Hospital

Case Study

On
“Hospital Management System”




Submitted by: Under the guidance of:
Ashish Bhandari Mrs. Rubinder Kaur
81103113008
It-6
th
Sem.



ACKNOWLEDGEMENT




The satisfaction that accompanies that the successful completion of any task
would be incomplete without the mention of people whose ceaseless
cooperation made it possible, whose constant guidance and encouragement
crown all efforts with success.

We are grateful to our project guide Mrs. Rubinder Kaur for the guidance,
inspiration and constructive suggestions that helpful us in the preparation of
this project.

We also thank our colleagues who have helped in successful completion of
the project.














CONTENTS
1. Introduction
 Definition
 Purpose
2. Goals of system
3. Components
 Laboratory Information System (LIS)
 Radiology Information System (RIS)
 Clinical Information System (CIS)
 Financial Information System (FIS)
 Nursing Information System (FIS)
 Pharmacy Information System (PIS)
 Picture Archiving Communication System (PACS)
4. Modules Involved
5. Different Phases
 Data Collection
 Feasibility Study
 Hardware/Software Requirement
 List of tables
 E.R. Diagram
 Data Flow Diagram
 Forms & output Reports
 Validation checks
 Implementation & Maintenance
 Testing
6. Benefits
7. Conclusion




Introduction:
In recent times, health care concept of the people has undergone a tremendous change which has led to
higher expectations and an increased demand for high quality medical care and facilities.
In order to accomplish this task, a HOSPITAL MANAGEMENT INFORMATION SYSTEM should be
developed.
Definition:
The Hospital Management Information System has been defined as a system that provides an
appropriate information support to each decision making level of the health care delivery system.
Purpose:
Hospital Management System aims at hospital and patient management. It stores and processes patient
data, accounting information, hospital administration and inventory updates with a client-server
approach. The interface should be user friendly and simple. HMS provides better information regarding
patients, pharmacy and staff. It shows the system of staff working in the hospital.
In addition to that the management of hospital has decided to automate their functioning like doctor’s
detail, room detail etc. there are many doctor working in the hospital. The doctor’s name, contact
number and specialization must be recorded. When the patient is admitted to the hospital, his particulars
along with the reason of admission must be recorded. If it is an accident case, additional information
such as Police man’s identification number, his name and accident description should be recorded.




Goals of the system:

1. Planned approach towards working: - The working in the organization will be well
planned and organized. The data will be stored properly in data stores, which will help in
retrieval of information as well as its storage.

2. Accuracy: - The level of accuracy in the proposed system will be higher. All operation
would be done correctly and it ensures that whatever information is coming from the center is
accurate.

3. Reliability: - The reliability of the proposed system will be high due to the above
stated reasons. The reason for the increased reliability of the system is that now there would be
proper storage of information.

4. No Redundancy: - In the proposed system utmost care would be that no information is
repeated anywhere, in storage or otherwise. This would assure economic use of storage space
and consistency in the data stored.

5. Immediate Retrieval of Information: - The main objective of proposed system is to
provide for a quick and efficient retrieval of information. Any type of information would be
available whenever the user requires.

6. Immediate Storage of Information: - In manual system there are many problems to
store the largest amount of information.

7. Easy to Operate: - The system should be easy to operate and should be such that it can be
developed within a short period of time and fit in the limited budget of the user.












Components:
It can be composed of one or a few software components with speciality-specific extensions as well as of
large variety of sub-systems in medical specialties.
 Laboratory Information system (LIS)
 Radiology Information system (RIS)
 Clinical Information system (CIS)
 Financial Information System (FIS)
 Nursing Information System (NIS)
 Pharmacy Information System (PIS)
 Picture Archiving Communication System (PIF)
Laboratory Information System (LIS):
Laboratory Information System is a class of software which handles receiving, processing and storing
information generate by medical laboratory processes. These systems often must interface with
instruments and other information systems such as hospital information system.
LIS include Biochemistry, immunology, blood bank (Donor and Transfusion Management), and
microbiology.
Radiology Information System (RIS):
Radiology is the study and use of X-rays and similar radiation in medicine.RIS is a computerised
database used by radiology departments to store, manipulate and distribute patient radiological data.
Clinical Information System (CIS):
A Clinical Information System is a computer based system that is designed for collecting, storing,
manipulating and making available clinical information important to the healthcare delivery process.
Financial Information System (FIS):
Financial Information Systems are computer systems that manage the business aspect of a hospital.
While healthcare organization’s primary priority is to save lives and not making profits, they do acquire
running costs from day to day operations; including purchase and staff payroll.



Nursing information System (NIS):
Nursing Information Systems are computer systems that manage clinical data from a variety of
healthcare environments, and made available in a timely and orderly fashion to aid nurses in improving
patient care.
Pharmacy Information System (PIS);
Pharmacy Information Systems are complex computer systems that have been designed to meet the
needs of a pharmacy department. Through the use of such systems, pharmacists can supervise and have
inputs on how medication is used in a hospital.
Picture Archiving Communication System (PACS):
Picture Archiving Communication System is a term to describe a set of systems that facilitate the
archiving, processing and viewing of digital radiological images and their related information.
Modules involved:
The various modules involved are represented in the following figure:

Information Management in Hospitals:
Definition of information management in hospitals:
Information management in hospitral is the sum of all management activities in hospital that process
information to fulfil the strategic hospital goals into hospital success. Therefore, it manages the
maintenance and operation of an appropriate information system for the hospital.

Definition of hospital information systems:

Hospital information systems can be characterized by their functions, their types of processed
information and their types of services offered. In order to support patient care and the associated
administration, the tasks of hospital information systems are to provide:
 Information, primarily about patients, in away that it is correct, pertinent and up to date,
accessible to the right persons at the right location in a usable format. It must be correctly
collected, stored, processed, and documented;
 Knowledge, primarily about diseases—but also for example about drug actions and adverse
effects to support diagnosis and therapy;
 Information about the quality of patient care and about hospital performance and costs.

This highlight that hospital information systems have to provide high quality communication between
the various hospital sectors in terms of both information and knowledge related functions.

Classification of information management tasks in hospitals:

The general tasks of management are planning, directing, and monitoring. For information management
in hospitals this means:
 planning the hospital information system, respectively its architecture,
 directing its establishment and its operation, and
 Monitoring its development and operation with respect to the planned objectives.

With respect to its scope information management can be differentiated into strategic, tactical, and
operational management.

Strategic information management in hospitals:

Strategic information management deals with the hospital’s information processing as a whole. It
depends strictly on the hospital’s business strategy and strategic goals and has to translate these into well
fitting information strategy.
The result of strategic information management planning activities is a strategic information
management plan. The plan includes the direction and strategy of information management and gives
directives for the construction and development of the hospital information system by describing its
intended architecture.
The strategic plan is the basis for strategic project portfolios. They contain concrete projects, which
implement the objectives of the strategy, and shall be revised regularly.
Directing a hospital information system as part of strategic information management means to transform
the strategic plan into action, i.e. to systematically manipulate the hospital information system in order to
make it conform to the strategic plan.
Strategic information management and in result the strategic plan are the vital requirement for tactical
and operational information management in a hospital.

Tactical information management in hospitals:

Tactical management deals with certain enterprise functions, i.e. with hospital functions as for example
the planning and documentation of operations. It aims to construct or to maintain components of the
hospital information system.
Planning in tactical information management means planning of projects and all resources needed. Even
though projects of tactical information management are based on the strategic plan they need a specific
i.e. tactical project plan. This plan has to describe the project’s subject and motivation, the problems to
be solved, the aims to be achieved, the tasks to be performed, and the activities to be undertaken to reach
the aims. Based on that directing in tactical management means the execution of such projects of tactical
information management in hospitals.
Therefore, it includes typical tasks of project management like resource allocation and coordination,
motivation and training of the personnel etc.
Monitoring means continuously checking, whether the initiated projects are running as planned and
whether they will still produce the expected results.

Operational information management in hospitals:

Operational information management is responsible for maintaining the installed hospital information
system and its components. It has to care for its operation in accordance with the strategic plan.
Planning in operational information management means planning of all resources like organizational
structures, finance, personnel, rooms, buildings that are necessary to ensure the faultless operation of all
components of the hospital information system. These resources need to be available for a longer period
of time.
Directing means the sum of all management activities, which are necessary to ensure proper reactions to
operating faults of components of the hospital information system i.e. to provide back-up facilities, to
operate a helpdesk etc.
Directing in this context deals with engaging the resources planned by the strategic plan in such a way
that faultless operation of the hospital information system is ensured.
Monitoring deals with verifying the proper working and effectiveness of all components of the hospital
information system.

Strategic information management plans in hospitals:

A strategic information management plan documents, how the goals of a particular hospital shall be
supported by information technology. Therefore, it describes how information management will be
organized, what the different working groups have to do and how the various stakeholders are
concerned. The strategic plan defines direction and schedule for all tactical and operational information
management activities in the hospital.

Stakeholders and their concerns:
There are various stakeholders5 involved in the creation, updating, approval, and use of strategic plans:
 Top management,
 Funding institutions,
 Employees, e.g. physicians, nurses, administrative staff,
 Clinical, administrative, and service departments,
 Information management departments.
 Consultants,
 Hardware and software vendors.

These stakeholders may have different expectations from a strategic plan and are involved in different
life-cycle phases of strategic plans:
Creation, i.e. writing a first plan,
Approval, i.e. making some kind of contract among the stakeholders,
Deployment, i.e. asserting that the plan is put into practice,
Use, i.e. the involved stakeholders refer to the plan whenever needed,
Updating, when a new version is required.

Top management is interested in seamless and cost-effective operation of the hospital. They approve the
plans, probably together with the funding institutions, which are primarily interested in the financial
consequences.
Employees as well as the different hospital departments should be involved in eliciting the requirements,
since they will use the resulting information systems. IM departments will usually create and maintain
proposals for the plans. They are interested in clearly defined requirements for their work, reflecting
tactical management issues. Additionally the IM department usually has to deploy the plan, which
cannot be done without effective backing from the top management.









Different Phases of the System:
 Data Collection
 Feasibility Study
 Hardware/Software Requirement
 List of Tables
 E.R. Diagram
 Data Flow Diagram
 Forms and Output Reports
 Validation Check
 Implementation and Maintenance
 Testing
Data Collection:
The information regarding hospital management system can gathered from the staff members and
patients, the computer user and the administration staff.
We can interview the persons who are a part of the hospital. We can listen to their problems and analyse
them properly.
The various problems in existing information system are:
1. The data is not in collective form: Data integrity is almost zero. No one knows about the existing
data. Every time patient comes, he has to get a new file made. It increases duplicacy and
redundancy in the database and more workload.
2. Inadequate Data: Data is not interconnected so every department does not have full information
about each records which results in incomplete information.
3. Insufficient Privilege: The privileges and authority are not defined because it’s data can be
corrupted and changed by an unauthorised person.
4. Unordered Reports: Due to lack of good information, report quality is very bad. Incomplete
reports are generated due to insufficient data.
To overcome such problems, new systems has come into existence that is Automated Hospital
Management System.:
1. Data will be collected in central at the server and others will get data and make updates directly
from them.
2. The Computerized Hospital Management System computerizes the whole information and
generates the reports having complete information.
3. Patient’s record will be stored in a file so that there will be no requirement of new file every time
the patient visits the hospital.
4. Records of doctors will be managed so that one can have full information regarding the doctors.
5. Inventory of pharmacy will ne managed so that one must be aware of the stock present in the
hospital.
6. The reports of the laboratory will be maintained so that every patient can enquire anytime about
his reports any time.
Feasibility Study:
Depending on the results of the initial investigation the survey is now expanded to a more detailed
feasibility study. Feasibility study is a test of system proposal according to its workability, impact of
the organization, ability to meet needs and effective use of the resources. It focuses on these major
questions:

1. What are the user’s demonstrable needs and how does a candidate system meet them?
2. What resources are available for given candidate system?
3. What are the likely impacts of the candidate system on the organization?
4. Whether it is worth to solve the problem?


During feasibility analysis for this project, following primary areas of interest are to be considered.
Investigation and generating ideas about a new system does this.

Steps in feasibility analysis:
Eight steps involved in the feasibility analysis are:

1. Form a project team and appoint a project leader.
2. Prepare system flowcharts.
3. Enumerate potential proposed system.
4. Define and identify characteristics of proposed system.
5. Determine and evaluate performance and cost effective of each proposed system.
6. Weight system performance and cost data.
7. Select the best-proposed system.
8. Prepare and report final project directive to management.

Types:
Technical Feasibility:
The system should be technically feasible. All the software and hardware which is being used by
the system should be available easily and they must be compatible with most of the computers.the
technical needs of the software include:










Front-end selection:

1. It must have a graphical user interface.
2. Scalability and extensibility.
3. Flexibility.
4. Robustness.
5. According to the organization requirement and the culture.
6. Must provide excellent reporting features with good printing support.
7. Platform independent.
8. Easy to debug and maintain.

Back-end selection:

1. Multiple user support.
2. Efficient data handling.
3. Provide inherent features for security.
4. Efficient data retrieval and maintenance.
5. Stored procedures.
6. Popularity.
7. Operating System compatible.
8. Easy to install.
9. Various drivers must be available.
10. Easy to implant with the Front-end.

Economic Feasibility:

The software should be economically feasible. It should be not very costly so that only few people can
buy it and should be worthy. It should be beneficial as per cost.

The financial and the economic questions during the preliminary investigation are verified to
estimate the following:

 The cost to conduct a full system investigation.
 The cost of hardware and software for the class of application being considered.
 The benefits in the form of reduced cost.
 The proposed system will give the minute information, as a result the performance is improved
which in turn may be expected to provide increased profits.
 This feasibility checks whether the system can be developed with the available funds. The
Hospital Management System does not require enormous amount of money to be developed.
This can be done economically if planned judicially, so it is economically feasible. The cost of
project depends upon the number of man- hours required.




Operational Feasibility:

The software should be operationally feasible. Every user can operate it easily. The software must be
user-friendly. It is mainly related to human organizations and political aspects. The points to be
considered are:

 What changes will be brought with the system?
 What organization structures are disturbed?
 What new skills will be required? Do the existing staff members have these skills? If not, can
they be trained in due course of time?

The system is operationally feasible as it very easy for the End users to operate it. It only needs
basic information about Windows platform.

Hardware/Software Requirement:
Hardware used for the system should be easily available in the market and portable. The system
should be easily run-able on any type of hardware. It should not be hardware specific.
Software required for the running or creation of the software should be easily available. Its
configuration should be less so that everybody can easily buy the software required to run it.

List of Tables:
There should be a list of following the table to store the information:
 OPD Records List
 Admission List
 Doctor Detail
 Pharmacy Detail
 Patient Billing

OPD Records List:
It stores the information regarding the OPD patient. It must contain:
1. Patient’s name
2. Age
3. Sex
4. Problem
5. Department No.
6. Doctors ID to be consulted, etc.






Admission List:
It stores the information regarding those patients who are admitted to the hospital. It contains
following attributes:
1. Patient’s ID
2. Patient’s Name
3. Address
4. Phone No.
5. Father/Husband’s Name
6. Charges
7. Ward No.
8. Room No.
9. Bed No.
10. Consulted Doctor
11. Pharmacy charges, etc.

Doctor Detail:
It contains the details of the doctors who are working in the hospital. They may be regular or part
time/visiting doctors, their specialised field, attributes:
1. Doctor’s ID
2. Doctor’s Name
3. Qualification
4. Specialization
5. Address
6. Full time/part time/visiting
7. Timing schedule
8. No. Of patients under supervision, etc.

Pharmacy Detail:
It contains the medicine available in the hospital, their stock, price etc. It must contain the
following attributes:
1. Medicine ID
2. Name
3. Type of Medicine
4. Pharmaceutical Name
5. Expiry Date
6. Manufacturing Date
7. Price
8. Stock in hand, etc.





 Patient pharmacy: It consists all the medicines which have been taken up by the patient.
It records the detail of each medicine which has been taken by the patient so that they can
easily charge at the time of discharging the patient.
 Patient_ID
 Patient_Name
 Phone_No.
 Medicine_ID
 Qty.
 Total amount

 Patient Laboratory: It contains all the lab reports of each patient. It must have the
following fields:

 Patient ID
 patient Name
 Test Name
 Type of Test
 Report
 Charges, etc.

 Accidental Patient: It consists the complete record of the patient having accidental issue.
It must have the following fields:

 Patient_Id
 Patient_Name
 Ploice_ID
 Police_Name

Patient Billing:
It contains the discharging report of each patient who is admitted to the hospital. It contains the
summary report of each patient. For e.g.:
1. Patient_ID
2. Admission Charges
3. Bed Charges
4. Lab Charges
5. Pharmacy Charges
6. Other Charges
7. Date of discharging
8. Status of Patient
9. Prescription, etc.



Entity Relationship Diagram: The E-R Diagram of Hospital management System is
depicted in the following figure:


















Data Flow Diagram:
After finding the data, analyst prepares a DFD which depicts the flow of data in different elements
of the system and which gives a graphical overview representation. To draw an analysis DFD:
1. Look at the system from inside to the outside.
2. Identify the activities.
3. Locate the data flows.
4. Show the relationships between activities.
5. Find the internal input or output that exists within the system.
6. Level complex process in the DFD into simpler one.
7. Look for duplication of data flows or data stores.


DATA FLOW DIAGRAM














Data Flow Diagram for Inpatient Details




Data Flow Diagram for Outpatient Details



Data Flow Diagram for Cashier Details

Data Flow Diagram for Doctors Appointment Details




Forms and Output Reports:

The software must contain the following forms:
 OPD Form
 Admit Form
 Doctors Form
 Pharmacy Master Form
 Patient Pharmacy Form
 Laboratory Form

OPD Form:

It shows the detail of the OPD patient. When a patient comes to the hospital his/her record
must be entered into the hospital database information system regarding the patient.

1. Patients ID should be unique and cannot be altered by the user. Its number must be
displayed and incremented automatically.
2. It must contain token number when the patient gets his turn.
3. It shows the list of doctors available for OPD.
4. The departmental detail of the department where the patient has to go.

Admit Form:

It enters the record of the patient who has been admitted to the hospital. It shows the vacant
bed in specific room. It allocates the doctor who will supervise that patient.
It summarizes all the changes which have to be taken up at the time of admission.

Doctors Form:

It stores the information regarding the doctor that is Doctor’s address, their specialization,
duty timings, etc.

Pharmacy Master Form:

It shows the detail of all the medicines which are in the stock of the hospital, when new
medicines are issued, the stock of specific medicine increases and vice versa.

Patient Pharmacy Form:

It enters the patient’s medicine detail. It keeps the record that which patient will be issued
how much medicine with their dates so that the time of discharging he/she faces no problem
while paying the Pharmacy charges.


Laboratory Form:

It stores the test reports of each patient and their result. All the tests which have been taken
by the hospital will be recorded there and at the time of discharge this amount will be added
into the amount paid by the patient.
Other than this there are various other report forms to be displayed and printed. For example:
 OPD patient list
 Pharmacy record
 Number of patients under each doctor
 List of doctors according to their specialization
 Pharmacy stock list
 Charges to be paid by the patient at any time
 Lab test reports
 Complete information about every patient, etc.

Validation Check:

The major validation checks of this system are:

1. Patient ID should be generated automatically.
2. The list of only those doctors should be displayed who are available and are of the
same department.
3. The transactions of only those patients should be allowed who are admitted to the
hospital.
4. In pharmacy form, expiry date should be bigger than the manufacturing date.
5. Lab test report should be printed only, reports of patient who are admitted etc. Other
validation check should also be marked according to the requirement.
6. The Accident, Patient list, Patient-ID must be in Patient data base- That Patient must
be admitted to the hospital.

Implementation and Maintenance:

The system should be implemented to each system. It should be properly maintained and
antivirus should be installed on the system.
Data integrity should not be violated during the operation or implementing phase.












Testing:

System testing begins by testing program module separately followed by testing “Bundle”
modules as a unit.
A program module may often work perfectly in isolation but may fail when interfaced with
other modules.
The test approach is to test each entity with successively larger ones, up to system test level.
Project testing consists of the following steps:
1. Program testing
2. String testing
3. System testing
4. Project documentation
5. User acceptance testing
The system should pass out every testing so that the system should be good software.


Benefits:

 Improve operational and streamlining operations.
 Maintain patient’s database.
 Maintain global standards.
 Reduce manpower.
 Accuracy
 Better customer service
 Improved management and control.
 Neat formatted report.





















Conclusion:

The project Hospital Management System (HMS) is for computerizing the
working in a hospital. The software takes care of all the requirements of an
average hospital and is capable to provide easy and effective storage of
information related to patients that come up to the hospital.

It generates test reports; provide prescription details including various tests,
diet advice, and medicines prescribed to patient and doctor. It also provides
injection details and billing facility on the basis of patient’s status whether it is
an indoor or outdoor patient.

The system also provides the facility of backup as per the
requirement.



References:


 www.google.com
 www.yahoo.com
 www.rediff.com