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8/9/2019 MELJUN CORTES - HCMIS_HIS

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A hospital information systems (HIS) is acomputer system that is designed to manage all the

hospitals medical and administrative information inorder to enable health professional perform their jobseffectively and efficiently. Hospital informationsystems were first developed in the 1960s and have

been an essential part in hospital informationmanagement and administration. Early systemsconsisted of large central computers connected to bydumb terminals, which are now being replaced bynetworked microcomputers. The systems were usedto manage patient finance and hospital inventory.


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Hospital information systems now focus on theintegration of all clinical, financial and administrativeapplications and thus could also be called an

integrated hospital information processing systems(IHIPS). Components of a hospital information systemconsist of two or more of the following:

Clinical Information System (CIS)

Financial Information System (FIS)

Laboratory Information System (LIS)

Nursing Information Systems (NIS)

Pharmacy Information System (PIS)

Picture Archiving Communication System (PACS)

Radiology Information System (RIS)


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Advancement in computer technology andthe development of information exchange

standards such HL7 and DICOM, make the taskadministering and integrating such systems a littlemore easier.

Benefits of Hospital Information System (HIS)

A 1992 survey of executive nurses (Simpson1992) listed these benefits:

Benefits of Hospital Information System (HIS) Increased time nurses spend with patients

Access to information


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Improved quality of documentationImproved quality of patient careIncreased nursing productivity

Improved communicationsReduced errors of omissionReduced medication errorsReduced hospital costsIncreased nurse job satisfactionCompliance with regulations of the Joint Commission on

Accreditation of Healthcare Organizations (JCAHO)Development of a common clinical databaseImproved patient's perception of care

Enhanced ability to track patient's recordEnhanced ability to recruit and retain staffImproved hospital image


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A study conducted by Mannle and Gaylin in 1997 entitledQuantifying clinical benefits created by integrated hospital informationsystems: a cost-benefit modelyielded these results: The fourVeterans Health Administration pilot hospitals could expect to realizeover $22.6 million in clinical benefits. Of the $22.6 million, benefits for

inpatient services accounted for $9.4 million, and benefits foroutpatient services accounted for $13.2 million. During the first yearof implementation, factors of incomplete clinical workstationsaturation, incomplete clinical workstation adoption, and incompleteuser proficiency produce underutilization of the HIS, resulting in 25percent lower clinical benefits than could be expected under optimalutilization. Despite this loss of potential benefits, in the first year of

implementation, projected savings exceeded projected costs (forsystem development, hardware, software, installation, maintenance,and training) by $5.8 million. These results are conservative--sensitivity analyses suggest that the total projected benefits could beoverestimated by 6 percent and underestimated by 47 percent. Netbenefits of implementing the system are positive and substantial.

Thus, for the Veterans Health Administration, HIS implementation isan investment worth pursuing at other VHA hospitals. Further,because environmental factors can reduce the potential benefits,saturation and training become important vehicles for ensuring thelargest possible benefits. This model offers a broadly applicable toolfor quantifying clinical benefits produced by HIS implementation inboth VHA and non-VHA settings.


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Nauright & Simpson in 1995 authored a paperentitled Front-line hospital staff from six hospitals ratebenefits of hospital information systems. The resultswere of the study states: A total of 695 respondents from

six hospitals described benefits related to the quality ofcare, interdisciplinary communication, and collaboration;these were realized to a greater extent and were moreimportant than benefits related to costsavings.

Perceptions of nurses regarding the extent towhich benefits were realized were not significantlydifferent than those of non-nurse staff; however nursesrated potential benefits much higher in importance thandid non-nurses. Perceptions were not consistently linked

to demographic variables; the factor most influencingperceptions, was the extent of computerization in thedepartment. Findings appear useful to researchersstudying HIS benefits and to system designers andvendors endeavoring to make HIS more user-friendly,functional, and marketable.


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Types of Hospital Information System

Centralized vs. Decentralized. This distinction is based onwhether information is kept primarily in a central computer, or

is distributed over a number of workstations or servers locatedaround the hospital.

There are variations on this; for example, a system may bepartially centralized but integrated with powerful andsomewhat independent satellite systems. Examples:

Some systems may centralized certain functions like billingand accounting in an administrative facility serving severalaffiliated hospitals, while other functions like patient record-keeping are carried out at the individual hospitals or medicalunits.

Other systems may centralize their patient record-keepingand have smooth exchange of information with a specializedclinical laboratory computer system which is mainly

independent of the primary HIS.


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Figure 1 Fully centralized system


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Figure 2 Centralized with access to a parallel system inclinical lab and radiology


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Business Oriented vs. Patient Oriented. Though both these

types of systems handle patient information, the orientation of theoriginal designers may affect the procedures and general "character"of a HIS.

Terminal vs. Workstation Oriented. Terminals andworkstations are computer devices that often look very similar: bothusually have a keyboard and a CRT display screen, and are oftenconfused with one another. Terminalsare electronic devices thatlet humans communicate with a computer. They are generally

connected to minicomputers or mainframes, which could be close byor halfway around the world. They may have some minor processingpower of their own, but are generally not able to do anything if notattached to a (functioning) computer. Terminal-oriented systems areby nature very centralized, since the terminal can't do anything ontheir own.


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Workstation-oriented systems can be either centralized or

decentralized, because the processing power of the workstation givessystem designers a lot of flexibility. The trend in most types ofcomputer work is toward decentralization, but this trend is somewhat

slower in hospitals because of the high risks associated with failure inhospitals and the consequent reluctance to change systems that areworking now. Workstationsare computers designed for professionaluse by one person at a time. They are fully functional computers ontheir own, but they can be networked to other workstations,mainframes, or minicomputers. Workstation-oriented systems offer a

number of advantages over terminal-oriented ones. Theseadvantages include: Greater flexibility: information can be either centralized ordecentralized. Workstations are much more independent: they can function tosome degree even when a central system is "down".

Since they are used by only one person at once, workstations don'tslow down when lots of people are using the system (except whenthey are requesting information from a central database). Workstations let people do many kinds of work, including wordprocessing and general calculation, which are not practical onterminal-based systems.


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Figure 3 Workstation oriented with

centralized patient records


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Figure 4 Fully distributed with workstations


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Visual Medsys

The Visual MedSys Information System is designed and developedby Kaiser/dela Cruz Consulting, Inc. (KCCI) located at 2933 Andres

Bonifacio Street, Barangay Poblacion, Makati City, Philippines. It isthe only fully integrated computerized system that has beensuccessfully installed in a number of leading hospitals andindustrial clinics in the Philippines. Visual MedSys is designed tobring together the whole hospital & clinic operating process fromregistration to discharge, encompassing both clinical and financialoperations records. This results in improved patient service, and

better control and reporting processes to management. Its missionis to make good hospitals and clinics even better providers ofpatient care and it envisions using computer technology to providean improved level of patient care. One good feature of the VisualMedSys is that it is HL-7 compliant. This is the new internationalstandard for interconnectivity between different hospitals and

medical providers, and even with laboratory and other medicalequipment. All software sold in the US today has little marketacceptance unless the vendor will certify that it is HL-7 compliant.Moreover, Visual MedSys comes complete with the very latestInternational Classification of Diseases (ICD)-10 codes. ICD-10 forthe terms (World Health Organization) and are built into our systemwith tools to facilitate there use by the medical records.


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After more than fifteen years of development Stages I, II &III of MEDSYS are now ready and fully tested for immediateuse. The features are easy to implement and regularhospital clerks can be trained to start operations within a

few days: There is no need to hire computer experts orsubject your staff to extensive training courses andexpenses.

THE FOUR STAGES OF COMPUTERIZATION

1. BILLING & FINANCIAL

2. INTEGRATED MEDICAL ASSISTANCE

3. MANAGEMENT INFORMATION SYSTEMS

4. INTERACTIVE HOSPITAL SYSTEMS

Stage 1 encompasses the financial area. This includesinpatient and outpatient billing, accounts receivable (selfpay, corporate & PhilHealth), pharmacy and CSR

inventory.


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Stage 2 brings in the medical aspects. The work flowsfrom admissions to nursing stations, includes clinicalareas and then to medical records. This is alsointegrated with the financial modules. The finalobjectives include the immediate communication toand from all hospital areas. Also, diagnosesstandardized, medical records automated and clinicalsummaries quickly prepared for authorized users.

Stage 3 brings VISUAL MEDSYS into the area ofmanagement information. Performance reports on thehospital's census, medical efficacy, finances are

automatically collated from the data in the system andput into graphic and statistical formats that will bequickly and easily interpreted by management.Doctors and nurses will be able to establish protocols

for orders that will monitor the quality of patient care.

Stage 4 will put the full power of computerization in your future


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Stage 4 will put the full power of computerization in your futurehospital. Using a new generation of hand held equipment nurseswill be able to input vital signs directly at the bedside, doctors willview xrays, EKGs, MRI scans from any computer terminal in thehospital or at the office, lab results will flow from linked equipmentdirectly into the system, doctors will get help in researching difficult

diagnosis, nurses can avail of on line visual training for complexprocedures, etc.

Mindanao Sanitarium and HospitalMindanao Sanitarium and Hospital is the only tertiary hospital in the city ofIligan City, Lanao Del Norte province located in the northern part of

Mindanao. It has a 150-bed capacity serving patients across all walks oflife. In 2001, this Seventh day Adventist institution passed the highlyrigid standards of the International Standardization Organization (ISO)and became an ISO 9000:2001-certified hospital facility, one of onlyeleven ISO-certified hospitals in the country today. Three years after, in2004, it purchased the Visual MedSys operating system for about 1.8million Php to keep up with the fast-paced technology of the modern timesand improve quality health care among its patrons. A number of computerunits were installed in each department which is interlinked within a localarea network. The Electronic Data Processing (EDP)- ManagementInformation Systems (MIS) department houses the mainframe whichhandles its computer database operating system and regularly updatesthe system from time to time such as price increases of new hospitalsupplies and monthly inventory checklists

References:


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References:1- Information System. ( 2009). Retrieved May 01, 2009, fromhttp://en.wikipedia.org/wiki/Information_systems2- Information system. (2009). In Encyclopdia Britannica.Retrieved May 01, 2009, from Encyclopdia Britannica Online:

http://www.britannica.com/EBchecked/topic/287895/information3- Types of Information System. (2008). Retrieved May 01, 2009,http://www.mckinnonsc.vic.edu.au/vceit/systems/infosystemtypes.htm4- Decision Support System. Retrieved May 1, 2009,http://en.wikipedia.org/wiki/Decision_support_systems5- Financial Information System. Retrieved May 1, 2009,http://www.answers.com/topic/financial-information-system6- Financial Information System. Retrieved May 1, 2009.http://about.reuters.com/productinfo/s/financial_information_systems/

7- Financial Information System. (2009). Retrieved May 1, 2009.http://www.biohealthmatics.com/technologies/his/fis.aspx8- Accounting Information System (2006). Retrieved May 1, 2009.http://earticles. info/e/a/title/ACCOUNTING-INFORMATION-SYSTEMS/

9 Hospital Information Systems (2009) Retrieved May 1 2009


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9- Hospital Information Systems. (2009). Retrieved May 1, 2009.http://en.wikipedia.org/wiki/Hospital_information_system10- Hospital Information Systems. (2009). Retrieved May 1, 2009.http://www.biohealthmatics.com/technologies/his/fis.aspx11- Hospital Information Systems. (1999). Retrieved May 1, 2009.

http://courses.wccnet.edu/computer/mod/m30c.htm#Definition.12- Quantifying clinical benefits created by integrated hospitalinformation systems: a cost-benefit model. (1997). Retrieved May1, 2009.http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102233424.html

13- Front-line hospital staff from six hospitals rate benefits ofhospital information systems. (1995). Retrieved May 1, 2009.http://www.ncbi.nlm.nih.gov/pubmed/8591272?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubme d_RVDocSum14- Visual MedSys. Retrieved May 1, 2009.http://medsys.8xo.com/body.html

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