White Paper on

RFHHA Sunday Panel Discussion no 42nd held on 23 Oct 2016

Hospital Information Systems Series 1: Basic for Hospital administrators

DR MADHAV MADHUSUDAN SINGH

RFHHA www.rfhha.org Page 1

 42nd RFHHA Sunday Panel discussion on 23 Oct 2016 , 1000- 1400 hrs

Topic : Hospital Information Systems Series 1: Basic for Hospital

administrators

The discussion was held on Whatsapp ( +919560852592 ) , and on Face book

https://www.facebook.com/groups/1416271691939651/

10.00 -11.00 : Hospital Information Systems : Basic concept

11.00- 12.00 : General Requirements, Planning & Designing of HIS for a

hospital ( Client vs Cloud Based )
12.00 -13.00 : Trends in HIS development & Types of HIS Modules available

13.00 14.00 : Q & A from members

All members are requested to invite your hospital administrators / IT In charge

/ management students to join this discussion on social media platform of
RFHHA. To join this forum please sends your request on 9560852592. Any body
interested to join as panellist , you are welcome.
Dr M M Singh

Panellist
Topic : Hospital Information Systems Series 1: Basic for Hospital
administrators
The discussion will be held on Whatsapp ( +919560852592 ) , and on Face book
Esteemed Panellist
Col S Patole , SM , Director IT AFMS
Shri A K Srivastava Director HIS , The Gemini India
Mr Sujeet Kumar , ASG Hospital Pvt Ltd
Shri R K Singh , TCS
Dr M M Singh , AFMS

RFHHA www.rfhha.org Page 2

All members are requested to attend, you can send question directly. You are
also requested to invite your hospital administrators / IT Manager/
management students to join this discussion on social media platform of
RFHHA. To join this forum please sends your request on 9560852592.
Dr M M Singh

The sessions started with the some video on HIS in India as under:
Health Information Management: Information Flow Across the Hospital
https://www.youtube.com/watch?v=VqVkYE2liGQ

Health Information Management: Basics of Quality and Performance

Improvement https://www.youtube.com/watch?v=d0N8sQUCutA

Yanthrik Hospital Management System

https://www.youtube.com/watch?v=zqaPfmfRb3w

Advance Hospital Management System (VB.NET + SQL Server 2008)

https://www.youtube.com/watch?v=rHivqzpDips

Introduction

Hospitals are the key institutions in providing relief against sickness and
disease. They have become an integral part of the comprehensive health
services in India, 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 depends upon the

RFHHA www.rfhha.org Page 3

efficiency with which he is able to achieve the goals and objectives. Some of
the major factors determining the effectiveness of a health institution includes
patient care management and patient satisfaction. Hospitals are very
expensive to build and to operate. Administrators and professionals have to be
extremely cost conscious. Effective computerised systems and procedures
need to be implemented to ensure proper utilisation of limited resources
toward quality health care
Dr M M Singh
Dear Panellist, Q. Can you tell in detail what is Hospital information system?
Hospital information system (HIS) is comprehensive software for patients
information integration for sending and exchange comprehensive patients
information between wards and other medical centers in order to expedite the
process of patient care, improve quality, increase satisfaction and reduce costs.
Col S Patole

Dear Panelist Q. How Preparation of software that performs functions

Separate works in HIS?
Each person or department administer feels commensurate with the
appropriate knowledge, understanding and the need for computer and
entrepreneurial it, and regardless of issues such as specialized information
State any impact on clinical findings on treatment process and the need for
integration of patient information in hospitals, uses a Stand Alone Software.
For example, in various duties in hospital units are done by different people
during patient treatment, such as admission and discharge patients that is
done in admission, is done transfer of patients between wards, visit and
determining the therapeutic actions and orders are issued by physicians and
are run by Nursing services, performing diagnostic procedures and matters
such as settlement and others .As you can see, all of these actions is performed

RFHHA www.rfhha.org Page 4

separately for each patient and is similar in all patients. If for these actions is
used separate softwares, in fact any duty may be done faster and better, but
on different actions of treatment and their impact on patient's entire
treatment process, will create less accelerate probably because the different
systems have no relationship to each other, and if the relationship between
dispersed systems is not done rapidly, the desired goals in the hospital
information management will not do. In this way, in every part, Suit the needs
of them, software is provided with capabilities and its features .The format of
the software, operating system and programming language will be completely
different and incompatible with each other, most likely the software have been
designed and prepared by different people in different intervals without regard
to the necessary connection between them, and even in terms of used
hardware will be incompatible completely . Thus the use of computer software
for doing hospital measures, possibility of create networks and exchange
patients information, there isnt even in the future, and since being dispersed
information in different systems cannot help to solve hospitals problems,
therefore evolution with time and new systems development, management
will be forced to change the existing systems, and this means loss of data,
costs, and time is a dynamic management system.
Using the computer, all therapeutic, and management and financial actions of
patient is done by comprehensive software that is made up of different parts .
All therapeutic actions, medication orders and diagnostic services are sent to
clinical and Para clinical and administrative centers such as accounting,
pharmacy, warehouses, and other units through the system and submitted
their response is received . Therefore the start time and end all actions will be
identified and followed in the system. in this method will not be delayed
between communication of systems like the first method, ultimately

RFHHA www.rfhha.org Page 5

therapeutic patient will be exchanged faster and with broader communication
between workstations of different treatment patient and therapeutic factors,
and will be taken to avoid a patient data entry form overlapping .The system
efficiency is, reducing patient treatment time through the introduction of blind
spots in its treatment process. This reduction in total lead time reduces costs
of treatment patients and the country's health system and will increase health
care quality and patient satisfaction .Also in this system, that any act is done in
treatment patient field by a person will be identified and investigated exactly,
so the control issue in medical environments is possible to management easily.
Col S Patole

Dear Panellist Q. Can you tell us some important goals of hospital

information system (HIS) ?
Main goals of hospital information system (HIS) :
Improving staff efficiency
To remove duplication and unnecessary procedures
Using computers as work tools
Statistics and data mining techniques faster and more accurate
Improving quality of health care status of
To create a modern working methods and systems and standardized
hospital
Data communication systems, medical engineering
Data communication between hospitals and medical centers in
The country reaching a distributed database in the country and make its
relationship with the World Health Networks
Promote community health
Col S Patole

RFHHA www.rfhha.org Page 6

Dear Panellist, Q. Can you some highlight on history of Hospital Information
System (HIS) ?
Reports relating to the use of computers returns to support clinical data
management activities in 1950, Although most early systems were created
to provide financial and repayment goals, but they was the founder of
modern electronic records. Until 1960, hospital information system (HIS)
emerged and probably the first hospital information system, data systems
was Technician that was created in the system of nursing stations. The first
time it was created in a hospital Kamynv, Mountain in December 1971 (EI
Camino, Mountain). Many countries including European countries have
moved toward automation hospital information system since the early 1980
.This system developed significantly until now, and it has been an
integrated system and with the inner core that called electronic medical
records (EMR) from one inconsistent system . Using hospital information
system (HIS)was introduced in Iran in 1978 and was launched in the hospital
anymore, Mashhad, Yazd, and Zanjan be as a pilot project for the first time.
Thus, in 1980 the country's first e-hospital, carried out in the 313-bed
hospital Imam Hussein of Shahrood, to the national pilot with the cost of
800 million Rials .One of the positive results of the implementation of
electronic information system was 12 percent reduction of medication in
this hospital.
Shri R K Singh

Dear Panellist , Q . When HIS started in India ?

A lot of hospitals in India are still rooted in traditional manual processes and
are unable to cope up with the large volumes of data being generated. IT has
been a late entrant in the field of hospital administration and most hospitals,

RFHHA www.rfhha.org Page 7

which forayed into this area started with small systems that were developed
in-house. Most first generation HISs of 1960s and early 1970s did not succeed
to match the hospitals needs for automation. It first came to AIIMS & KGMU
Lucknow. The second generation of hospital information systems, which
started in middle of 1970s and ended at the end of 1970s, mainly served as
financial systems and their main purpose was to transmit information from
end users to financial systems. They did not save any patient related
information but were used only to store and retrieve financial information.
Third generation of HISs, which started in the late 1970s was influenced by
database technology, which was introduced in early 1980s and focused on
patient care planning and departmental solutions such as laboratory and
pharmacy. Till the middle 1990s, no standardized solutions were available and
these local innovations were the pioneers. However, they neither gave the
desired results nor could they be integrated with newer systems.
Shri R K Singh
Dear Panellist , Q . Why I Should use HIS systems in my hospital ?
Generation of alert and Reminds: HIS systems help with the creation of
Wake series warning messages to remind doctor in diagnosis. For
example, patient has an abdominal pain that is may be 45 diseases that
have the same symptoms but doctor remembers only 10 of them.
Critical Pathway of Decisions: HIS systems help a doctor in serious cases.
In very serious cases, that there isnt the opportunity for doctor to
decide, these systems help the doctor and bring his response quickly in
emergency cases.
Automatic reporting: one of advantages and performances of HIS
systems is that can be provided report of patients diagnostic - care
information automatically by them.

RFHHA www.rfhha.org Page 8

 Reduce cost: HIS systems effect very significant in reducing the costs. So
if you have detection algorithms in the system, you wont need to
review Problem Oriented of patient. In this case you wont require
performing additional tests and etc.
Access to diagnostic information care of patient with a PC: using of the
appropriate Work station, physician can access patients and hospitals
easily from your location or where he/she is present.
Suitable Administration: One of the benefits of HIS systems is that allow
the patient to call the hospital network from home and reserve time to
meet with the doctor. Thus make an Appointment is much easier.
Reducing errors: because all data have been collected in one place,
fewer mistakes occur.
Better Managing & Following :patient management and follow patient
can be done better in these systems .Therefore, accessing to previous
information of patient will be better.
Data Presentation, T-standardization, better communication of
information and decrease.
Mr Sujeet
Dear Panellist , Q . What Properties and characteristics of hospital
information system (HIS) required in broad sense ?
As per my opinion, Properties and characteristics of hospital information
system (HIS) should based on :
It acts based on standard.
It doesnt make any mandatory in existing manual system, but it
matches itself with these systems.
It acts based on "medical events" and is independent of the cycle of
moving patients .

RFHHA www.rfhha.org Page 9

 Using this system, the previous manual and the current trend does not
change much .
It keeps the old computer systems and promotes and improves their
futures.
It offers the best solution for coordination between different lines of
work and different units in the hospital
It coordinates all wards and hospital system.
It increases the quality of decision making and managerial.
It includes rich knowledge-based medicine databases such as SNOMED
and ICD-10 .
The data entry are required to type in only 2 %of cases and in 98 %cases,
for data entry, clicking method is used by the help of the mouse.
Operation is very simple and completely visual and user-friendly.
Smart cards are used for identification and control of hospital staff
access to patient records (to enhance security) .
It is equipped with video conferencing system between health care
professionals.
It is equipped with knowledge-based intelligent system for diagnosis and
treatment.
It provides Access to information via the Internet to communicate with
the mobile phone.
Filing and retrieval of medical information dense is possible to easy
access to the complex and stratified set of data.
It is equipped with open standards for the implementation of local
language.
It allows to peoples common use of medical information recorded and
Protocol Guide electronically.
RFHHA www.rfhha.org Page 10
 Using multimedia technology, audio and video recording various
Information is possible in it .
Sri R K Singh
Dear Panellist, Q . What is HL 7 (Health-Care Level 7)?
Health-Care Level 7 is accepted standard (protocol) in the world that provides
the common language for information exchange and electronic patient records
in both domestic and abroad .This world standard is recognized by the
Common Market of Europe in 1992and Central Office in 1994 by ANSI and the
WHO.
Col S Patole
HL7 is an international forum with health care that its goal is working with
professionals and health scientists to create standards for information
exchange, management, and integration of electronic health information .HL7
strives that we use of such standards within and between health care
organizations to increase efficiency and effectiveness of health care activities
such a manner that is in favor of all. In other words goal of HL7 is facilitating
communication in configuration Health Care.
Col S Patole

Dear Panellist , Q . What features of a hospital information system (HIS)

software should be there ?
The software should be able to make a separate computerized record
(EMR / CPR) for every admitted patient .
System has accepted standard for transferring medical information
between different medical centers.
Software is designed Based on Object Oriented Technology, it means
that different layers (different tasks) can be run separately from each

RFHHA www.rfhha.org Page 11

 other and be implemented, so it can implement in various center of
health systems.
System could support Interface (hardware interfaces) of advanced
devices such as radiography; MRI, CT scan, etc.
The Software has capabilities of Tele Communication & Tele Medicine.
The software must be able to support multimedia capabilities
(Multimedia).
Level of computer users access to file system is classified based on each
individual task in patient treatment and position.
Software persuades users to use it or is User Friendly.
Standard Numbering and archive systems are predicted in it.
System works in the network and covers all clinical and Para clinical
units.
Data confidentiality is guaranteed by certain methods .
HL7 Standard has a lot of flexibility information exchange in the types of the
hardware and software infrastructure. Also it has a closely coordination with
other accepted standards of medical informatics, and can be used in all health
care environments.
Shri R K Singh

Dear Panellist , Q . What are the Standards in Healthcare IT and

Interoperability used for HIS ?
The data flow between different modules of the HIS and other disparate
systems like third party software needs integration with existing and new
architectures, application systems, and services. These systems further need to
go beyond their geo-graphical boundaries and share clinical information with
clinical systems of other hospitals in the same city, country, or with systems in

RFHHA www.rfhha.org Page 12

other countries. Classical example of this clinical data sharing is in cases of
medical tourism where patients travel to different countries for cheaper and
international quality of healthcare services.
Some of the commonly used standards involved in healthcare information
infrastructure are Digital Imaging and Communications (DICOM), Health Level
Seven (HL7), Institute of Electrical and Electronic Engineers, Inc. (IEEE),
(Medical Data Interchange Standard (MEDIX), Clinical Data Representations
(CODES), International Classification of Diseases (ICD) codes, The Systematized
Nomenclature of Human Medicine (SNOMED) International, Laboratory
Observation Identifier Names and Codes (LOINC). These are some of the main
standards and namespaces used in healthcare informatics and are followed in
hospital information systems with international standards implemented in
hospitals that provide world class patient care. It is vital for information sharing
that clinical information is captured in systems using internationally
understood codes and language.
Col S Patole
Dear Panellist, Q . What are the Implementation difficulties are found in
hospital?:
1. Infrastructure, application, and organization of the implementation
processes;
2. management of end user contribution;
3. Integration of different information systems, external systems, and
independent physician groups;
4. Struggling with balance among different departments ,end users and
stakeholders;
5. Redundant, inaccurate, uninformative, or confusing master data;
6. Standardization of data definitions, representation, and vocabulary;

RFHHA www.rfhha.org Page 13

7. Technical requirements planning;
8. End user profile and resistance;
9. End user training;
10. Software immaturity;
11. Support after implementation;
12. Lack of information about HIS implementation;
13. Ignorance of administrative needs of hospital.
Col S Patole

Dear Panellist, Q . Is there is any plan of GOI to include National HER

standards with National UID or AADHAR?
With uniformity in this view, EHR standards were released in August 2013 by
the Ministry of Health & Family Welfare, Government of India. The EHR
standards were formed after a thorough study and analysis of National
EMR/EHR and Healthcare IT (HCIT) programs implemented in the world. These
standards emphasize the use of National UID or AADHAR number as the
primary or secondary Unique Health Identifier (UHID) of a patient visiting a
healthcare facility. The AADHAR number will serve as the unique patient
identifier for all healthcare organizations across the nation. The other ID, may
be used to identify the patient within the CDO and as a reference in its EMR
system. The EHR standards also define the Healthcare IT (HCIT) Standards
applicable for India, besides the inclusion of National UID or AADHAR number.
So, going forward, the AADHAR number will act as the unique identifier for the
EHR of an Indian citizen, which will be a longitudinal health record of a citizens
lifespan with several clinical encounters in different care set-tings.
The basic idea of the EHR standards is to have a country wide rollout of EHR for
all healthcare organizations and link it to the National UID of the patient

RFHHA www.rfhha.org Page 14

(AADHAR). Connecting rural and urban healthcare delivery systems through
UID and EHR standards seems like a magnanimous task for now, but if giv-en
aggressive timelines and adequate impetus of implementation, will surely see
the foreseen success. With more and more hospitals adopting HIS in India, this
dream will eventually come true. Once clinical data begins to get captured in
the HIS, the paper- based medical records will be replicated if not replaced by
the electronic medical records. EMRs created by the various care providers
that a person visits during his/her lifetime will be stored in a central clinical
data repository or at least be shareable through the use of interoperable
standards prescribed by the EHR standards. This will, sooner or later create
electronic health record or EHR of the person bringing his complete health
information together, for supporting better clinical decisions, and more
coordinated care amongst various care providers. With a boom in global
medical tourism trends, in the coming years, EHR of an Indian patient may
even be accessible by care providers of other countries and vice versa.
Shri R K Singh

Dear Panellist, Q . How much will be annual spent on HIS with respect to
annual operating expenses ?
Hospitals spent approximately 2-3% of annual operating expenses on IT.
Shri R K Singh
Dear Panellist, Q . What is clientserver model?
The clientserver model is a distributed application structure that partitions
tasks or workloads between the providers of a resource or service, called
servers, and service requesters, called clients. Often clients and servers
communicate over a computer network on separate hardware, but both client
and server may reside in the same system. A server host runs one or more

RFHHA www.rfhha.org Page 15

server programs which share their resources with clients. A client does not
share any of its resources, but requests a server's content or service function.
Clients therefore initiate communication sessions with servers which await
incoming requests. Examples of computer applications that use the client
server model are Email, network printing, and the World Wide Web.
Mr Sujeet

Dear Panellist, Q . What is Cloud computing based serve model ?

Cloud computing is a type of Internet-based computing that provides shared
computer processing resources and data to computers and other devices on
demand. It is a model for enabling ubiquitous, on-demand access to a shared
pool of configurable computing resources (e.g., computer networks, servers,
storage, applications and services), which can be rapidly provisioned and
released with minimal management effort. Cloud computing and storage
solutions provide users and enterprises with various capabilities to store and
process their data in third-party data centers that may be located far from the
userranging in distance from across a city to across the world. Users access
cloud computing using networked client devices, such as desktop computers,
laptops, tablets and smart phones and any Ethernet enabled device such as
Home Automation Gadgets. Some of these devicescloud clientsrely on
cloud computing for all or a majority of their applications so as to be
essentially useless without it.
Mr Sujeet
Dear Panellist, Q . What is Digital Health Knowledge Resource ?
Digital health knowledge resource is a concept where contents are stored in
digital format e.g. digital medical library in which information are collected and
stored in digital formats and accessible by computers. A health or medical

RFHHA www.rfhha.org Page 16

digital library is designed to assist physicians, health professionals, students,
patients, consumers and medical researchers in finding health and scientific
information to improve, update, assess or evaluate health care. Medical
libraries are typically found in hospitals, medical schools, and private industries
and in medical or health associations. It has several advantages. It can be
accessed at any point of time and from any location where internet facility is
available. It needs little space for storage. The cost of maintenance is much
lower than that of a traditional library. Digital libraries are user-friendly
interfaces, giving clickable access to its resources. To handle the growing
volume of electronic publications, new tools and technologies have to be
designed to allow effective automated semantic classification and searching.
Shri R K Singh
Dear Panellist, Q . What is role of technology in Health sector?
Technology can play an important role in overcoming the various challenges
faced in Indian health care system, in improving the efficiency of the
healthcare system and also in improving the quality and expanding reach of
healthcare services, especially in the context of serving a billion plus
population of India. Large scale and sustainable implementation of ICT
interventions in healthcare services i.e. eHealth has a significant potential in
addressing such challenges. Ministry is making use of ICT to obtain reliable
health information and near real-time data for policy making, and ensuring
efficient healthcare program& service delivery by rolling out a number of IT
systems and applications.
Shri R K Singh

Dear Panellist, Q . What is the Current ICT Solutions in on Govt Platform in

India ?

RFHHA www.rfhha.org Page 17

 Mother and Child Tracking System & Facilitation Centre for efficient
delivery of Health care services to expectant mothers and children with
an objective of improving IMR, MMR, and morbidity in women and
children.
Health Management Information System to monitor delivery of services
at facility level has been adopted extensively across the country at
district, state and national levels.
Hospital Management Systems have been put in place by many hospitals
and health centres, supporting administrative and clinical functions and
providing electronic medical records. Some states have rolled out state-
wide Hospital Information Systems to cover all public hospitals across
the state, thus enabling continuity of care within the state.
Integrated Disease Surveillance Programme for disease surveillance with
surveillance units at centre, all State/UT head quarters and all 640
districts in the country, connected through IT network.
Nikshay for Tuberculosis control programme, to monitor and track
services and status relating to screening, diagnosis, treatment and
follow-up of Tuberculosis cases.
Human Resource Management Systems for optimising human resource
utilisation have been in place.
Telemedicine- Various tele-medicine pilots have also been initiated in
many states over the years, some of them on a large scale.
National Health Portal- a citizen portal for health to provide authentic
information on health various issues to public and serve as a single point
of access for consolidated health information and services has come into
operation recently.

RFHHA www.rfhha.org Page 18

 Mobile Health solutions -Swasthya Slate, Kilkari, Mobile Academy have
demonstrated good health outcomes by strengthening of health
frontline workers.
Social Media platform use of MyGov, Twitter, You Tube etc. for
dissemination of information & interaction with citizens.
Shri R K Singh
Dear Panellist, Q . What are the changes you have observed in the healthcare
industry in the last one year?
There is an increased demand for health information, especially from the
patients and their caregivers. Apart from getting health and disease
information from the web, people are also using mobile applications to get
information and often doing home care for medical conditions (mHealth/Tele-
home care).
Shri R K Singh
Conclusion:
Integrated Hospital Information System (HIS) is vital to good decision making
and plays a crucial role in the success of a hospital. In computerized hospitals,
HIS has enabled improved patient care, patient safety, efficiency, plugged in
revenue leaks and pilferages and has reduced costs. It has provided easy
access to critical information, thereby enabling hospital administration to
make better decisions on time. It has helped in meeting the short-term
objectives of computerization, to reduce costs and improve the accuracy and
timeliness of patient care, accounting and administration, record keeping, and
management reporting and also the long-term goals to build and maintain
patient database for analysis of data to facilitate decision-making process.

RFHHA www.rfhha.org Page 19

Hospitals in India, hence, must ensure computerization of all its departments in
due course of time and contribute towards developing an Integrated
Healthcare Delivery System for In-dia.
Dr M M Singh

Respected Members
This concludes the 42nd RFHHA Panel Discussion on Hospital Information
Systems Series 1: Basic for Hospital administrators. I thank all panellist and
administrative staff, members for their active participation. You critical
comment is welcome. All the technical inputs by the panel have been taken
from references has been given in this white paper. Next week we will meet on
another topic. Till then........
Jai Hind
Dr M M Singh

RFHHA www.rfhha.org Page 20

References

1. Degoulet.P, M.Fieschi, 1997. Introduction to Clinical Informatics.

Springer, New York
2. Ash JS, Gorman PN, Lavelle M, et al, 2003.A Cross-Site Qualitative Study
of Physician Order Entry.Journal of American Medical Infor-matics
Association. USA
3. Weitekamp M.R. 1997. Integrated Health Systems- Logic, Infor-mation
and Strategy. A Masters Paper. Pennsylvania State Universi-ty. USA.
4. Ball, M.J. 2003. Hospital Information Systems: Perspectives on Prob-lems
and Prospects. International Journal of Medical Informatics. USA
5. Berg, M. 2001. Implementing Information Systems in Health Care
Organizations: Myths and Challenges. International Journal of Medi-cal
Informatics. USA
6. Benson, T. 2002. Why General Practitioners Use Computers and Hospital
Physicians do notPart 1: Incentives. British Medical Jour-nal. UK
7. Little Johns, P., Wyatt, J. C., & Garvican L. 2003. Evaluating Comput-
erized Health Information Systems: Hard Lessons Still to be Learnt. BMJ
Publishing Group Ltd. BMJ.com
8. Joel Rodrigues. 2009. Health Information Systems: Concepts, Meth-
odologies, Tools, and Applications, Volume 1. Medical Information
Science Reference. USA
9. J. Dudeck, B. Blobel, W. Lordieck. 1997. New Technologies in Hospi-tal
Information Systems. IOS Press. Netherlands
10.Mani S.V, Bedi B.S, Mishra S.K, et.al.. April 2013. Recommendations on
Electronic Medical Records Standards in India. Ministry of Health &
Family Welfare. Government of India. India

RFHHA www.rfhha.org Page 21

 11.Rudi Van de Velde, Patrice Degoulet. 2003. Clinical Information Sys-
tems, A Component Based Approach. Springer- Verlag. New York. USA
12.BM Sakharkar. 1998. Principles of Hospital Administration and Plan-ning.
Jaypee Brothers Medical Publishers (P) Ltd. New Delhi. India
13.A.V Srinivasan. 2008. Managing a Modern Hospital 2nd Edition. SAGE
Publications India (P) Ltd. India
14.Chandra Ballabh. 2008. Encyclopedia of Hospital and Health Services
Management Volume 5 Modernisation of Health Services. Alfa
Publications. New Delhi. India
15.S.L Goel, R. Kumar. 2002. Hospital Managerial Services- Hospital
Administration in the 21st century. Deep & Deep Publications. New
Delhi. India

TO JOIN THIS PANEL DICUSSION SEND A MESSAGE ON +91 9560852592

RFHHA www.rfhha.org Page 22