Patient Information System

Abstract

We have developed a comprehensive but economical system for hospital management. The system acts as a handy tool for doctors and also has ERP capabilities to manage various allied services, like finance, insurance, and pharmacy, associated with a hospital. Of special mention is the fact that there a few hospital information management systems being used in India today but none of them are economical to purchase and maintain.


Introduction

Today, computers and information systems are being used extensively in the healthcare industry. This has led to the development of Clinical Informatics, which is a much studied and talked about subject. Clinical informatics is used to formulate disease management programs that offer the benefits of lower disease occurrence, improved patient care and lower healthcare costs. In such programs, the key mechanism used to identify individuals at risk for targeted diseases is the Electronic Health Record (EHR) [Ledbetter and Morgan, 2001]. 

The Patient Information Management System

This system would help in maintaining the day-to-day patient information of a hospital [HMS Brochure]. Besides patient-related information, this system caters to the information needs of other allied areas such as insurance, drugs, pharmacy, and medical tests. Since it keeps the electronic health record (EHR) of each patient [Handle], it would be very convenient for doctors and other medical staff to keep track of each patient’s progress. The system has been designed using Java (J2SE) for the front-end and JDBC as a bridge between the front-end and the back-end [Schildt, 2002]. The back-end can be any database server [Loney and Koch, 2002], like Oracle 9i.

Patient Schema

The following database schema (Refer Table I) encompasses the personal data, including unique patient id and total fees and expenses till date, of each patient.




Departmental details

The dep_detail schema maintains the details of each department and its respective doctors (Refer Table II). The schema also has other doctor-related data like their field of expertise, visiting charges, and outstanding earnings.



Treatment Schema

This is the main schema (Refer Table III) of the whole system and contains the core data of the EHR. Using the data for a patient, a doctor can easily examine the patient taking into account his medical history. The diagnosis and prescription are appended to a patient’s record with the corresponding date of visit. Details of medical tests suggested by a doctor can be inserted in the prescription_test column. The results of the tests can then be entered by the concerned doctor (e.g. radiologist) in the diagnosis column. 



Front-end

As mentioned above, we have implemented the front-end of this system using J2SE. Thus the front-end is comprised of many inter-related classes. We explain the internal working of the front-end through the major classes that have been used to implement it. And the classes are as follows:

NewPatient and NewDialog: These classes (Refer Figs 1, 2, and 3) take care of the handling of the new patient details. 






Treatment and SelService: These classes (Refer Figs 4, 5, and 6) are designed to the handle the host of services that a large hospital would typically offer. They are the crux of the front-end system as most of its functioning depends on them directly or indirectly. As the name suggests, the Treatment class is used to cater to the prescription, diagnosis, and other feedback related issues of a patient’s visit to every doctor.







Update: This class facilitates updating of expenses and other financial details of every visit. It is also used to update the diagnosis, prescription, and other comments by a doctor after each patient’s visit (Refer Figs 7 and 8). It also updates the fees charged by the doctor so that he can claim them from the insurance company. 





Coordination between Front-end and Back-end

As mentioned above, whenever a new patient is added to the system, the patient’s details are stored via the patient schema. Once a new patient is registered, information generated from every visit is added through a combination of the patient and treatment schemas. The dep_detail schema is also vital in that it provides the financial details associated with each doctor. These financial details can then be used various allied agencies, like insurance agencies, associated with a hospital and a doctor. The relevant data can be used the insurance to disburse payments to the patients according to the insurance plan they have with the company. Also, the cumulative data related to each doctor’s fees and earnings can be used to make payments to them on a regular basis, for example fortnightly or monthly. Moreover, most hospitals have pharmacies attached to them. The diagnosis and prescription details specified by the doctor or doctors, if treatment for multiple medical problems is underway, can be used the pharmacy directly to provide appropriate medicines to the patients. Once any transaction is executed by a user, like a pharmacist or an insurance agent, the results of the transaction are reflected in the system.

Conclusions

This system has been developed in a modular manner and then integrated and tested using many sample cases. A few sample screenshots of illustrating the working of the system are shown above. We plan to make this system more extensive and include other allied areas also. Nevertheless, we hope that this system would provide a robust but economical way for hospital information management in India. 

References

1. Handle, Thomas et. al. HIMSS Electronic Health Record Definitional Model Version 1.0. The Healthcare Information and Management Systems Society (HIMSS) Electronic Health Record Committee.

2. Ledbetter, Craig S. and Morgan, Matthew W. (Summer 2001) Towards Best Practice: Leveraging the Electronic Patient Record as a Clinical Data Warehouse. Journal of Healthcare Information Management - Vol. 15, No 2.

3. HMS Brochure. Tata Consultancy Services (TCS), India.

4. Loney, K and Koch, G. Oracle 9i: The Complete Reference. Berkeley, California, McGraw-Hill Osborne Media, 2002. 

5. Schildt, H. Java 2: The Complete Reference. 5th Edition. Berkeley, California, McGraw-Hill Osborne Media, 2002.

About Authors

Avinash Agarwal, Ashish Mangalampalli, Ajeet K Jain , B M Anand Krishna
Scholar
Computer Science and Engineering Department
ICFAI Institute of Science and Technology, ICFAI University