eliminates the need to manually
file, retrieve, or transport film jackets.
Radiology Information System (RIS) :
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These systems are also popular for their ability to provide radiology billing
services, appointment scheduling as well as reporting and patient database storage.
The radiology practice has become more complex with advances in technology and
more hospitals now turn to RIS to manage the business side of their practices.
Clinical Information Systems (CIS):
A Clinical Information System is a computer based system that is designed for
collecting, storing, manipulating and making available clinical information
important to the healthcare delivery process. Clinical Information System helps
healthcare organizations improve the delivery of clinical services. hospital
information systems present clinical information and reports that enable clinicians
to make more informed decisions at the point of care.
Nursing Information Systems (NIS) :
These computers based information systems are designed to help nurses provide
better patient care. A good NIS can perform a number of functions and deliver
benefits such as improving staff schedules, accurate patient charting and improve
clinical data integration. The nursing department can have a better managed work
force through schedule applications enabling managers to handle absences and
overtime. The solution can also be used to monitor staffing levels and achieve more
cost-effective staffing. Patient charting applications allow users to enter details
regarding patients’ vital signs. Nurses also use it for admission information, care
plan and all relevant nursing notes. All-important data is securely stored and can
be retrieved when required.
Clinical data integration is also very useful, allowing nurses to collect, retrieve and
analyze the clinical information and then integrate it to design a patients' care plan.
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All these features in NIS ultimately lead to a reduction in planning time and better
assessments and evaluations. The chance of prescribing the wrong medication also
decreases since there is always a reference for electronically prescribed drugs.
Physician Information Systems (PIS) :
As the name suggests, PIS systems aim to improve the practice of physicians and
are also recommended by the government for placement. Physician information
systems are delivered through computers, servers, networks, and use widely
deployed and popular applications such as, electronic medical records (EMRs),
electronic health records (EHRs), and more. Most of these services have 24/7
remote support that allows hospital staff to troubleshoot problems occurring during
system usage.
Pharmacy Information Systems (PIS) :
Designed to address the demands of a pharmacy department, PIS helps
pharmacists monitor how medication is used in hospitals. PIS helps users supervise
drug allergies and other medication-related complications. The system allows users
to detect drug interactions and also helps administer the proper drugs based on the
patient’s physiologic factors.
Financial Information System (FIS):
Financial Information Systems are computer systems that manage the business
aspect of a hospital. While healthcare organization’s primary priority is to save
lives and not making profits, they do acquire running costs from day to day
operations; including purchase and staff payroll.
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Laboratory Information System (LIS):
A Laboratory Information Management System (LIMS), sometimes referred to as
a Laboratory Information System (LIS) or Laboratory Management System
(LMS), is a software-based laboratory and information management system that
offers a set of key features that support a modern laboratory's operations.
Phases of implementation of hospital information system:
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.
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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
7.Human-Computer Interactions 8. System Validation Plan
II) Implementation Design
1. Design Inputs 2. Design Outputs 3. Design Files and Databases, Design Controls
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 implementation,
training, operation, and maintenance procedures as well. Includes the following
steps:
1. Train users 2. Install System 3. Manage and Maintain System
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f. Evaluation Phase (I)
The evaluation and test approach is to test each entity with successively larger ones,
up to system test level. Steps of project testing are: Program testing; String testing;
System testing; Project documentation; User acceptance testing.
The following criteria are considered essential in selecting a Hospital information
system and can be used as a basis for evaluation:
1. Applications 2. Overall system performance 3. Evaluation features 4. Ease of
system 5. Configuration or programming performance 6. Security 7. Simplification
of reports 8. Database access 9. Hardware and software reliability 10.
Connectivity 11. System cost
g. Evaluation Phase (II)
Methods and tools for evaluating a system s functional performance include:
1. Record review 2. Time study 3. User satisfaction 4. Cost-benefit analysis
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. Decision support systems 5. Artificial intelligence
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