Hospital information system
A hospital information system (HIS) (sometimes referred to as a healthcare information system or clinical information system) is a comprehensive, integrated information system designed to manage the medical, administrative, financial, and legal aspects of a hospital and its service processing. As information management demands become more rigorous, "hospitals are becoming more reliant on the ability of [a] hospital information system (HIS) to assist in the diagnosis, management and education for better and improved services and practices."
The idea of implementing a computerized information-handling system in the hospital sphere came as early as 1965, when Lockheed Martin conducted an information gathering project on the feasibility of such a system. Lockheed built a prototype hospital information system called "MIS" or "Medical Information System," and El Camino Hospital agreed to pilot it incrementally. In 1971 Lockheed was forced to sell its HIS research division to Technicon Data Systems; however, El Camino ultimately decided to fully implement it in 1972. The system had features such as laboratory test scheduling, IV ordering, and pharmacy management.
By the late 1970s to the early 1980s, other hospitals around the world had implemented hospital information systems with functionality like accounting, budgeting, patient census, inventory, scheduling, registration, and even instrument automation. Researchers and companies were also debating and writing about the efficacy of these systems. Yet by this same time period, HIS's positive impact on hospitals — based on operating costs — was not apparent.
In the early to mid-1990s Japan was leading the way in adoption of hospital information systems and their integration into the majority of the activities in the hospital, including the preparation of health insurance claims. In 1991, 81.6 percent of all Japanese hospitals were using health informatics technology to prepare claims. Picture archiving and communication systems (PACSs) were becoming fully integrated into the HIS along with the connections needed for medical imaging equipment. Integration of the HIS with the systems of insurance associations was also being prototyped, creating the potential for more integrated patient medical record databases.
During this time hospitals and developers were also focused on two particular goals for the HIS: to further adapt the system to the clinical environment, and to establish communication links between the HIS and other outside entities like laboratories and pharmacies. The achievement of these and other integration goals became apparent by the middle to late 1990s, with many health systems becoming consolidated and/or linked through interfaces. The road towards integration of the HIS with other health care systems was still difficult due to the diversity of tasks, the technical limitations, the preference towards departmental systems, and developer philosophy at the time. Performing synchronous updates between heterogeneous systems, managing communication servers, and handling overlapping functionality were other key problems in this integration process.
By the 2000s, advances in component-based technologies, communication systems, distributed systems, and network-centric architectures brought the opportunity for homogeneity and data sharing to a new level. Improved communication standards like Health Level 7 and XML packaging structures like Simple Object Access Protocol (SOAP) also contributed, bringing a new "era of real medically oriented information systems that encourage integration of all existing satellite systems (external and internal) into one coherent, interoperable environment around electronic health records (EHR)."
A modern HIS may be composed of one or more software components, including specialty-specific extensions as well as a large variety of sub-systems in medical specialties, including laboratory information systems, (LISs), radiology information systems (RISs) or picture archiving and communication systems (PACSs).
Primary functionality of a hospital information system includes:
- patient care management
- procedure management
- medical-administrative care management
- research and training
- general and cost accounting
- human resource management
- inventory control
- ancillary systems management
- medical record management
The functionality of a HIS may also include assistance with paper-based information processing, resident work positioning, pharmaceutical management, and mobile data acquisition and presentation.
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