Hospital Information System Assignment

SCHOOL OF NURSING AND ALLIED HEALTH SCIENCES
HHIT101
"Health and Hospital Information System"
Hospital Information System in the Hemas Hospital

Intensive Care Unit (ICU)
MOHAMED ANWER ANLEEF
Reg. No - OUM12/15/054
UGS00019676
NIC No- 882912671V
E-Mail –mohamedanwernaleef@gmail.com
Contact No-0094716136936
Tutor’s Name: Dr. K. Edirisinghe & Mr. Tharindu Dushyantha Dewalegama
Learning Centre: IIHS, Welisara, Srilanka.
December, 2015 Semester

M A Naleef UGS00019676
Table of Content
Appendix
Acronyms/ Abbreviations
1. Hospital Orientation .........................................................................................................5
1.1. Introduction of Hemas Group of Hospitals ...................................................................... 5
1.2. Hemas Hospital Wattala ................................................................................................... 5
1.2.1. The Logo of the Hospital .......................................................................................... 6
1.2.2. Hemas Promise ......................................................................................................... 6
1.2.3. Accreditations ........................................................................................................... 6
1.3. Affiliates in the Hospital .................................................................................................. 6
1.4. Infrastructure .................................................................................................................... 7
1.5. Departments in the Hospital ............................................................................................. 8
1.6. The Department Studied in Details ................................................................................ 11
1.6.1. Hemas Hospital Wattala Intensive Care Unit ......................................................... 11
1.6.2. Human Resource Capacity of Hemas Wattala ICU ................................................ 11
1.6.3. Equipment Resources availability of Hemas Wattala ICU .................................... 12
1.7. Current Hospital Information System ............................................................................ 13
2. Process Analysis................................................................................................................13
2.1. Process Flow ................................................................................................................ 14
2.2. Core Patient Care ........................................................................................................... 14
2.2.1. Main Functions related to Core patients care ......................................................... 14
2.2.2. Main activities related to core patients care ............................................................ 15
2.3. Supplementary Patient Care ........................................................................................... 18
2.3.1. Main functions related to supplementary patient care ............................................ 18
2.3.2. Main activities related to supplementary patient care............................................. 18
1
2.4. Problems Related to Patient care .................................................................................... 24
3. Proposal for New Hospital Information System................................................................26
3.1. Introduction .................................................................................................................... 26
3.2. Objectives ....................................................................................................................... 26
3.3. Implementation............................................................................................................... 27
4. Instruction to the Software Engineer regarding New HIS.................................................28
4.1. Existing System .............................................................................................................. 28
4.2. Proposed System (Expectation) ..................................................................................... 28
4.3. ICU Requirement regarding Hospital Information system ............................................ 28
5. Conclusion.........................................................................................................................33
6. References.........................................................................................................................34
2
Appendix
Page
1. Appendix 1 : Process Flow of the ICU......................................................................17
2. Appendix 2 : Process Flow of Drug Management.....................................................19
3. Appendix 3 : Process Flow of Blood Transfusion.....................................................20
4. Appendix 4 :Transfer the patient another hospital further management....................21
5. Appendix 5 : Process Flow of Transfer the patient to ward.......................................22
6. Appendix 6 : Process Flow of dead body handling.................................................. 23
3
ACRONYMS/ ABBREVIATIONS
 HIS Hospital Information system
 CSSD Central Sterile Services Department
 CT Computerized Topography
 ECG Electrocardiogram
 ETU Emergency Treatment Unit
 F&B Food & Beverages
 HR Human Resource
 ICU Intensive Care Unit
 IT Information Technology
 MICU Medical Intensive Care Unit
 OPD Out-patient Department
 OT Operation Theatre
 LIS Laboratory Information System
 RIS Radiological Information system
 EMR Electronic Medical Record
 BB Blood Bank
 HH Hemas Hospital
 MO Medical Officer
4
1. Hospital Orientation
1.1. Introduction of Hemas Group of Hospitals
The Hemas Group of Hospitals is a Largest healthcare provider in Srilanka. There are three
large multi Specialty hospitals in Srilanka. The Internationally accredited, multi Specialty,
family hospital chain situated in Wattala, Galle and most recently, Tahalawathugoda. This
three hospitals are Accredited ACHSI, ISO Standards, OSHAS and other healthcare
accreditation. In the Hemas hospitals, The largest Multispecialty Hospital is Wattala Hemas.
Its Situated In Gampaha District and Near the main Colombo Road. There is about 6km in
the Colombo Main Road (Hemas, n.d).
1.2. Hemas Hospital Wattala
The Hemas Hospital Wattala There is largest Hospital in Gampaha District. This is a Pioneer
hospitals for other Hospitals. In Wattala Hemas 100 Bedded capacity hospital. In more than
1000 employer capacity and There are major special units for providing best care of patients.
In Hemas Wattala more than 1500 Visiting consultants, professors, and residential
consultants are any time ready to care of patients, more than 500 of paramedical staffs such
as MLTs, Pharmacists, Physiotherapists, Nutritionist, Speech therapists, Audiologist,
Dietitians, etc..... and Specially trained Nursing staffs such as Renal care Nurse, Critical Care
Nurse, Emergency Nurse, Ostomy care Nurse, trained Code Blue, Code Red and Code
Yellow team, Trained Nursing assistant and multi task assistant for providing satisfactory
patient care. In Hemas hospital Wattala there is General Wards, Luxury rooms, semi luxury
rooms, Medical Surgical Wards and Medical Surgical Rooms. It's a Private hospital using
the advanced technological equipments and information technology for care of patients
(Hemas, n.d).
5
1.2.1. The Logo of the Hospital
1.2.2. Hemas Promise

As a chain of multi specialty family hospitals give the best in health care whilst
ensuring get value for money with no hidden charges. Hemas assure patients the
highest safety standards following and benchmarking with international best
practices.
At Hemas Hospital strive to care for patient with the same level of respect ad care.
The Hemas caring and professional staff undergoes meticulous training and
international exposure to cope with all the anxieties and uncertainties that
accompany a hospital stay, turning a potentially stressful visit into an easy and
comfortable experience (Hemas, n.d).
1.2.3. Accreditations
 The Hospital Chain obtained the prestigious Australian Council on Healthcare
Standards international (ACHSI) Accreditations.
 ISO 9001:2008 Certificate was awarded to Laboratory chain of Hemas
Hospitals.
 ISO 15189:2007 Certificate was Awarded to Wattala Hemas Hospital
Laboratory.
 OHSAS 18001 Certificate ( International accreditation for Occupational
Health and Safety Standards) was awarded to Hemas Group of Hospitals.
(Hemas, n.d)
1.3. Affiliates in the Hospital
6
1.4. Infrastructure
The hospital offers world class infrastructure. It is designed as a Yellow building to allow
natural light into almost all parts of the building especially patient care areas. The
architecture allows conservation of energy. The building is earthquake resistant. CFL
lights have been used, thereby reducing power consumption. The space provided in the
various departments is sufficient to move freely. CCTVs installed all over the building
act as digital watchmen and help in security services.
The Hospital is equipped with:

 100 bedded hospital.
 ICU with 9 beds: Medical, Surgical, Liver Transplant, Kidney Transplant with 3
Mechanical Ventilators.
 Neonatal ICU for three incubators.
 OT Complex for 4 OT Rooms and 1 Ambulatory theater
 9 bedded Emergency Treatment Unit
 3 bedded Dialysis centre equipped with modern dialysis machines like SLED
(sustained low efficiency dialysis machine) and providing 24 hrs. Coverage.
 Diagnostic facility comprising of 1.5 Tesla MRI scanner, 64 slice CT scan, 4 X-
Ray units, 3 Ultrasound units, 1 Mammography machine and 1 Bone dexa scan
machine.
 All laboratory services of world class standard like histopathology, microbiology,
biochemistry and hematology are present.
 Ambulances which transport patients to the hospital emergency.
 Fully equipped Advanced Technological Nurses Training School.
 Supervisory and Nursing Specializations Training Centre.
7
1.5. Departments in the Hospital
The Outpatient Department are:
 Pulmonology
 Rheumatology
 Obstetrics & Gynecology
 Pediatrics
 Physiotherapy
 Orthopedics
 Psychiatry
 Ophthalmology
 Dental
 Dermatology
 Diabetes and endocrinology
 Internal medicine
 Sports medicine
 ENT
 Emergency medicine
 Radiology
 Speech therapy
 Music therapy
 Gastroenterology
 Neurology
 Neonatology
 Infertility
 Dialysis
 Nutritionist and Dietitians
 Speech and Physiotherapist
8
The In Ward Departments are :
 Medical Surgical Department

 Radiology Department
 Immunization Centre
 Cardiology
 Emergency Treatment Unit
 Medical and Surgical Department
 Suwataha Piyasa
 Physiotherapy Department
 Laboratory
 House Keeping Department
 Pediatric Department
 Gynecological and Obstetrical Department
 High Dependent Unit
 Neonatal Intensive Care Unit
 Ophthalmology Department
 Day Treatment Unit
 Dialysis and Kidney Transplant Unit
 Surgical step Down
 Operation Theater Complex
 Ambulatory Theater
 Intensive Care Unit
9
The surgical procedures carried out in the hospital are :
 General Surgeries
 Laparoscopic GI
 Bariatric surgery
 Small Vascular surgery
 Plastic and reconstructive surgery
 Liver transplant
 Bone-marrow transplant
 Kidney Transplant
 Gynecological and Obstetric
 Orthopedic Surgery
 Thoracic Surgery
Other services in the hospital are :
 Blood Bank
 Laboratory services
 CSSD
 Pharmacy
 Preventive health check-ups
 Patient care service
 Clinical nutrition
 Immunization Centre
 Food and Beverage
10
1.6. The Department Studied in Details
1.6.1. Hemas Hospital Wattala Intensive Care Unit
Hemas hospital Intensive Care unit is situated in third floor of the hospital. This is a
General ICU, There is nine bedded capacity large spaced area and one positive pressure
isolation room for care of immune suppressive and transplant patients and other eight
beds are separated for care of Surgical and Medical patients. The Hemas hospital ICU is
situated in near the Operation Theater Complex, CSSD, Surgical Step Down Unit and
Day Treatment Unit. In Hemas ICU staffs working together for care of patient life. In the
Hemas Wattala ICU caring the patient for one to one care.
1.6.2. Human Resource Capacity of Hemas Wattala ICU
In charge Consultant Anesthetists 02

In charge Senior Medical officer 01
Anesthetic Medical Officer 01
Critical Care Medical Officers 04
Sister In Charge 01
Sister Grade Nurse 01
Critical Care Nurses 05
Nursing Officers 14
Nursing Assistants 02
11
1.6.3. Equipment Resources availability of Hemas Wattala ICU
Bed Capacity 09
Positive Pressure Room 01
Mechanical Ventilators 03
Portable Ventilators 02
C-PAP Machine 02
ABG Machine 01
Advanced T4 Cardiac Monitors 04
Cardiac Monitors 05
Portable X Ray Machine 01
Ultra Sound Scan Machine 01
Advanced Tech Syringe Pumps 20
Advanced Tech Infusion Pumps 09
Other Facilities
Suctions
Inter Costal Drainage System
Deep Vein Thrombosis Pump
Bi Pap to given oxygen to patient
Other all equipments are available in any time in ICU. The Hemas ICU was fully automated
infection control Air conditioner working an every ten minutes, it's prevent the infective
agent growing. In the ICU care of patient with medically and surgically ill patients together
trained and experienced staffs.
12
1.7. Current Hospital Information System
In the Hemas group of hospitals using current Hospital Information System is WIPRO its
very fast but staffs facing some problems when using the information system.
Benefits of Using WIPRO HIS :
 Keep patient information's

 Medication Ordering
 Investigation Orders and keep pt investigation results
 Fluid managements chart
 Keep Consultations Notes
 Keep Nurses Notes
 Medication Chart
 Paramedical Visits
 Patient payments and bill
 Drug returning
 Internet access for web searching
 Reference Guide
13
2. Process Analysis
2.1. Process Flow
Input Processing Output
Admission Patient Care Discharge

1. Registering the 1. Monitor Vitas signs 1. Discharge
patient
2. Medications 2. Transfer to ward
2. Allocation the bed
3. Investigations 3. Transfer to
3. Initial assessment of another Hospital
Nurse and MO 4. Blood Transfusion
4. Death
4. Initial Investigations 5. Dressing
5. Inform Consultants 6. Laundry service
2.2. Core Patient Care
2.2.1. Main Functions related to Core patients care
Functions Activities Issues
In the ICU setting there is three functional units. Admission, patient care and Discharge.
In the Admission function firstly registering the patient in reception section. then to
allocation the bed regarding the patient condition, the patient is divide the medical and
surgical case. After the allocating the bed initial assessment done by allocated nurse and
ICU medical officer. In the assessment as a nurse done head to toe assessment and done
with proper Nursing Care Plan. The medical officer done assessment order the initial
14
management and initial investigations. The nurse administer medications and done
investigation as ordered by medical officer in initial assessment.
In admission function unit initially informing the consultant by ICU medical officer for
patient relevant conditions and get opinion the consultant regarding patient treatment and
investigation to be done. The medical officer order the further investigations and
medications as consultants instructions.
In the patient care function routine nursing care and special care for necessary time. The
routine care such as monitor patient vital signs gradual interval in the ICU setting
continuous monitoring for patients Heart rate, blood pressure, body temperature,
respiration rate, ECG and oxygen saturation level. Administer medications, done
investigations, maintain patient fluid management, dressing, prepare the patient for
surgery, blood transfusion if needed and more caring functions are doing in the ICU.
In patient Discharge process there is four categories are included. Direct discharge from
ICU, Transfer to Ward, transfer to another hospital and Death. In direct discharge of the
patient ICU is rare but patient went to LAMA (Leave Against Medical Advice) and
normal discharges are commonly consider Direct Discharge. In Transfer to ward is after
critical management transfer the patient to ward for continuing the treatment such as
antibiotic cause and others also.
In transfer to other hospital process is when patient need further management,

unavailability of treatment in hospital and financial affordable problems also consider
about Transfer out. and lastly Death is confirmed by medical officer and informed
relatives. If there is needed inquest or not decided by Consultants. If there is no cause of
death consultant will ordered inquest and relatives can ordered also.
2.2.2. Main activities related to core patients care

 Admission related activities
 Welcome the patient Gentle Curtsy.
 Registering the patient.
 Allocation the bed.
 Initial Assessment by the Nurse.
15
 Initial assessment by the Doctor.

 Initial Investigations.
 Stat Medication administer.
 Inform the patient condition to the Consultant.
 Medication related activities

 Medication received from the pharmacy.
 Show and Conform senior staff.
 Check the Five rights.
 Conform the patient, ask name, age and address if possible.
 Explain the procedure to the patient.
 If Intravenous injection prepare the patient.
 Draw the injection.
 Administer the injection slowly.
 Explain indication, side effect of drug to the patient.
 Proper Charting after administering the injection or oral.
 Blood Transfusion related activities

 Blood pint received from Blood bank.
 Cross check the blood pint and BHT about patient name, age, BHT no and
blood pint no by Doctor.
 Cross check the blood pint and BHT about patient name, age, BHT no and
blood pint no by Nurse.
 Explain the patient regarding blood transfusion.
 Obtain Written Consent by patient or relatives.
 Before transfusion start ask about any allergic in blood products.
 Conform patient name, age, address and blood group.
 Explain about allergic reaction.
 Start Blood transfusion slowly.
 Monitor Vital signs and allergic symptoms frequent interval.
16
HHIT102
Appendix 1. Process Flow
Yes
Patient Need Obtain Consent Ventilate Pt Blood Laundry

Ventilate
Records Transfusion Service
No
ETU Medication
Identified
Another Disease Admission Observation Patient
Hospital Conditio
n Food
Care Serving
No
Operation Medical
Need Arrange Connect Pt
Theater Ventilator to Records
Ventilator Investigations
Ventilator Physiotherapy
Ye
Pt Discharge
Hand Method of Pt Discharge OR Transfer
Arrange the
over Payment
Transport
Reports
Home Transfer Transfer to

to Ward Another Hospital 17
2.3. Supplementary Patient Care

2.3.1. Main functions related to supplementary patient care
 Blood Bank relative activities
 Specimen handling
 Management of death
 Material management
 ICU staff roaster
 Utility management
 Linen Handling and Laundry service
 Stationary and consumable Ordering
2.3.2. Main activities related to supplementary patient care

 Blood bank related activities
 If not available blood in Hemas hospital inform sister to ICU for delay.
 Inform NCTH BB requirement of blood by BB Mo.
 Arrange Hospital in Charge BB staff.
 Arrange the Vehicle.
 Proper Container and Preservatives.
 Transfer the DT sample and request NCTH by MTA
 Received blood from NCTH BB
 Check the blood correct/ not by BB MO
 Inform and Send the blood to the ICU.
 Specimen handling related activities

 Collect the proper sample.
 Proper labeling the sample (name, age, BHT no, Ix name)
 Prepare the Request
 Send the sample to laboratory
18
Appendix 2. Process Flow of the Drug Management
Medication Ordered By
Consultant
Written Medication Chart

by Medical Officer
Drugs Ordered through

System
Availability
Yes of Drugs in
Hospital No
Received Drugs Write Prescription Send Prescription

from Pharmacy by Medical Officer to the Pharmacy
Need IV
access Pharmacy
receiving drugs
No from out side
Yes
Received drugs
Conform & from pharmacy
Oral
inform the Patient
Administration
IV Cannulation
done by Nurse
Administer the
Medication 19
Appendix 3. Process Flow of Blood Transfusion
Patient low Hb%

OR Anemia
No
Need Blood
Ordered oral/Iv Drugs
Transfusion
through System
Yes
Received Drugs from
Conform & Order by Consultant Pharmacy
Fill DT Form by Medical Officer

End Administer Medications
Oral/Injection
Inform Pt & obtain consent
Finished transfusion
appropriate duration Collect DT & Grouping Sample by Nurse Inform other hospital
by blood bank M/O
Monitor Vital Signs Send DT sample &

& allergic reactions form to the Blood Bank Send to the DT sample &
form appropriate Blood
No
Prepare Pt and Start
Received matched Blood
Trnsfusion
Availability pint from appropriate
of blood in outside hospital
hospital
Recheck by M/O &
two Nurses
Yes
Received Blood from Received Cross Matched from

Hemas Blood Bank HemasHospital Blood Bank 20
Appendix 4. Transfer the patient another hospital for further Management
Transfer the patient another

Hospital
Conform & Decide

Consultant
Arrange all Documents and payment

method
Reason for
Financial affordable Need further
Transfer
problem Management
Arrange the ambulance Inform Hospital in

Charge
Prepare the patient for Inform patient condition for appropriate

Transfer hospital ICU M/O & Nurse
Arrange the
Ambulance
Prepare the Patient for

Transfer
Transfer the patient to
appropriate hospital
21
Appendix 5. Process flow of Transfer the patient to the Ward
Written order by Consultant
Inform relatives
Arrange and Selecting

the Room
Inform Ward Staff

regarding patient condition
Prepare the patient for

Transfer
Transfer the patient to

Ward
22
Appendix 6. Process flow of Dead body Handling
Death Conformed by Medical Officer
Inform Relatives
Death Certificate and Cause of death written

by Medical Officer
Inquest No
Order
Transfer the Body to Yes
NCTH Faculty Prepare the Dead body
Inform Coroner by
Nursing Staff
Payment Methods
Submit Pt Documents and
Dead body seen by Coroner
Belongings
No Submit Pt Documents and

Belongings
Payment Methods Need
Postmortem
Handed over the body to

Yes
relatives and undertakers
Arrange the Ambulance to

transfer the body to NCTH
23
2.4. Problems Related to Patient care

 Lack of IT Knowledge.
 Taking more times and system slow.
 In the Admission there is a Mistakes in patient name, age and other details.
 The ICU admission Nurse more time spending to filling the printed forms,
E.g. Charts of investigations, medications, ICU chart, care plan, Nursing assessment
form, Falls risk assessment form, pressure ulcer tool, nutrition assessment form,
consent, etc....
 After the procedure nurse used consumables and others need to writ the charges sheet,
then billing clerk update the patient account. In many procedure doing time difficult
to remember used items.
 In Drug ordering activity there is one generic name but in the system many brand
names are showing, after ordering the any brand, the pharmacist call back and order
this brand because previous ordered drug not available in the pharmacy. The ordering
nurse don't know which brand drugs are available in the pharmacy.
E.g. Paracetamol 500mg is a generic name but in the system Panadol, panadol tablet,
paragon, paracetol, actifast, etc......
 The Lab investigation procedure, many investigations names are not available in the
system, staffs ordering the manual barcode.
 In Hospital using HIS but there is investigation order still on paper request and
sometimes need to send before procedure.
E.g. CT Scan, before procedure appointment take over the phone and written request
send to radiology also.
 When patient discharge/ death before making final bill have to balanced medication,
that time taking more time and compare system and pt medication chart, from
admission to discharge.
 Time delay for making final bill, because after patient discharge billing clerk to be get
all patient consultant charges, drug balanced, consumable updating, etc.....
 The Entrance of ICU patient details white board is there. in every shift nurse should
write ICU patient name, BHT no, Consultant name, etc.. no digital display in the ICU.
24
 When taking a paramedical referral, nurse need to inform regarding unit over the
phone with patient relevant conditions.
 The patient investigation results are not updating the system, its receiving paper
report. In some urgent investigations are nurse need to call and ask the laboratory.
E.g. Troponin I >1 hours
 The radiological investigation reporting are very slow, because radiologists are not
available in any time. So nurse travel ICU to radiology two times, 1st doing the
investigation, 2nd to collect the report. Because Films are not upload the system.
 After the final bill ready the patient/ relatives need to go and collect printed paper bill
at second floor billing department, then need to go ground floor for payment counter,
after that back to ICU for submit Discharge intimation.
 After the patient discharge nurse need to inform supportive service units. E.g.
Physiotherapy, Nutritionist, Kitchen, House Keeping, etc.....
 The outside medication and discharge medication need to send written prescription to
the pharmacy.
 In ICU every month stock counting nurse physically count the consumables and cross
matching the system.
 When sending the Bed Head Ticket to the Medical Record Room, the BHT rearrange
and make file.
25
3. Proposal for New Hospital Information System
3.1. Introduction
A Hospital Information System is an important factor in health care sector for managing the
administration, financial and clinical aspect of the hospitals. Hospitals are deal with life and
health of their patients. good medical and nursing care relies on well trained Nurses and
doctors and on high quality equipment facility and advanced technology system also. In main
advantage of the HIS is Record keeping and others are Speed work, easy, accurate, low cost,
low human resource and can maintain the standard of the institute (Odit, 2011).
A HIS is a system or process that providing the information necessary to manage an

organization and institute efficiently. An information system is a combination of IT and
people's a activities using that technology to support operations, management and decision
making. The IS for hospital is generally considered prerequisite for efficient delivery of high
quality health care in hospitals. Hospitals around the world are adopting HIS for enhancing
their efficient for providing improved health care. The main objectives of HIS is to achieve
the conceivable care of patient and facilitate administration in various tasks by providing
electronic data processing (Varshneya, 2012).
3.2. Objectives
In implementing a successful cost-effective integrated Health Information System of

Hemas Hospital ICU, Expecting objectives are:
 To apply a solution that is time saving, cost efficient and user enthusiastic for all
staffs in Unit.
 To implement a solution that enables a transparent, presentation driven work
environment competent of monitoring inputs, procedures and outputs of processes in
Unit.
 To implement a critical mission solution that is protected, consistent, scalable, easy to
use, easy to get to everywhere and disaster recoverable.
 To give idea to implement an incorporated health Information system software.
26
 To enable an effective and efficient intra and interdepartmental personnel

communication platform.
 To facilitate the development of an IT Support Unit
 To setup a process of moving present paper based medical records to a completely
electronic platform both prospectively and retrospectively.
(Technologies, 2012)
3.3. Implementation
In the Implementation the most crucial stage in achieving a new successful system and in
giving confidence on the new system for the users that it will work efficiently and
effectively. The system can be implemented only after thorough testing is done and if it is
found to work according to the specification (Hirachan, A. et al. 2014).
It involves careful planning, investigation of the current system and its constraints on
implementation, design of methods to achieve the change over and an evaluation of
change over methods a part from planning. Two major tasks of preparing the
implementation are education and training of the users and testing of the system
(Hirachan, A. et al. 2014).
27
4. Instruction to the Software Engineer regarding New HIS
4.1. Existing System
Hospitals currently use a system for the management and maintenance the activities. The
current system is some short of system slow, Missing some data, options and using some
request papers. Often information (on forms) is incomplete, or does not follow management
standards. Multiple copies of the same information exist in the hospital and may lead to
inconsistency in data in various data stores (Hirachan, A. et al. 2014; Zai & Bukhari, 2011).
4.2. Proposed System (Expectation)
The Hospital Information System (HIS) is designed for Any Hospital to replace their existing
manual, paper based system. The new system is to control the following information; patient
information, room availability, staff and operating room schedules, and patient invoices.
These services are to be provided in an efficient, cost effective manner, with the goal of
reducing the time and resources currently required for such tasks (Hirachan, A. et al. 2014;
Zai & Bukhari, 2011).
4.3. ICU Requirement regarding Hospital Information system

The hospital new information system as a Nurses Expectation of system menu under the
points. That are
 Implement the Nursing Information system (NIS). The day to day updated nursing
information system are useful for nurses to carry the patient care. In NIS need main
functions. that are
o Nursing Clinical Record

o Care evaluation
o Discharge planning
o Workload assessment (prospective and or retrospective)
o Personnel management
o Staff roaster
28
o Attendance recording
o Skill mix management
o Costing
o Budget management
(Varshneya, 2012)
 Patient information System
In ICU patient Dashboard need to show patient all details, bed type, bed
no, responsible consultant, and relevant details also.
 Comprehensive Electronic Medical record
The Central depository for all medically related documentation showing

the medical history of each patients into a single medical record with a single mouse
click can view the patient consultants visit, diagnosis, investigation result, medical
examinations, treatments, histories and medication histories. which will help to
o Improve quality and convenience of patient care
o Increase patient participation in their care
o Improve accuracy of diagnoses and health outcomes
o Improve care coordination
o Increase practice efficiencies and cost savings
(Varshneya, 2012; Orion, n.d)
 To prevent sending request forms for investigations and others. when ordering any
investigations. outsource drugs and others have to order system through. Which will
help to time serving, no need extra human resource and papers.
 Patient Management
The manage entire patient care workflow from registration patient

information, allocation the bed, transfer the patient, and discharge.
29
 Patient medication system
The patient medication management system that help increase the patient
safety by decreasing risk of wrong medication. Patient drug ordering done through
electronic or prescription scanning and the full description about drugs save in system
any time. A patient medication profile show his past and current medication history.
 Patient Diagnostic Order Entry
When the order medication, do the investigation and patient special or

abnormal activity automatically go to patient diagnostic order entry. It's very useful
for when patient discharge the hospital no need to copy paste the investigation report,
medication history and others. it's automatically updated, so when "press" the print
it's output is all details in one paper (Orion, n.d).
 Combine Radiology investigation System
The radiological investigation order through system not in a form. All

radiological investigations stored in patient information system. When the radiologist
reporting the X ray or other radiological investigation through the system, consider
patient all health history. Because radiologist can see the patient all condition related
information in the system. So Radiologist Diagnosis is 100% accurate (Odit, 2011;
Hirachan, A. et al. 2014).
 Laboratory Investigation system
In laboratory investigation system, patient investigation order patient

profile through the system and get the bar code it's contain patient name, patient ID
and investigation name also. In system have brief details about investigation, which
type of container need, indication, when report will ready and other relevant
information also. After the report due time it can see the report patient investigation
column in due time (Orion, n.d; Odit, 2011; Odit, 2011).
30
 Operation Theater management System
In the ICU patient are need surgical management, so theater booking done
be a system. In the system contain brief details about surgeries and related videos,
surgery cost and pre operative preparation also. It will help to explain the patient and
relatives when obtain consent, patient also aware what will going to me (Orion, n.d).
 Material Management System
In the material management option system through order the stationary,

consumables, housekeeping materials, CSSD request, Breakdown Request,
Maintenance request, Laundry request and Equipment request also. After the material
received it's automatically update the unit stock, because when taking the stock count
every month it's easy for Nurses (Orion, n.d).
 Human Resources Data
In HR data contain who are people working in ICU, they full bio graphic
data, Qualifications and other descriptions, Consultants who are responsible in ICU,
Medical officer details, Staffs duty roaster and other human related updated data have
to uploaded in new system (Orion, n.d; Hirachan, A. et al. 2014).
 Statistic Information System
In ICU, care of major critically ill patient, so any time patient was get
cardiac arrest, intubation the patient, can occur death, surgeries, Injuries, Hazards
and other unplanned events. So these are discussing with quarter, annual meetings so
difficult to create the reports at meeting time but in upcoming new system need to
facility to calculate monthly, annual rates of death, cardiac arrest and other data its
easy and time serve (Hirachan, A. et al. 2014).
31
 Financial and Billing system
In billing system it's help to make patient bills automatic entering the
consumables and stationeries through the bar code system. In example - when taking
a syringe feed the barcode in the machine after that can use now automatically
entered the syringe charges in patient personal account. It's simple and easy, so no
need a billing clerk each units and same procedure for consultant visit, when making
a consultant note routinely charges will be update. When the patient discharge its easy
and no time waste to make a final bill, it's all are up to date (Orion, n.d).
 Specific Personal security system
The all information systems are created perfect but no use without security
and responsible person. So each and every staffs have username and password
confidentially. Because all work are order the system but no proof for who are order
the drug, investigations and other activities. But when using a username and password
can identify the responsible person who are ordered (Orion, n.d).
 Proper Information System handling Training
32
5. Conclusion
In this paper very briefly described and explained hospital staff facing problems due to current
HIS. In proposing new HIs are more effective and efficient to work staff easily. In the End of this
assignment (4th chapter) Instruction to the software engineer for requirements are given for the
ICU. So as a Nurse is a major role in the hospital and nurse also facing more problems related to
IT. Because lack of IT knowledge and poor handling.
In this small study I hope Hemas hospitals executive professional and IT professionals to put
more effort and consider related IT issues in the Hemas Hospital. The proposing new system is
should have a patient and nurse oriented HIS, that is a outcome and good will of the hospital.
The Nurses expectation also.
33
6. References
Hemas, H. (n.d.). Hemas Group of Hospitals . Retrieved from Hemas hospitals:

https://hemashospitals.com/about/our_promise.php
Hirachan, A., Bista, B., Manandhar, N., & Shresha, R. (2014). Hospital Record Management
System. Kathmandu: Akash College.
Odit, A. D. (2011). Records Management Systen for Mabarara Hospital. Uganda.
Orion, H. (n.d.). Orion Health Information system. Retrieved from Orion Health:
https://www.orionhealth.com/nz/hospital-information-system/features
Technologies, S. (2012, February 26). Successful Implementation of a Functional Health

Information System. Victoria, Island Lagos.
Varshneya, A. K. (2012). Hospital information system. Bangalore : Institute of Health

Management Research.
Zai, Q., & Bukhari, S. W. (2011). A Plan for Implementation of Hospital Information System in
Developing Country: Recommandation From Socio - Technic Prespective. Swedan: Linnaeus
University.
34
M A Naleef UGS00019676 HHIT102
Assignment Rubrics
Course Code : HHIT 101
Semester : September 2015
Criteria Weigh (0) Low (1) Fair (2) Above Average Excellent (4) Score
t
The description on The description The description on the The description on
There is no the topic of on the topic of topic of discussion is the topic of
description one discussion is poor discussion is fair; good; ideas to be discussion is
the topic of ideas to be ideas to be discussion are relatively excellent; ideas to be
1. Introduction discussion. discussed are very discussed are clear and organized but discussed are very
5 vague and vague and inadequate explanation. clear and well 8
disorganized. disorganized. organized. The intent
of the work is
explicitly explained.
No clear Contents are not Satisfactory Good contents presented. Excellent analysis
2. Organization of 4
1 contents. focused. contents presented.
write up
presented.
Demonstrate Demonstrate Demonstrate through

Does not Demonstrates reasonable considerable & insightful
demonstrate insignificant understanding on understanding on service understanding on
3. Understanding on services process process analysis. service process 8
understanding understanding on
services Process 2 analysis. Relevant & specific analysis creatively
on services services process
analysis supportive evidence include relevant &
process analysis.
analysis. included. specific evidence.
4. Discussion on Does not Insignificant Reasonable Considerable Demonstrate through 16

35
New process demonstrate demonstration new demonstration demonstration new & insightful
new process process flow new process flow process flow eliminating understanding on
flow eliminating the eliminating the the issues mentioned in demonstration new
eliminating the issues mentioned in issues mentioned both core patient care and process flow
4 issues both core patient in both core nursing process. eliminating the issues
mentioned in care and nursing patient care and mentioned in both
both core process. nursing process. core patient care and
patient care nursing process.
process &
nursing
process.
No special Special instruction Special Special instruction to the Special instruction to 6
instruction to the software instruction to the software engineer and be the software engineer
5. Role of the 1.5 given engineer and be software engineer innovative think outside and be innovative
software Engineer innovative think and be innovative the box is not relevant think outside the box
outside the box is think outside the and adequate. is not relevant and
not relevant box is not comprehensive.
relevant and
adequate.
There is no A poor conclusion A fair conclusion A good conclusion which An excellent 4
conclusion to which does not which indicate indicate reasonable conclusion which is
6. Conclusion 1 summarize the indicate an attempt reasonable analysis and synthesis of concisely and
write up to synthesize the analysis and idea. precisely written. It
discussion synthesis of idea. provides concluding
remarks that shows
an analysis &
synthesis
There is no Citations for Some citation for Most citations are All citations are 4
7. References & references or statements included statements included in the included in the
citation according to 1 citation in the discussion included in the discussion and most discussion and most
the APA format are not presenter discussion references match the references match the
references which references are not citations according to the citations according to
are included not found in the text. APA format. the APA format.
found in the text.
Total 50
36
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Hospital Information System Assignment

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SCHOOL OF NURSING AND ALLIED HEALTH SCIENCES

"Health and Hospital Information System"

Hospital Information System in the Hemas Hospital

MOHAMED ANWER ANLEEF

NIC No- 882912671V

Tutor’s Name: Dr. K. Edirisinghe & Mr. Tharindu Dushyantha Dewalegama

Learning Centre: IIHS, Welisara, Srilanka.

December, 2015 Semester

1. Hospital Orientation .........................................................................................................5

1.1. Introduction of Hemas Group of Hospitals ...................................................................... 5

1.2. Hemas Hospital Wattala ................................................................................................... 5

1.2.1. The Logo of the Hospital .......................................................................................... 6

1.2.2. Hemas Promise ......................................................................................................... 6

1.2.3. Accreditations ........................................................................................................... 6

1.3. Affiliates in the Hospital .................................................................................................. 6

1.4. Infrastructure .................................................................................................................... 7

1.5. Departments in the Hospital ............................................................................................. 8

1.6. The Department Studied in Details ................................................................................ 11

1.6.1. Hemas Hospital Wattala Intensive Care Unit ......................................................... 11

1.6.2. Human Resource Capacity of Hemas Wattala ICU ................................................ 11

1.6.3. Equipment Resources availability of Hemas Wattala ICU .................................... 12

1.7. Current Hospital Information System ............................................................................ 13

2.1. Process Flow ................................................................................................................ 14

2.2. Core Patient Care ........................................................................................................... 14

2.2.1. Main Functions related to Core patients care ......................................................... 14

2.2.2. Main activities related to core patients care ............................................................ 15

2.3. Supplementary Patient Care ........................................................................................... 18

2.3.1. Main functions related to supplementary patient care ............................................ 18

2.3.2. Main activities related to supplementary patient care............................................. 18

2.4. Problems Related to Patient care .................................................................................... 24

3. Proposal for New Hospital Information System................................................................26

3.1. Introduction .................................................................................................................... 26

3.2. Objectives ....................................................................................................................... 26

4. Instruction to the Software Engineer regarding New HIS.................................................28

4.1. Existing System .............................................................................................................. 28

4.2. Proposed System (Expectation) ..................................................................................... 28

4.3. ICU Requirement regarding Hospital Information system ............................................ 28

1. Appendix 1 : Process Flow of the ICU......................................................................17

2. Appendix 2 : Process Flow of Drug Management.....................................................19

3. Appendix 3 : Process Flow of Blood Transfusion.....................................................20

4. Appendix 4 :Transfer the patient another hospital further management....................21

5. Appendix 5 : Process Flow of Transfer the patient to ward.......................................22

6. Appendix 6 : Process Flow of dead body handling.................................................. 23

 HIS Hospital Information system

 CSSD Central Sterile Services Department

 ETU Emergency Treatment Unit

 F&B Food & Beverages

 ICU Intensive Care Unit

 MICU Medical Intensive Care Unit

 OPD Out-patient Department

 LIS Laboratory Information System

 RIS Radiological Information system

 EMR Electronic Medical Record

1.1. Introduction of Hemas Group of Hospitals

1.2. Hemas Hospital Wattala

1.2.1. The Logo of the Hospital

1.2.2. Hemas Promise

The Hospital is equipped with:

1.5. Departments in the Hospital

The Outpatient Department are:

The In Ward Departments are :

 Medical Surgical Department

The surgical procedures carried out in the hospital are :

Other services in the hospital are :

1.6. The Department Studied in Details

1.6.1. Hemas Hospital Wattala Intensive Care Unit