Hospital Management Information

Systems (HMIS)Mahmoud eldefrawy

2012

Why??

Management of information

• We manage information to make and take decisions

Why and How ?

Management?? • Planning• Directing• Organizing• Motivating• Controlling

Where is the change?

stop

The new system approach

How to change ??

expressions• Flat organization??• Team work• Automated system

Where do We Find IT ?!

Information Technology (IT)

• Factory• Office• Home• Bank • Supermarket• Garage• Hospital

Carry out Transactions

Provide Information

Record Data

Make Decisions

Perform Tasks

The Use of IT

IT used for

• Information Technology (IT)

• Information Systems (IS)

• Management Information Systems (MIS)

The Differences between IT, IS & MIS…?

Definitions

“The acquisition, processing, storage and dissemination of vocal, pictorial, textual and numeric information by a micro-electronics based combination of computing and telecommunications”.

IT:

What is IT?

Acquisition DisseminationProcessing Storage

IT

Vocal

Pictorial

Textual

Numeric

INFORMATION

“They are the tools which convert

data to information relevant to the

user”.

IS:

Definitions

MIS:“A system to convert data from internal and external sources into information and to communicate that information, in an appropriate form, to managers at levels in all functions to enable them to make timely and effective decisions for planning, directing and controlling the activities for which they are responsible.”

Definitions

IS

ImageProcessin

g

WordProcessing

VoiceProcessing

DataProcessing

HumanResources

HumanResources

HumanResources

HumanResources

What is IS?

Networking

What is MIS?

PROCESSING

USERS

INFORMATIONFLOWDATA FLOW DECISIONS

MIS

Watch Out The Problems?!

Problems with MIS:• Lack of Management Involvement.

• Inappropriate Emphasis of computers.

• The concentration on Data Processing

Applications.

• Lack of Management knowledge.

• Lack of Top-Management Support.

• No Appreciation by Information Specialists of

Management’s Information Requirements.

MANAGEMENT & MIS

StrategicManagement

TacticalManagement

OperationalManagement

Raw Data

Inf

orm

atio

n, S

umm

arie

s, R

epor

ts, A

lter

native

s

Objectives, Plans, Instructions, Budgets, Targets

The Flow of Information

Operational Management

Day-to-Day Activities

INPUT

OUTPUT

Data from operationalTransactions

Reports

The Flow of Information

Why Do We Need Information?

DATAINFORMATION

PURPOSES

EfficientManagement

BusinessPlanning

Outputs From Level OneSome Examples:

• Bed Reservations.• Doctors/ Nurses on duty.• Patients Admissions.• Patients Discharged.• Medicines on Stock.• Out-door Patients Records.• Statistical Reports.

Required Configuration at Level One

Real Time Computer System

Hardware Networking ApplicationSoftware

Required Configuration at Level One …(cont’d)

Hardware PCs/ Mini Computer

Network LAN/ WAN

Application In-House Development

Software Ready Made Package

Characteristics of Real Time Computer System:

• Reliable

• Inbuilt Recovery

• Speed

Required Configuration at Level One… (cont’d)

Level Two

Tactical Level

Implement Objectives

Monitor Operations

• Budgetary Control• Medical Treatment Control• Equipment Control• Medicine Inventory Control• Human Resources Control

Improves Healthcare

Required Configuration at Level Two …(cont’d)

a) Control SystemMonitorsHospitalsActivities

ExternalInformation

Internal Sources

• Medicines• Doctors• Equipment• Diseases• Legislation• Prices

Internal Reports

b) Database Systems Process & StoreInternal & ExternalInformation

“Hospital Memory”

Required Configuration at Level Two… (cont’d)

c) Enquiry Systems Planned Databases

ExternalInformation

InternalInformation

Forecasting

Required Configuration at Level Two… (cont’d)

Outputs From Level Two

Some Examples:Reports:

• Patients Analysis & Profiles• Clinic Profitability• Number of Patients Handled/ Doctor/Clinic • Number of Operations/ Day• Wages & Salary Analysis• Doctors Turn Over Statistics

Outputs From Level Two…(Cont’d)

Some Examples:Reports:

• Accident/ Death Reports• Absentee Reports• Training Reports• Joint Consultation And Minutes Reports• Expenditure Analysis/ Ward/ Clinic/ Dept… etc• Standard Costs & Variance

Ready Information

Level Three

Strategic Management

Immediate Decisions

Required Configuration at Level Three

• Decision Support System• Expert Systems• Executive Information System

Computing Packages

Dental Clinic

Ophthalm

ology

Clinic

Cardiology Clinic

Orthopedic Clinic

Pediatrics ClinicsEchoCardio-Graphy

GP.

Medical Imaging

Interfacing With Lab

Equipment

MEDICAL RECORDS

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Patient data base

Software Package

Integrated Application Software Package

Word Processing

Data Processing

Image Processing

Voice Processing

Networking

How To Build An Application?

• How Needs

• Who Top Management

• Where Top-to-Bottom

or bottom-to-top

What to Study?

• Needs

• Volumes

• Workflow

• Relationships

• Current System

What to Study? ...(Cont’d)

• Deficiencies

• Requirements

• Reporting System

• Layout of Reports

• Expectations

What To Evaluate?

• Easiness

• Integration

• Features > Requirements

• Modularity

• Flexibility

• Documentation

• Training

What To Evaluate? …(Cont’d)

• Language

• Platform

• Customization

• Speed

• Maintenance

• Compatibility

• Cost

How To Implement?

Implementation

Prototype

(Planning Overview)

How To Plan?

• Deliverable• Milestone• Responsibilities

Implementation Plan

Where is the Technology Growing in

Healthcare abroad ?Future Trends

• Super Highway

• Video Conferencing

• Internet/ Intranet

• Image Processing

• Electronic Mail

• Electronic Commerce

• Smart Cards

How To Create a Request for Proposal?

RFP1. Introduction

2. Objectives

3. Enterprise Profile

4. Current Operational System

5. Problems

How To Create a Request for Proposal? ...(Cont’d)

RFP

6. Required System

7. Functionality or Required System

8. General Terms & Conditions

9. Enclosures

RFP Contents1. Introduction

Why am I issuing this RFP?

2. ObjectivesWhat are the objectives which I am trying to achieve?

3. Enterprise ProfileA brief history about the hospital.

RFP Contents … (Cont’d)

4. Current Operational SystemA brief description of the current system in usage.

5. ProblemsWhat are the deficiencies of the current systems?

6. Required SystemDetailed Description of the required system.

RFP Contents … (Cont’d)7. Functionality of Required System

What are the functions which the new system will provide?

8. General Terms & Conditions: Delivery Installation Warranty Maintenance Training Acceptance Criteria

9. EnclosuresAny technical reports or attachments related to the enterprise to be enclosed for more clarifications if required.

How to Study the Needs of the Technical Products?

1. Define the Needs2. Functionality3. Features4. Determine the Users5. Number of the Users6. Integration7. Input/ Outputs8. Expected Future Needs

Needs DefinitionWHO DEFINES THE NEEDS ?

Technical Products Services

1. Users2. Technical Staff3. Middle Management4. Top Management

1. Concerned Department2. Middle Management3. Top Management

Technical Products

1. Lab Equipment2. Computer Hardware3. Computer Application Software4. Telephone Switches/ Equipment5. Medical Equipment6. Networking7. X-Rays Equipment8. Etc.

Types of system

Open System

An open system in an organization is the

system which is connected or related to other

systems within the same organization.

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Closed System

The closed system does not accept

interaction with other systems. It is designed

to exist on an island. It does one job only. No

input and no output.

14

Interactive System

Therefore in any business or any service there

are certain objectives to be achieved. It could

maximize profit, increase the market share…

etc.

We cannot achieve this objective except if

there is a proper interactive system.

System Interaction Definition

Interactive system means that it links with

other system, it compliments other systems,

and it works with other systems to achieve an

objective.

Sub-Systems

Therefore in any organization there are a

number of sub systems which compliment

each other and react with other external

systems to serve the needs of the

surrounding society.

Sub-Systems… (Cont’d)Each system requires a subsidiary system,

like for example:

• Production system requires distribution outlets.

• Construction system requires buying materials and designers to build an infra-structure.

• Vehicle manufacture requires stores, materials and control.

Systems TypesWe have to understand the nature of

systems. There are two types of systems:

• Rigid systems which are closed and do

not interact with any other systems.

• Flexible systems which are open and

interact with other systems.

OrganizationHaving understood the nature of systems we

have to understand the nature of organizations

as well.

An organization is a group of people working

together within a system to achieve an

objective.

EmpowermentWhen we talk about a system in an

organization we have to take into consideration two aspects:

1. The authority of each individual within the system, and

2. The responsibilities of each individual within the same system.

Without defining these two parts we cannot implement any system.

System CreationIn the closed system you design the system and then put the people within the system without understanding their capabilities and background.

However, in the open system you find out what people can do. Then, you design the system based upon their capabilities and backgrounds.

System FunctionAny system within an organization has 3 main

functions:

1. Planning for the future to accomplish the vision of the organization.

2. Doing things, the service itself, and

3. Controlling the execution of planning and operation.

Planning, System Operation & Monitoring

• Planning means looking into the future to achieve objectives.

• Operating systems means doing things to meet the needs of organizations.

• Control Systems means planning + operating to achieve the objective of the organization.

cost

Cost and Benefit Patterns

Return

Time

$

Investment Benefits

Costs

System Cost

The costs involved fall into four categories:

1. Hardware

2. Software

3. Installation

4. Maintenance

System Cost …(Cont’d)

1. Hardware

• Equipment

• Supplies

2. Software

• Operating System

• Application Software

System Cost …(Cont’d)

3. Installation• Stationery • Training• Integration with present systems

4. Maintenance• 10% of the total hardware and

software/annum• Increase

System Benefits

Benefits fall into two board categories:

1.Quantifiable

2.Unquantifiable

Quantifiable Benefits

Quantifiable Direct increase in profits

If project did not occur would not take place

Unquantifiable Benefits

Unquantifiable General Improvements which are not associated with an

Increase in profits.

Unquantifiable Benefits

• Improvements in information on stock and sales.

• Better information for production planning.

When?

Time Scale

How long it will take for the benefits to be

realized?

“ It is not uncommon for the benefits of

computer based systems take several years

to appear.”

System Division

“Systems should be subdivided so that

management do not have to wait too long

before benefits appear.”

1

2

3

Phase Benefits start here

Development Installation

Time

Watch Out!?Problem!!

Performance lags behind the plan

Costs Accumulates

Benefits become harder to produce

Watch Out?!...(Cont’d)Therefore:

We have cost of failure!!

Cost of Failure

What is cost of failure?• Failure to develop the system within the

costs levels agreed. So, benefits created

are inadequate.• Failure to produce the benefits predicted.• Failure to produce a working system.

Management Agreement

“ No system should be designed and installed

unless it has been full justified and agreed

by Management.”

Why??

Management Agreement…(Cont’d)

• Management must share the responsibility for failure.

• Management must be fully committed to the new system.

• Management must take full responsibility for the success of the implementation.

Management Agreement…(Cont’d)

Management Agreement Involvement in all stages of system design.

Management Support

Management Support

Sharing Failure

Taking Responsibility

How To Obtain Management Agreement?

• Discussion

• Demonstration

• Explanation

How To Obtain Management Agreement?

Discussion

Formal

Informal

Designers listen and learn

Ad hoc conversation

Meetings

Managers give opinions and ideas

How To Obtain Management Agreement? … (Cont’d)

Explanation Discussion

Written report

Training & EducationUser Education and Training

Training is concerned with 2 factors:

1.Knowledge

2.Skill

Training & Education…(Cont’d)

Knowledge

Skill

What to do?

Being able to do it.

Training program should cover both these factors.How??

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Phases of TrainingEssential rules for successful training:

• Training should be carried out by local

management, this gives confidence to the

staff that supervisors are fully aware of the

system.

Phases of Training…(Cont’d)

• User manuals should be available

during training.

• Training should be phased with the

final session taking place immediately

before the live data.

Phases of Training…(Cont’d)

Phases of training:

Level1: General overview of the system.

Level2: Specific procedures and activities, including use of reports.

Level3: Controls, error procedures and recovery procedures.

System Testing Levels of Testing:

• Program testing

• Run testing

• Systems testing

System Testing…

(Cont’d)Program testing

Run testing

Tools to test performance.

Several programs workingTogether form a run.

System Testing…

(Cont’d)User

Computer Personnel

Systems Analyst

Data (actual)

Run

Check

System Testing

Report Testing1. Changes

• Nature of change• Effects on the system• Reasons for the change

2. Operating requirements

3. Summary of tests

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Report Testing…(Cont’d)

4. Monitoring

5. Go – No go

6. Implementation (Steps)

Changeover

“When a new system is being installed

replacing an existing system. This means that

existing documentation and procedures have

to be changed.”

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Changeover

Changeover can be carried out in 4 main ways:

Parallel

Phased

Direct

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Changeover…(Cont’d)

Parallel New system parallel to the old system

Phased Stages

Direct Immediately

Data ConversionCase Study

A courier service company decided to

change the manual system to a computer-

based system.

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Data Conversion… (Cont’d)The problems were:

1. How was it to be done?

2. Should history documents be converted?

3. If a history, for how long?

4. What would happen to movements in the

accounts during the changeover?

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Data Conversion… (Cont’d)

• New files have to be verified with the old

files.

• Data conversion provides an opportunity to

clean the records and make a fresh start.

Documentation

Manuals

Training

procedures

Operating

Implications of Change

• Physical

• Psychological

Implications of Change …(Cont’d)

Physical

Psychological

Equipment, furniture offices layout

Resistance to new system

Overcome

Training Involvement