Presentation

STUDY OF WORKFLOW CHANGES ON IMPLEMENTATION OF
HOSPITAL INFORMATION SYSTEM,DESIGNING OF MASTERS
AND DATA MAPPING

RIDHI AGARWAL
PG/11/080
IIHMR NEW DELHI

ABOUT THE HOSPITAL
• The 100 bedded National Heart Institute (NHI) established in
1981 is an integral part of the All India Heart Foundation
(AIHF).

• The AIHF is the only Heart Foundation in India affiliated to the
World Heart Federation

• It is recognized as a Collaborative Centre of WHO in
Preventive Cardiology since 1980, the only one in the SEARO
region.

NHI VISION
To create long term relationships by caring as no
one has done ever before"

NHI MISSION
To provide superior, compassionate and innovative
cardiac care to prevent and treat disease
maintaining highest standards in safety and quality

HIS team

Team
Team Leader coordinator

Software Hardware
Implementers
Developers Supporters

We, as interns, were made a part of the Implementing
Division of the HIS team in NHI.

OBJECTIVES

 To study the changes in workflows of OPD associated
with implementation of HIS
 To perform gap analysis to map existing data to
masters in HIS
 To enrich the masters.

RATIONALE OF THE STUDY

• OPD services otherwise called as Ambulatory Care Services.

• The existing workflow of OPD in NHI is not computerized
which has its own drawbacks. With the implementation of HIS
there will be a transition from manual to automate which will
bring about a change in the whole process. To understand this
change this module was chosen.

INTRODUCTION

 HIS is a comprehensive, integrated information systems

It is designed to manage the
medical, administrative, financial and legal aspects of a
hospital and its service processing.

 Hospital master - a comprehensive , integrated
information system designed to manage the
administrative, financial and clinical aspects of a hospital.
 This encompasses paperless based information processing as
well as data processing
 manipulation for efficiency and timely delivery of needed
information to people.
• Data mapping – it involves matching between a source and
a target.

METHODOLOGY

Study Design- Qualitative study based on observations.

Study Area – EDP Department in National Heart
Institute

Data Collection- Hospital records

Duration – 2 Months 10 Days

INVESTIGATIONS WORK FLOW

Patient registers Patient goes to
and goes to billing counter Patient pays and Patient goes and
OPD; doctor and a bill is raised the billing clerk gets the x-ray
advices for for the tests/ stamps the bill done
tests/

FOR OTHER PATIENT CLASSES IN NHI

• Hard copies of the charges for investigations
and procedures maintained in the billing
department.
• Billing clerk charges the patient according to
the charges mentioned under the scheme.

CHANGES AFTER HIS IMPLEMENTATION

1) Use of registers reduced.
2) Utilization of Man resource improved
3) Patient Satisfaction improved
4) Registration time reduced
5)Billing process improves
6)Fastest information flow between the various department.

Description on out patient registration module

• Act as an entry point to schedule an appointment
with the hospital resident doctor for medical
consultation and diagnosis
• Patient visits are divided into New and review
• The end user log into the system

• Than clicking on the ADD option than press
F8, it opens the patient master index

STEPS IN DEVELOPING IN COMPUTERIZED
SYSTEM

• System analysis
• System Designing
• System Programming
• System Testing
• System Implementation
• System Evaluation

Master Plan Designing

That requires studying different aspects
• Objectives of the master plan
• Whether the existing system is meeting the objectives?
• Need for new system or alternation to existing system
• Priorities and phases of system introduction
• Budgetary requirement (cost effectiveness)
• Time schedule to obtain target
• Monitor the progress to prevent obstruction

System designing components

 Data flow diagram
 Data designing- (Data items,data types, description)
 Forms designing

Types of masters
• CLINICAL DEPARTMENT MASTER-
• PAYER MASTER
• CONSULTANT
• REFERRAL MASTER-
• PROCEDURE CATEGORY MASTER-
• PROCEDURE SUBCATEGORY MASTERS
• PROCEDURE MASTER
• OTHER CHARGE HEAD MASTER-
• WARD MASTER-.
• LOCATION MASTERS-
• BED Master
• COMMON MASTERS-

SYSTEM IMPLEMENTATION

GAP ANALYSIS
To identify the data to be entered in to the masters.
COLLECTION OF DATA
-schedule of charges
(consultant charge list, procedure charge list, investigation charges
etc.)
MAPPING THE MASTERS WITH DATA
Enrich the database.
SYSTEM TESTING
The enriched database was put to use to identify any bug in the
software .

DATA MAPPING
• It involves matching between a source and a
target.
Source Target

BASIC EXAMPLES OF DATA MAPPING
FROM NATIONAL HEART INSTITUTE
• STEP 1) If we take an example of doctor charge master.

• Here, Source doctor is Gupta L.C. And Target is Patient Class.

• STEP 2) When user will open the doctor charge
master,the charges of doctor of that particular doctor
for each patient class can be viewed as:

• STEP3) TRANSACTIONAL LEVEL- The user while
entering the name of a particular consultant his/her
professional fee will automatically get mapped.

CONCLUSION

 Implementing a Hospital Information System is an
enormous challenge for the health service.
 HIS improves overall activities of the hospitals.
 The clerk considered HIS more efficient in the
registration of patient in the OPD,
 Easy retrieval of patient record during second and
third visit to hospital.

Contraints :-

• Could not do the actual database designing as
the templates were already defined.
• Could not make any changes as the masters
were already defined.

RECOMMENDATIONS

 Proper documentation of the data should be
available so that any problem arises in the future
than it can be mapped easily to HIS.
 End Users need to be educated and trained to HIS
as it enhances cooperation between IT managers
and the users.
 HIS implementation needs proper planning by
both the implementer and major stakeholders- the
users and the department itself.

Assessment of computer literacy among
nurses of National Heart Institute

ASSESSMENT OF COMPUTER LITERACY STATUS AMONG THE
HOSPITAL NURSING STAFF IN NATIONAL HEART INSTITUTE

• Introduction
Computer literacy may be defined as the understanding of
computer capabilities, applications and the concept of
algorithmic design

Computer skills for the nurses are important as they are
required to admit and discharge patients, for indents etc.

METHODOLOGY

• STUDY DESIGN – quantitative study

• SAMPLE SIZE- 30(ranged within the age group of 30- 40 years)

• SAMPLING METHOD- convenient sampling

• AREA OF STUDY – the study was conducted in National Heart
Institute during implementation phase of Hospital Information
System

• TOOLS OF DATA COLLECTION – a closed ended
questionnaire was designed consisting of 11
questions aimed at determining knowledge of
 Basic computer operation and function
 Word processing skills
 Internet & Web skills
 Multimedia & Email skills

Observations
 Demographics of the respondents
 Out of the 30 respondents, 16 nurses were between the age
group 25-34 and 10 were between 35-44 years.

 Turn on/off computer - 30% were able to turn on/ off the
computer
 Recognize computer parts - 77%
 Prior Use of computer - 27%.
 Ability to create folders and access information - 6%.
 Use of software like MS word, excel etc - 30%
 Difficulty in using computer - Around 80%
 Using e-mail facilities - 11%
 Own PC - 23%

Discussion
• As nurses are the end users of the IPD module in HIS so
they are required to possess basic computer skills in
order to manage different functions on IPD module such
as patient admission, discharge and raising indents
• Nurses were quite reluctant to use computers as most of
them were unfamiliar with computers.

Conclusion
• The findings of the study show that there is a great need for
training of basic computer skills among the nurses to be able
to use HIS.
• Structured training program should be there to ensure same
level of literacy and boosting up their self confidence.
• It is also believed that with adequate computer
literacy, nurses will become more productive and efficient in
their work.

REFERENCES

1) OPD flow process.,Vijay pratap raghuvanshi,30/01/2009
2) GeekInterview.com, 18th Apr 2008,
3)Wisegreek(article on data mapping). Jason C. Chavis,2003
4)Data Design,Visual Studio .NET 2003
5)Data mapping From Wikipedia, the free encyclopedia
6)Kuwait medical journal 1998,30,52-57.Makhdoom ashah.
7)Created by EDISTA.Adarsh, March 15, 2012
8)Journal of AHIMA 79, no.11 (November–December 2008):
69-74 Kelly Abrams, MPA, CHIM
9)www.National heart institute.com
10)www.softlinkinternational.com

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