Healthcare IT Checklist for Small & Midsize Indian Hospitals by HIMSS

Hospital Information System Checklist for Small & Medium Hospitals

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DISCLAIMER

HIMSS Asia Pacific India Chapter has exercised professional care and diligence in collection and processing of the information in this report. This report is intended to be of general interest only and does not constitute professional advice. HIMSS Asia Pacific India Chapter makes no representations or warranties about the accuracy of the data in this report. HIMSS Asia Pacific India Chapter is not be liable to any user of this report or to any other person or entity for any inaccuracy of information contained in this report or for any errors or omissions in its content, regardless of the cause of such inaccuracy, error or omission. Furthermore, to the extent permitted by law, HIMSS Asia Pacific India Chapter, its members, employees and agents accept no liability and disclaim all responsibility for the consequences of you or anyone else acting, or refraining from acting, in relying upon the information contained in this report or for any decision based on it, or for any consequential, special, incidental or punitive damages to any person or entity for any matter relating to this report even if advised of the possibility of such damages.

This document is NOT aligned with the HIMSS Analytics EMRAM (EMR Adoption Model). The checklist will be aligned to EMR Adoption Model in the next phase of work.


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CHAIRMAN’S MESSAGE

I am happy that HIMSS Asia Pacific India Chapter has come out with the much needed HIT Checklist for small and medium size hospitals.

Having served on the board of medium and large size hospitals, I have seen the pain of failure of HIT/HIS (Hospital Information Technology/ Hospital Information Systems), the transition to a new system and the financial loss to the organizations for the failure of the HIS. In three organizations, I have at the board level, written off about Rs. 10 Cr (approximately USD 2 million) due to an ill-conceived HIT/ HIS system.

The problem starts at the ordering stage itself, as a wrong RFP for a HIT/ HIS solution would lead to a wrong solution being developed, and the vendor may not be responsible for the failure. To make the job easier for the hospital administrators, experts at HIMSS have come out with a checklist which has been reviewed by a leading panel of experts. We hope that using this HIT checklist as a reference, the hospitals can design the right HIT /HIS solution .This is the first HIT checklist and we will await your feedback and improvise on the next version.

Pankaj Vaish, Vice President, Board Member - HIMSS Asia Pacific India, deserves credit for taking out time from his busy schedule and making this happen with the help of other board members, and our deep heart-felt thanks to the eminent expert panel for their review and feedback.

HIMSS is committed to the transformation of healthcare using IT, and we look forward to your feedback on this initiative

Rajendra Pratap Gupta Chairman, Board of Directors HIMSSS Asia Pacific India Chapter


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HIMSS ASIA PACIFIC INDIA CHAPTER

Rajendra Pratap Gupta Chairman , Board of Directors

Vishal Gupta President, Board of Directors

Pankaj Vaish Vice President, Board of Directors

Manick Rajendran Vice President, Board of Directors

Madhubala Radhakrishnan Treasurer

Dr Pankaj Gupta Joint Secretary

Vamsi Chandra Kasivajjala Member, Board of Directors

Amit Mishra Secretary, Board of Directors

Shailendra Ravi VP, Senior Director, Business Strategy EMC

Email: [email protected]

mailto:[email protected]


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ACKNOWLEDGEMENT

HIMSS Asia Pacific India Chapter is pleased to publish this document that is intended to serve as a checklist for Small & Medium Hospitals in India while they embark on their journey to choosing the right Healthcare IT Solution in the form of a Hospital Information System (HIS). This document can be used by most small and medium hospitals across public and private sector settings in India and to a certain extent can also be extended to hospitals outside of India in neighbouring regions with similar level of maturity of adopting Health IT and a comparable socio economic status as that of India. This checklist covers key functional areas for IT automation in hospitals and addresses both functional and technical requirements.

The initial draft was prepared by members of the board of HIMSS Asia Pacific India Chapter. This report also bears the efforts of significant contributions through review and revision of the document and hence it is important to place on record appreciation to the following members whose contribution has resulted in finalizing and publishing this checklist.

Expert Review Panel

1. Mr. Praneet Kumar CEO, BL Kapoor Hospital, New Delhi, India 2. Dr. Mahesh Inder VS CEO, Saket City Hospital, New Delhi, India 3. Dr. Dharminder Nagar Managing Director, Paras Healthcare Pvt. Ltd., India 4. Dr. Karanvir Singh Chief Medical Information Officer, Apollo Healthcare, India 5. Dr. Gayatri Mahindroo Director, NABH, New Delhi, India 6. Dr. Kiran Venugopal Vice President – Product Management, HealthFore Technologies, Bangalore, India 7. Mrs. Neena Pahuja Independent HIT Consultant, NCR Region, India 8. Mr. Rajesh Batra Kokilaben Dhirubhai Ambani Hospital, Mumbai, India 9. Mr. Aditya Mani Pushpanjali Crosslay Hospital, NCR Region, India 10. Mr. J P Dwivedi CIO, Rajiv Gandhi Cancer Institute & Research Centre, Delhi, India 11. Mr. R S Bapat Adtiya Birla Memorial Hospital, Pune, India


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DEFINITIONS

1. EMPI Enterprise Master Person Index 2. MRN Medical Record Number 3. EMR Electronic Medical Record 4. CPOE Computerized Physician Order Entry 5. IV Intra Venous 6. OPD Out Patient Department 7. OT Operation Theatre 8. OR Operating Room 9. ICU Intensive Care Unit 10. SaaS Software as a Service 11. TAT Turn Around Time


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FUNCTIONAL REQUIREMENTS Legend

G: Indicates the proposal fully comply the requirement/ clause

A: Indicates the proposal partially meet the requirement / clause; supported with remarks

R: Indicates the proposal does not meet the requirement / clause; supported with remarks

S. No. Module Sub Module/ Function Requirement Importance Weightage Vendor

Remarks HIS/1 Patient Registration & EMPI

HIS/1.1 General The system shall auto generate a unique Patient ID (aka MRN or UHID) which shall use alpha numeric characters. The logic used to generate the Patient ID should be definable by the Hospital.

Critical

HIS/1.2 General Types of Registration - General, VIP, Emergency and External. General registration is used in all normal cases. VIP is registration that is used for VIP patients or can be a part of general registration with a separate Flag/Indicator. Emergency registration should take only approximate age and gender as an input. External registration can be used for patients visiting for Diagnostic services and/or Pharmacy services only.

Critical

HIS/1.3 General Flexible fields to capture unique Patient Identifier like PAN card, Aadhar Card, Passport, Referral Source etc.

Important


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Remarks HIS/1.4 Patient

Search Patient Search shall have multiple search capabilities. It shall be able to qualify searches by name, date of birth, sex, national individual identifiers (such as Aadhar, PAN Card, Passport etc.). The index shall support a variety of possible internal identifiers such as Patient ID (MRN/UHID), case number, multiple account numbers, etc., for each patient and be able to maintain cross reference to other existing identifiers in each of the facilities used by the patient in the same site or in other locations.

Critical

HIS/1.5 Patient Search

The HIS shall support a EMPI at multi-site, multi-institutional, district, or national levels that links existing patient indices together.

Critical


The EMPI shall support multiple names so that patients who change their names can still be located with a EMPI search.

Critical


Ability to search patient name using soundex as well as multi-part names.

Desirable


Name alert search. Patients with same last name and same first name and initial shall be flagged to alert users of possible conflict.

Critical

HIS/1.9 Patient merge

The system should have the capability to merge 2 records under a single record and allow searching for either record resulting in one final search result of merged identity.

Desirable


The system should have the capability to let the end user choose the visits and records which need to be merged.

Desirable


During the merge process, across the system except for super users, the normal users should be able to see only one record.

Desirable

HIS/1.12 Patient Unmerge

The system should have the capability to unmerge the merged records

Desirable


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Remarks HIS/1.13 The system should have the capability to control if end

user is allowed to choose the visits and records which need to be unmerged and also the association of all the transactions to the right Patient Unique ID and the visits and if access is not granted, system should automatically decide unmerge rule.

Desirable

HIS/1.14 Demographic Profile

The system should have capability to capture dependant information against a patient profile and also maintain a family tree association where applicable to enable reviewing family records where necessary. Linking of mother and child record or donor and recipient record should also be supported.

Desirable

HIS/1.15 Pre-Registration

The system must have support for bulk registration in case of mass patient enrolment from medical camps as well as have a provision to perform pre-registration which can later be converted to a permanent registration

Desirable

HIS/1.16 Eligibility The system must have support for capture of patient eligibility along with registration process which can include payor plans, authorizations, effective dates for eligibility etc. that will impact encounter wise invoicing

Important

HIS/1.17 Tagging The system must support tagging of patients as either VIP, Free patient, staff etc.

Desirable

HIS/2 Appointment Scheduling HIS/2.1 General The System shall support integrated scheduling of

appointments and resources across the organisation. Critical

HIS/2.2 General System shall be able to retrieve the patient’s demographic data captured with capability to update/make changes.

Critical

HIS/2.3 General System should allow different kinds of appointments namely Appointments with Doctors, Multi Appointment (Appointments across multiple dates with a single doctor, or appointments with multiple doctors on a single day or a

Critical


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Remarks combination), Diagnostic appointments, Check-up appointments, follow up visits.

HIS/2.4 General The Appointment Scheduling module will be used: • To minimise patient’s waiting time. • To flag No-Show patients. • To optimize resource utilization

Critical

HIS/2.5 General System shall allow online booking of appointments. Desirable HIS/2.6 General Upon confirmation of an appointment, notification must

be sent to the patient via SMS and email/Fax. Also reminders via SMS should be sent x no of hours before the appointment. This is applicable only to those cases which are not walk ins.

Important

HIS/2.7 General The System will allow for multi-step appointments to be created. For ex: if the patient first has to get a lab test completed and only after the report is available, the patient’s appointment with the doctor needs to get confirmed.

Desirable

HIS/2.8 General The above multi-steps cancellation and/or re-scheduling rules needs to be taken into consideration.

Desirable

HIS/2.9 General System shall alert in the event of any appointment clashes or future appointments including during admission.

Important

HIS/2.10 General System shall generate appointment slips with details including Date, Time, Room No, Doctor Name, Token number, etc. These details should be configurable by the end user.

Critical

HIS/2.11 General It is preferable that the scheduling screen depicts a calendar view similar to outlook or mac calendar

Important

HIS/2.12 General Alert or prompt rules should be configurable and by default should consist of conflict rules, duplicates, etc.

Important


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Remarks HIS/2.13 General The system should handle resource planning and this

should include resource definition, resource time slot planning, appointment transfers, appointment slot swapping features, etc.

Critical

HIS/2.14 General Types of appointments include one-to-one, one-to-many, many-to-one and many-to-many combinations and all of them needs to be handled by the system

Critical

HIS/2.15 General The system should accommodate overbooking and forced booking functionalities based on configurable rules.

Critical

HIS/2.16 Reports System should have inbuilt reports for Daily appointment lists, no show lists, cancellation lists, etc.

Critical

HIS/2.17 Communication

System should have support to generate reminder messages to be sent to patients/attendants based on context of schedule or appointment – e.g. Reminders on confirmed consultation appointments, reminders based on vaccination schedule

Desirable

HIS/2.18 Booking System must allow for bulk management of appointments including bulk booking of multiple patients into a slab / timeframe or allow for bulk re-scheduling or cancellations based on resource constraints that are unplanned – e.g. Doctor on emergency leave or delayed due to other critical cases outside of the OPD setting

Important

HIS/3 Outpatient Management

HIS/3.1 Billing System should cater to both Pre-Billing and Post-Billing scenarios.

Critical

HIS/3.2 Billing System should auto alert cashier desks/stations for a patient's bill collection.

Important

HIS/3.3 Registration System should have the ability of Pre-Registration (Online), Self-Registration (Kiosk and/or Web), and interfacing with payment gateway.

Desirable


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Remarks HIS/3.4 Triage The system should have the ability to capture basic clinical

information from a nursing desk or by a junior doctor. Critical

HIS/3.5 EMR The ability to view the patient's EMR by the consulting doctor at any point of time is a must. Also, the EMR should be accessible by multiple doctors at the same time but only the first doctor would have read/write rights and rest all would have read only rights. Provision to have intuitive user interface to see the continuity of care in case sheet style and book flip style.

Critical

HIS/3.6 CPOE The consulting doctor should have access to the order entry module.

Critical

HIS/3.7 Information Through the system, users must be able to pass information securely similar to a messenger or a chat application. The same should be stored and audited.

Desirable

HIS/3.8 Quality It is desirable that the system can track turnaround times for various activities and escalates when the TAT are missed.

Desirable

HIS/3.9 Worklist Doctors OPD patient worklist should be configurable based on various criteria

Desirable

HIS/4 Admission, Discharge & Transfer HIS/4.1 Admission System should be able to handle different kinds of

admission namely Pre-Admission(online), Direct Admission, Emergent Admission, Walk-in Admission, Referral Admission and Planned admission

Critical

HIS/4.2 Admission System should have the ability to provide with a bill estimation at the time of admission. Further system must also have capability of admitting under joint management such that billing and apportioning of expenses is possible to respective medical conditions/disciplines.

Important


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Remarks HIS/4.3 Admission The system should show a graphical representation of

available and occupied beds in the hospital. The system should be able to search for beds based on multiple criteria, e.g. vacant bed, vacant beds user a particular speciality, beds of a particular class (e.g. deluxe) that are under housekeeping – about to become vacant, etc.

Important

HIS/4.4 Admission The system should capture details of the guarantor and/or Insurance/TPA/Corporate/CGHS/ESIC details.

Critical

HIS/4.5 Transfer The system should have the ability to transfer a patient from one ward to another based on configurable business rules.

Critical

HIS/4.6 Transfer The system should have the ability to transfer the patient from one admitting consultant to another.

Critical

HIS/4.7 Transfer The system should have the ability to transfer based on configurable billing rules like retrospective billing, etc.

Desirable

HIS/4.8 Discharge The system should have configurable workflow based discharge. From Clinical discharge to Physical discharge, there could be multiple steps involved based on each individual hospital's workflow and they should be configurable in the system. Ex: Pharmacy Discharge, Diagnostic discharge, Financial discharge, etc.

Critical

HIS/4.9 Discharge The system should send alerts about the discharge status in real time to the relevant actors.

Critical

HIS/4.10 Discharge The discharge summary/detail report should be configurable and should have the ability for the hospital to decide which transactions during the patient's journey should become a part of the discharge.

Critical

HIS/4.11 Transfer The system should support transfer of care from ER/EM (emergency care) to Inpatient care without having to close and re-open a new encounter – this should also

Desirable


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Remarks support combining of charges into a single IP Invoice

HIS/5 Bed & Ward Management

HIS/5.1 Bed Mgmt. The system should have the ability to create different kinds of bed and associate it with multiple attributes. Ex: Normal bed which is billed on a daily (24 hour) basis and has a bassinet and ventilator attached to it which will be charged at a certain value.

Critical

HIS/5.2 Beds should be billed either on a hourly basis or daily basis Critical HIS/5.3 Bed Census report is required Critical HIS/5.4 The available, occupied and under maintenance beds

should also be shown in a graphical representation Desirable

HIS/5.5 Ward Mgmt. The system should provide the ability to certain users to order, track and return consumables, medications, etc. from the ward management screen

Important

HIS/5.6 Ward Mgmt. The system should track diet/food orders and returns. Important

HIS/5.7 Ward Mgmt. The system should provide the overall status of a ward at any given instance in terms of pending orders, bed status, housekeeping requests, etc.

Critical

HIS/5.8 Bed Mgmt. Scheduling of housekeeping and maintenance activities Critical HIS/5.9 Bed Mgmt. Should facilitate the estimation of appropriate waiting

times for patients Important

HIS/5.10 Bed Mgmt. Forecasting of bed availability based on all vacant beds and all potential beds that can be made available based on planned discharges and planned maintenance tasks on blocked beds

Desirable

HIS/6 CPOE

HIS/6.1 General The system should gave the ability to handle different kind Critical


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Remarks of orders namely medications, IV, Radiology, Laboratory, Blood, Procedures, Nursing, Diet, etc.

HIS/6.2 General The system should track the orders - ordering, status, administration (where applicable) and results without losing information and in real time.

Critical

HIS/6.3 General Orders should be processed by the relevant actors by providing them the information through worklists/ dashboards or similar functionalities.

Critical

HIS/6.4 General Orders progress needs to be recorded through relevant screens and the same should be visible in real time to the relevant actors. For ex: Lab order when processed and the report is available, the same should be visible to the ordering doctor in the EMR.

Critical

HIS/6.5 Results The system should have the ability to enter multiple levels of results. Ex: Unverified results, Verified results and authorized results.

Critical

HIS/6.6 Results Based on configurable rules, the results should appear in the EMR at the right stage (Unverified/Verified/Authorized)

Critical

HIS/6.7 Order Sets The ability to create order sets based on problem, diagnosis, doctor or pathway is desirable.

Desirable

HIS/6.8 Medication Orders

The ability to order for medications based on types of medications is critical. Ex: Variable dosing, Sliding Scale, Tapering dose, etc.

Important

HIS/6.9 Medication Orders

The system should interface with drug database to provide both default dosage details while prescribing medications as well as provide decision support alerts for contraindications or interactions

Important

HIS/6.10 IV Orders The system should have the ability to order for the right kind of IV and with built in rules depending on the drip rate, type of IV, and the mode of delivery - Bags, Infusion pumps, etc.

Important


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Remarks HIS/6.11 Radiology The system should mandatorily send basic clinical

information along with the radiology order as per HL7 guidelines.

Critical

HIS/6.12 Laboratory The system should be able to handle different kind of lab orders and the results, such as Pathology, Histopathology, Microbiology, Cyto-Genetics, Immunology, etc.

Important

HIS/6.13 Results The results should have the ability contain text, images, audio and video and should be stored in the EMR.

Desirable

HIS/6.14 Results The results should be sent to EMR in real time. Critical HIS/6.15 Results The system should have the ability to create reports based

on the due date of results. Important

HIS/6.16 Surgical Procedures

System should support workflow to order/initiate surgical procedures and schedule such procedures within a surgical theatre complex

Important

HIS/6.17 Diet Module Recording of Dietics Visit (Prescription) & Billing Critical HIS/6.18 Diet Module View of Treating Doctor's recommendations Important HIS/6.19 Diet Module Diet/Meal Plan Critical HIS/6.20 Diet Module Interface with F&B Module for Diet preparation Important HIS/6.21 Diet Module Alerts of new Admissions, Transfers and Diet

recommendations Important

HIS/6.22 Discharge Summary

Multi-Level Templates (Unit, Department, User Group, User) Critical HIS/6.23 Speech to Text Support Important HIS/6.24 Macro based Reporting Feature Important HIS/6.25 Import EPR entries (Investigation Results, Illness History,

Treatment Record etc.) Important

HIS/6.26 Capture Pictures and Annotations Important HIS/6.27 Diet Module Preparation of meal tickets that can be used to affix on

meals for delivery that contain patient and location details for smoother management of logistics of meal delivery

Important


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Remarks HIS/7 Pharmacy HIS/7.1 General The worklist show the Inpatient, Outpatient, Emergency

orders against the patient/ward Critical

HIS/7.2 General The system should show the return requests against a patient/ward in a worklist.

Critical

HIS/7.3 General The dispensing should be based on closed loop of medication principles.

Critical

HIS/7.4 General It is desirable to have the drug details including monograph, interactions, etc. shown to the pharmacist on the relevant screens.

Desirable

HIS/7.5 General Drug and Patient search capabilities to be available Critical HIS/7.6 General The system should be able to show the available drugs

based on batch details and should be dispenses on First Expiry First Out principle. (FEFO Model)

Important

HIS/7.7 General Controlled substances and narcotics should be stored separately and should be accounted for based on governmental regulations. Reports for the same to be available.

Critical

HIS/7.8 Stock Stock movement should be tracked Critical HIS/7.9 Stock Stock requests, indentation, receipt functionalities to be

available Important

HIS/7.10 Label The ability to print labels in multiple languages and the data that needs to be printed on a label should be configurable.

Critical

HIS/7.11 Label Labels should be printed automatically on pre-defined network printers in real time or in batch mode.

Critical

HIS/7.12 Label Directions for usage of medications should also be available and should be configurable.

Important

HIS/7.13 OTC It is desirable to have Over the Counter sale functionality Desirable HIS/7.14 Inpatients It is desirable to have medication list functionality at a

ward level Desirable


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Remarks HIS/7.15 Reports Reports are extremely important and at the minimum

should print patient (OP) bills, stock lists, regulatory reports, etc.

Critical

HIS/7.16 General Bar Code Enabled Important HIS/7.17 Medication Maintenance of Generic and Brand Mapping Important HIS/7.18 Medication Drug Substitution based on common attributes across

trade names/brand names of drugs / medications Critical

HIS/7.19 Medication Interface with Third Party Drug Database Critical HIS/7.20 Medication Batch, Expiry Management Critical HIS/7.21 Pharmacy Dispensing & Inventory management - Should support all

the standard processes of In-Patient and Out-Patient Pharmacy within a Hospital. This module should also support processes of sub-stores like Operation theatre, Procedure rooms etc. A robust inventory control with audit trail should form the backbone of the system. The standard processes to be supported include Material Receipts, Issues, Transfers, Dispensing, Stock Tracking, Stock Taking, Automatic Indenting

Critical

HIS/8 Nursing Management

HIS/8.1 General The nursing personnel should have access to their worklists based on their activity within OPD, Inpatient wards, OT/Surgical wards and/or ICU.

Critical

HIS/8.2 General The nursing personnel based on access control should have access to EMR

Critical

HIS/8.3 Orders The nursing personnel should be able to place orders on behalf of a doctor or due to verbal orders after documenting the same.

Critical

HIS/8.4 Orders The nursing personnel should be able to start the discharge process on behalf of a doctor based on verbal orders, and after documenting the same.

Critical


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Remarks HIS/8.5 Documentat

ion Clinical documentation features in terms of Triage notes, Progress notes, visit notes should be available.

Critical

HIS/8.6 Care Plans It is desirable to have Nursing Care Plans functionality. Desirable HIS/9 Laboratory HIS/9.1 Worklist All lab orders should be reflected in the respective

user/sub-department worklist Critical

HIS/9.2 Worklist The status of all the lab orders should be reflected in real-time within the worklist

Critical

HIS/9.3 Workflow As the workflow of the lab process within each sub department typically differs from hospital to hospital, it is important to have configurable workflows or desirable to have an inbuilt workflow engine.

Important

HIS/9.4 Rules The rules for TAT, result validation, result entry, etc. differ and hence it is important to have configurable rules or desirable to have an inbuilt rules engine.

Important

HIS/9.5 Results Results must be in real time updated in the EMR and also the configurable alerts need to be sent to the respective users.

Critical

HIS/9.6 Laboratory Customizable workflows Critical HIS/9.7 Laboratory Customizable alerts for critical values Critical HIS/9.8 Laboratory Laboratory KIT Management Critical HIS/9.9 Laboratory Support for Digital Signatures Important HIS/9.10 Laboratory Standards based Uni Direction / Bi Directional interface to

Various Analyzers Critical

HIS/9.11 Reports List of reports need to be available and at the minimum Individual Test reports, consolidated detail/summary patient report, stock report, worklist reports, etc.

Critical

HIS/9.12 Reports Ability to compare previous results and perform a delta check

Important

HIS/10 Billing & Insurance


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Remarks HIS/10.1 Integration Billing module needs integration with almost all the

modules within the system starting from Registration and till Finance, Procurement and Inventory. So the interfaces need to be robust and well tested.

Critical

HIS/10.2 Integration Integration to orders, registration, appointment, admission is a must

Critical

HIS/10.3 Integration Integration with AR, AP and GL is important Important HIS/10.4 General The main worklist should have the ability to filter the list

based on type of patient (IP, OP, A&E, Day-care, External, etc.), type of Payer (Insurance, Cash, TPA, Corporate, CGHS, etc.)

Critical

HIS/10.5 General Cash Counter tracking and auditing functionalities including reports

Critical

HIS/10.6 General The system should able to generate Trial, Instant and Final invoices in real time.

Critical

HIS/10.7 General The system should have the full-fledged functionalities of Invoice, Deposits, Refunds, Settlements, and interfaces to credit and debit notes

Critical

HIS/10.8 General It is desirable to have a patient ledger functionality, where the billing details of a patient across all his/her visits are stored

Desirable

HIS/10.9 Reports Reports are critical and at the minimum should consist of Patient Invoice, Patient Settlement, Deposit, Refund, Counter wise - Shift wise collection report, Day wise summary/detail report, etc.

Critical

HIS/10.10 Reports Dashboards are a desired functionality Desirable HIS/10.11 Insurance The ability to define different types of payers is critical Critical HIS/10.12 Insurance The system should handle pre-authorizations, claim

preparation, claim submission and reconciliation functionalities.

Critical


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Remarks HIS/10.13 Insurance The system should be able to handle different charges for

the same order (test/service/consumable/etc.) different payers through configuration and also manage printing of payer specific terminology(Codes and descriptions)

Critical

HIS/10.14 Packages The ability to define fixed and variable packages based on configurable billing rules is critical

Critical

HIS/10.15 Rules It is important that the billing rules are configurable and desirable that system has an inbuilt rules engine.

Important

HIS/10.16 General System should support collection of advance payments/deposits either at a patient level which can be later utilized across visits or at a specific visit level for adjustment during closure of visit

Important

HIS/10.17 General System should support definition of alternative Nomenclature of services and products based on payer guidelines in order to generate payer invoice based on such specific nomenclature or grouping.

Important

HIS/10.18 General System should be able to allow customization of invoice formats based on payer preferences

Desirable

HIS/10.19 General System should be flexible to define various levels of taxation and other applicable surcharges based on regulatory guidelines in the region

Important

HIS/10.21 General System must support charging for one or more surgical procedures performed within the surgical care setting with flexible rules to determine charge dynamics based on primary procedure, surgeon preferences and packages assigned

Important

HIS/10.22 Billing (RCM) Multi-Dimensional Tariff structure Desirable HIS/10.23 Billing Support for Multiple versions of tariff Desirable HIS/10.24 Billing Facility to create multiple Tariffs Desirable HIS/10.25 Billing Support for Hospital / Company (CGHS, Arogyashree, ESI)

nomenclatures for services Critical


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Remarks HIS/10.26 Billing Flexible settlement options (Credit, Cash, Cards, and

Coupons etc.) Critical

HIS/10.27 Billing Interface / Integration with Swipe card machines Critical HIS/10.28 Billing Facility to accept deposits against Patient ID (MR No) and

subsequently apply the same to all types of bills Critical

HIS/10.29 Billing Support Tariff conversions for OP, IP, Day Care and Emergency Billing

Critical

HIS/10.30 Billing Support for Bills in Process (BIP) for inter-unit Transfers Critical HIS/10.31 Billing Alerts for Pending bills Critical HIS/10.32 Billing Alerts / reminders for deposit collection Critical HIS/10.33 Billing Support for comprehensive discount/Concessions process

with ability to authorize partial or full write off in case of non-payments

Critical

HIS/10.34 Billing & Collection

Advance Collection (Patient Specific or Multi-patient)with ability to allocate advances to a specific visit or utilize the advance across multiple visits.

Important

HIS/10.35 Settlement of Deposits Critical HIS/10.36 Billing based on Corporate or PSU (Price and Naming) Important HIS/10.37 Bill Submission and Receivable Tracking Important HIS/10.38 Aging of Receivables Important HIS/10.39 Localization of Tax's (VAT, Services etc.) Critical HIS/10.40 Refunds from Advances Critical HIS/10.41 Refunds against Billed Items (with Approval workflows) Critical HIS/10.42 Visitor Pass (Interfaced with Billing) Important HIS/10.43 Clearance for Surgery/Procedure, Discharge Important HIS/10.44 TPA/Insurance Workflow Important HIS/10.45 Insurance Authorization Amount Interface with Billing Important HIS/10.46 Date wise Billing to Patient Important HIS/10.47 Contracts Inclusion and Exclusion of Service Items based on Payer

(Quantity and Amount Based) Critical


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Remarks HIS/10.48 Contracts Price Master Important HIS/10.49 Contracts Billing override tracking Important HIS/10.50 Contracts Billing of combined and dependent Items (Surgery, Re-Do,

OT, Anaesthesia charges) Important

HIS/10.51 Doctors Payout

Service based definition of Fee Structure Important

HIS/10.52 Doctors Payout

Recording of Services rendered from Billing/Ordering/Payment Realization

Important

HIS/10.53 General Automated and Manual Discounting based on Business Rules with feature to define discounts for a period, discounts with user based limits etc.

Essential

HIS/10.54 OT Billing Billing Enquiry for OT Cases (Surgery Clearance) Important HIS/10.55 Patient

Billing Package subscription with support for managing a single package across multiple visits/encounters

Critical

HIS/10.56 Patient Billing

Billing Estimates and Counselling Forms Important

HIS/10.57 Payor Billing Credit Billing for PSU and Insurance customers Important HIS/10.58 Payor Billing Receivables Management (Aging and Collection) Important HIS/10.59 Payor Billing EDI Gateway Desirable HIS/10.60 Payor Billing Eligibility Inquiry and Response Important HIS/10.61 Payor Billing Claim Status Inquiry and Response Important HIS/10.62 Payor Billing Request from Provider and Response from Health Plan or

Administrator Important

HIS/10.63 Payor Billing Claims Management / Adjudication Important HIS/10.64 Package

Billing Flexibility to define mode of revenue recognition on package invoices and also support for managing consults within package where doctor is assigned dynamically at a later stage once all results are available for consultation in case of OPD packages

Important

HIS/10.65 Package Services

Ability to track incomplete package services and prompt for such services to be completed in a forthcoming visit

Desirable


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Remarks HIS/10.66 Ad-hoc

Billing Ability to allow miscellaneous billing (in case some masters are yet to be configured and billing needs to be done immediately) with restriction in terms of access rights

Desirable

HIS/11 Reporting Services HIS/11.1 General System must have capability to generate various statistical

and analytical reports based on key performance indicators of the organization

Critical

HIS/11.2 General System must allow representation of report related information in multiple formats including a combination of tabular and graphical outputs with ability to drill down from summary based reports

Important

HIS/11.3 General System should allow personalization of dashboards that consolidate specific set of reports based on user preference

Desirable

HIS/11.4 General Multi-format reports like tabular, graphical etc. from RDBMS, XML Based Data Source

Critical

HIS/11.5 General Use for Scheduling Report Processing or accessing Reports on Demand

Critical

HIS/11.6 General Use for publishing various Reports Important HIS/11.7 General Reports can be exported to various formats HTML,PDF,XML,

E-Mail etc. Important

HIS/11.8 General Add interactive features by providing links to sub reports and drill through reports

Important

HIS/11.9 General Ability to customise and personalize individual user dashboards and configure alerts/reminders upon dashboards being populated with relevant information that requires immediate attention

Desirable


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TECHNICAL REQUIREMENTS


Remarks HIS/Tech/1

User Interface

HIS/Tech/1.1

Client The system should be web based and should be browser agnostic i.e. it must be able to run on most popular browsers such as Microsoft Internet Explorer, Apple Safari, Mozilla Firefox and Google Chrome browsers

Critical

HIS/Tech/1.2

Client Must support multi lingual interfaces Important

HIS/Tech/1.3

Client Should be able to run in multi windows Desirable

HIS/Tech/1.4

Client The system should have the capability where the end users can define keyboard shortcuts in real-time.

Important

HIS/Tech/1.5

Client able to suspend use after a present period of inactivity Critical

HIS/Tech/1.6

Client Usage of icons is strongly recommended Critical

HIS/Tech/1.7

General Ability to reach the desired functionality in less than 4 clicks is strongly recommended from login completion step.

Important

HIS/Tech/1.8

General Ability to achieve single sign on in case of multi-solution environment

Desirable

HIS/Tech/1.9

General Password management to prompt users to manage their password changes on periodical basis based on password policy

Desirable

HIS/Tech/2

Architecture

HIS/Tech/2.1

General The system should have the ability to be hosted on a private/public cloud infrastructure

Critical

HIS/Tech/ General The system should have been designed to be modular and Critical


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2.2 scalable HIS/Tech/2.3

General It is preferable that the system was designed to handle multi tenancy and multi-location requirements.

Important

HIS/Tech/2.4

General It is desirable that the system has inbuilt workflow and rules engines

Important

HIS/Tech/2.5

General Ability to run on clustered environments to provide high availability

Important

HIS/Tech/3

Database

HIS/Tech/3.1

General It is preferable that the system uses industry standards like ANSI SQL

Important

HIS/Tech/3.2

General It is preferable that system provides a full-fledged data dictionary.

Important

HIS/Tech/3.3

General Referential integrity must be enforced Critical

HIS/Tech/3.4

General Central master tables should be used by multiple modules Critical

HIS/Tech/3.5

General Please mention the database backup features and how they are used by the system natively.

Critical

HIS/Tech/3.6

General All activity in the system, be it related to patient registration, EMR, CPOE, stock management, etc. should be auditable.

Critical

HIS/Tech/3.7

General System must allow configuration to control which activities must log audit data so at to optimise the overhead and disk storage space used. This should be feasible using end user interface without having to programmatically extract such data each time.

Important

HIS/Tech/4

Integration & Interfaces

HIS/Tech/4.1

Integration It is desirable that the system has an inbuilt integration engine

Desirable

HIS/Tech/4.2

Integration It is critical that the system has the ability to communicate with other Healthcare Informatics systems via HL7 V2.x

Critical


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messages HIS/Tech/4.3

Integration It is Desirable that the system has the ability to communicate with other Healthcare Informatics systems via HL7 V3 messages

Critical

HIS/Tech/4.4

Integration It is desirable that the system has pre-built interfaces with SAP, Oracle and/or Tally

Desirable

HIS/Tech/4.5

Integration It is important that the system has the ability to communicate with lab equipment (Uni/Bi Directional interfaces)

Important

HIS/Tech/4.6

Integration It is desirable that the system has the ability to communicate with Patient Monitoring devices, Infusion pumps and/or other medical devices

Desirable

HIS/Tech/4.7

Integration System must have capability to adhere to national guidelines and standards that are in use to contribute towards interoperability of EMR/EHR data as well as standard related to patient safety and quality (e.g. NABH, NABL)

Important

HIS/Tech/4.8

Integration System must have capability to integrate with third party systems to enable adoption of digital signatures, speech to text conversion, drug database decision support, electronic claim management etc. and facilitate compliance to standards that warrant error free transactions.

Desirable

HIS/Tech/5

Deployment

HIS/Tech/5.1

General It is critical that the system can be deployed on a private/public cloud environment

Critical

HIS/Tech/5.2

General It is desirable that the system can work as a SaaS model Desirable

HIS/Tech/5.3

General It is critical that the system has at least 99.9% uptime. Critical


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COMPLEMENTING SERVICES

S. No. Functional Service

Sub Module/ Function Remarks Importance

HIS/Comp/1 HIS/Comp/1.1 Training HIS Modules Vendor should extend effective training sessions on all the HIS

modules supplied. Training personals must be from healthcare domain background with relevant implementation experience

Critical – For a complete / successful implementation

HIS/Comp/1.2 Post Implementation Support/ Maintenance

Constant Client Interfacing

24/7, well defined / structured service levels to be extended by the vendor for post implementation maintenance. The levels of support should be determined keeping 99.99% of uptime of the application without disturbing hospital operations. Extensive / elaborated support models to be offered with defined team members coming from healthcare implementation / support experience

Critical

HIS/Comp/1.3 Data Migration Services

Masters/ Demographics

Vendor should extend the minimum master / demographic data migration required to use the new application.

Important

HIS/Comp/1.4 Mater Data Mgmt.

Starter Data Sets Vendor should extend support in providing pre-populated master data / starter data sets based on a combination of industry standard code sets as well as best practices of other institutes where information on master data structures can be exposed to other clients. This will result in reducing turnaround time on system configuration

Desirable

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Healthcare IT Checklist for Small & Midsize Indian Hospitals by HIMSS

Health & Medicine

Transcript of Healthcare IT Checklist for Small & Midsize Indian Hospitals by HIMSS