HIS Lecture 2

3-Data Source
These can be divided into two main

categories;
1.
Population-based approaches (censuses, civil

registration and population surveys) and
2. Institution-based data (individual records, service
records and resource records).
A number of data-collection approaches and sources do
not fit into either of the above main categories but can
provide important information that may not be available
elsewhere. These include occasional health surveys,
research, and information produced by community based
organizations
4-Data Management
This covers all aspects of data handling from
Collection,
Storage,
Quality-assurance and
Flow, to processing, compilation and analysis
5-Information Product
Data must be transformed into information that
will become the basis for evidence and
knowledge to shape health action.
The terminformation productis typically
associated with educational e-books (of either
Kindle, simple PDF, or e-pub variety), audio
recordings, or digital video recordings, and, in
most cases, a combination of all of the above.
6-Dissemination and use

The value of health information is enhanced by making
it readily accessible to decision-makers and by providing
incentives for, or otherwise facilitating, information use.
The primary objective of ahealth informationis
toprovidereliable, relevant, up to date adequate,
timely and reasonably completeinformation
Dissemination and use

Information systems, particularly at lower levels of the
health system (closer to the collection source), need to
be simple and sustainable and not overburden health
delivery staff or be too costly to run
Architectures of Hospital
Information System
After this lecture, you should be able to
answer the following questions:
What kind of data has to be processed in
hospitals?
What are the main hospital functions?
What are the typical information processing tools
in hospitals?
What are the different architectures of HIS?
How can integrity and integration be achieved
within HIS?
Information System
Hospital Information System architecture has three
main levels;
Central Government Level,
Territory Level, and
Patient Carrying Level.
Information System
Domain Layer: data to be processed in Hospital
Entity types related to Patient Care (examples)
Typical entity types representing certain object classes and data
related to the patient and his or her histories:
Entity type
Descriptor of an instance of the represented object class
Case
mostly comprises a patients stay in a hospital from patient

admission to patient discharge or several ambulatory treatments
related to one disease; information about a case includes the case
identification number (CIN
Patient
is a person being subject of care; information about a patient

includes the patient identification number (PIN)
Order
is a request for a diagnostic, therapeutic or drug service, e. g., a

laboratory order or a radiological order
Diagnosis
is the identified cause or nature of a disease or medical condition
Note: we can express kind of data by entity types
Information System
Entity types related to Resources (examples)
A hospital must guarantee that all resources needed for patient
care are available continuously. The following resources are
necessary:
Entity type
Appointment
determines what persons have to be at a certain place at a given

time. Examples are appointment for patient admission,
examination or surgery.
Bed
must be managed according to its occupation.
Health care
professional
a health care professional who treats according to his or her

specialization (e. g. nephrology or pediatrics) patients with certain
diagnoses. Health care professionals are for example physicians
and nurses.
Drug
is a substance administered to a patient for treatment, diagnosis or

prevention
Health Information Systems
Information System
Entity types related to Administration (examples)
Besides information about resources, hospital administration
needs the following entity type:
Entity type
Patient record
archive
describes how and where the electronic or paper-based patient record can be
found.
Classification
consists of a set of classes summarizing concepts not to be distinguished

during analysis.
Classification of
diagnoses
e. g. the International Classification of Diseases (ICD).
Cost unit
information about a person or an institution responsible for bearing the costs or

a part of the costs for the services to be provided
10
Information System
Entity types related to Management (examples)
Management relates to the hospital as a whole and, thus, needs
compressed information about the hospitals operating. The
following entity types are necessary for management:
Entity type
Business
strategy
defines the hospitals long-term strategic goals
Strategic
information
management
plan
a strategic plan, which gives directives for the construction and development
of a hospital information system
Project
a unique undertaking that is characterized by management by objectives, by

restrictions with regard to available time and resources, and by a specific
project organization (DIN 69901)
Quality report
openly published report about a hospitals performance
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Information System
Domain layer: Hospital Functions
We will now elucidate, how and where data about these entity
types are processed in hospitals.
We use enterprise functions to summarize classes of information
processing activities.
And since we focus on hospitals, we call them hospital functions
here, which can also be considered as representatives of processes
12
Information System
We will present hospital functions and their interpreted and
updated entity types in greater detail, but we do not (yet) focus on
how they are typically supported by various computer-based or
non-computer-based information processing tools
We will focus on the following questions:
What are the main hospital functions that have to be supported by a
HIS?
What information is interpreted or updated by hospital functions?
Which functional aspects have to be considered when implementing
information processing tools?
13
Information System
Main enterprise function to be supported by a HIS:
Patient care
Supply and disposal management, scheduling and resource
allocation
Hospital administration
Hospital management
Research and education
14
Information System
Patient care:
Patient admission
Decision making, planning and organization of patient
treatment
Order entry
Execution of diacnostic, therapeutic and nursing procedures
Coding of diagnoses and procedures
Patient discharge
15
Information System
Patient admission:
Patient admission (short: admission) aims at recording and
distributing the patient demographics and insurance data as well
as medical and nursing data of the patient history
In addition, each patient must
becorrectly identified, and a
unique patient and case identifier
must be assigned
16
Information System
Patient admission
This hospital function can be decomposed as follows:
Appointment scheduling
Patient identification and checking for recurrent
Administrative admission
Medical admission
Nursing admission
Visitor and information service
17
Information System
Apointment scheduling:
The hospital must be able to schedule an appointment for a
patient's visit. In addition, unplanned patient admissions must be
possible (e.g., in case of emergencies)
18
Information System
Patient identification and checking for recurrent:
A unique patient identification number (PIN) must be assigned to each patient:
This PIN should be valid and unchangeable lifelong (i.e., the PIN should not be based on
changeable patients attributes such as the name)
The PIN is the main precondition for a patient-oriented combination of all information arising
during previous, recent as well as future hospitalizations
Before a PIN can be assigned, the patient must be correctly identified, usually based
on a health insurance card and on available administrative patient master
information (such as name, date of birth)
..
19
Information System
If the patient has already been in the hospital, she or he must be
identified as recurrent, and previously documented information
must be made available (such as previous diagnoses and
therapies).
If the patient is in the hospital for the first time, a new PIN must be
assigned.
In addition, the hospital must be able to distinguish different cases
or hospital stays of a patient. Therefore, in addition to the PIN, a
case identification number (CIN) is usually assigned (see
administrative admission).
20
Administrative admission:
Administrative admission starts following patient identification. It creates a
so-called case, being the aggregation of several contacts, clustered
according to specific clinical and/or organizational purposes of the hospital
In case of inpatient treatment, a case summarizes the hospital stay from
patient admission until discharge
Each case is uniquely identified by its CIN. Important administrative data
such as insurance data, details about special services, patient's relatives,
admitting physician, and transfer diagnoses must be recorded
..
21
Information System
Some of the administrative data must be available to other
hospital functions through the help of certain organization media.
Administrative data form the backbone of information processing
In case of changes, patient data must be maintained and
communicated. If the admitting physician has communicated
relevant information (e.g., previous laboratory findings), this
information must be communicated to the responsible physician in
the hospital
..
22
Information System
Administrative admission is usually done either in a central patient
admission area or directly on the ward (e.g., during emergencies
or on the weekend)
Even in emergencies patient admission is necessary. At least
patient identification and checking for recurrent has to be
performed in order to assign a proper PIN and CIN. In these cases
a short version of administrative admission may be applicable
If the patient is unconscious and does not bear an identity card,
only a dummy name may be recorded to provide PIN and CIN. It
will be no problem to replace the dummy name by the correct
name later
23
EMR: Support Patient

workflow
Architectures of Hospital Information

Systems
Medical admission:
The responsible physician will carry out the medical admission. This
typically comprises the patient history (disease history, systems review,
social history, past medical history, family history, medication). Some of
this information may be collected from documents of the referring
physician and is taken to the hospital by the patient himself. Medical
admission is usually done on the ward
As a result of medical admission the admission diagnosis has to be stated
and to be coded according to ICD10
The basic patient history data have to be made available for other hospital
functions. For the patient history there may also be department-specific,
(semi-) standardized data entry forms available
Health Information
Systems
The collected information should
be available
during the whole stay
25

Systems
Nursing admission:
The responsible nurse will proceed with the nursing admission. This
typically comprises the introduction of the patient to the ward and the
nursing history. Nursing admission is usually done at the ward
Administrative data and the reason of hospitalization are already at her or
his disposal
For the nursing history there may be computer-based or departmentspecific, (semi-) standardized data entry forms available. These may
contain information about the current diagnosis and therapy, orientation,
communication ability, social contacts, nutrition, mobility, personal
hygiene, and vital signs
The collected information should be available during the whole stay
26

Systems
Visitor and information services:
The hospital management must always have an overview of the recent bed occupation, i.e., about the
patients staying at the hospital.
This is, for example, important for

the clerks at the information desk,
who must be able to inform relatives
and visitors correctly, and also for
some general hospital management
statistics
27

Systems
Patient admission
image HIS.pptx
Extract of the domain layer of the 3LGM based reference model describing
the enterprise function patient admission, its subfunctions and interpreted
and updated entity types.
28

Systems
Patient care:
Patient admission
treatment
Order entry
Patient discharge
29

Systems
treatment
All clinical procedures of health care professionals must be
discussed, agreed upon, efficiently planned, and initiated. This
process is repeated each time new information is available

Decision making and patient information
Medical and nursing care planning
30

Systems
Decision making and patient information:
Responsible team members must decide upon the next steps
such as certain diagnostic or therapeutic procedures.
Depending on the complexity of a diagnostic or therapeutic
decision, they should be able to consult internal or external
experts
Staff members must be able to access all relevant patient data
specific to a situation, in addition to general clinical knowledge
supporting patient care
31

Systems
Medication prescription may be supported
knowledge about adverse drug events
by
providing
The patient should be involved in the decision-making process,

the consequences of the planned diagnostic or therapeutic
procedures should be explained, and his or her informed consent
must be documented as well
Decision making is a permanent enterprise function which is
triggered by new information about the patient
Decisions about clinical procedures must be documented
32

Systems
Medical and nursing planning
For each medical procedure (such as a radiological examination,
an operation or a chemotherapeutic treatment) as well as for
each nursing procedure, the type, extent, duration, and
responsible person have to be determined.
In nursing, care planning is documented in nursing care plans,
containing nursing problems, nursing goals, and planned nursing
procedures.
Care planning in cancer treatment is often performed in tumor
board reviews. I.e. a number of physicians who are experts in
different specialties (disciplines) review and discuss the medical
33
condition and treatment options of a patient

Systems
treatment
the enterprise function decision making, planning and organization of
patient treatment, its subfunctions and interpreted and updated entity
types.
34

Systems
Patient care:
Patient admission
treatment
Order entry
Patient discharge
35

Systems
Order entry
Diagnostic and therapeutic procedures must often be ordered at
specialized service units (e.g., laboratory, radiology, or
pathology).
These units execute the ordered procedures and communicate
the findings or results back to the ordering department
Preparation of an order
36

Systems
Preparation of an order
Depending on the type of order, specimens that must be
unambiguously assigned to a patient are submitted (e.g., blood
sample)
Depending on the available service spectrum offered by a
service unit, which may be presented in the form of service
catalogs, the health care professional selects the appropriate
service on an order entry form Patient and case identification,
together with relevant information such as:
recent diagnoses,
the relevant questions,
the service ordered (e.g., laboratory, radiology), and
other comments (e.g., on special risks) are documented
..
37

Systems
An order should be initiated only by authorized persons.
When computer-based tools for order entry are used,
computerized decision support systems could alert the physician
in case of medication errors, e.g. when a medication is ordered
to which the patient is allergic
The order must quickly and correctly be transmitted to the
service unit. If a specimen is transferred, it must be guaranteed
that the order and the specimen can be linked to each other at
the service unit.
If necessary, modification to already transferred orders by the
ordering health care professional should be possible
38

Systems
Depending on the type of order, the patients appointments
must be scheduled (e.g., in radiological units)
During scheduling, the
demands of all parties (e.g.,
ordering physician, service
unit, patient, transport unit)
must be fairly balanced
A paper-based order entry form for laboratory

testing
39

Systems
Order entry
the enterprise function order entry, its subfunctions and interpreted and
updated entity types.
40

Systems
Patient care:
Patient admission
treatment
Order entry
Patient discharge
41

Systems
The planned diagnostic, therapeutic, or nursing procedures (such as
operations, radiotherapy, radiological examinations, medication) must be
The hospital must offer adequate tools and resources (e.g., staff, room,
equipment) for the execution of the necessary procedures
It is important that changes in care planning that may be due to new
findings are promptly communicated to all involved units and persons,
enabling them to adapt to the new situation
..
42

Systems
All clinically relevant patient data (such as vital signs, orders,
results, decisions) must be recorded as completely, correctly,
and quickly as necessary. This supports the coordination of
patient treatment among all involved persons, and also the
legal justification for the actions taken
Data should be recorded as structured as possible, so to allow
for data aggregation and statistics, computerized decision
support, or retrieval of data
It is important that data can be linked by PIN and CIN, even
when data originate from different areas (such as ward, service
unit, outpatient unit)
..
43

Systems
Usually, the hospital has to fulfill a lot of different legal
reporting (such as epidemiological registers) and
documentation requirements
The items to be documented depend partly on the documenting
unit and the documenting health care professional group (such
as documentation by health care professionals, documentation
in outpatient units or in operation rooms).
Clinical information should also be available for other functions
such as:
financial accounting, controlling, quality management, or
research and education Patient admission
44

Systems
Execution of diagnostic, therapeutic and nursing procedures
The planned diagnostic, therapeutic, or nursing procedures (such
as
operations,
radiotherapy,
radiological
examinations,
medication) must be
The hospital must offer adequate tools and resources (e.g., staff,
room, equipment) for the execution of the necessary procedures
Execution of diagnostic and therapeutic procedures
Execution of nursing procedures
45

Systems
Execution of diagnostic and therapeutic procedures
The planned diagnostic and therapeutic procedures:
must be executed,
all procedures must be documented,
findings and reports must be transmitted (as quickly as necessary) back
to the ordering unit and
presented to the responsible health care professional
They must be unambiguously assigned to the correct patient and the

responsible physician should be informed about new results, and critical
findings should be highlighted
..
46

Systems
The hospital function execution of diagnostic and therapeutic
procedures can be specialized for example:
execution
execution
execution
execution
execution
execution
of
of
of
of
of
of
operations,
irradiation,
chemotherapy,
radiological examinations,
lab examinations or
prophylaxis and medication
47

Systems
Execution of nursing procedures
The planned nursing procedures (concerning excretion,
decubitus, hair und nail care, skin care, wound treatment, body
washing, oral and dental care, nutrition and liquid balance,
thrombosis) are executed
All patient care procedures, their impact on the patient's health
status and changes to the care plan have to be documented
The responsible physician must be informed about therapyrelevant facts
48

Systems
Execution
procedures
of
diacnostic,
therapeutic
and
nursing
the enterprise function execution of diagnostic, therapeutic and nursing
procedures , its subfunctions and interpreted and updated entity types.
49

Systems
Patient care:
Patient admission
treatment
Order entry
Patient discharge
50

Systems
The hospital must be able to document and code all diagnoses
stated and all medical procedures carried out in a correct,
complete, quick, and patient-oriented way.
These data are the basis for the hospital's billing. Diagnoses and
medical procedures are also used for controlling. In addition,
some of the data must be documented and communicated due
to legal requirements
..
51

Systems
Diagnoses and medical procedures are recorded and coded in a
standardized way (e.g., using the International Classification of
Diseases, ICD-1030 for diagnoses codes), and then processed.
Diagnoses and medical procedures should be at least partly
derivable from clinical documentation.
To support their documentation, adequate coding catalogs must
be offered and maintained, containing lists of typical diagnoses
and medical procedures relevant for a unit or a hospital
52

Systems
the enterprise function coding of diagnoses and procedures, its subfunctions
and interpreted and updated entity types.
53

Systems
Patient care:
Patient admission
treatment
Order entry
Patient discharge
54

Systems
Patient Discharge and Transfer to Other Institutions
When patient treatment is terminated, the patient is discharged
and then sometimes referred to other institutions (e.g., a general
practitioner, or a rehabilitation center)
Patient discharge and transfer to other institutions (short:
discharge) covers administrative, medical and nursing discharge
Administrative discharge and billing
Medical discharge and medical report writing
Nursing discharge and report writing
55

Systems
Administrative discharge and billing
The process of administrative patient discharge initiates final billing and
the fulfillment of legal reporting requirements (e.g., statistics on
diagnoses and procedures)
DRG (Diagnosis Related Groups) systems have been introduced for
patient billing in most of the industrial countries
That means, bills for patient treatment are no longer calculated based on
daily rates, but on the diagnosis related group in which a patient case
was classified. Diagnoses, procedures, patients age, and some more
criteria serve as an input for the calculation of a DRG
56

Systems
Medical discharge and medical report writing
Medical discharge entails completing of documentation and writing of a
discharge report by the attending physician
The medical report includes:
the relevant diagnoses,

important findings,
therapeutic procedures,
the current patient state and
recommendations for further treatment
..

Systems
Medical discharge and medical report writing:
Medical discharge entails completing of documentation and writing of a discharge report by the
attending physician
The medical report includes:
the relevant diagnoses,
important findings,
therapeutic procedures,
the current patient state and
recommendations for further treatment
.....

Systems
The hospital must be able to transmit this and other information
(e.g., radiological images) to other institutions as quickly as
possible.
To speed up this process, a short report (i.e., physician's
discharge letter) is often immediately communicated to the
next institution, containing, for example, the diagnoses and
therapeutic treatments. It is then later followed by a more
detailed report.
59

Systems
Nursing discharge and medical report writing
Nursing discharge entails completing of documentation and writing of a
nursing report by the attending nurse.
The nursing report comprises, for example:
information about activity level,
diet, and
wound care

Systems
Patient Discharge and Transfer to Other Institution
the enterprise function patient discharge and referral to other institutions,
its subfunctions and interpreted and updated entity types.
61

Systems
Main enterprise function to be supported by a HIS
Patient care
Supply and disposal management, scheduling and
resourch allocation
Hospital management
62

Systems
Supply and disposal
resource allocation:
management,
scheduling
and
The hospital must offer sufficient and well-organized resources

for patient care. This is true for:
wards (ward management),
outpatient units (outpatient management), and
service units (department management)
Efficient process organization is extremely important for
hospitals and it can be supported, for example, by providing
working lists for individual staff members, by issuing reminders
about appointments, or by visualizing actual process flow
..
63

Systems
The hospital information system must be able to support
communication between all persons involved in patient care
This comprises synchronous (e.g., telephone) and asynchronous
(e.g., blackboards, brochures, e-mail) communication.
Staff members must be able to be contacted within a prescribed
period of time
The hospital function supply and disposal management,
scheduling and resource allocation can be decomposed as
follows:
Supply and disposal management
Scheduling and resource allocation
Human resourch management
64

Systems
Supply and disposal of materials, food, drugs, and so on must be
guaranteed. All departments of the hospitals should be able to order
from up-to-date catalogs. The corresponding service units (stock,
pharmacy, and kitchen) must be able to deliver correctly and on time
Supply and disposal management can be decomposed as follows:
Catering
According to their health status, patients have different nutritional
needs. It must be ensured that the patients are provided with the right
dietary food at the right time
..
65

Systems
Material and Medication Management
Nurses and doctors must be able to anticipate lacks of material
like medical strips, bandages or needles to order new material
from a central supplier in
Laundry Management
The hospital must permanently be supplied with linen, towels,
sterile scrubs, surgical masks etc
Management of Medical Devices
In addition to other resources, medical devices must be
registered and maintained according to legislation. Due
maintenance must be organized, documented and completed
66

Systems
the enterprise function supply and disposal management, its subfunctions
and interpreted and updated entity type.
67

Systems
Supply and disposal management, scheduling and resource allocation
Supply and disposal management,
Scheduling and resource allocation,
Human resource management

Systems
Scheduling and Resource Allocation:
Various resources are needed for patient care, and resource
management comprises staff planning, bed planning, room
planning and device planning
All resource planning activities must be coordinated.
When procedures are scheduled, the demands of both the
service unit and the ordering unit with regard to scheduling the
appointment must be considered.
..
69

Systems
Request, reservation, confirmation, notification, postponement,
and cancellation must be supported
All involved staff members and patients should be informed
about the appointments
Postponements and cancellations should be communicated in
time to all involved persons
This hospital function can be decomposed into the functions
appointment scheduling, scheduling and resource planning with
the medical service unit and scheduling and resource planning
with the patient transport service
70

Systems
Scheduling and Resource Allocation
Extract of the domain layer of the 3LGM based reference model describing the
enterprise function scheduling and resource allocation, its subfunctions and interpreted
and updated entity type
71

Systems
Supply and disposal management, scheduling and resource allocation
Scheduling and resource allocation
Human resource management

Systems
Human resource management:
This contains all tasks for the development and improvement of the
productivity of staff. It comprises, for example, staff and position
planning, the staff register, staff scheduling, and staff payrol
Administration of human resource master data

Human resource planning
Work organization and time management
Payroll accounting
Administration of business trips and further training

Systems
Human resource management:
Extract of the domain layer of the 3LGM based reference model describing the
enterprise function human resources management , its subfunctions and interpreted
and updated entity types
74

Systems
Main enterprise function to be supported by a HIS
Patient care
Supply and disposal management, scheduling and resourch allocation
Hospital management

Systems
Hospital administration supports the organization of patient care and guarantees the financial
survival and the economic success of the hospital
Hospital administration can be decomposed as follows:
Patient administration
Archiving of patient information
Quality management
Cost accounting
Controlling
Financial accounting
Facility management
Information management

Systems
Patient administration:
Patient administration comprises the administrative tasks in a
hospital dealing more or less immediately with patients.
Thus it is an aggregation of the subfunctions administrative
admission, patient identification and checking for recurrent,
visitor and information service and administrative discharge
and billing
77

Systems
Patient administration
Archiving of patient information
Quality management
Cost accounting
Controlling
Financial accounting
Facility management
Information management

Systems
Archiving of patient information:
Relevant data and documents containing patient information must be
created, gathered, presented, and stored such that they are efficiently
retrievable during the whole process of patient treatment.
The storage of these data and documents is primarily done in patient
records. Today, usually a mixture of paper-based and computer-based
patient records is used. Certain legal requirements usually must be
considered
Opening the patient record
Administration and allocation of patient records
Long term archiving

Systems
Opening the patient record:
Administrative admission triggers the opening of a patient
record. The patient record may be electronic or paper-based or
a mixture of both. For the filing formats of documents standards
have to be established and used
80

Systems
Administration and allocation of patient records:
A paper-based hospital archive must be able to manage patient
records and make them available upon request within a defined
time frame
The exact location of each record should be known (e.g., in
which archive, on which shelf)
Robot systems may store and gather paper-based records
Lending and return of records (e.g., for patients coming for
multiple visits) have to be organized, while respecting different
access rights that depend on the role of the health care
professionals in the process of patient care
81

Systems
Long term archiving:
After discharge of the patient, patient records must be archived
for a long time (e.g., for 10 or 30 years, depending on the legal
regulations)
The archive must offer enough space to allow the long-term
storage of patient records
Their authenticity and correctness can be proven more easily, for
example in case of legal action, when they are archived in
accordance with legal regulations
82
Types of
Healthcare
Information
Systems
1. Clinical Information Systems

Nursing
Monitoring
Order entry
Laboratory
Radiology
Pharmacy
Other Ancillary Systems ( Physician
Practice, Ambulatory, Long-term, Homecare )
1.1. Nursing Information

Systems
Supports the use and documentation of
nursing activities and provides tools for
managing the delivery of nursing care:
view/ update vital data /patient condition

access to online drug info, procedure guidelines
databases
provide quality patient care
Nursing Information System

Advantages
Improve access to information
Better documentation
Improve quality of care
Improve productivity and communications
Tracking capability
Enhanced regulatory compliance
1.2 Monitoring Systems
Monitor patient vitals and other findings, or
automatically feeding the input into a clinical

information system.
Immediately alert the caregivers abnormal findings,

real-time patient conditions
1.3. Order Entry Systems
Direct entry of orders for medications and treatments
by the physician, nurse practitioner, physical therapist,

or other providers (CPOE)
Transmitted online orders to the appropriate areas
(pharmacy, laboratory, radiology, social services and

others )
Computerized Provider Order

Entry - CPOE
Improve the quality of care and reduce

medication errors
Eliminates transcription error

Expedites treatment
Encourages more accurate, complete orders
1.4. Laboratory Systems

Alert providers when new or stat tests results are back or
values are critical

Send results to clinical system for view
Accept input from bedside devices
Generate labels for specimen collection
Use rules to order additional tests when indicated
Address issues such as turnaround time, duplicate testing,
errors
1.5. Radiology Systems

Allows direct order entry or accepts orders from other
systems
Provide scheduling of diagnostic tests

Generate client instructions
Permit transcription of results
Provide picture archiving and transmission of images
and tracking of film
Generate charges once procedures are done
1.6. Pharmacy Systems
Provide checks in order and administration process

using evidence-based guidelines
Reduce errors when used with bar code technology

Use lab results, allergy, and interaction information
from clinical systems
Track medication use, costs, and billing information
Pharmacy
May include:
In pharmacy dispensing systems (robots)

Unit-based dispensing cabinets in care areas
Barcode and RFID Medication Administration
Barcode and RFID Medication

Administration
Use barcode on the unit-dose
medication
package and patient bracelet to ensure
right patient, right drug, right dose, right
time, right route
Use radio frequency identification (RFID)

tags on medication package
E-prescribing
Provide a longitudinal prescription record

Check formulary compliance and reimbursement
Provide alerts about drug interactions
Generate reminders to order home meds for the
discharged client
Eliminate phone authorization for refills
1.5. Physician Practice

Management Systems
Capture of demographic and insurance
data, scheduling, billing, outcome tracking,

and report capability
May connect to hospital electronic patient

records or maintain separate patient
records
Long-Term Healthcare Systems

For the improved quality of care and efficiency
Integration with other systems needed to best serve
patients
Can include all features seen in other clinical

information systems
Home Healthcare
May communicate with hospital systems to exchange

data
Support demands for excessive documentation

Improve payment for services because it is easier and
quicker to find information needed for billing
2. Administrative Systems
Client Registration
Financial
Payroll and Human Resource
Risk management
Quality assurance
Contract management
Materials management
Scheduling
Other Administrative Systems
2.1 Registration Systems
Admission/discharge/transfer (ADT) systems

Collect and store demographic and insurance data that
are verified and updated at the time of each visit
Critical to operations to ensure correct patient

identification and reimbursement for charges
2.2. Financial Systems
Charge for service and receive reimbursement

Access patient demographic data and insurance
information from registration system
2.3. Risk Management
Enhance ability to identify potential risks and develop

appropriate strategies
Track back to the point of origin to address specific

liabilities
2.4. Contract Management
Provide visibility and control to negotiate better
contracts with the third parties (vendors, suppliers )
Ensure contractual obligations, compliances, deliveries
2.5. Scheduling Systems
Schedule client appointments and facilities/resources

Dates and times, Department, Room, Staff, Equipment,
Insurance approval and charging information
2.6. Decision Support and

Expert Systems
Use organizations historical data of to facilitate decision

making and overall efficiency.
What-if analysis, scenario analysis, case-based analysis

to select of viable options
Large-scale Database in HIS

Able the location, abstraction, comparison of patient
information in many format came from many sources,

stored in many places
Real-time information
Network database
Knowledge Representation
(Dashboard Display)
Display all real-time data/ indicators/ trends from many

sources on one screen for overview
Allow to go to details of each area (drill-down)
Mobile Devices in HIS

Mobile devices to improve the functionality of HIS
personal digital assistants (PDA),

tablet computers,
iPhones / iPads
Impact of Mobile Computing
Allow access to data at the point of care to facilitate

treatment decisions
Test results
Evidence-based practice guidelines
Facilitate documentation at the point of care for

improved accuracy

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3-Data Source

These can be divided into two main

Population-based approaches (censuses, civil

6-Dissemination and use

Dissemination and use

Descriptor of an instance of the represented object class

mostly comprises a patients stay in a hospital from patient

is a person being subject of care; information about a patient

is a request for a diagnostic, therapeutic or drug service, e. g., a

is the identified cause or nature of a disease or medical condition

Note: we can express kind of data by entity types

Descriptor of an instance of the represented object class

determines what persons have to be at a certain place at a given

must be managed according to its occupation.

a health care professional who treats according to his or her

is a substance administered to a patient for treatment, diagnosis or

Descriptor of an instance of the represented object class

consists of a set of classes summarizing concepts not to be distinguished

e. g. the International Classification of Diseases (ICD).

information about a person or an institution responsible for bearing the costs or

Health Information Systems

Descriptor of an instance of the represented object class

defines the hospitals long-term strategic goals

a unique undertaking that is characterized by management by objectives, by

openly published report about a hospitals performance

Health Information Systems

Health Information Systems

Health Information Systems

Health Information Systems

Health Information Systems

Health Information Systems

Health Information Systems

Health Information Systems

Health Information Systems

Health Information Systems

Health Information Systems

EMR: Support Patient

Architectures of Hospital Information

Architectures of Hospital Information

The collected information should be available during the whole stay

Architectures of Hospital Information

This is, for example, important for

Health Information Systems

Architectures of Hospital Information

Health Information Systems

Architectures of Hospital Information

Health Information Systems

Architectures of Hospital Information

This hospital function can be decomposed as follows:

Health Information Systems

Architectures of Hospital Information

Architectures of Hospital Information

The patient should be involved in the decision-making process,

Architectures of Hospital Information

Architectures of Hospital Information

Health Information Systems

Architectures of Hospital Information

Health Information Systems

Architectures of Hospital Information

Architectures of Hospital Information

Health Information Systems

Architectures of Hospital Information

Architectures of Hospital Information

A paper-based order entry form for laboratory