DPR Rajendra Institute of Medical Sciences

DETAIL PROJECT REPORT
RAJENDRA INSTITUTE OF MEDICAL SCIENCES

Integrated Health Care ICT
10/16/2014
Contents
1. Executive Summary ......................................................................................................................... 3
 Following Departments are available with RIMS........................................................................... 4
2. Drawbacks of current system with requirement of re-vamping ........................................................ 7
3. Vision for end-to-end Hospital Information Management System with integrated PACS & RIS ....... 10
 Health Care Information Management System Application (HIMSA) .......................................... 12
 Front Office Systems .............................................................................................................. 13
 Medical Systems .................................................................................................................... 14
 Back Office Systems ............................................................................................................... 16
 Administrative Systems .......................................................................................................... 16
 PACS & RIS Integration with HIMSA............................................................................................ 18
 Laboratory Information Management System (LIMS) & Integration with HIMSA ........................ 22
 Hardware & Communication Network ....................................................................................... 23
 Access Control System Integrated with HIMSA ........................................................................... 26
 Hospital Security & Video Surveillance ....................................................................................... 28
 Digital Display Data Walls........................................................................................................... 31
 Hospital Interactive Patient EMR Portal cloud application & 24 X 7 Remote Patient Call Centre
Assistance Access .............................................................................................................................. 33
 Legacy Health Records Digitization & Document Management System ...................................... 36
 IT Infrastructure Managed Services along with Facility Management ......................................... 40
4. Scope of Work (SOW) on turnkey basis .......................................................................................... 43
 Implementation & Customization of HIMSA ............................................................................... 43
 Required Detail Functionality of HIMSA .................................................................................. 43
 General Features requirement and required Architecture of HIMSA....................................... 50
 HIMSA System Qualification Criteria....................................................................................... 52
 HIMSA Warranty Support & Training requirements ................................................................ 52
 PACS & RIS Integration with HIMSA............................................................................................ 53
 Implementation & Customization of LIMS & integration with HIMSA ......................................... 55
 LIMS warranty & Training requirements ................................................................................. 55
DPR for Integrated Health Care

 Hardware & communication Network ........................................................................................ 56
 Data centre Infrastructure with User Nodes and Network setup............................................. 57
 Proposed SAN Solution and 3 Node Disaster recovery with site failure ................................... 58
 Access control system Integrated with HIMSA............................................................................ 60
 Components of an access control system ............................................................................... 60
 Technical requirements of access controls ............................................................................. 61
 Hospital Security & Video surveillance ....................................................................................... 67
 Digital display & video Walls ...................................................................................................... 67
 Hospital Interactive Patient Portal cloud application & 24 X 7 Remote Patient Call Centre
Assistance Access .............................................................................................................................. 68
 Legacy Health Records Digitization & Document Management Systems (DMS) .......................... 69
 IT Infrastructure Managed Services along with Facility Management ......................................... 71
 Annexure –A (Estimated BOM list for IT Hardware & Network) .................................................. 74
 Annexure –B (Estimated BOM List for Access control System ) ................................................... 76
6. Cost Matrix (Based on cost heads and BOMs) ................................................................................ 77
7. Implementation Methodology to be adopted ................................................................................ 79

1. Executive Summary
The Rajendra Institute of Medical Sciences (RIMS) is a medical institute of Ranchi
University in Ranchi, the capital of Jharkhand, India. The college is an autonomous body
established under an act of Jharkhand Assembly and is one of the premier medical
colleges in the state and India.
The institute was established in 1960 and was originally called Rajendra Medical College
Hospital after Rajendra Prasad, the first President of India. The medical college hospital
came into existence in February 1965. Currently RIMS is in news for its up gradation.
The institute provides free medical service to the patients along with essential drugs.
The college has 1500 bedded multi- specialty hospital with advanced diagnostic tools.
There are upcoming Centre’s under construction like the Oncology Centre with the latest
radiation machinery, a 100 seated dental college is about to function from the 2014
session. The college also has a 14 bedded trauma Centre, the first of its kind in Eastern
India.
RIMS offers its patient services by means of well trained and highly qualified Doctors
and trained Para Medical Staff with some of the finest Physicians and surgeons who are
renowned in their specialized fields. It also offers its patients excellent radiological &
pathological investigation facilities. All these put together with positive attitude of every
member of the Institute’s Staff, gives the Institute an extra edge and makes I the
premier health care institute of the state.

Rajendra Institute of Medical Sciences is located at Bariatu Road, just beside the Eye
bank and easily approachable from main points of the city.
1. 11 Kms. from Ranchi Airport

2. 8 Kms from Railway Station
3. 6 Kms from Birsa Bus Stand.
 Following Departments are available with RIMS
 Administration
 Anesthesiology
 Anatomy
 Biochemistry
 Blood Bank
 Central Emergency
 Laboratory Medicine (Clinical Pathology)
 Dentistry
 E.N.T
 Eye
 Forensic Medicine
 Microbiology
 Medicine
 Neurosurgery
 OBST & GYNAE
 Orthopedics
 Pediatrics
 Pediatric surgery
 Pathology
 Pharmacology
 Physiology
 P.S.M
 Psychiatry
 Skin S.T.D & Leprosy
 Surgery
 Radiology
 TB & Chest
 Cardiology
 Oncology
 Urology
 Cardiothoracic
 PMR
And following specialties are available:
Round the Clock Services
 24-hour Accident and Emergency Services

 Licensed Blood Bank
 State –of- the- art Radiology and Imaging

 Specialized laboratory and Diagnostic Services
 Cardiac Care
 24 hour Pharmacy
Department of Surgery
 Intensive care unit (ICU)

 Round the clock emergency services
 Pediatric surgery
Emergency, Trauma & Critical Care
 Round the clock Emergency services with transport and Resuscitation unit
 Intensive care provides committed, quality care for critically ill patients.
 State of the art Ventilatory and Monitoring equipment.
 Pre-anesthesia clinic
Department of Medicine
 Intensive care Unit (ICU)

 Intensive Coronary Care Unit (ICCU)
 Haemo Dialysis
 Electro Cardio Gram (ECG)
 General Cardiology Clinic
 Color Doppler
 TMT
 Non-Invasive Cardiology – ECG, Stress ECG, Echo Doppler, Trans esophageal Echo,
Vascular Profile, Ambulatory BP Monitoring, Ambulatory ECG, Event Recorder
Diagnostic Imaging and Interventional Radiology Centre
 Multi Slice Scanning

 Computed Radiography
 Ultra Sonography and Color Doppler
 Conventional Radiology
 X-Ray
 MRI(being installed)
Department of Ophthalmology
 Operating Microscope for Cataract-Operation for Cataract, ECCE, SICS

 Petrygium Surgery
 Dacryocystorhinostomy, DCT
 Lid surgery
 Trauma Management
Department of Anesthesiology

 Gas Anesthesia
 Spinal and Epidural Anesthesia
 Boyls Apparatus
 Cardiac Monitor
 Pulse Oximeter
 Ventilator
Department of Neuro-surgery
 Neurological Emergencies
 Neurological OPD Facility – Adult & Child Neurology Services
 Neuro Electrophysiology Studies:
1. EEG, EEG Video recording, EMG
2. Nerve Conduction Studies
3. Evoked Potentials- Visual, Auditory & Somoto sensory
Department of OBG (Obstetrics & Gynecology)
 Round the clock Emergency Services

 Antenatal & postnatal Care
 Family Planning
 Laparoscopic Surgery
 All major & minor Surgeries
Department of Pediatrics
 Neonatal Care
 Photo Therapy
 Pulse Oximeter
 Warmer(Radiant)
 Exchange Transfusion
Laboratory Facilities (Specialized Referral Testing Lab Services)
 Clinical Pathology
 Biochemistry
 Histopathology
 Microbiology
 Molecular Biology
 Hematology
Physiotherapy and Rehabilitation
 Pain Management
 Exercise Programmer for Geriatric, Obesity
 Antenatal Exercise Programme

The unique feature of the Hospital is that it renders specialty and super specialty services
through Modern Medicine and Surgery under one roof.
Statistical Information:
 Average number of Out-patients registered per Year - Estimated 600-000 to

700-000 Per Annum
 Average Number of in-patient registered per Year – Estimated in the range of
200,000
 Beds Available – 700+
2. Drawbacks of current system with requirement of re-vamping
Keeping in view India environment scenario as the following aspects:-
(i) Working environment of the Hospital.

(ii) The thought-process and attitude of Indian people.
(iii) The literacy rate of India.
(iv) The Existing system, being used in the majority of Hospitals.
(v) The availability of Infra-structural facilities likes finance, skilled personals, and
working environment.
And our staggered investments over some period of time in some of the automated
process of the hospitals which are working on individual silos the systems are not
giving the hospital the required productivity in day to day Hospitals functions like
Room activities, Admission of New Patient, Discharge of Patient, Assign a Doctor, and
finally compute the bills etc.
 The Current System has lot of manual process and has lot of paper work
 To maintain the Records of Patients and their health records is a time consuming
job.
 Retrieval of previous records of patient is a tedious jobs
 No integrated systems for hospital administrations and patient care facilities
 There are issues of Information reliability, accuracy, timeliness of information
along with validity of the Information available with the hospital.
 The current manual process also add in the problem of capacity as the staff is in
limited number and the workload is increasing and vis-à-vis productivity required
from them decreases with lot of manual validations and manual Information

gathering. We are now in the process to revamp our hospital information
management system so that Hospital Information Management System provides the
benefits of streamlined operations, enhanced administrations and controls, superior
patient care, strict cost control and improved productivity. The System has to
flexible, easy to use and is designed and developed to deliver real conceivable
benefits to hospital and it is backed by reliable and dependable support. The New
Hospital Information Management system should be designed for multi-specialty
hospital administration and management processes. The system required will be an
integrated end-to-end hospital Information management system that provides
relevant information across the hospital to support effective decision making for
patient care, hospital administration and critical financial accounting, in a seam less
flow.
The Information system should be capable to provide

 Consultation by Doctors on Diseases.
 Diagnosis for diseases.
 Providing treatment facility.
 Facility for admitting Patients (providing beds, nursing, medicines etc.)
 Immunization for Patients/Children
Various operational works that are done in a Hospital are:-
 Recording information about the Patients that come.

 Generating bills.
 Recording information related to diagnosis given to Patients.
 Keeping record of the Immunization provided to children/patients.
 Keeping information about various diseases and medicines available to cure
them.
These are the various jobs that need to be done in a Hospital by the operational staff
and Doctors. All these works are done on papers. The work is done as follows:-
 Information about Patients is done by just writing the Patients name, age and
gender. Whenever the Patient comes up his information is stored freshly.
 Bills are generated by recording price for each facility provided to Patient on a
separate sheet and at last they all are summed up.

 Diagnosis information to patients is generally recorded on the document,
which contains Patient information. It is destroyed after some time period to
decrease the paper load in the office.
 Immunization records of children are maintained in pre-formatted sheets,
which are kept in a file.
 Information about various diseases is not kept as any document. Doctors
themselves do this job by remembering various medicines.
Presently all this works are done manually / or thru some office automations
applications by the administrative and operational staffs and lot of papers are needed
to be handled and taken care of. Doctors have to remember various medicines
available for diagnosis and sometimes miss better alternatives which are available
Various reports needed by the in-patient departments needs to be waited in absence
of integrated Hospital information management system integrated with PACS & RIS
systems . The proposed Information Management System will increase staff
productivity and efficiency by:
 standardizing data, resulting in fewer corrections and significantly lowering

the incidence of missing or incorrect data
 consolidating data stores into one location ensuring data integrity and
providing a database for future statistical and management reporting
 reducing the time spent by staff filling out forms, freeing resources for more
critical tasks
 speeding up the billing process by having accurate, timely data, resulting in
quicker payments and a better cash flow
 increased error checking to reduce errors made in scheduling, making
schedules more reliable, increasing staff morale, and reducing the amount of
Time spent by administration creating and publishing schedules
Any person of staff at the hospital will be able to use the system. Normally, clerks
and admitting nurses will input patient information and print invoices, while
administration staff will prepare and enter schedules. Doctors and nurses will also be
able to access the information in the integrated system.
The proposed Hospital Information Management System will take care of following:
 Health care platform strengthening links between the health provider and
the patient
 An enterprise-wide “patient management” system, throughout the patient’s
life.
 Federated / enterprise wide data repositories, specifically in areas such as
EMR, EHR, etc.
 Automation of Patient referral processes across the delivery Chain

 Enterprise Application Integration which tie up the new structure with existing
legacy Assets.
3. Vision for end-to-end Hospital Information Management System

with integrated PACS & RIS
Integrated end-to-end Hospital Information Management System refers to the
broad class of information Integration that aids health care organizations in
achieving efficient and effective care delivery. An Integrated approach encompasses
software applications, hardware, Communication Networks as well as requisite
people, policies, and processes. We as an upcoming multi-specialty hospital needs
to develop a plan that describes its long range goals for acquiring and achieving
effective use of Integrated Hospital Information management System with PACS (
Picture Archiving & Communication System ) and RIS ( Radiology Information
System) . Without a guiding roadmap, We are always in a reactive position,
responding to what a vendor offers or what appears to be a regulatory requirement.
Getting true value from Integrated HIMS comes from setting your own Information
Requirements & communicating expectations, engaging all stakeholders, and
celebrating success with Patient Centric Repository.

So Integrated Hospital Information Management Systems can be spell in following
heads:
 Health Care Information Management System Application (HIMSA)

 PACS & RIS Integration With HIMSA
 LIMS ( Laboratory Information Management System) Integration with
HIMSA
 Hardware & Communication Networks
 Access Control Systems Integrated with HIMSA
 Hospital Security & Video Surveillance
 Digital Display Boards
 Hospital Interactive Patient Portal cloud application & 24 X 7
Remote Patient Call Centre Assistance Access
 Legacy Health Records Digitization & Document Management Systems
(DMS)
 IT Infrastructure Managed Services along with Facility Management

 Health Care Information Management System Application (HIMSA)
Based on the functionality required for our hospital, the modules of the application
can be broadly divided in to four groups
 Front office Systems

 Medical Systems and Integration With HIMSA
 Administrative systems &
 Back office systems
Front office system - Provides services across the counter to patients such as
Patient Registration, Out Patient billing & Cash Handling, In Patient Administration,
In Patient Billing & Cash Handling, Pharmacy and Night Auditing modules. These are
the base modules for patient management and medical systems.
Medical System – Caters to the upkeep of various records such as Laboratory

module for test reports, Operation theater scheduling, Blood Bank, Nurse Station,

Medical Records, OPD patient’s Case History, Cathlab reports and Stress Test
reports.
Administrative System – Ensures efficient management of various administrative

functions such as Equipment Maintenance, Patient Complaint Monitoring,
Maintenance Tracker, and Linen & Laundry Management.
Back Office System – Handles back office functions such as Credit Companies
Accounting, Doctors Accounting, Financial Accounting, Payroll, General Stores and
Purchase Management.
 Front Office Systems
Patient Registration Module

Serves the basic and most important module for the hospital system. All the patients
visiting the hospital for outpatient or in-patient services are first registered using this
module. It captures the basic demographic details of a patient, which are permanent
in nature and generates a Medical Record Identification that can be used for
compiling medical records for patient’s visits.
Out-patient Billing & Cash Handling Module

Captures the deposits and charges of outpatient services provided by various service
departments. It can be set up for centralized as well as decentralized cash
departments in the hospital. Linked to patient appointments to Doctors . It will also
have the link to doctor’s Electronic Medical records where on payment by the patient
is indicated to doctor sitting in consultation room thru EMR .
In-patient Administration Module

Records the patient’s admission details and keeps track of them. Allows the transfer
of a patient from ward / bed / class to another. Provides the facility to make
advance booking of patients for admission. Features include on-line bed positions,
doctor-wise admissions, bed type-wise occupancy and many more.

In-patient Billing & Cash handling Module
Posts online the charge for the in-patient services provided by the hospital and
ensures that charges are reflected to patient’s outstanding which once captured, are
available to view by all concerned. The billing and cash handling of in-patients is
done here. It allows multiple bill preparation for a single patient and also provides a
“help-line” on patient’s outstanding which gives complete details of charges posted
at various diagnostic centers of the hospital.
Pharmacy Module
Browses receipts of medicines from suppliers and issues to in-patients as well as out
patients and updates the stock of medicines. The system provides a scientific method
of stock level i.e. Re-order level, Economic Order Quantity, Safety Quantity which
prevents stock out and over stocking situation. It updates the patient’s account on-
line upon issue of medicine to in-patients and also provides facility to issue against
medicine requisitions from wards.
Night Audit Module

End of day procedures such as posting of room charges for all in-patients, weekly bill
printing, and housekeeping and data backups are performed by this module.
Electronic Medical Records Management System
The System allows Doctor to define the case paper structure where he can set series
of questionnaires with alternative answers . The system allows to doctor to create
followings
 Create case history

 Record clinical Findings
 Order for Tests /Procedures
 Order for Medicines
 Record Allergies
 Case notes
 Request for reservation for admissions
 Medical Systems
Laboratory Reporting & Information Management Module

Provides registration for tests in various diagnostic centers in the hospital. Creates
user definable formats for each test conducted in the hospital and provides facility to
set default values based on sex, age etc. It will also create the Interfaces with
various laboratories instruments Present in the Hospital
Theater Scheduling Module

Makes advance booking of operation and other critical facilities in the hospital.
Provides tracking of various pre-set formalities for carrying out operations.

Blood Bank Module
Maintains donor database and tracking of each blood bottle right from blood
collections to the transfusion. Maintains details of grouping & cross matching of
blood, ageing and expiry of blood.
Nurse Station Module

Throbs as the heart of the medical system software package and helps nursing staff
to minimize their administrative duties so that they can concentrate on patient care.
Captures doctor’s orders and converts them into requisitions for various diagnostic
and pharmacy department. Provides on-line information of the patient’s condition
and also captures parameters for Apache Scoring of critical patients.
Medical Records Module

Furnishes on-line information on patient’s medical history and maintains various visit
records of a patient in the hospital and treatments given to the patient. The user
definable forms allow easy setting up of various medical forms and discharge
summary.
Case Paper Scanning System
If the doctor is not using electronic medical Record system than the system should
allow the medical record staff to scan the case paper documents into the systems
and the case paper documents are attached to the patient . The system should allow
linking multiple in-patient and out-patient visits to hospital for single case type . The
system should also allow to enter his comment on any document. The comment can
be recorded as a test or audio. The system will also allow manual linking of DICOM
/NON-DICOM Images of the patient which can be viewed along with the case paper.
Out Patient’s Case History Module
Registers the patient's case history, medical and tests prescriptions by the doctor
sitting in his OPD clinic. The doctor can make an admission / reservation advice for
an OPD patient. The data captured here is directly picked up by the relevant module
i.e. medicine prescriptions are picked up in the pharmacy, test requisitions are used
by pathlab and radiology for registering tests.
Stress Test / Cathlab Report Module
Charts specially designed data for stress test and Cathlab related tests. It also
provides pictures and color coding based on values entered by the user.

 Back Office Systems
Credit Company Accounting Module

Maintains the Accounting of credit companies having an arrangement of sending
their patients to the hospital and tracks the pending bills for credit company’s
patients. This covers the outstanding for patients like CGHS or Insurance companies
who have credit facilities with the hospital.
Doctor’s Accounting Module

Keeps track of the accounting of payments to doctors providing their services to the
hospital. It provides facility to capture various visit types by doctors i.e. routine
visits, night visits, OPD Consultations, Special Consultations etc. It also allows
flexible payment procedures such as sharing doctor’s services based on percentage
as well as fixed amount on various tests.
General Ledger Module

This module captures the financial accounting vouchers. The module also captures
the front office transactions automatically during the ‘day-end’ procedures. The
module provides multiple cash & bank accounts, on-line trial balance for multiple
locations, balance sheet, profit & loss accounts, cash flow and fund flow analysis.
Accounts Receivable / Payable Module

Prepares on-line information of trade creditors and debtor’s outstanding. It also
maintains bill-wise outstanding information and provides age-wise outstanding
reports in detail and summary forms for efficient control on outstanding of the
hospital.
Payroll Module
Holds a database of employees in the hospital and provides user definable formula
setting for various earnings and other standard deductions. The Income tax module
captures the sections of income tax and employees investment details.
General Stores Module

Arranges on-line information of receipts & issues of items at general stores. The
system allows setting up of multiple stores and also captures the consumption of
various cost centers in the hospital.
Purchase & Indent Management Module

Gathers details of purchase orders raised by the hospital with various vendors. It
provides the facility for tracking of a purchase order till the material is received and
cost is accounted in the system. The re-order level, safety quantity and economic
order quantities ensure that there is no under-stocking of critical items. The history
on supplier’s performance and vendor information provides useful MIS.
 Administrative Systems
Equipment Maintenance Module

Helps the hospital management to monitor the critical equipments in the hospital and
maintains the warranty and A.M.C. details, maintenance history and up-time &
downtime statistics of each of the critical equipments in hospital. It also maintains
the stock of expensive spare parts and their costs.
Patient Complaint Monitoring Module

Collects patient’s complaints and the track of the redressal. This helps management
to maintain high standard of services and ensure maximum patient care and efficient
services by all concerned.
Maintenance Tracker Module

Catalogs various items in the wards such as fan, A/C, TV etc. Any complaint related
to this can be tracked and resolved immediately.
Linen & Laundry Management Module
Controls movement of clothes between wards, laundry and linen departments. The
system also helps the house-keeping department in stock maintainance of linen at
various locations in the hospital.
Mobile Interface
The application Should have a mobile interface to provide an access to some critical
functionality on mobile and also provide SMS facility upon’s patient admissions
/cross consultation/Bulk SMS to groups
Patient electronic Record On smart Card
When Patients are dis-charged the patient electronic records with patient
demographic data to be provided to Patient for future use and keep tab of their
registration process in future visits to the hospital and can capture the Photograph
and biometrics of the patient.

 PACS & RIS Integration with HIMSA
The technology for acquiring, storing, retrieving, displaying, and distributing images
has advanced dramatically in recent years. Radiology information systems (RIS) and
picture archiving and communication systems (PACS) have become more
sophisticated; adopted more logical, effective, and consistent user interfaces; and
taken advantage of Web technology, the proliferation of broadband,

and faster and better hardware to efficiently distribute images outside the confines of
radiology departments. Now the push is toward enterprise-wide image management
solutions, where digital images from radiology, cardiology, and other “Technologies”
are seamlessly linked with information from clinical information systems and other
databases, and they are accessed seamlessly from a single point of end-user
interaction.
One of the earliest issues that plagued the progress of HIS/RIS/PACS integration was
a matter of language. Healthcare information systems communicate using a standard
protocol—Health Level-7 (HL7), which carries patient data between billing and
information systems
Broker Solution
To solve the language barrier, a translation was needed between HL7 and DICOM.
Enter the broker: a software and hardware device that accepts HL7 messages from
the RIS then translates, or maps, the data to produce DICOM messages for
transmission to the PACS. With RIS information now available electronically, PACS
and modalities could accept RIS data.
 The RIS needed to integrate Directly to Imaging Modalities

 The RIS needed to have bi-directional communications to PACS
 RIS & PACS functions needed to be integrated on the Desktop providing
Radiologist full access to RIS information from the PACS workstation.
 Dictation or voice recognition needed to be integrated to the RIS and PACS
 The Electronic Patient record (EPR) needed to be image enabled i.e.; linked
to radiology reports and allowing the end-user to launch PACS image viewing
within the EPR or HIMSA

PACS & RIS Integration with HIMSA benefits
 Provides a means for vendors to state explicitly their products’ integration

capabilities
 Allows users to be informed and to hold vendors to their IHE commitment
 Improves service to patients
 Improves service to referring physicians
 Improves efficiency and workflow
 Promotes modernization of imaging and information systems
 Promotes systems integration
 Enables healthcare organizations to achieve clinical goals
 Promotes the use of standards; removes the need to use proprietary methods
 Improves the efficiency and effectiveness of clinical practice
 Improves the flow of information
 Enables interaction among multiple systems
 Breaks down vendor walls by providing a common set of languages and rules
 Improves the use of industry communication standards by removing excessive
flexibility
 Enables systems to communicate more efficiently
 Streamlines implementation by providing a clear integration framework

 Laboratory Information Management System (LIMS) & Integration with
HIMSA
Laboratory Information Management System (LIMS) is a a new state-of-the-art
systems designed for highly automated laboratory. The system will provide Bi-
directional integration of all critical laboratory equipment’s which have interfacing
capabilities.
 LIMS will maintains Track of each sample including the result data for
multiple Runs
 The System designed will be in line with NABH Requirements
 The System will provide a facility to send results to patient /Doctors thru
Emails
 The System will also keep tracks of tests which are sent out ( Out-sourced out
due to any reasons ) . The System will also generate packing list & results
received from the outside laboratory can be scanned and attached to the
patient’s which can be viewed by concerned user on-line.
ELECTRONIC MEDICAL RECORDS MANAGEMENT SYM
The following would be the CORE modules of

LIMS:
 Sample Collection & Pre Login

 Work Assignments
 Interfaces with Equipment’s
 Result Entry
 Result Reporting
 Snow Med codes implementation
 Generic Data Distribution
 Rules for Samples
 Interfaces for Automation
 Image Management from Microscopes
 Generic Patient Registration function
 Security
LIMS will be integrated seamlessly with HIMSA
for Patient demographics and will integrate with
Patient registrations of HIMSA

 Hardware & Communication Network
Of course, information system applications require computer hardware. Hardware
includes the various processing devices and servers to run the applications. Data
entry requires various input devices (e.g., desktop computers, tablets, personal data
assistants [PDAs], speech microphones) and output devices (monitors, display
screens, printers, fax machines, speakers, etc.). Data must also be archived, so
storage functionality is needed. This may include various forms of storage devices,
each with their associated media (such as magnetic disks, optical disks, flash drives,
etc.). Various storage area networks and storage management systems are used to
manage large volumes of archived data. As the HIMSA & Other integrated Systems
becomes more mission critical, backup storage and redundant processing devices are
necessary, often with middleware applications to provide automatic failover. All of
these devices must connect to one another in a network, so various network devices
and their associated media (including various forms of cable for wired networks and
wireless network capability) must be acquired and maintained. So a proper
Architecture has to be designed and implemented for Hardware & Related linked
infrastructure on the Network.
Hence a Blue print to define the Architecture has to be laid down for Hardware and
application requirements including Integration Systems so that the Hardware and
Networking infrastructure provides
o High Availability
o High Reliability
o High scalability
o Server Consolidation
o Storage consolidation

A Detail Plan has to be implemented as per the Hospital and Various Departments
requirements as shown below in the Diagrams.

So we have Hardware and connectivity of Infrastructure as shown in Figure below

 Access Control System Integrated with HIMSA
Today there are challenges in Identity management as the business needs are growing so is
the traffic of human access is growing in the Hospital. The hospital needs to track
Way staff spends their time in various capacities and need to track their attendance and
their movement areas.
Physical Access controls

 Special & Restricted areas with limited access control
 Areas where authorization is needed to access controls
 Information Access from the Network systems
So today HIPAA compliance need for Access and security is required for Information
security and access controls security.
So Hospital need to issue a Hybrid (Contactless /Contact) Smart Identity card To each and
every staff (Permanent / Contractual) to track the Attendance and access control Physical as
well as at Information access and to be integrated with HIMSA.

 Hospital Security & Video Surveillance
In Today’s environment Video Surveillance is a necessity rather than privilege. In
Hospital premises the same is required for various security Reasons some of them
are
 Improve Public safety

 Mitigate Risk of crime & Terrorism
 Protect assets
 Prevent Frauds
 Improve efficiency & Productivity
 Provide better Health care
In hospitals and healthcare facilities, video surveillance is an effective tool not only for
increasing security, but also for controlling costs. Surveillance cameras can work to protect
hospital employees and patients from security breaches, and provide valuable visual
evidence that can be used to increase productivity and prevent dishonest claims. IP video
technology is providing hospitals with added flexibility in their video surveillance
installations, while offering benefits such as remote video monitoring and more effective
storage capabilities.
Developing a comprehensive Surveillance solution requires the construction of multiple

devices and the assembly of several components. The following diagram shows the relevant
products and typical topology of a Security Surveillance solution.
Product components
Digital Video Recorder (DVR) Interfaces with traditional analog CCTV camera in
either SD or HD resolution. Performs video encoding,
video display, real-time video analytics, and local video
storage.
Hybrid Digital Video Recorder Interfaces with both analog and IP cameras. Similar
(Hybrid DVR) functions as DVR.
Network Video Recorders Interfaces with IP camera only. Primary focus on video
(NVR) decoding, display, video analytics and video storage
function. NVR usually has more storage capacity than
DVR system.

Video Analytics Server DVR/NVR/IP Encoder/IP Camera offload data to the
server which performs real-time and forensic video
analytics processing of data.
IP Encoder /IP Hub Encodes analog video streams into digital IP streams
with selected video codec and streams over to NVR and
video analytics server.
IP Decoder/Video Wall Driver Decodes IP video streams and sends display over to
surveillance video wall.
IP Camera Captures and digitizes video input stream, encodes with
video codec, packetizes it and streams it over to NVR
or video analytics server
Network Attached Storage NAS provides a remote networked centralized storage
(NAS) file system for a smaller user pool. It helps offload the
local storage burden and ease network throughput for
video file streaming in a surveillance video network
environment.
Storage Area Network (SAN) SAN is designed for bigger corporate storage arrays
that handle block-based video files for archiving and
backup purposes.

 Digital Display Data Walls
The solutions for Complete Data & Video Displays near operation Theaters and At
Hospital reception is proposed so that
 Enhanced video display options to improve ongoing surveillance and incident

management
 Designed to achieve higher security levels in mission-critical, multi-user

environments
 Fully digital solution providing virtual matrix, video-wall operation and

powerful event handling

Architecture for designing video Walls are shown in the pictorial diagram below

 Hospital Interactive Patient EMR Portal cloud application & 24 X 7
Remote Patient Call Centre Assistance Access
The objective is to design, develop and implement the Interactive cloud
application for the portal for RIMS patient to access their Electronic medical
Records with Access to Smart Discharge /Registration cards or with Hospital
Patient number identification.
Based on our preliminary understanding, the following have been tentatively

identified as the key facets of the requirement pertaining to the RIMS portal
Cloud application initiative:
 It should serve as a single sign-on Unified application comprising of
Personalized internet Gateway to applications, services and people
 The application should interface directly with Remote EMR available to both
IPD and OPD patients and create a consolidated record for storing all the
vital information of patients and all other stake holders in terms of Internet
/Intranet or Extranet Users
 The clinical data on the patient portal includes
– Test Results
– Allergies
– Health issues
– Medications
– Immunizations
– And other clinical reports
 EMR Portal Application should reflect the brand development objectives of

the organization
 User centered analysis and design
 Professional look-and-feel
 Lively and user friendly surfing experience for visitors
 Facilitation of content aggregation and organization
 RIMS EMR Application for Portal to be designed to reflect:
– Optimized workflow & communication flow
– Fast, flexible and focused access to information
– Enhanced quality of customer service
– Lower distribution cost
– Strengthened customer relationship

– Expand customer base
– Accelerate value creation
– Reflection of RIMS patient’s care long-term goals
– Scalable and robust software and hardware with the capacity to perform
optimally as the online activity on the portal increases and more
applications are added
– Ability to address security and bandwidth concerns
– Serve as a publicity vehicle to improve awareness about RIMS and help in
building corporate identity
– 24X 7 Access to Patient response Centre thru SMS , Tool free Number ,
emails .

 Legacy Health Records Digitization & Document Management System
The Ideology to be followed is Spend more time on patients not paperwork. Despite the fact
that more healthcare organizations are implementing EHR systems, many are still highly
dependent on paper-based processes. Digitizing the paper forms organizations use every-
day improves patient care and creates customized document management solutions for the
healthcare industry to scan, index, store, and manage critical medical records & manage
electronic medical records (EMRs), create organized electronic health records (EHR) allowing
immediate access to the information to improve patient care. The DMS solutions will reduce
the time necessary to transcribe, file and manage charts improving chart access. A secure
web-based interface to be provided for access to documents from anywhere in the world, at
any time.

Key Features of Document Management System
 Document Acquisition
o Imaging ( Digitization of Paper Documents)
o Browsing
o Drag & Drop from the Viewer
o OCR (Optical Character Recognition)
 Editing
o Applying annotations (additional information) on the documents without

changing the actual contents
o Merging, Splitting and dividing of documents
o Cut, copy and paste from one folder to another
 Viewing
o View multiple file formats like email, fax, word, ppts, excel, Pdf, audio, video
etc)

o Provide various views for the documents like Thumbnail view, Small Icon
View, Detail View, List View.
o Display documents in a non-editable format.
o Link multiple documents for quick referencing
 Profiling
o Customizable Form Design for Profile Entry, Profile Search, and Hit List forms
used in creating and searching for documents
o Capture optional and required metadata about user defined document types
 Indexing
o Sample Indexing
o Visual indexing (marking a zone on the image and automatically capturing the
relevant text as the index value)
o Selecting from a list of index values defined earlier
o Defining auto OCR zones
 Document Storage
o Create any number of folders and subfolders to store documents.
o Store and organise documents in the user defined hierarchy (e.g., Cabinet --
> Folder --> Sub-Folder --> Document --> Page)
 Search: Search on folders and documents on the following basis :
o Profile Searching lets you find documents matching any entries in any one or
more of the fields in the Document Profile
o Content Searching enables you to search the text of your documents and
profiles using specific words, phrases, or words within a given proximity of
each other.
o Quick Search allows you to store frequently-used searches for quick access.

 IT Infrastructure Managed Services along with Facility Management
In recent years, many information technology (IT) departments have sought to increase
their agility, overcome short-term capability deficiencies, and/or accommodate the impact
of hiring restrictions by utilizing staff augmentation arrangements with IT service providers
or by contracting directly with independent contractors. As a temporary strategy, this
approach has a number of advantages compared to the alternative of directly hiring staff.
Under a staff augmentation model, the cost of hiring for temporary requirements and
disengaging once those requirements have been met can more than offset the higher cost
of engaging more permanent resources. Moreover, staff augmentation requires minimal
contracting effort, has a simple cost model (rate times hours worked), can scale up or down
quickly and has minimal impact on the existing operating model of an IT organization. Staff
augmentation, however, can become problematic when it morphs into a permanent
operating model. As a long-term solution, it has none of the benefits of alternative long-
term external sourcing models, such as managed services (outsourcing) and, in fact, can
create a number of serious risks and potentially destroy value .
Benefits and Issues with Staff augmentation model
Benefits – As a temporary Solution Issue as a permanent mode of operation

 Rapid access to missing capabilities  Higher cost
& skills  Fosters a management style that
 Accommodate staff shortage due to does not plan
un-expected events  NO Service level commitments
 Avoidance of hiring de-hiring costs  All issues attributed to in-sufficient
 Cost scalable to demand staffing
 No impact on operating model  Increased overheads managing
 Easily contracted individual sub-contractors
 Cost model transparent  Knowledge invested in individual ( as
with internal staff , but with less
control)
Dis-advantage of Staff Augmentation Model
By its nature, staff augmentation represents higher labor costs. Contracting organizations
must add overhead and margin to their labor costs and, while some of this can be avoided
by contracting directly with individuals, this too entails higher administrative costs
internally, as well as some inherent risks. When used as a long-term solution, the natural
offset that staff augmentation provides to higher labor costs through the avoidance of
hiring/de-hiring is lost. More significantly perhaps is that reliance on staff augmentation as a
permanent model tends to foster a management style that does not plan for resource
consumption. Resources are too easily accessed. The consequence is gradual “staff creep”
and an unrecognized “head count” that slips under the organization’s human resource
governance radar.

Contractors are added continually or become embedded in the organization as high cost
permanent staffing. Because staff augmentation has no associated service level
commitments other than hours available to work, the linkage to value derived is unclear and
seldom measured. The response to any service issue is generally (and conveniently)
attributed to insufficient staffing, adding to staff creep. Perhaps most significant is the loss
of knowledge control. As contractors become embedded in the organization, they
accumulate information and capabilities upon which the organization is functionally
dependent. With no contracted service commitment or requirement to document knowledge
in a transferrable manner, contractors can and do often hold organizations hostage,
perpetuating the permanency of their engagement.
Advantage of Managed serviced (out sourcing Model)
If an organization is involved in a staff augmentation engagement, transitioning to managed

services (outsourcing) model can yield all of the benefits of flexibility and skill access it
seeks, while overcoming the major disadvantages associated with staff augmentation
described above. The managed services (outsourcing) model differs from staff augmentation
in a number of ways.
Comparing the model Managed Services Vs. Staff Augmentation
Managed Services (Out Sourcing) Staff Augmentation (out- Tasking)

 Supplier Assumes control of all or part of  Supplier commit to provide the
the execution component of IT Resources of defined capability at defined
 Service Delivery component as defined price structure
as Service levels under SLAs  No Service delivery commitments related
 Pricing Tied to service Levels & volumes to the outputs or deliverables
where applicable  Pricing on Time allocation model
 Supplier manage Delivery model (process  Customer manages the delivery model
& Tools ) and responsible for service delivery
 Impacted employees –Assets & contracts  No change to customer operating model
may be transitioned to supplier (  Knowledge vested in the individual
supplier need to acquire or create an  All Delivery risks remains with the Client
ability to deliver)
 Knowledge must be documented and
transferred Commitment To Provide an Input
 Supplier assumes the risk of transition &
operations
Commitment to Deliver an Outcome

A key value of the managed services (outsourcing) model is that, with execution
commitments secured, the IT organization can reduce in size and focus on the strategic
management of IT. Historically, the lack of strategic management is the prime value
destroyer in IT. Many of today’s IT leaders have a technology, not a business, background
and, quite frankly, prefer to manage the execution. The staff augmentation model allows
these types of IT leaders to overcome the hurdles of staff limitations and retain operational
control. The value of the managed services (outsourcing) model is generally very clear at
the senior management level, but often resented at the level of IT management. So we are
biased towards getting support for our IT Infrastructure, Data bases, applications,
Networks, Patch works And other Interfaces on Managed services Model.

4. Scope of Work (SOW) on turnkey basis
The scope of work includes under stated components for Customization, & Implementation
of an integrated Hospital Management Information System along with creating
Infrastructure on a turnkey basis by a System Integration (SI) Partner who would provide
all the elements of the solution. The SI Partner is expected to propose an integrated IT
solution, which includes off-the-shelf (i.e. Readymade, integrated & customizable) items
suitably adapted to the requirements mentioned above . Various components for this
integrated Turnkey solution is mentioned as under
Various Components of SOW are as follows:
 Implementation & Customization of HIMSA
 Required Detail Functionality of HIMSA
Master Patient Index
Patient Data
 Unique personal Identification Number (PIN)

 Demographic Data
 Details of next-to-kin
 Insurance details (if available)
 Corporate Information (if available)
 Basic Health record including Allergies , medical history , Current
medications etc;
 Referral Data
 Capture Mobile number , Email id so that SMS and mail could be
routed
OPD Billing & Cash handling
 Patient Registration – new and repeat visit

 Consultants /Doctors allocations , scheduling etc.;
 Confirmation and generation of reservation slips
 Linked to patient appointment for Doctor
 Linked to doctor’s Electronic medical Records where on payment by the
patient is indicated to doctor sitting in consulting room thru EMR function
 The auto-generated Queue number can be displayed on the electronic
display board.
 Orders entered by doctor in EMR module is electronically available to cash
counter clerk where upon entry of patient ID, system displays doctor’s
orders for investigations

 Allows adjustment of OPD deposit collection against patient’s visits. The
feature can be used for chemotherapy / physiotherapy patients where full
amount collected for multiple visits can be adjusted against each visit.
 Allows consulting doctors to send SMS for patient’s cross reference where
doctor can send details of cross consultation to the refereed doctor.
In-patient Registration
 Patient Registration if Smart Patient card is not available

 Generation of service orders
o Prescription
o Investigation
o Imaging
o Surgery
o Diet
 Nursing schedules
 Requesting for Pharmacy and Material
 Capture patient Photographs and Biometrics data
 Smart/Ordinary Card Printing Facility
 Allows allotment of beds to reserved patient in advance where system
generates SMS to patient where he can be directed to get physical admission
upon arrival. Once he physically occupies the bed, the admission formalities
can be completed by relatives, thus minimizing admission time
 Provides facility to send SMS to attending doctors & his RMOs when
patient is admitted informing doctor of patient’s bed details
Admission/Discharge/transfer
 Admissions from various sources such as OPD, Emergency units

,Transfers from other hospitals/clinics, confirmation of reservation
 Accurate an easy lookups for bed availability by service class ,
waiting lists etc.
 Access to Financial information
 Interface with AR , AP and GL
 Cash collection control
 Multiple trial invoices
 Generation of admission number and printing of admission slips
 Interface to billings ( If required)
 Discharge/Transfers such as discharge notes and summary
 Issue of Smart card based EMR with Patient demographic data
during discharge so that Patient can use the same to access the
EMR data from Patient EMR Portal cloud application and also could
be used for registration in future consultation (OPD or IPD)

Discharge
 Updates to bed availability and status

 Discharge slip generation and summary
 Patient Account settlements
 Discharge smart card for EMR Reference & follow up information ,
final observation and doctor’s notes
Transfers
 Inter-ward and Intra-ward transfers

 Easy bed swaps
 Interface to billings
 Generation of Transfer requests
Online enquiry related to patients
Online reservation request
 Reservation request for facilities , such as room etc;

 Request for consultant appointments
Clinical appointment scheduling
Calendar set up
 Global across setup

 Across specific modules
 Across specific personnel
Planning and scheduling of appointment
 Across consulting , LAB and operations

 Ability to book walk in appointment
 Identifications for critical and cancelled appointments
Reminder and alerts for appointments
 Appointment cancellations
 Critical appointments
 Ability to send message though emails.

Accident and Emergencies
 Registration , Admission , Death records and Reports

 Legal reporting in case of Accident patients
 Treatment protocol for attending patient , quickly ordering for
blood ,X-rays ,Lab tests , disaster management crash call support
Consulting Services
 Visiting Doctor/consultant /Master Maintenance

 Clinical notes ,patient history and clinical interrogation sub
specialty wise
 Graphical support ,online physicians , ordering of X-rays ,Drugs
recording note
 Calendar management for consultants
 Fees management
 Interface to payroll and accounts
Wards
Bed Management
 Setting up of bed Information

 Setting up of service classes
 Bed maintenance
 Billing Support
Doctor and Nursing Workbench
 Patient health care information

 Medication to patient and automatic stock updates
 Recording of patient health care data , Nursing notes , Medication
charts
 Patient diets notes
Pharmacy
Drug Master
 Drug formularies
 Replenishment levels for stores and sub stores
 Inventory stocking
 Labeling of items
 Narcotics and control drugs , Inventory , monitoring , ordering
etc.

Indent/Issue/receipt/Maintenance of items
Alerts for critical drugs in stock-out positions
Inventory management
 Tracking of issues to patients and hospital staff

 Tracking of items as per lot, batch or serial numbers
 Tracking expiry date of medicines and X-ray films
Operation Theatre
Planning and scheduling
 Maintenance of OT and staff calendar

 OT scheduling
 Scheduling of various resources such as surgeons,
anesthesiologist, equipment and material
 Facility to place orders on Pharmacy , Laboratories etc, required
to perform the schedule service in OT
 Recording of material , pharmacy issued to the patients
Selection of Procedures
 Recording details of operation

 Facility to enter procedure notes and nursing operations
 Anesthetists notes (pre-operation , during operation and post
operation )
 Access to images
Pre and post-operative procedures
 Recording of pre and post-operative procedures
Integration to billings and accounts
 Cost tracking and Patient billing integration

 Surgeon/Doctor fee integrations with accounts

Blood bank
 Collection , classification and storage of Blood

 Shelf life record maintenance
 Expiry date alerts and processing
 Transfer and loan of blood between banks
 Donor management
 Processing of service requests
 Integration with Accounts for cash payments
House Keeping Services
Housekeeping and maintenance of wards
 Setting up of wards
 Setting up of paramedical staff and visiting doctors
 Management support for all housekeeping activities
Diet and Canteen management
 Diet/Nutrition chart master

 Interface to patient records
 Scheduling and planning for food requirements
 Interface to purchase and inventory management
Laundry Management
 Cost capturing and analysis of laundry activities

 Location wise tracking of activities
 Management of receipt, process and delivery/issue of laundry
Equipment Maintenance
 All aspects of equipment maintenance

 Service schedules and management of AMCs
Electronic Medical Record
 Ability and search capability for relevant information with

minimum key strokes
 Ability to recalled by patient name /Patient Number and from the
smart patient card parameters
 Online and all information for all visits for a user defined period
 Demographic details
 Insurance details
 Medical history

 Laboratory reports
 Medical treatment reports
 Imaging reports
o Ability to generate reports with user oriented report
writing capabilities
o Active and other delinquent records identifications
o Privacy and confidential
Security and Administration
 User defined security Access management

 User based Menu Personalization
 User based internet access to Applications
 User based Field level access
 Built in security against hacking and unauthorized data access
Inventory & Procurements
Inventory Management
 Receipts , Issues & Transfers of material including loan transfers

 Tracking of material with ability for lot, batch or serial numbers
 Planning & Scheduling of material with replenishment strategies
 Standard Inventory reporting of material with replenishment
strategies
 Ability to create & maintain sub-stores
 Authorizations for material movements
 Classification of items
 Integration to purchase order , vendors , accounts & Requisition
Purchase Order
 Generation of purchase orders automatically or through indent
requests
 Buyer master with item classification , authorization & group
purchases
 Delivery of Purchase orders
 Creation & Maintenance of rate contract orders
 Price agreements
 Integration to inventory management , Vendor accounts and
Requisitions
Requisition management
 Generation of requisition manually and through system

 Consolidation of requisition across department
 Requisition authorization and workflow
 Requisition process to stores and purchase
 Integration to Inventory management , purchase order , vendor
and accounts

Vendor Management
 Vendor Master
 Integration to inventory management ,purchase order , vendor and
accounts
Stock Management
 Issue/receipt of supplies from store/Pharmacy

 Requisition request
 Periodic requirement generation
 Various stock reports
 General Features requirement and required Architecture of HIMSA
General HIMSA features & Architecture Requirements
 System Can be configured for multi –location

 SMS facility upon patient’s admission/cross consultation/bulk SMS to groups
 The System provides facility to access selective functions using mobile applications
 The proposed solution architecture to be built on .net Web technologies that allow
the application to run on Central server to be accessed from various locations. It is
designed based on service-oriented architecture (SOA) which helps to achieve higher
level of code re-use, allowing applications to bind to services that evolve and
improve over time without requiring modification to the applications that consume
them. The architecture comprises of loosely coupled services in distributed
transaction environment.
 Flexibility: System should be an Open Architecture so that wherever possible, system
design must employ tables and /or logic rules that can be changed "on the fly" rather
than hard-coded logic or parameters that would require recompilation. It is to be
expected that Hospitals processes will undergo substantial revision within the next
few years and that continuous improvement will be a consistent goal. The system
must be flexible enough to accommodate these changes without difficulty.
 Proposed HIMSA should be Open System and must permit easy import/export of
information from/to a wide variety of other applications using XML format, including
desktop applications such as the Microsoft Office suite; World-Wide Web; the
electronic mail system; other RDBMS-based systems, on and off Hospitals; data
warehouses; executive information systems; and HealthCare system products of
other vendors. Where possible, system must permit direct access to information by
other applications, and be capable of direct access to information stored in other
applications.

 Modular Plug and Play The design of the HIMSA system must facilitate rapid and
correct response to changing needs at RIMS. The modular form of system should
have the flexibility to add modules as and when required.
 Robust: the HIMSA system should have sufficient intelligence to be able to warn the
user when it receives corrupt data or inconsistent data.
 Stable: The software must be technically stable and bug-free. We expect prompt
notification by the vendor of bugs reported by other users and receipt of appropriate
patches or upgrades free of cost to address the problems.
 Easy to Use: The system must have a consistent and lucid interface that facilitates
use and simplifies complex activities. The supporting documentation (on-line and
paper) will be accessible by non-technical users and will facilitate the resolution of
problems and the training of users. The vendor of the software should provide
several levels of support including access to other users, timely telephone support,
remote diagnostics of the system, initial on-site installation and training.
 Maintainable: the system will have an underlying structure that enables the vendor
to improve its function, to respond to changes in hardware and software design
concepts, and to minimize "bugs." Updates and "fixes" should require minimal
downtime and minimal alteration of the existing structure.
 Secure: the system must ensure the confidentiality of key information. The system
must provide various levels of security extending to individual data elements as well
as security auditing of essential functions.
Database Support Architecture requirements of HIMSA
 Underlying RDBMS must be ANSI standard SQL (current version) compliant/Oracle or

Open Source Database
 Underlying RDBMS must be ODBC compliant
 Referential integrity must be enforced, preferably at the RDBMS level.
 System must be capable of storing searchable free-form data elements.
 System should be capable of referencing image- based documents, and should be
able to perform context searches in image-based documents
HIMSA System Architecture Support for Network Interface & Security
 It is required that HIMSA software work with 10MB Ethernet, 100MB Ethernet, Fast
Ethernet, Wireless ,Switched Ethernet, FDDI, ATM, and token ring transport.
 It is required that HIMSA software work with TCP/IP, IPX, and ATM communication
protocols.
 User access to the data and application can be restricted by using Security and
Identity Management System provided along with the proposed HIMSA solution.
 Complete Audit Trail of each and every transaction with time and date stamp should
be provided by HIMSA Application on critical functions.

 HIMSA System Qualification Criteria
 The Proposed Solution of HIMSA by System integrator Partner should have Minimum
of 50 (Fifty) Implementations experience with Supportive implementation with
o Minimum of 03 (Three) Implementations should be for large
hospitals/Medical college hospitals ( More than 1200 Beds )
o Minimum of 03 (Three ) Implementation should be for Medical college
Hospitals
 HIMSA Warranty Support & Training requirements
o One Year Warranty support for HIMSA after Implementation

o Training of all departmental Staff /Administrators/Users of the system

 PACS & RIS Integration with HIMSA
In medical imaging, PACS is an acronym for Picture Archiving and Communication System.
PACS healthcare solutions were developed to facilitate electronic diagnostic imaging
workflow and provide economical storage (and archive), rapid retrieval of images, access to
images acquired with multiple modalities, and simultaneous access from multiple sites. In
laymen’s terms, PACS is the software and hardware that is responsible for displaying,
transporting, storing, retrieving and archiving your X-ray, MR (magnetic resonance), and
other medical images when Person visit a doctor’s office or clinic or Hospital. PACS uses a
standard format for image storage and transfer called DICOM (Digital Imaging and
Communications in Medicine), but can also encapsulate non-image data, such as PDF and
JPG in DICOM format. Vendor Neutral Archives are also facilitating the distribution, viewing
and efficient archive of both DICOM and Non-DICOM studies.
PACS and RIS Components and Features

A PACS solution consists of four major components:
1. Imaging modalities such as CT, mammography, MRI, and X-ray. (These are
instruments and various types of equipment which produce images of the
body using X-ray, ultrasound, magnetic resonance, or other methods of
recording such as gastrointestinal and ophthalmology.)
2. Secured network for the transmission of patient information
3. Storage and archive of image studies and reports.
4. Workstations used to retrieve, interpret, and review images
The following illustration shows the various components used in providing a PACS solution.
A PACS solution has four main uses:
1. Replace hard-copy medical images with electronic images.

2. Provide remote access of a patient study (patient information and images) for off-
site viewing, which enables tele-radiology or the ability for practitioners in different
physical locations to access the same information simultaneously.
3. Create an electronic image integration platform for radiology images that
interfaces with other medical automation systems such as Hospital Information

System (HIS), Electronic Medical Record (EMR), and Radiology Information System
(RIS) to facilitate the diagnostic workflow.
4. Provide Radiology Workflow Management, which is used by radiology personnel to
manage the workflow of patient exams.
A RIS solution incorporates a computerized database used by radiology departments to

store, manipulate, and distribute patient radiological data and imagery. The system also
generally provides patient tracking and scheduling, result reporting, and image tracking
capabilities. RIS complements HIMSA (Hospital Information Management Systems
Application) as well as PACS (Picture Archive and Communication System) and is critical to
providing efficient workflow for radiology practices.
Below figure shows RIS Solution Components
Most RIS solutions today support the following features:

 Patient registration, scheduling, tracking, and list management.
 Interface with Modality with a wordlist
 Request & Document Scanning
 Results entry
 Report Print out , Faxing and emailing of Clinical reports
 Interactive document & custom reports
 Modality & Material management
 HL7 Interfaces – Communication between RIS , HIMSA /PACS And EMR
 Radiology Department work flow
We have an assumption that
The scope of this section is not to acquire PACS and RIS and is only limited to Integration of
Available PACS and RIS with HIMSA that is
Interaction with the HIS/RIS: Describe what systems are in place and how the PACS and
HIS/RIS would interact, including order entry requisitions, patient identification, report
transfer, report approval, and exam billing.

This would mean following:
We would look forward an interface implemented as a series of messages passed between

processes in the PACS and the external system. The precise definition of the interface
requires interaction between the PACS and HIMSA.
The SI Partner proposing HIMSA should be able to use any /both communication protocols
of which SI PARTNER is aware. DICOM defines a standard for communication between a
PACS and an HIMSA, but few if any HIMSA Partners support it directly, most favoring HL7
instead. The interface can also be implemented using HL7-DICOM translators. And the
exchange of Information / merging the demography /ADT as an interface and integration
should be Bi-directional with HIMSA and PACS/RIS
 Implementation & Customization of LIMS & integration with HIMSA

The scope of Laboratory Information Management System (LIMS) core module includes
following:
 Parameters & Masters

 Security
 Accessions
 Sample Handlings
 Departmental Workings
 Reporting
 Image Management from microscopes
 Interfacing Engines & Bi-Directional interfacing with Instruments /Analyzers
 Integration with HIMSA ( HL7 Interface Integration protocol)
 The LIMS should be state-of-the-art for highly automated laboratory. The
system Should provide bi-direction integration of all laboratory equipments which
have interfacing capability.
 LIMS should be in line with the NABH requirements
 The LIMS should maintains track of each sample including the result data for
multiple runs.
 The LIMS should provides a facility to send results to patient / doctor thru
email
 The LIMS Should also keeps track of tests which are sent out. The system
generates packing list and results received from the outside laboratory can be
scanned and attached to the patient’s which can be viewed by concerned users on-
line.
 LIMS warranty & Training requirements

 Warranty of one year required on Laboratory Information management System
(LIMS)
 Trainings of all System User/Administration for laboratory department on the system

 Hardware & communication Network
The HIMSA Software application will be deployed in centralized architecture as

per requirement by RIMS, the detail of which is mentioned below.
The software application shall be hosted in the Centralized environment

where main server will be co-located at Primary Data Centre, RIMS
premises.
The central database server shall act as an information repository for the
entire RIMS with a redundant backup database and application server .
The Remote Locations if any planned for tele-medicine will be working, as

independent entities and will be connected to the central server Primary Data
Centre either on centralized or distributed Hybrid architecture ( As required)
through dedicated VPN link.
Building 2 Primary Data Centre

Local Local LAN/WAN Rout App
Manageme Swit
nt serve
Mod
LAN
clients Back
Centr
up
al
SAN
Building 3
Local Local Building 4
Mod
ITSM HelP Desk
Mod
Mod
Indicative Network architecture frame work for centralized
HIMSA and its Integration with PACS/RIS & LIMS

 Data centre Infrastructure with User Nodes and Network setup
 The Network will be Equipped with state of the art Hardware and
Technologies
 The Data centre clients and Outside hospitals will be connected to the data
centre through the secure MPLS VPN on redundant internet links
 All the traffic to the Primary Data centre will be scanned at the
Firewall/IPS/IDS level
 The Network solution proposed:
 Will be based on a hierarchical central topology. This will eventually
terminate into the Primary data centre.
 Factors in important network parameters like scalability and
redundancy in the network and hardware components.
 Will allow the complete network to fall back into the Secondary data
centre in the eventuality of a disaster.
 The broad architecture followed is a Hub and Spoke centralized
topology wherein all the respective category of locations i.e. clients
and remote offices terminate into the Centralized Primary Data Centre
(PDC) in two redundant high speed links
 Will have hot stand-by servers for high availability and first level
recovery
High Availability Platform

 Proposed SAN Solution and 3 Node Disaster recovery with site failure
 The Storage solution will be a Fibre Channel Based Storage Area Network
 The SAN Solution consist a Fibber Channel Fabric for complete redundancy
 The proposed solution remove backup and recovery traffic from the LAN,
reducing congestion, improving backup windows, and efficiently utilizing
storage resources
 The FC SAN can eliminate single points of failure, incorporate failover
software, and data mirroring at geographically dispersed data centre for
disaster recovery
 FC over IP protocol will be used for data replication as it creates
one logical fabric between remote SANS and FC switches
 The proposed solution will be centralize consolidated storage for all
Department level and file level data
 The storage solution provide flexibility in system management, configuration,
connectivity, and performance to meet the needs of growing business
environment

 The Data Centre Disaster Recovery solution to be been designed in such a way so that
the fail over time is minimal.
 The solution will be 3 node disaster recovery model where data will be mirrored in three
places
 This approach is sometimes known as “multi hop” and combines the technologies to
provide a high probability of zero permanent data loss for the majority of disaster
scenarios over a long distance
 In the event of failure the primary applications or servers will causes the local hot
standby server to run the application with minimum disruption to the users and clients
 The network will be design in such a way that the hot stand-by server will take place of
the primary servers
 In case of complete disaster, data will be available on DR site the links will be pre-
configured to terminate into the Secondary data centre.

 Access control system Integrated with HIMSA
“Security” is a term that has been associated with the Health data and Health care has it
significance evolved over refinement around technology Practices or Implementation. The
advances in technology have brought in multi-dimensional approaches to intrusion as well
as security. Adoption of these technologies & rapid up-gradations are the only solutions for
achieving the minimum necessary standards for satisfactory level of security.
Smart card based access control is viewed as the leading technology and the way to go
towards forward going access control security. This technology is being increasingly
deployed across the word in health care Industry. Electronic security offered by smart card
technology is more robust as compared to any other security technology available in Health
care industry.
Access control & Identity management at crucial health care installations is a basic
requirement since not everyone can be allowed to enter Intensive cares and other Health
care installations secured zones or access to the Health Record of the patient which is a
confidential data . The authenticity & need of the person desirous of entering such a
secured zones or access to the information of the patient is evaluated by various means
and only than the person is allowed an entry. In larger Hospitals Like RIMS people entry is
to crucial zones are achieved by issuing Staff /authorized personnel with passes or
identification Cards .
I-cards are the primary means of achieving physical access controls for the staff (
regular/contractual) in in the Hospital Premises . This system has been in place for a long
time now and is well established. However with commonly available technology today that
was in use to produce physical & visual features on the I-card , the system is posed with a
threat of fake I-cards which would be hard to detect .
The Smart card based access control system have a distinct advantage over paper /Other
PVC card based I-cards.
So Access control system is an integrated solution that consists of hardware and

software designed to control entry into selected areas and manage movement of
people/vehicles within. The system is designed to increase security by defining access
permissions based on area and time for each user and maintaining a log of all events.
 Components of an access control system

Software: Used to adjust all parameters of the system, control hardware, display events
related to movement of users, alarms, and operation of hardware devices. The software

is also used for storing all events in the database and generating reports based on
requirements defined by an operator.
Electromechanical hardware:
- Electric locks
- Parking barriers and garage gates
- Turnstiles
Electronic hardware:
- Controllers: receive settings from software and control the electromechanical

hardware of the system.
- Contactless readers: read unique numbers of identification cards/tags and forwards
the numbers to controllers.
- Fingerprint readers: scan fingerprint images, compare them with the templates
stored in the internal reader database (or on a smart card) and send the verification
results to controllers.
System users:
- Operators: responsible for administrating the system, creating new users, issuing
cards and performing other regular daily tasks.
- Installers: responsible for installing, programming, maintaining and troubleshooting
the system.
- Users: regular staff of the company, with permanent or long-term ID cards (or
PINs), who use the system to gain access to certain building areas as configured by
operators.
- Visitors: people that are not employed by the end-user company, but still have rights
to access certain areas (contractors, visitors, delivery people, etc.).
- Vehicles (or other equipment): are accounted for and their in/out movements are
controlled and tracked by the system, in order to prevent unauthorized vehicles from
entering parking areas, or valuable equipment from being taken without
authorization.
 Technical requirements of access controls
Software
1. There shall be no limitations on the number of PC workstations, readers and

alarm inputs.
2. Support for active cards and Support cards for user types
3. access levels per user shall be supported.
4. Access levels should be assigned to a user, not to a card, in order to help
issue a new card in a fast and easy manner, without reassigning access
levels.
5. The software shall support holiday dates and have automatic holiday
rescheduling feature.
6. The software shall have the ability to perform scheduled automatic database
maintenance and backup tasks at user selected intervals and ability to
configure the amount of history stored in the active database.

7. The software shall have the ability to produce the following report types:
system and alarm event reports, user reports, hardware configuration
settings, access level reports, employee time & attendance reports.
8. The reports shall be available in Adobe PDF and MS Excel formats.
9. Report filters must be convenient and user friendly: allow operator preview
user photos, content of access levels, hardware settings and time zone
configuration.
10. The software shall facilitate integration with other systems of the building.
11. The software shall have the ability to transfer entry and exit events to HR
systems with the purpose of work time calculation.
12. The software shall store information and provide reports about visitors and
visits to access levels.
Hardware
1. The hardware shall support open architecture. Communication protocols shall

be available to system integrators and software development companies in
order to protect end-users from being constrained to a single brand of
hardware or software.
2. The hardware shall support all industry standard readers that output
information in Wiegand or Clock/Data formats (up to 128 bits).
3. There shall be at least 2 types of controllers: (a) for one door with an entry
reader and an exit button and (b) for one door with two readers (entry and
exit) or for two separate doors with entry readers and exit button.
4. There shall be an IP-reader available. The IP-reader shall integrate a
contactless card reader and controller in a single body, designed for surface
mounting on a wall or a door frame eliminating the need for enclosures.
5. Each controller and IP-reader shall have a standard network port for
communication with software and other controllers.
6. Controller and IP-reader shall support standard Ethernet 10/100BaseT
network and TCP/IP communication protocol.
7. Systems using Ethernet converters, adapters, or terminal servers that enable
network connectivity for legacy controllers by tunneling RS-232/485 serial
data over Ethernet shall not be acceptable.
8. Single-door controller and IP-reader shall have enough memory to store at
least 40,000 users. Two-door controller shall have enough memory to store at
least 250,000 users.
9. In case communication with the host PC is interrupted, the controller and IP-
reader must have enough memory to store at least 5000 latest events (FIFO
buffer).
10. Operation of controller and IP-reader shall be completely independent of the
PC or “Master controller”. Should the PC or the communication link fail, the
users should not be affected in any way and all functions should continue
working.
11. IP-reader shall have the following inputs and outputs:
i. Exit button input
ii. Door contact input
iii. Auxiliary alarm input
iv. Tamper sensor and tamper input

v. Inputs for monitoring AC power and backup battery state. There
should be an option to reconfigure these inputs to function as general
purpose inputs.
vi. Relay for controlling an electric lock.
vii. General purpose auxiliary output relay.
12. One-door controller shall have the following inputs and outputs:
i. Power output for the reader
ii. Outputs for controlling LEDs and beeper of the reader
iii. Wiegand or Clock/Data input
iv. Exit button input
v. Door contact input
vi. Auxiliary alarm input
vii. Tamper input
viii. Inputs for monitoring AC power and backup battery state. There
purpose inputs.
ix. Relay for controlling an electric lock.
x. General purpose auxiliary output relay.
13. Two-door controller shall have the following inputs and outputs:
i. Power output for two readers
ii. Outputs for controlling LEDs and beepers of the readers
iii. Two Wiegand or Clock/Data inputs
iv. Two exit button inputs
v. Two door contact inputs
vi. Two auxiliary alarm inputs
vii. Tamper input
viii. Inputs for monitoring AC power and backup battery state. There
purpose inputs.
ix. Two relays for controlling an electric lock.
x. Two general purpose auxiliary output relays.
14. Relays of controllers and IP-readers should support two modes of operation:
(a) dry contact and (b) powered mode, whereas power to the lock is provided
via relay contacts this way simplifying wiring and eliminating the need for an
additional power supply.
15. Controllers and IP-readers shall have an RS-232/485 communication port that
would act as a backup communication channel in case the network connection
was interrupted.
16. Controllers and IP-readers shall have a built-in PoE capability, in order to
reduce wiring and provide backup power effectively. PoE feature must comply
with the 802.3af standard.
17. Controllers and IP-readers shall be capable of supplying up to 600mA @
12VDC to peripheral devices: readers, electric locks, sirens, detectors, etc.
18. Controllers and IP-readers shall accept the standard 12VDC power input in
case an existing network infrastructure does not support PoE.
19. In case the main PC of the system fails, controllers and IP-readers shall
accept a connection from a laptop in order to diagnose the problem, change
settings or control peripheral devices.
20. In case of an alarm controllers and IP-readers shall initiate communication
and provide timely notifications to operators. Hardware that does not initiate

communication and needs to be polled frequently will not be acceptable due
producing needless traffic on the network and processing load on the PC.
21. The system shall support biometric IP-readers with the following or better
specifications:
i. Specified fingerprint template storage capacity
ii. 1-to-many verification in less than 1 second
iii. 1-to-many verification with the database of 9000 users.
iv. Built-in USB, RS-232/485, LAN and WLAN communication ports
v. Selectable operation modes: fingerprint, fingerprint + card, fingerprint
+ PIN.
vi. Door-phone function
vii. Microphone, speaker and 2.5“ QVGA color LCD
viii. 72MB flash memory
ix. Door contact and exit button inputs
x. Lock control relay
Typical connection diagrams
1. IP reader

2. Single-door IP-controller
3. Two-door IP-controller
4. Two-door IP-controller (controlling entry & exit on one door)

5. Biometric reader

 Hospital Security & Video surveillance
Similarly the Security surveillance using CCTV camera are used so that the Central command is
established to analyze the security requirements of the Hospitals.
 Digital display & video Walls
Digital Display walls on the Network will be established so that it could be planned
near the operation theatres to display the Patient surgery schedule and Operation
theatre and also on the main reception of the hospital for General Information of
the hospital

 Hospital Interactive Patient Portal cloud application & 24 X 7 Remote
Patient Call Centre Assistance Access
Interactive Patient Portal cloud application & integrated 24x7 Remote patient Call
Centre Assistance access will be established so that
• Single sign-on Unified Portal application comprises of ….

Personalized internet Gateway to applications , services and people will be
planned for EMR with access to smart cards
Internet
Intranet
Extranet

 Legacy Health Records Digitization & Document Management Systems
(DMS)
All previous Medical records of patients will be digitized and will be stored in
Document Management system which will be implemented to have the Patient
Electronic medical Records . The Process for the same for the digitization will be as
follows :

 IT Infrastructure Managed Services along with Facility Management
Responsibility of Response Desk (User and system Support Managed services)
 Receive and record all calls from users and Technical Support
 Provide first-line support (using knowledge resources)
 Refer to second-line support where necessary from online –offline mode
 Monitoring and escalation of incidents
 Keep users informed on status and progress
 Provide interface between ITSM ( IT Services Management) disciplines

Various Supports will be provided for the entire system :

 Annexure –A (Estimated BOM list for IT Hardware & Network)
(Subject to be changed based on actual Requirement study)
Seri Item Description Estimated Estimated

al Quantity Prices( INR in
No. Lacs)
1 High End Application server 02
18.60
2 High End Data Base Server 02
18.60
3 High end Nodes 250 105.50
Laser Printers 10
Mid size MultipleFunction scanners & Printers 10
CCTV Cameras 05
BIG LCD Screens 05
4 ℎ ℎ As per 85.50
5 ℎ 24 ℎ Requirement
Study done by
6 6 ( ) the department
7 Estimated cost
8 / ( ) given based on
24 the
9
Departmental
10 3
Blue prints
11 7
12 6 ( 25 )( )
13 6 ( 50 )( )
14 6 ( 38 )( )
15 6 ( 20 )( )
16 ( )(
17 , 24 ( ℎ )
ℎ
18 ( )
19 ( )
20 / ( )
21 ( )3
22 (25 )(
)
23 (
)
24 ( )( )
25 , 24 ( ℎ )
26 ( )
27 ( )
28 /

( )
29 ( )3
30 , &
,
ℎ
( )
31 Laying, Digging/ trenching, filling, 0.05

splicing & terminating of fiber and other
media or service component as
applicable according to industry norms
are part of supply, installation &
commissioning, testing & certification of
Fiber Cores
(In Meters )
Storage Features Price

Area in
Network Lacs
Enterprise 28.00
SAN
Ports Single chassis: Up to 384 16 Gbps universal (E, F, D, M, and EX) Fibre
Channel ports using up to eight 32-, or 48-port Fibre Channel blades. Up to
512 Gbps universal (E, F, M, and EX) Fibre Channel ports using 64-port 8
Gbps Fibre Channel blades.
Multi-chassis with ICL ports: Up to 3840×16 Gbps universal Fibre Channel
ports (using 16 Gbps 48-port blades); up to 5120×8 Gbps universal Fibre
Channel ports (using 8 Gbps 64-port blades); ICL ports (32 or 16 per chassis,
optical QSFP) connected up to nine b-type SAN768B-2/SAN384B-2 chassis
in a full-mesh topology or up to 10 chassis in a core-edge topology. Deploying
five or more chassis with ICL connections within a fabric requires an
Enterprise ICL license
Link Fibre Channel: 2.125 Gbps line speed, full duplex; 4.25 Gbps
Speeds line speed, full duplex; 8.5 Gbps line speed, full duplex; 10.53
Gbps line speed, full duplex; 14.025 Gbps line speed, full
duplex; auto-sensing of 2, 4, 8, and 16 Gbps port speeds; 10
Gbps and optionally programmable to fixed port speed
operating Microsoft Windows 2008, Windows 2012

Systems Red Hat Linux, Red Hat Linux Advanced Server
SUSE Linux, SUSE Linux Enterprise Server (SLES)
IBM AIX®

 Annexure –B (Estimated BOM List for Access control System )
Line Item Quantity

1 Security system management workstations Application 01
ID card production workstation 02
Indicated card printer type: (a) single-side (b) dual-side (c) color (d)
monochrome (e) lamination (f) encoding
2 Doors with entry and exit readers 15
Indicate the type of the readers: (a) 125khz contactless (b) 13.56Mhz
contactless/smart (c) keypad (d) fingerprint (e) long range
3 Doors with entry reader and exit button 15
Indicate the type of the readers: (a) 125khz contactless (b) 13.56Mhz
contactless/smart (c) keypad (d) fingerprint (e) long range
4 Emergency exit doors 05
5 Doors with door-contact only as per
requirement
study
6 Alarm input points (motion, glass-break, infrared and others) as per
requirement
study
7 Alarm output relays (for controlling sirens and strobes) as per
requirement
study
8 Parking gate with entry and exit readers as per
(a) 125khz contactless (b) 13.56Mhz contactless/smart (c) keypad (d) long range requirement
passive, 50cm / 20 inch (e) long range active, 1.5m / 5 ft (f) operator activated study
RF
9 Parking gates with entry reader and exit detector/loop as per
(a) 125khz contactless (b) 13.56Mhz contactless/smart (c) keypad (d) long range requirement
passive, 50cm / 20 inch (e) long range active, 1.5m / 5 ft (f) operator activated study
RF
10 ID cards as per
Indicate card type: (a) printable (b) non-printable (c) key fobs requirement
study

6. Cost Matrix (Based on cost heads and BOMs)
Serial Cost Heads ( Modules) Cost /Price ( INR in

Nos. Lacs)
01 Health Care Information management System
Application (HIMSA)
Enterprise Application licenses , Implementation 115.00
Training and warranty
 Patient EMR /Discharge Summary on Smart
cards @ 350 Per Patient During Dis-charge
02 PACS & RIS Integration with HIMSA 12.50

03 Laboratory Information Management System (LIMS)
Enterprise Application Licenses , Interfaces with
Instruments on Bi-directional basis , Implementation 28.50
and Integration with HIMSA on HL7 Protocol
04 Hardware & Communication Network
 Hardware ( As per Hardware Annexure-A) 142.70
 Communication & Network (Annexure-A) 92.50
 Storage Area Network (Annexure –A) 28.00
Implementation & Commissioning Of Hardware & 75.00

Networking Total : 338.20
05 Access control Systems Integrated with HIMSA

 Access Control Application 20.00
 Access controls Entry & Exit Hardware’s and 18.00
card readers with biometric control
 Smart Cards ID with Printable format @ 300 03.00
for 1000 People ( Staff & Contractual labors)
Total : 41.00
06 Hospital Security & Video Surveillance
 CCTV cameras already accounted in Hardware
List ( Annexure –A)
 Integration with command Centre and 15.00
Implementation of Security Networks and
application
07 Digital Display Boards /Big LCDs

 Big LCDs already accounted in Hardware List (
Annexure-A)
 Integration with Command Centre & 25.00
Implementation of Networks with content
display application

08
Hospital Interactive Patient Portal cloud application

& 24 X 7 Remote Patient Call Centre Assistance
Access
 Cloud Application Set up fee 06.00
 Toll Free No. ( As per Actual cost)
 Call Centre Assistance @ 10000 Per Seat per 22.00
month for one Shift (optional)
Assuming 3 Shifts with 2 Seats per month we

have 6 Seats Per months so for three years
We have
Total 28.00
09 Legacy Health records Digitization and Document

Management application
 Legacy Health record Digitization @70 paisa 350.00

Per record ( Assumption of 50000000 Health
record)
 Implementation of DMS application with 30.00
Enterprise License
Total : 380.00
10 IT Infrastructure Manages services along with facility
management for 3 Years 225.00
** Taxes on and above as per applicable slots

7. Implementation Methodology to be adopted
The Rapid Project Alignment (RPA) methodology is used to align project and end
user goals for product/application customization & implementations. The underlying
concept of methodology is that customer satisfaction comes not only from
achieving project objectives, but also from configuring and deploying a product
that provides benefit to all the customers using it. This improves the customer
acceptance of the product and makes achieving project objectives attainable.
The Rapid Application Deployment (RAD) methodology is an iterative deployment

methodology that takes as inputs, the user requirements, project objectives and
configuration plans, and delivers as output, the technical infrastructure,
information technology support model, and configured product with help of the
program management Team.
Running throughout both RPA (Rapid Prototype approvals) and RAD (Rapid
Application deployment) are processes and tools to ensure end-user customer buy-
in and satisfaction. However, the ‘Customer Satisfaction Audit’ process has been
defined as one that runs parallel with the project, to monitor the customer during
and after the product deployment.
Within the implementation project, is the capacity planning process wherein

analysis, testing and tuning of the different system architecture components
(hardware, network, database and application) takes place. The main objective of
capacity planning is to ensure that the overall system performance will meet
expected performance requirements.
RPA Overview
 The RPA (Rapid Prototype Approval) methodology is designed to be

complementary to RAD, and other deployment methodologies used by partner
system integrators. The RPA points of integration to deployment
methodologies are:
 Project Planning and Strategy Stage: User acceptance and satisfaction
attributes, project objectives, and measures clarification.
 Design Stage: Stakeholder requirements definition and prioritization.
 Customization/ Development Stage: Key features to be included as a result of
stake holder feedback, and project objective measures.

 Deployment Stage: Key features that should be highlighted in training;
communications to improve end user buy in and usage; and benefit measures
to see if objectives were attained.
RAD Methodology Overview
Rapid Application Deployment (RAD) Methodology ensures the rapid and successful
implementation of Applications and Products by vendors in timeframes ranging
from 4-6 months. The RAD Methodology kit includes a summary description that
explains typical project phases, timelines and structure, roles, and responsibilities
for the project team. It also includes a Microsoft Project Plan template, which is
used to develop the customer specific project plan, and a series of implementation
tools including an entire hardware and capacity planning worksheet/ toolkit. The
RAD Methodology can be used in its entirety or as a template, guideline, and/ or
checklist for departments or System Integration Partners that prefer to use their
own implementation methodology.
The key assumptions for using the RAD Methodology are:
 The SI Partner understands our requirements for their

Application(s)/product customization and implementation. The vendor
should conduct a requirements definition exercise as part of their GAP
Analysis project stage. However, the RAD Methodology does not
contemplate business process re-engineering activities or organizational re-
alignments, as part of the implementation process.
 The SI Partner has to be actively executive sponsorship for the project,
user representatives, and management participation throughout the
Application(s)/Product deployment along with Program management team
for customization and solution along with Hospital key Users as
implementer.
 The SI Partner will be taking a phased approach to implementing
Applications/Products. All modules will be rolled out in a series of phases.
The first phases will have core modules including the end user ‘hooks’
necessary to ensure a high level of user acceptance.
 The SI Partner will ensure an appropriate system infrastructure in terms of
network capacity, connectivity, and operational standards to support the
initial phases of the Third party Application customization and deployment.
 The Hospital pilot users will use the Application/Product as their production
system. Their feedback will be closely tracked, prioritized and incorporated
into the application/product before the full production roll out. The Hospital
should plan on at least one complete feedback iteration. No more than two
to three iterations should be required. The first complete feedback iteration
usually takes 6 weeks, when users familiarize themselves with the new
system and provide feedback regarding workflow, layout, capabilities, etc.
This feedback is then incorporated into the application by the project
Implementation team of vendor. Subsequent feedback iterations typically
take 3-4 weeks.

 The SI Partner will adequately staff all aspects of the implementation
design, development, testing, training, help desk, database, and systems
administrator internally. Program management team will actively participate
in the project team providing implementation advice, leveraged expertise,
and technology transfer.
The key stages in the Customization & implementation process methodology Should
be:
 Project Strategy
 Gap Study
 Construction/Customisations of Gaps
 Testing and Production Pilot
 Rollout
The broad objectives of these phases are:
Project Strategy
During this initial stage of the project, the contours of the system, and the over all
project objectives and scope are set. Through existing documentation of the
products /applications available with Vendor for their applications, and interviews
with users, management, and technical infrastructure teams, the project team
develops an understanding of the business and infrastructure requirements.
At the end of this stage, the expected functionality of the system, its architectural
complexities, and its interfaces to other systems are well understood. This
understanding is formulated in terms of a proposed solution that specifies the
critical application components, and estimates the technical architecture required
for its implementation. The corresponding project plan and organization are then
defined, which outline the specific tasks, resource requirements, timelines, and
deliverables to implement the proposed customization of the Product solution.
While all the deliverables of this stage are critical to the success of the project, the
primary objective will be to ensure that the processes selected for optimization and
automation will have a significant positive impact on RIMS end user satisfaction
and productivity.
For a RAD only implementation, the overall technical and functionality

requirements, the current system infrastructure design, and future upgrade plans
should be available prior to the final Product /application selection. Evaluate the
specific Application /Product capabilities and set up tasks against the customer
requirements, and incorporate them into the project plan.

In the event that complete technical and functional requirements are not available,
or are considered not sufficiently defined to drive design specifications, the project
team will conduct a business requirements gathering exercise as part of the Gap
Study Stage of the implementation.
Gap Study
The GAP STUDY stage of the project is focused on analyzing the business
processes, all data and functional requirements, and breaking them down into
components to create a Product map catering the availability of features .processes
required by end users and customization Road map for customization/development
of features/Processes which are not existing with the product . During this stage,
the major technical architecture and configuration choices will be made based on
the knowledge of the hardware and product environment, user acceptance criteria,
and performance demands.
The workflow, supporting data, and system requirements are reviewed for each
group of proposed system users. These requirements are mapped and documented
into application screen flows and layout designs, which are then reviewed with key
user representatives. Supporting data, reporting, system interfaces, and technical
requirements are reviewed based on the proposed application configurations, and
are then prototyped at par with RAP methodology and documented.
For a RAD only implementation, where business requirements are already

available, this stage typically takes between two to four weeks to complete,
depending on the extent of software customizations and interfaces, availability of
user and system requirements documentation, and effective user involvement
during design reviews. Otherwise, up to three more weeks may be required to
conduct user interviews with the different stake holders to define and prioritize all
business requirements, re-align with the system acceptance criteria, determine the
critical deliverables for each phase, and update the project plan accordingly.
Customization/Construction
During the customization/construction stage of the project, the configured

application and reports are produced, and the supporting system infrastructure,
training materials, deployment and support plans are built based on the defined
scope and design for the Product.

The objectives of this stage are:
 Develop Product/ Application screen configurations, and set up application

parameters according to design specifications required by end users.
 Integrate the Product/ Application, and all other required outside applications
into a complete working business solution.
 Acquire if necessary, and assemble required computer hardware, networks,
and system software
 Set up training and support infrastructure, operations, and help desk required
for a successful deployment.
For RAD implementation, the key is to ensure that an adequate number of

resources with the appropriate skill levels are involved to tackle different areas of
work in parallel, including: hardware and software set up, interface and conversion
development, and configuration and training development. Given the appropriate
staffing levels and a phased roll out approach, this project stage can be usually
completed in 1 to 3 months, depending on the complexity of the deployment, and
the number of user feedback cycles or user requirement constructions.
Testing and Production Pilot
During the testing and production pilot stage, the major objectives are to verify the
system readiness against business features and performance requirements, and to
obtain system acceptance from the business sponsor(s) before the final production
roll out.
Depending on the number of feedbacks and development enhancement iterations

desired prior to rollout, this stage may be completed between 1 to 3 months.
The following are the key deliverables completed during this stage:
 Acceptance Criteria and Test Plans

 Production Pilot Cut over and Support Plan
 Production Pilot Design Changes
 End User of RIMS Formal Sign-off

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DETAIL PROJECT REPORT

RAJENDRA INSTITUTE OF MEDICAL SCIENCES

DPR for Integrated Health Care

DPR for Integrated Health Care

DPR for Integrated Health Care

1. 11 Kms. from Ranchi Airport

 Following Departments are available with RIMS

And following specialties are available:

Round the Clock Services

 24-hour Accident and Emergency Services

DPR for Integrated Health Care

 Intensive care unit (ICU)

Emergency, Trauma & Critical Care

 Intensive care Unit (ICU)

Diagnostic Imaging and Interventional Radiology Centre

 Multi Slice Scanning

 Operating Microscope for Cataract-Operation for Cataract, ECCE, SICS

DPR for Integrated Health Care

Department of OBG (Obstetrics & Gynecology)

 Round the clock Emergency Services

Laboratory Facilities (Specialized Referral Testing Lab Services)

Physiotherapy and Rehabilitation

DPR for Integrated Health Care

 Average number of Out-patients registered per Year - Estimated 600-000 to

2. Drawbacks of current system with requirement of re-vamping

Keeping in view India environment scenario as the following aspects:-

(i) Working environment of the Hospital.

DPR for Integrated Health Care

The Information system should be capable to provide

 Recording information about the Patients that come.

DPR for Integrated Health Care

 standardizing data, resulting in fewer corrections and significantly lowering

DPR for Integrated Health Care

3. Vision for end-to-end Hospital Information Management System

DPR for Integrated Health Care

 Health Care Information Management System Application (HIMSA)

DPR for Integrated Health Care

 Front office Systems

Medical System – Caters to the upkeep of various records such as Laboratory

DPR for Integrated Health Care

Administrative System – Ensures efficient management of various administrative

 Front Office Systems

Patient Registration Module

Out-patient Billing & Cash Handling Module

In-patient Administration Module

DPR for Integrated Health Care

Night Audit Module

Electronic Medical Records Management System

 Create case history

Laboratory Reporting & Information Management Module

Theater Scheduling Module

DPR for Integrated Health Care

Nurse Station Module

Medical Records Module

Case Paper Scanning System

Out Patient’s Case History Module

Stress Test / Cathlab Report Module

DPR for Integrated Health Care