Hospital Information System (HIS) has been defined in the literature as a set of interrelated components working together to gather, retrieve, process, store and disseminate information to support the activities of health system planning, control, coordination and decision- making both in management and services delivery.
The purpose of HIS is to automate the core processes of the hospital, minimize data inaccuracy and redundancy of data collection, connect and support caregivers with structured evidence based knowledge, improve health outcome, reduce medical error and lower cost. Huge amount of money has been invested in research, development and marketing of these HIS which leads to hyped marketing of enterprise solutions that promise far more than they can deliver. A well designed and implemented HIS has significant potential to contribute to cost-effective clinical management of diverse patient population across the entire spectrum of patient care
Hospitals must ensure that the HIS they choose have the following modern day features besides the administrative, revenue and clinical modules and functionalities that are generally available with most HIS vendors today:
a) The HIS must have data orientated to a patient centric longitudinal health record with a master patient index (MPI) which is the unique code that identifies a patient throughout the healthcare enterprise and a group of care delivery organizations in the long run.
b) A user friendly graphical user interface or GUI, distributed network based system with either a client-server architecture or secure web-based/ enabled technology is a must have in any modern HIS. Multiple screens with too many passwords, slow response time, complex screen layout with long learning curve, not ample attention given to standardization and simplification of clinical data entry and confusing navigation steps may decrease chances of acceptability of the HIS amongst users.
c) It is not realistic to eliminate legacy systems completely. A good HIS will have an interface engine that will map and translate disparate health care data from multiple existing legacy systems to a common data repository.
d) The HIS must have a central and relational repository with the capacity to integrate data received from different sources which can be queried by authorized users.
e) A data dictionary must be in place to translate medical terminology into computer understandable codified language.
f) The data dictionary should follow international standards like ICD, SNOMED-CT, LOINC, DICOM etc. Standards are benchmarks. Standards are generally required when excessive diversity creates inefficiencies or impedes effectiveness. Compatibility with standards will help to index and catalogue health related information for rapid retrieval and to obtain uniform clinical data for research purposes. This is a prerequisite to cost efficient and accurate data collection and storage which enhances the retrieval of quality health information needed to obtain the correct knowledge on which to base decisions.
g) Modern HIS have features like clinical alert systems in the form of computerized physician order entry or CPOE , user friendly clinical and business rules and protocol engine, knowledge or non-knowledge based clinical decision support systems or the CDSS, orders manager including e-prescription, work flow manager, evidence based medicine support with uncompromised data security systems in place.
h) The HIS must be scalable to be able to grow as the enterprise grows.
i) It must be capable to support enterprise wide communication by e-mail, sms, video-conferencing, intranet and internet access. Sharing of select data with outside world and patients over secure web access should be possible.
j) HIS must be able to collect, query and retrieve clinical information irrespective of the physician’s location inside or outside the healthcare enterprise.
k) It must support clinical research and help in producing clinical forecasts, outcomes and risks
The author of this article is –Ms. Ranjeeta Basra Korgaonkar, Assistant Professor,International Institute of Health Management Research, New Delhi-India–http://www.iihmrdelhi.org