Hospitals are an integral part of the comprehensive health services, both curative and preventive. Significant progress has been made in improving their efficiency and operations. Effectiveness of a health institution - hospitals or nursing homes, depends on its goals and objectives, its strategic location, soundness of its operations, and efficiency of its management systems. The administrator's effectiveness is directly related to the efficiency with which hospital is able to achieve the goals and objectives, which include patient care management and patient satisfaction.

Building and running an Hospitals is very expensive affair. Administrators and professionals have to be extremely cost conscious. Effective computerized systems and procedures need to be implemented to ensure proper utilisation of limited resources toward quality health care. It becomes even more important when an in-house medical facility is provided by an industry for it’s employees, as is the case for BALCO Hospital.

Patient care management in Balco has fully utilised the power of computers in Medicare, whereby network of integrated systems maintaining patient database for the hospital services in the areas of Pathology, Radiology, Medical Research, In-patient Admissions and Billing, Medical Stores & Pharmacy are operational. The implementation of the above modules has evolved user-friendly computerized systems, which are loved and cared by all.

This paper tries to cover giving an insight to the Hospital Information system implemented at the BALCO Main Hospital, which is being fully utilised to provide quality service. The computerised system has enabled the medics to serve their customers with a smile and to meet the corporate objective set by the founders.

Balco Hospital at Korba caters its services to the thousands of employees of Balco Plant, their families, and dependent relations. It also extends it’s facilities to patients coming from in and around Korba. Balco Hospital is a 100+ bedded hospital equipped with modern facilities and catering all specialities. Computerisation at Balco Hospital has started in a limited way since 2003 when SoftLink International Pvt. Ltd. installed standalone Inventory management system to take care of the Stores and Pharmacy activities of the Hospital. Medicare areas were not computerized then. A need for an integrated patient management system was felt
and a study was conducted by Team of Hospital representative and SoftLink . Since 2006 an integrated information system have been implemented in the areas of Pathology, Radiology, Medical Research, Medical Stores & Pharmacy, Inpatient Admissions & Billing. Finally Hospital started implementing the Clinical records of the patient where-by enabling on-line sharing of information from ICU and wards. With full integration of LIS the test results where made available on-line enabling prompt remedial action by doctors and thus ensuring best service to the Patient.

Effective systems and procedures have helped Balco administration in achieving and fulfilling their quality objectives -
“We constantly try to provide our employees, their families and dependent relations prompt and expert comprehensive health care services in a most customer friendly environment”.
- Mr. Mittal (GM Purchase)

The short term objectives of the on-line computerised system in Balco were to reduce costs and improve the accuracy and timeliness of patient care, accounting and administration, record keeping, and management reporting. The long-term goal are to build and maintain a patient database for analysis of data to facilitate decision making process.

During the requirement analysis stage conducted by a team of SoftLink International along with Hospital IT Staff, patient care related areas were given priority in order to achieve the objective of better patient care.

Balco has computerised the following functions:

• Admissions/Discharges/Transfers
• Pathology test result information
• Radiology test with appointment scheduling
• Special test Information system at Medical Research
• Inventory maintenance of medicines & other appliances
• Issue of medicines of patient
• Communications with external world using E-mail and web technology
• Patient billing and above all
• Computerisation of entire Clinical departments by which Softlink has developed a tool to generate the complete EMR of each patient.

The project execution methodology was carefully designed. Main emphasis is given on participative, user driven, highly interactive, stress on quality, use of productive tools, phase
approach etc. Each phase end was certified by key users, Steering Committee members, and
finally by Central Quality Assurance (CQA) group at Hospital.

A brief outline of the functions covered in various modules is given below.

Admissions/Discharges/Transfers: This module caters to the in-patient admissions and
discharges or transfers from various wards/ cabins/ICU. Registration of casualty/ observation patients. Birth and death records maintenance. On-line and web based enquiry facility. Daily bed availability and monthly Management Information System (MIS) statistical reports.

Accounts Billing: This module caters to money receipt generation and instant bill calculation
for paying cases. Medicine, Pathology, Radiology, MRC charges are available on-line for billing. Monthly generation of reports for recovery from Balco employees/Associated and Contractor companies/Govt. Employees.

Pathology: This module caters to pathological test request handling and consolidated result
entry. Worksheets are printed by various sections of path lab (i.e Bio-chemistry, Histology, clinical, haematology etc) to perform the respective tests. 911 blood autoanalyser has been linked with RS 6000 for data transfer eliminating data entry and increasing data accuracy and timeliness.

Medical Stores: This module maintains medicine and other appliances, close monitoring of inventory with the help of online stock enquiry. Issues of medicines driven by expiry of medicines and maintenance of batch details. Analysis of movement, consumption and indent data available with improved vendor control supported by VED/ ABC analysis and vendor rating facility.

Pharmacy: This module caters to accounting of medicines dispensed to patients from counters maintained by automatic indenting from substore. Control of medicine over dosage and drug to drug interactions are maintained. Statistical analysis available on drugwise/ doctorwise.

Radiology: This module caters to accounting of X-ray films, scheduling of appointments, and
reporting of X-ray requests and result entry. Linked with Billing module. Statistical analysis of graphical data doctorwise/unitwise/ type of X-ray film wise utilisation versus wastage etc.

Medical Research: This module caters to request and result entry for special tests conducted such as T3, T4, TSH, HIV, Hepatitis, FSH etc. Linked with Billing module. Statistical analysis of data patientwise/testwise etc.

A few examples are illustrated below:

• Retrieval of reference data (i.e name, age, sex, dept) for an employee to facilitate online printing of case sheet at the time of admission, reducing the patient admit time.
• On-line enquiry as well as web based new admissions information availability, improved customer service.
• Computer printed stickers for blood samples eliminated any chance of sample mixup.
• Single requisition entry for all tests has increased time for doctors at attend to patients.
• On request test result print/reprint facility eliminated the patient waiting time for report collection.
• Retrieval of past results for statistical analysis of data such as incidence rate of occupational hazard like asbestosis Ca lung in workers of Balco Plant and Incidence rate of breast cancer below 40 years of age
• On-line scheduling for appointments by doctors eliminated patient waiting time.
• Early alarm system for notification on expiry of medicines.
• Automatic declaration of medicine as obsolete after expiry date.
• Viewing/printing facility of test results from wards/ICU/Remote locations to effect prompt action by doctor
• Data bank of Medical Research cases such as records of HIV positive cases
• Instant billing facility improved customer service and revenue savings to hospital
• Warnings during issue of medicines on Overdose of medicines and drug to drug interactions avoiding any chance of adverse reactions to patients.
• Statistical Analysis of data for proper utilization of resources (MIS)
• Doctor wise tests conducted
• Patient wise medicines consumed
• Counter wise load distribution
• Demographic analysis of diseases

It can thus be seen that deploying IT can help the medical profession in improving its quality of service and thus automatically increasing the preparedness and defensiveness. Of course, it is of vital importance that the software must have the right type of modularity and openness so that it
is manageable, maintainable and upgradeable and SoftLink International’s PANACEA provided us with that.