CABARAN DAN PENGALAMAN MEMBANGUNKAN HOSPITAL INFORMATION SYSTEM PERSPEKTIF KKM

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CABARAN DAN PENGALAMAN MEMBANGUNKAN HOSPITAL
INFORMATION SYSTEM PERSPEKTIF KKM

• MINISTRY OF HEALTH MALAYSIA

Health Informatics Awareness Day 2008 11 June 2008
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Agenda

• HIS- Overview
• SPP Background
• SPP Overview
• SPP Modules
• Benefits
• Experiance
• Challenges
• Conclusion

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HIS Overview- Conceptual Landscape
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Implementation Strategy- SPP as backbone
Operation Theatre System
Laboratory Information System (LIS)
Pharmacy Information System
Radiology Information System (RIS)
Other systems
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Background

• Sistem Pengurusan Pesakit (known as SPP) is a
  hospital based patient management system.
• MOH Owned.
• Developed from end-users aspiration
• SPP is intended to replace the existing SPPD

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Implementation Plan

• Pilot sites Hospital Tuanku Jaafar, Seremban
  and Hospital Port Dickson
• Subsequent plan to all hospitals in Negeri
  Sembilan
• Other States in stages

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SPP Overview
Hosp. Kuala PIlah
Hospital Daerah Port Dickson
Hosp. Jelebu
Hospital Tuanku Jaafar Seremban
Pilot Sites
Hosp. Tampin
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Modules

• Outpatient Management
• Ward Management
• Billing and account
• Medical Record
• Diet and Catering
• Staff Administration
• System Maintenance

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Where can the system be used

• Anywhere within the network
• Outpatient Department
• Wards
• Emergency Department
• Daycare
• Etc.

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Strengths of the system

• MOH proud owner of IPR of the software
• Build to easily interface/ integrate with other
  system(s)
• Enhance communication between clinics and
  hospital staff
• Highly configurabe to cope for possible future
  changes

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Privacy and confidentiality

• Secure log in to SPP network
• Access to information will be role based
• Authorisation to view certain information.
• Sensitive record can be classified
• Audit trail to track users activities
• Who called
• Who enter
• Who changed

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What the system can do
1. Patient registration
Pendaftaran pesakit dilakukan di BDM/ Klinik
Pakar/ AE / Wad Bersalin

• One time registration
• Registration counter for admission
• Emergency Department
• Labour room admission counter / screening room
• Specialist Clinic
• Other registration counters within the network

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What the system can do
2. Billing
Bil akan dikira mengikut kelayakan pesakit dan
resit bayaran akan dikeluarkan.

• Auto Billing
• Depending on billing group/ eligibility
• Auto calculation from registration and will
  follow through
• until client leaves the facility
• Auto calculation upon order execution
• Able to view interim bill
• Follow fee act
• Address exemption, waive etc.
• No more filling in the charge sheet

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What the system can do
3. Ward Booking
Pesakit akan dimasukkan ke wad mengikut kelayakan
dan kekosongan katil

• Can be done from registration counter
• Facilitate patient transfer
• Facilitate receiving of patient upon arrival
• Nurse will assign bed in the ward
• Allow change class
• Allow transfer in and transfer out

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What the system can do
4. Tests and treatment
Maklumat ujian dan rawatan pesakit

• Online order result
• Laboratory
• Radiology
• Interface with other system
• Sharing of results
• Reduce unnecessary repeat tests
• Reduce frustrating result tracing
• Reduce repetitive handwritten documentation

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What the system can do
5. Diet and Catering
Pesanan makanan Pengendalian klinikal diet
pesakit

• Online diet order
• Different Categories
• Normal diet
• Therapeutic diet
• Patient diet
• MAC
• Referral to dietitian
• Diet and catering activities

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What the system can do
6. Patient Discharge
Pesakit akan didiscajkan samada atas risiko
sendiri atau mengikut arahan doktor

• Template for discharge summary
• Final Bill generation upon discharge
• Appointment and scheduling booking online

• Online referral
• Via referral letter
• Scheduled time
• Emergency- real time
• Alert notification on referral case at receiving
  hospital

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What the system can do
7. Appointment and Scheduling
Temujanji ke klinik pakar/ klinik lain Rujuk ke
hospital lain

• Manage appointment and scheduling
• Control appointment number
• Allocate appointment for urgent cases
• Change / cancel appointments
• Schedules created by each clinic dicipline
• Customised for local needs
• Online appointment to Sp. Clinics (from wards/
  other referring hosp)
• Can be used by all clinics- diet, physio etc
• Able to detect defaulters

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What the system can do
8. Medical Record Tracking
Memantau kedudukan rekod pesakit Memohon pinjaman
rekod

• Borrowing of medical record
• Issuing medical record
• Track medical record by location and name
• Monitoring of NIA 52 and 53
• Alert on late medical record return
• Processing of medical report
• Doctors to make report through template in system

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What the system can do
1. Patient registration
2. Ward Booking

• Tests and treatment

Maklumat ujian, rawatan dan perpindahan pesakit
Pendaftaran pesakit dilakukan di BDM/ Klinik
Pakar/ AE / Wad Bersalin
Pesakit akan dimasukkan ke wad mengikut kelayakan
dan kekosongan katil
4. Diet and Catering
Temujanji ke klinik pakar Rujuk ke hospital lain
7. Appointment
Pesanan makanan Pengendalian klinikal diet
pesakit

• Billing

Pesakit akan didiscajkan samada atas risiko
sendiri atau mengikut arahan doktor
Bil akan dikira mengikut kelayakan pesakit dan
resit bayaran akan dikeluarkan.
5. Patient Discharge
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Benefit

• 1. Improve Patient Management
• Save a lot of time- reduce repetitive manual
  documentation
• 2. Improve quality of care
• 3. Access at any point of care
• 4. Minimize possible errors
• Reduce repetitive handwritten documentation
• Medicolegal protection

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Benefit

• 5. Pre set format for certain charts/ forms
• Reduce repetitive handwritten documentation
• Lab forms etc
• 6. System capture daily workload
• Census
• Returns
• Allow system to generate weekly/ monthly ( at
  intervals set)

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Benefit

• 7. Informed clinical decision making
• Alert and warnings
• Easy to track previous patient encounter
• Able to view previous discharge summary

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Benefit

• 8. Supervision and monitoring
• Dashboard with important information
• View staff roster
• View staff attendance
• View pending medical report by department
• Supervision at any point of time, anywhere within
  the hospital
• Not dependent on reports
• Can view ad- hoc /real time

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Benefit for others

• Patients
• Better care and administration - efficiency
• One time registration at point of care - Reduce
  transaction time
• Easy to track previous patient encounter
• Minimize possible errors
• Public at large
• Efficient service and confidence

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What it takes?

• UNDERSTANDING THE REQUIREMENT AND PROCESS OF THE
  SPECIFIC HOSPITAL
• UNDERSTANDING THE POLICY AND THE PEOPLE

Process must be totally reconfigured to exploit
the full potential of technology
To design systems around functions which focus on
the business process rather than locations or
division of services/departments
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The experience - unavoidable facts.

• The undertakings difficult and vulnerable
• A battle against our own legacies revert the
  old ways
• Managing expectation (and the unexpected)
• Deal with turf wars (warlords)
• Retaining top-notch committed people
• Recognise the phase denial, anger, acceptance,
  action.

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Challenges

• People

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Challenges

• Process

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Technology
Challenges
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For a Successful HIS Implementation

• Support from Upper Management
• Project Organization
• Project Planning
• Competence Project Team
• Appropriate Implementation Team and participation
• Support from Team Leader/Owner Team

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For a Successful HIS Implementation

• Time Availability Commitment
• Training Approach, programs and Attendance
• Clearly Defined Processes and Procedures
• User Buy-in
• Follow Through, and more Follow Through.

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Key factors for HIS-SPP implementation success
Conclusion

• Over 150 factors have been identified
• Only two are consistently associated with
  successful implementations
• top management support
• users involvement
• Several additional key elements have been
  repeatedly identified
• Buy-in
• Clear understanding Significant change
• Active Local Champions
• Support OM

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Thank You

• www.moh.gov.my