A hospital information system (HIS) is an element of health informatics that focuses mainly on the administrational needs of hospitals. In many implementations, an 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 architecture has three main levels,
Central Government Level, Territory Level, and Patient Carrying Level.
Generally, all types of hospital information system (HIS) are supported
architectures for networking and processing. Most work
positions for HIS are currently resident types. Mobile computing began with
wheeled PC stands. Now tablet computers and smartphone applications are used.
Enterprise HIS with Internet architectures have been
successfully deployed in Public Healthcare Territories and have been widely
adopted by further entities.1 The Hospital Information System (HIS) is a province-wide
initiative designed to improve access to patient information through a central
electronic information system. HIS’s goal is to streamline patient information
flow and its accessibility for doctors and other health care providers. These
changes in service will improve patient care quality and patient safety over
The patient carries system records patient information, patient
laboratory test results, and patient’s doctor information. Doctors can access
easily person information, test results, and previous prescriptions. Patient
schedule organization and early warning systems can provide by related systems.
HIS has data warehousing as the main topic, hence a more static
model of information management. HIS is often composed of one or several software components with
specialty-specific extensions, as well as of a large variety of sub-systems in
medical specialties from a multi-vendor market. Specialized implementations
name for example Laboratory
Information System (LIS), Policy and Procedure
Management System,2 Radiology
Information System (RIS) or Picture
archiving and communication system (PACS).
Architecture is based on a distributed approach and on the
utilization of standard software products complying with the industrial and
market standards must be utilized (such as: UNIX operating
systems, MS-Windows, local area
network based on Ethernet and TCP/IP protocols, relational database
management systems based on SQL language or Oracle databases, C programming
Portable devices such as smartphones and tablet computers may be used at the
Hospital Information Systems provide a common source of
information about a patient’s health history. The system has to keep data in a
secure place and controls who can reach the data in certain circumstances.
These systems enhance the ability of health care professionals to coordinate
care by providing a patient’s health information and visit history at the place
and time that it is needed. Patient’s laboratory test information also includes
visual results such as X-ray, which may be
reachable by professionals. HIS provide internal and external communication
among health care providers.
The HIS may control organizations (a Hospital in this case),
official documentations, financial situation reports, personal data, utilities
and stock amounts. The HIS also keeps in a secure place: patients’ information,
patients’ medical history, prescriptions, operations and laboratory test
The HIS may protect organizations, handwriting errors, overstock
problems, conflict of scheduling personnel, and official documentation errors
like tax preparations errors.
The systems administrator-database administrator is responsible
for systems administration/or data administration in all aspect of utilizing to
ensure the high uptime of the system
and for handling all database back-up and restoration activities.
The hospital’s application specialist together with the software
vendor is involved in all the activities required for implementing the
application software. Trainers train and retrain new employees in the hospital.
Hardware/Network engineers are responsible for maintaining the
hardware and network systems in the hospital. They undertake all
troubleshooting activities that may be required to keep the system online and
patient data available to doctors and nurses.
There is no standardization, except for data formats and for
data interchange, as with the HL7 initiative supported by ISO.
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.
Enhances information integrity, reduces transcription errors,
and reduces duplication of information entries.3
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.
Hospital Information System (HIS) is vital to decision making and plays a
crucial role in the success of the organization. Computerization of the medical
records and documentation has resulted in efficient data management and
information dissemination for the users. Hospital Information System addresses
the entire major functional areas of modern multi-specialty hospitals. The
package enables improved patient care, patient safety, efficiency and reduced
costs. It provides easy access to critical information, thereby enabling
management to make better decisions on time. Aims: The short-term objectives of
the on-line computerized system are to reduce costs and improve the accuracy
and timeliness of patient care, accounting and administration, record keeping,
and management reporting. The long-term goal is to build and maintain patient
database for analysis of data to facilitate decision-making process. Methods:
To run the system it requires some Hardware & Database for IT Department.
The technique involves Patient Registration System, Finance & Accounts,
Human Resource Management System, Laboratory, Out Patient Management System,
and Inpatient Management System. Results: In the mid seventies, a complex was
established at Shahbag area in the name of Bangladesh Institute of Research and
Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM). From
1982 BIRDEM was designated as the WHO collaborating centre for research on
prevention and control of diabetes. It is first of its kind outside Europe. Now
from 2000 BIRDEM has successfull developed & implemented some crucial part
of HIS System like Patient Admission & Billing System, Finanace &
Account System, Human Resourse Management & Payroll System, Store Inventory
& Procurement Management System, Labrotary Management System, Assets
Management System, Radiology & Imaging Management System. Conclusions: It
can thus be seen that deploying IT can help the medical profession in improving
its quality of service and thus automatically increasing the preparedness and
defensiveness. Of course, it is of vital importance that the software must have
the right type of modularity and openness so that it is manageable,
maintainable and upgradeable. They can perform the complex task of matching,
tabulating, calculating, retrieving, printing and securing the data as
required. Well designed, integrated computer system can be a great tool in the
hands of the hospital management in improving services, controlling cost, and
ensuring optimal utilization of facilities.
Systems can be defined as massive, integrated systems that support the
comprehensive information requirements of hospitals, including patient, clinical,
ancillary and financial management. Hospitals are extremely complex
institutions with large departments and units coordinate care for patients.
Hospitals are becoming more reliant on the ability of hospital information
system (HIS) to assist in the diagnosis, management and education for better
and improved services and practices 1.
Hospital Information System
(HIS) is vital to decision making and plays a crucial role in the success of
the organization. Computerization of the medical records and documentation has
resulted in efficient data management and information dissemination for the
users. Managers, clinicians and other healthcare workers can now access the
information without delay or errors. Present study reveals, the existing system
requires upgradation to meet the requirements of the managers and the
clinicians. Participants feel HIS assists in decision making, and medical
audit. Participants felt that the existing HIS resulted in longer time for OPD
consultation and delay in investigation results. Majority of the participants
feel that HIS helps in education and research.
Hospital Information System
addresses the entire major functional areas of modern multi-specialty
hospitals. The package enables improved patient care, patient safety, and
efficiency and reduced costs. The system provides the benefits of streamlining
operations, enhanced administration and control, improved responses, cost
control and improved profitability.
The System is developed to
maintain a secured database of patients and business information. This system
was planned to address the challenges encountered by healthcare centers such as
small & large hospitals and private clinics 2.
The importance of the HIS
are reduced patient waiting time for appointment, billing and collection of
medicine from pharmacy and reduced time for diagnostic result preparation by
directly capturing the data from machines. Patient records available in the
hospital and can be referred by any consultant any time from any location. On-line
statistical data is available for middle and top Management for decision
making. Financial data is available at any given point of time. Human resource
data available on-line for taking any decision on manpower required. In HIS
on-line data is available on revenue, patient statistics, doctor performance,
department performance and financial data on budget for Management decision. It
also helps to improve patient care, cost control and data security 3.
1.2. Experiences in Asia
In Southeast Asia the
health information technology market continues to grow as healthcare services
are improved and expanded.
healthcare system is well developed with easy access to both primary and
secondary care facilities. Health IT is high on the Government’s strategic
agenda. Malaysia is the world’s third most popular destination for medical
tourism and the market is expected to grow by 30 percent per year over the next
couple of years.
• Singapore–Singapore has
one of the most mature healthcare sectors in Southeast Asia with an efficient
well-developed infrastructure, a highly educated population and local
technological expertise. A 10 year IT Master Plan has a US$300 million budget
for IT systems. The main goal is to have a nationwide electronic health record
• Thailand–three main
health insurance schemes act as the main healthcare purchasers. There are plans
to develop an electronic health information system to link the systems used by
these three schemes. Demand for healthcare services has continued to increase
since universal healthcare programme became free for patient visits to the
doctor or the hospital. Thailand’s healthcare system is struggling to cope.
1.3. Bangladesh Prospect
The system is well
developed in developed countries but almost absent in developing countries like
Bangladesh. Some of the private hospital in Bangladesh has taken initiative but
could not operate properly. In this regards BIRDEM as a non-profit socio
voluntary medical organization has taken initiative and to some extend become
successful. So it is a pioneer study in this field.
In a large hospital, which
devotes considerable emphasis on patient care? The short time objectives of the
computerized system are to reduce costs and improve the accuracy and timeliness
of patient care, accounting, administration, record keeping, and management
reporting. The long-term goal is to build and maintain patient database for
analysis of data to facilitate decision-making process.
This vision to maintain
complete paperless and film less patient records, where patient will not carry
any papers anytime to come to the hospital was a major challenge for us.
To run HIS it requires some
hardware, software and database for IT department like two node cluster SERVER
with storage device, application SERVER, backup SER VER, server rack, switch
RAC, KVM switch, on Line UPS, voltage stabilizer, database(RDMS) with RAC,
network cable, network switch, RJ-45 connector, laptop, computer, lager
printer, DOT matrix printer, technical Instrument.
The technique involves some
systems like Patient Registration, Patient Appointment, Patient Billing,
Finance & Accounts, Pharmacy Management, Medical Store, Procurement
Management, Assets Management, Human Resource Management, Payroll Management,
Laboratory Management, Patient Appointment Management, Out Patient Management,
Inpatient Management, Nursing Care Management, Accident & Emergency Management
, Kitchen Management, Diet & Nutrition Management, Library Management, OT
Management, Infection Control Management, Social Welfare Management,
Engineering Management, Intensive Care Information, Mortuary Information,
Forensic Medicine Information, Security & Access Control Management
3.2. Process Description
When a patient comes to any
health center for medical service, the procedures for providing the patient
with the desired service(s) are covered in this module which are described
There are two types of
patients visits a hospital and healthcare center. One type of patients are
registered ones, and another type of patients are those who do not get
registered (T_ID) with any center. The process description is provided
according to the visits (1st visit and subsequent visits of registered
patients, and visit of T_ID patients) to a healthcare center. The visits of
patients are described below:
1. First Visit
of a Registered Patient
Visits of a Registered Patient
3. Visit of a
T_ID Patient Detailed process description of the above three categories are
3.2.1. First Visit of a
Registered Patient (Shown in Figure 1)
Processes involved in
maintaining and providing service to a new patient visiting for the first time
to a hospital or health center who gets registered with the center are as
The patient at first comes
to the reception for registration and hospital information. For the patient
willing to be registered, his/her primary information will be put into the
system and the system generates a registration number known as CRN (Computer
Registration Number) for the patient. This CRN will be used throughout the
whole system as the reference ID for that particular patient. The receptionist
will consider about the patient whether he/ she is a corporate client (preset
categories of patients who get special facilities) or not. These and some other
categories of patients may have free registration facility. In these cases,
such patients will go directly to the Nurse Station, ignoring the step 3.1.2
& 3.1.3 (The whole process may be carried out at the Nurse Station in case
of increased workload at the reception).
From the reception the
patient is sent to the Cash Counter to pay the registration fee.
The person in duty at the
Cash Counter will receive registration fee from patient and he/she may come to
the reception again.
If the patient wants to
avail Social Welfare facility, he/she then is sent to the Social Welfare
Department. From Social Welfare Department the patient will come to the Nurse