IT & its impact on Hospital Management
Information System


By
Dr. Vijay Pithadia
Assistant Professor & Kidevices Chair
School of Management Studies
Shri Lauva Patel Trust College For Women
Amreli
Mobile:  (91)09898422655
E-mail:
Vijaypithadia@lycos.com

Dr. Vandana Parmar
Associate Professor
Department of Anaesthesiology
PDDU Government Medical College
Civil Hospital Campus, Rajkot-360001
 


Abstract:

In the paper we are tried to focus on digital technology and its impact towards consumer behavior of hospital management information system. Right now in India such Hospital Organization are doing good efforts in same areas i.e. All India Institute of Medical Sciences; New Delhi, Sanjav Gandhi PG Medical Research Center; Lucknow, Apollo Hospitals - Chennai, Escorts Heart Research Center; New Delhi etc. We anticipate good impact on human beings with reference to health care.

Key Words:

Digital revolution, Integrating hospital information system, upgrading the Coding System, Verify patient information, Patient ID System, Inventory of Healthcare Technology


Availability of Data:

Data are available from public sources identified in the study. Introduction:

While the digital revolution has been felt in every industry, nowhere has it been more visible than in health care. The introduction of wireless and other advanced technologies as critical business tools has impacted every aspect of medicine--from research to diagnostics, and surgery to record keeping. And, it's constantly evolving thanks to the advent of new technologies. While this isn't big news, what is news is how hospital design is changing because of it.

As the first paperless hospitals come online, the industry is moving away from traditional nursing stations and standard patient rooms. In their place are facilities that respond extremely well to the actual progress of moving patients. For example, in today's newer hospital a patient admitted from the Emergency Department would be whisked to an inpatient room that's slightly larger than the old standard (it's bigger to accommodate diagnostic machines at the bedside). This would all take place in an unconventionally shaped patient floor that enables busy caregivers to monitor many patients at once.

In addition to mobile diagnostic devices, hospitals are increasingly using handheld wireless units that go beyond the first generation of computerized provider order entry systems. These can do everything: track lab specimens, provide up-to-date information on patient tests, communicate with the hospital's pharmacy, coordinate prescriptions and prevent negative drug interactions. These units rely on either wireless radio or third-generation cellular technology, which is capable of such wizardry as voice command communication. This allows caregivers to call for specific assistance without leaving the patient room.

A nurse can identify the room, the patient and the kind of help she needs just by talking. Sophisticated communications systems take it from there and notify the proper staff. These automated alert notifications would prompt staff that emergent care is required, provide reminders for therapy progress and notify the proper staff.

Integrating hospital information system:

A hospital information systems (HIS) is a computer system that is designed to manage all the hospitals medical and administrative information in order to enable health professional perform their jobs effectively and efficiently. Hospital information systems were first developed in the 1960s and have been an essential part in hospital information management and administration. Hospital information systems now focus on the integration of all clinical, financial and administrative applications and thus could also be called an integrated hospital information processing systems (IHIPS).

Components of a hospital consist of two or more of the following:

Clinical Information System (CIS)
Financial Information System (FIS)
Laboratory Information System (LIS)
Nursing Information Systems (NIS)
Pharmacy Information System (PIS)
Picture Archiving Communication System (PACS)
Radiology Information System (RIS)

A look at the list above shows how complex a hospital information system can be. Advancement in computer technology and the development of information exchange standards i.e. DICOM, make the task administering and integrating such systems a little more easily.

No hospital information system can be regarded as a success unless it has the full participation of its users. Thus human and social factors would have to be considered in its design, more often than not, they could be easily addressed by providing adequate training and education about the system.

Previously, the hospital needed 7-10 days after a typical outpatient visit to process the paperwork and generate the bill. Now patient data is transferred electronically between the hospital information system and the coding system, eliminating data re-entry and the need to hand carry documents between departments. DRG codes assigned by the coding software are electronically uploaded to the hospital information system and immediately available for billing. Outpatient charges may be billed within 24 hours of the visit.

Patients ID Cards & Coding System:

The software also handles the complex APC coding for ambulatory visits. Clinical Coding Expert's APC Processing feature accurately assigns APC by evaluating the diagnoses and procedure codes and groupings in accordance with OPPS regulations. Hospital management decided to replace the mainframe system with networked PCs, needed new business software to replace the mainframe programs, and needed the new system to be integrated with the coding system.

The evaluation process turned up a hospital information system called Cardinal 2000 from Remote Support Services (RSS) that met Harper County's requirements. The vendor is a Springfield, MO-based software Development Company that provides health information systems for small to medium size hospitals. The use of paper forms to transmit information between departments had been eliminated. In the past, the hospital used a manual process to assign DRG codes to procedures. Coding was done by one person who spent 40 hours per week going through patients' charts, looking up their diagnoses and the services they received in the ICD-9 and CPT-4 manuals, and used a tree to get to the appropriate DRG.

Verify patient information:

One serious ailment affecting the healthcare industry is uncompensated care. But, thanks to some recent technological advancement, providers have a number of accurate and reliable methods available to them for reducing uncompensated care. By harnessing the power of a patient ID verification system, hospital facilities can now verify demographics, reduce fraud, increase productivity, manage costs, and more easily comply with paperwork reduction requirements. A patient ID verification system delivers accurate patient information, such as demographics and financial information, directly to a facility's registration system, eliminating duplicate data entry and improving the registration process flow. The validated patient information is obtained from one of the three major consumer credit reporting agencies - Trans Union, Equifax, and Experian that information is updated on a daily basis and relied upon for millions of secure financial transactions.

For the same purpose we can use Patient Card System, which provides more patient satisfaction by providing simple solutions to admission questions. And it reduced admission time and increase accuracy while strengthening patient loyalty. The flexibility of the Patient Card also permits the storage of multiple access codes, allowing affiliated hospital sites and clinics with different computer systems to retrieve vital patient information from the same card.

Making the Patient ID System:

Each time there is patient contact; the potential exists for mistaken identity. When registration processes rely on self-reported and subjective patient information, healthcare facilities are more vulnerable to errors, outdated or mistaken information, and even outright fraud. An example is an injured, but conscious, patient entering the emergency room without identification or an insurance card. With a patient ID verification system, the facility could confirm his name, address, and other pertinent information prior to discharge, enabling the facility to process and submit the bill in a seamless process. Properly designing and using a patient ID verification solution in clinical applications can streamline many hospital processes. The healthcare-related areas that can be positively affected by patient ID verification include admissions, business office, financial counseling, medical records, collections, discharge, donor programs, and clinical research/follow-up.

Many healthcare institutions are concerned if patient ID verification could affect compliance with the regulations outlined in HIPAA and EMTALA. In fact, patient ID verification can help a healthcare organization in following the guidelines by bringing electronic identification solutions to what were primarily manual processes.

Inventory of Healthcare Technology & EPHI:

In order to conduct a risk assessment of sensitive healthcare technology, healthcare organizations will need to identify all of their sensitive healthcare technology. This would include any healthcare technology that is used to monitor, diagnose and analyze the health of the patient. In addition, health information that is generated, stored and/or transmitted by the healthcare technology may require compliance with privacy and security regulations. Healthcare technologies that are connected to networks (i.e. LAN, WAN, Interact, Intranet, Extranet, Partner networks or modems) are at higher risk and should be noted in the inventory.

To conduct a risk assessment of electronic protected health information for regulatory compliance. An organization must identify all of the business processes and system applications, computers, databases, and networks that store and transmit PHI, as well as the healthcare technology, which in turn is monitoring, aggregating, storing (logging), analyzing (diagnosing), transmitting, and/or utilizing electronic protected health information. The application (i.e. Web servers, databases, etc.), computer and network infrastructure should also be documented.

The Inventory of healthcare technology and electronic protected health information should be the focus of this risk analysis. In addition, any security monitoring, protection and detection mechanisms that have been deployed must be assessed as well. The risk assessment should be conducted from an end-to-end perspective. For example, follow the electronic protected health information flow from its entry points through business system applications, handheld devices, workstations, servers, databases, network devices and internal and/or external networks to its final destination. Particular attention should be made to the access, storage and transmission of this information.

However, additional steps beyond the electronic protected health information will be required for sensitive healthcare technology. In this case, the organization will also need to assess both access and internal controls of the technology. Healthcare organizations should involve safety personnel to understand the potential risks of death and/or harm to the patient, through accidental and/or intentional electronic misuse of this technology.

Risk Management Strategy:

Organizations must determine what steps will be taken to manage the risks that are identified through the risk assessment process and/or reported through other channels. There are several strategies that can be adopted: eliminate, mitigate, insure and/or accept the risks. An organization's risk management process should include a consistent approach in making the risk management decision. It should also recognize the existence of privacy and security best practices and standards, security protection and detection technologies, and early warning and response capabilities.

When determining rite most effective way of mitigating risk, start with the threats, vulnerabilities and exposures that pose the greatest risk to the particular organization. In most cases, threats cannot be eliminated. However, many known threats can be detected and/or prevented from exploiting information and technology assets. Most known vulnerabilities can be corrected. However, the ability to correct these vulnerabilities will vary within each organization. Most known exposures can also be eliminated and/or reduced through effective configuration management and protection technologies.

The most cost-effective way to mitigate risks is through automated procedures and mechanisms. Document and prioritize risk mitigation requirements, identify and document the objectives of the security technology solution and how to measure its effectiveness, and then identify security technology solutions from reputable and financially sound security providers. In today's blended-threat environment, it is imperative to deploy security technology solutions that can interact together too effectively manage and respond to threats.

Conclusion:

Each year, healthcare organizations and their professionals become more dependent on technology. With devices such as tablet PCs, PDA and wireless networks connecting them to electronic patient health information (PHI), the need to secure the technology from privacy breeches has become a veritable priority for health information executives. Assessing the threats, vulnerabilities and exposure in an organization's IT infrastructure is the first step to mitigating risk. Several procedures can be used to identify the risks to sensitive health information and healthcare technology.

Abbreviations:

ICD-9: International Classification of Diseases Issue No 9
CPT-4 manuals: Current Procedural Terminology; 4 Manuals
EMTALA: Emergency Medical Treatment and Active Labor Act
HIPAA: Health Care Insurance Portability and Accountability Act
RMA: Records Management Application
DRG: Diagnostic Related Groupings
APC: Ambulatory Payment Classification System
DICOM: Digital Imaging and Communications in Medicine
RSS: Remote Support Services
IHIPS: Integrated Hospital Information Processing Systems
HIS: Hospital Information Systems
EPHI: Electronic Protected Health Information

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Dr. Vijay Pithadia
Assistant Professor & Kidevices Chair
School of Management Studies
Shri Lauva Patel Trust College For Women
Amreli
Mobile:  (91)09898422655
E-mail:
Vijaypithadia@lycos.com

Dr. Vandana Parmar
Associate Professor
Department of Anaesthesiology
PDDU Government Medical College
Civil Hospital Campus, Rajkot-360001
 

Source : E-mail December 15, 2004

 

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