Hospital Information Management System - Cover Page

Hospital Information Management System Leonoid Technologies Pvt. Ltd

Project By: Chandrima Das (07030241006) Raveesh Goswami (07030241024) Sampreeth Agara (07030241029) Saurabh Soni (07030241032) Surbhit Bansal (07030241033) Vijay Chakule (07030241035)

Table of Contents 1. Introduction ………………………………………… 1 2. Scope ……………………………………………….. 1 3. Requirements for HIMS ……………………............. 1 4. Functioning ………………………………………… 2 5. Salient Features …………………………………….. 2 6. Features Overview …………………………............. 3 6.1 Patient Registration …………………………….. 3 6.2 Billing ………………………………………….. 3 6.3 Electronic Medical Report (EMR) …………….. 3 6.4 Reports …………………………………............ 4 6.5 Resources ………………………………............ 4 6.6 Scheduling ……………………………………... 5 6.7 Knowledge Repository ………………………... 5 7. Estimation …………………………………………….. 5 7.1 Function Point Model …………………….................. 5 7.2 COCOMO Model …………………………………… 10 8. Probable risks and Solution …………………………… 11 References ……………………………………………….. 12

Hospital Information Management System – Leonoid Technologies Pvt. Ltd

1. Introduction: Hospital Information Management (HIMS) System is designed for hospitals, which covers the wide range of hospital administration and management processes. It provides relevant information across the hospital to support effective decision making for patient care, scheduling and billing, in a seamless flow.

2. Scope: 1. The base product is an integrated system for storing, visualizing, querying and retrieving patient medical records, cost of treatment and hospital inventory. 2. The system caters to various departments in a hospital setup. 3. The system has facility to register patients with a unique ID. 4. The System features a Knowledge Repository that includes Standard Protocols and Drug Information. 5. Appointment scheduling is an integral part of the system. 6. The system provides facility to generate customized Reports/Discharge summary. 7. The system has facility to export data that can be customized.

3. Requirements for HIMS (Functional and Non-Functional): Functional: 1. 2. 3. 4. 5. 6. 7. 8. 9.

Patient information Clinical laboratory, radiology, and patient monitoring Patient census and billing Staffing and scheduling Outcomes assessment and quality control Pharmacy ordering, prescription handling, and pharmacopoeia information Decision support Finance and accounting Supplies, inventory, maintenance, and orders management

Non-Functional: 1. 2. 3. 4. 5. 6. 7. 8. 9.

Access to information. Improvement in quality of documentation. Improving quality of patient care. Improvement in communications. Reduction in errors of omission. Reduction in medication errors. Reduction in hospital costs. Development of a common clinical database. Enhancing ability to track patient's record.

Hospital Information Management System – Leonoid Technologies Pvt. Ltd

10. Improving hospital image.

4. Functioning: The system is a software application that consists of seven modules that would be developed by Leonoid Technologies Pvt. Ltd. These seven modules are basically providing various controls functioning between various functions that concern a hospital management. The system is connected to an EAI that communicates between database of hospital and front end application. The front end application is being developed by us and the cost of integrating it with EAI would be an additional cost that would depend on the number of licenses that the hospital opts for.

5. Salient Features/Functionalities The base product has the following functionalities:       

Registration Billing Electronic Medical Records (EMR) Reports Resources Scheduling Knowledge Repository

Hospital Information Management System – Leonoid Technologies Pvt. Ltd

6. Features Overview 6.1 Patient Registration (Admission) This feature will enable the user to capture information about the Out/ In Patient. Patient Registration includes essential details such as „Name‟, „Surname‟, „Sex‟, „Phone Number‟, „Date of Birth‟, „Age‟ etc. A unique ID is generated by the application for each registered patient. In addition, there is a provision to capture a unique identifier for each patient, which can be his/her „Passport‟, „PAN issued by Income Tax Department of India‟, „Driving License‟, „Voter‟s ID issued by EC of India‟, etc. A combination of the Patient ID and the identifier will be unique and would help in distinguishing patients sharing the same name, surname or date of birth. Patient Registration also includes facility to capture more details such as „Marital Status‟, „Contact Address‟ of the patient and place of registration. Additionally, facility to capture details of person to be contacted in case of emergency, like „Name‟, „Relationship‟, „Contact Number‟, „Address‟ etc, has been provided. If the patient is covered under Medical Insurance, then there is provision to capture information regarding the same including „Policy No.‟, „Sum Insured‟, „Insurer‟, „TPA‟, etc. 6.2 Billing This feature will allow user(s) with appropriate privileges to generate, store and retrieve information of billing and keep track of individual payments for the following categories: 1. 2. 3. 4. 5.

Consultation – General, Health Check-up, Specialist, etc. In-Patient – Ward/Bed Charges, Surgical, etc. Laboratory – Diagnostics like Blood Sugar test, Biopsy, ECG etc. Pharmacy – Medicines, Consumables, etc. Miscellaneous – Anesthetist Charges, Dressing, Accommodation, etc.

6.3 Electronic Medical Record (EMR) This feature will help users (usually Doctors, Nurses or any authorized person) to capture information of the patient in an electronic format. Following are few typical categories: 1. Medical Data - Examination, Operation (Surgical) Procedure, Observation, Diagnosis, Prescription, Diet Instruction, etc. 2. Radiology Data - USG, ECG, X-ray, etc. Hospital Information Management System – Leonoid Technologies Pvt. Ltd

3. Wet Lab Data - Information of the analyzed sample obtained from the patient for investigations like Biochemistry, Hematology, etc. 4. Time Series Data - Time-dependent parameters of the patient such as Partogram, Temperature Chart, Nurse‟s Bedside Report, Diabetes management, Blood pressure monitoring (PIH), Drug administration, etc. 6.4 Reports The following types of reports can be generated for In/Out Patients: 1. Investigation Reports 2. Discharge Summary 3. Depending upon the specialization of a department, report formats can be customized and/or templates can be provided. 6.5 Resources This feature will contain information regarding: 1. Organization structure – Divisions, Departments, Labs, People, etc. 2. People – Affiliation of human resources such as Doctors, Nurses, etc. to various divisions, departments. 3. Inventory – will have information regarding inventory items in labs and pharmacy. Inventory will be categorized as: 1. Consumable - Any resource that will be used up and not generate immediate hazardous remnant. Ex: Injectables, Medicines, food supplements, etc. 2. Disposable - Any resource that will be used up and generate disposable remnant. Ex: Syringes, gloves etc. 3. Reusable - Any resource that will be reused over a period of time, but servicing/refilling will be needed after every cycle of use. Ex: Linen, Oxygen cylinders, etc. 4. Durable - Any resource that will be used over a period of time, but servicing/refilling may not be required after each cycle of use. Ex: Refrigerators, Beds, ICU equipments, Instruments, Apparatus, Computers, Printers etc 5. Biosample - Any resource that is collected from the patients as a part of medical examination, Ex: Bio-fluids, Tissues etc. Hospital Information Management System – Leonoid Technologies Pvt. Ltd

6.6 Scheduling This feature will facilitate: 1. 2. 3. 4.

Doctor Scheduling Appointment Scheduling for Patients Operation Theatre Scheduling Duty Roster

6.7 Knowledge Repository This feature will help to capture information on the following: 1. Drug Information - Description, Clinical Pharmacology, Indications & Dosage, Side effects & Drug interactions, Warnings & Precautions and Overdose & Contraindications about relevant drugs. 2. Standard Protocols - Medical procedures undertaken at predefined conditions.

7 Estimation through Function points and COCOMO model: 7.1 Function Point Estimation: Some points considered before calculating the FP‟s for this system: 1. Module 1:- 1 Display, Maximum inputs from the users and contains patient information. 2. Module 2:- Total 4 displays, each function sub divided into more sub-functions, only the major functional applications have been shown. Getting 1 Input from module1. 3. Module 3:- 2 Displays, Investigation and discharge, 6 inputs from module 1 and 11 from module 2. 4. Module 4:- 3 Displays and 10 inputs from mod-1, 4 from mod-2, 1 from mod-3, 6 from mod-6 and I from mod-7. 5. Module 5:- 3 Displays and 2 inputs from mod-1, 2 from mod-6 and 1 from mod-7. 6. Module 6:- 1 Display and 2 inputs from mod-1, 2 from mod-2 and 1 from mod-7. 7. Module 7:- 1 Display and 1 input from mod-1, 6 from mod-2 and 1 from mod-4. Hospital Information Management System – Leonoid Technologies Pvt. Ltd

All these inputs and connectivity‟s have been used to calculate the internal logic connections in the system. Note: -The details have not been given in complete but on an average each function shown below in the module tables can be further divided into 4-5 sub-functions whose complexities would be low. EIF: - USG, ECG, Data Base (Back end through EAI), BP, Pathology, Temperature, Diabetes. The complexities shown below are based on parameter that each function is going to hold i.e. <=19 is low, <=49 is average and >=50 is high. Modules and their complexity values which have been used for calculating function points. Module- 1 Patient Registration

Features Name Surname Sex Ph. No DOB Age Marital Status Address Bed No. Insurance Policy No. Person to contact during emergency Name Relationship Contact Number

Module -2 EMR (Electronic Medical Reports) Complexity Low Low Low Low Low Low Low Low Average Low Low

Low Low Low

Complexity Medical data Examination Observation Diagnosis Prescription Diet instruction Radiology Data USG ECG X-Ray Wet Lab data Biochemistry Hematology Time Series data Blood Pressure Diabetes Temp Chart. Partogram Drug Administration Bed Side report

Hospital Information Management System – Leonoid Technologies Pvt. Ltd

High Average Average Average Low Average Average Average Average Low Low Low Low Low Average Low

Module - 3 Reports Complexity Investigation report Blood Urine ECG Chest X-Ray Sonography Blood Clotting Time Blood grouping Blood Sugar Discharge Summary Name Age Sex Diagnosis Date of Admission Date of Discharge Presenting Complain Past History Investigation done Treatment given Follow-ups Medication Name of the Doctor

Module - 4 Billing Complexity

Average Average High High High Low Low Low Low Low Low High Low Low Average Average Average High Low Low Low

Consulting General Health Check-up Specialist IPD Ward/Bed Charges Surgical Laboratory Blood Sugar Biopsy ECG Urine Blood Grouping Blood Pharmacy Medicine Surgical Misc Anesthetist Charges Dressing Accommodation

Average Average Low

Low Average Low Low Average Average Low Average Average Average Average Low Low

Module - 6 Resources Complexity

Module -5 Scheduling Organization Structure Complexity Division Low Department Low Doctor Lab Average Scheduling Average People Average Appointment For Patient Low Doctor Low OT Schedule Average Nurse Duty Roster High Inventory Consumables Injectable Average Medicine Average Module - 7 Knowledge Food Supplements Low Repository Disposable Complexity Syringes Low Drug Info Gloves Low Description Average Re-Useable Indication and Doses Average Oxygen Cylinders Low Side effects and Drug Interactions High Linen Low Warning & precautions/ Overdose High Durables Contraindications Average Clinical Pharmacology Average Refrigerator Low Bed Low ICU Average Instrument Average Computer/Printer Low Apparatus Average Hospital Information Management System – Leonoid Technologies Pvt. Ltd Bio-Sample Tissues Average Bio-Fluid Average

Estimation through Function Points: ASSUMED

VALUES

COMPLEXITY

FACTORS

S.NO

LOW

AVERAGE

EXTERNAL INPUT

31

EXTERNAL OUTPUT

TOTAL

HIGH

LOW

AVERAGE

HIGH

28

5

3

4

6

235

8

7

4

4

5

7

95

EXTERNAL QUERY

15

12

4

3

4

6

117

INTERNAL LOGIC FILE

38

34

7

7

10

15

711

EXTERNAL INTERFACE

4

2

1

5

7

10

44

TOTAL

1202

VALUE

ADJUSTED

FACTORS

General System Char.

Value

Value

Data Communications

3

Distributed Processing

2

General System Characteristic On-Line Updates of Master File Complex Processing

Performance Heavily Used Configuration Transaction Rates

4 2

2 4

1

Reusability Conversion & Installation Ease Operational Ease

On-Line Data Entry

1

Multiple Sites

3

End-User Efficiency

3

Backup & Recovery

3

Total Degree of Influence (TDI)

34

VAF (Value adjusted factor) = (TDI*.01) +.065= (34*.01) +.65= 0.99 COUNT TOTAL= VAF*FUNCTION POINT= 1202*0.99= 1189.98 Hospital Information Management System – Leonoid Technologies Pvt. Ltd

0 2

4

The above table here uses an empirical method of calculating effort and cost. (Sources have been mentioned in References). Assumptions:1. Programming language is Visual C. 2. No. of persons required 6. 3. Cost per person per day 25$ (Used in India). 4. Miscellaneous cost for other expenses like traveling etc. Hospital Information Management System – Leonoid Technologies Pvt. Ltd

5. Buffer of 15 days for safety purpose. 6. Quality and testing 15 days set and same persons are going to do. 7. Saturday and Sunday have been considered holidays and so adjusted with extra 24 days.

Computing Function Points

Module 1 (Patient Registration) Module 2 (EMR) Module 3 (Reports) Module 4 (Billing) Module 5 (Scheduling) Module 6 (Resources) Module 7 (Knowledge Repository)

EI

EO

EQ

ILF

EIF

16 0 9 16 3 20 0

1 4 4 1 6 2 1

4 2 7 4 4 7 3

20 3 9 16 6 20 1

0 4 3 0 0 0 0

Functionality Parameters 20 18 21 16 4 20 7

7.2 Estimation using COCOMO model: COCOMO model uses LOC for calculations. COCOMO has been defined for three classes of software‟s and we are going to use “SEMI-DETACHED” because the project is of rigid as well as flexible requirements. Assumptions: 1. Programming Language is Visual C. 2. Average LOC by a developer in a day is 60 (source in references) according to estimates made by experts. (Min-40 and max-100). 3. Person working are 6. Software project

a

b

c

D

4. Project is to be completed in 5 months so approx 120 days of working.

Organic Project

2.4

1.05

2.5

.38

5. Cost per person per day 25$.

Semi-Detached

3.0

1.12

2.5

.35

Embedded

3.6

1.20

2.5

.32

Calculations: E = aKLOC b ----(1) Development Time = cEd ------(2)

Hospital Information Management System – Leonoid Technologies Pvt. Ltd

The system has in all 75 functionalities (specified in modules shown above) and each application on an average has 5 sub-functions. The average line of code according to information available from sources (References) is 95-120 lines per Application functionality in C/C++ so we are taking 110 lines as average. Therefore, Total LOC= 5 (sub-Fn) *75(Main Fn)*110 (LOC) = 41250 LOC=41.25 KLOC. Now applying it in equation (1) we get E= 3 *(41.25^1.12) = 193.37 person month Putting in equation (2) D= 2.5*(193.37^0.38) = 18.48 months/person Considering 6 developers = 18.48/6 = 3.08 months Adding one month of buffer and quality and testing= 3.08 + 1= 4.10 months approx adding 24 days of holidays i.e. 24/30= 0.8. Total time is then 4.8 months. Cost would be 25$ * 45(Conversion to Rs.) * total 116.3 days= 7, 85,995.3 Rs Adding 1, 00,000 as miscellaneous for other expenses (Travel etc) we get 8,85,995.3 Rs.

8. Probable Risks and their Solution: 1. The electricity may go while the entries are still being done so the system would be available with a dedicated battery back up. 2. The communication of front end application with back end may create problem so we would take services of an oracle certified partner. 3. Any module may show error and hinders the progress of work thus we have designed modules to work independently. 4. Incomplete data may be entered in the system so some field are made mandatory which have to be filled before the entry can be made. 5. During emergency, system may show error so the system may be run in safe mode with minimum functionality. 6. Data stored unsorted at the back end so proper normalization techniques are used while storing of data. 7. Security risks are one of the major threats so minimum connectivity with the internet is provided. Hospital Information Management System – Leonoid Technologies Pvt. Ltd

8. End user may not be comfortable with system so proper training needs to be provided to the hospital staff. 9. The interfacing done with various systems may not be proper so a suitable middleware application needs to be chosen also a certified implementer is required.

Hospital Information Management System – Leonoid Technologies Pvt. Ltd

REFERENCES 1. http://www.softwaremetrics.com/Function%20Point%20Training%20Book let%20New.pdf 2. http://ieeexplore.ieee.org/xpl/freeabs_all.jsp?arnumber=1492375 3. http://ieeexplore.ieee.org/Xplore/login.jsp?url=/iel5/10923/34372/01640 4. http://www.codeproject.com/gen/design/Estimation.asp 5. http://www.codeproject.com/gen/design/cocomo2.asp 6. http://www.ijcim.th.org/past_editions/v13n1/IJCIM-V131-pp3.pdf 7. http://www.softdevtools.com/modules/weblinks/viewcat.php?cid=39 8. http://msdn2.microsoft.com/en-us/library/bb245774.aspx 9. “Software Engineering” by Roger R. Pressman.

Hospital Information Management System – Leonoid Technologies Pvt. Ltd